Form for the member’s physician to complete if the member cannot manage property, finances or business affairs because of an impairment in the ability to receive and evaluate information or make or communicate decisions even with the use of technological assistance.
ET-4944
Form
Active Employee /
Retiree /
Other Benefit Recipient
Employers, use this form to verify that you viewed the employee’s original required document(s) to verify the employee or dependent(s) is eligible for benefit coverage, as administered by ETF.
Employers, complete to designate an employee as the agent representing the employer in matters pertaining to the programs administered by the Department of Employee Trust Funds.
As part of transferring files to SharePoint Online employers will need to use Multi-Factor Authentication (MFA). This page provides guides to setting up common MFA applications.
ET-4925
Brochure
Active Employee /
Retiree /
Other Benefit Recipient
