ET-2385
Form Active Employee / Local Employer / State Employer

Health Savings Account (HSA) Enrollment

For UWs use only, as a paper alternative for a member who cannot complete their HSA enrollment online.

Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2004

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of December 31, 2004.

Health Care Flexible Spending Account (FSA)

A Health Care Flexible Spending Account (FSA) allows you to set aside tax-free dollars each year for health care expenses not covered by insurance. You may use these funds to pay for eligible health care expenses incurred by you, your spouse, and your qualified dependents.

Plan Year
  • 2026
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Health and Wellness News
Oct 6, 2025 12:00pm
A dad piggybacks his child, with healthcare staff on the background.

Open Enrollment Starts Today

The annual open enrollment period has started and ends October 31, 2025. Know some notable changes for your insurance in 2026.

ET-4938
Form Active Employee / Retiree / Other Benefit Recipient

Appeal Form

Submit this completed form to ETF to appeal a determination regarding your ETF-administered benefit(s).

Your Unmarried Dependent Over Age 26 Becomes Disabled and Gains Eligibility

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

Program Option
  • Local Annuitant Health Program (LAHP)
  • Local Deductible Health Plan (PO14) & Supplemental Benefits
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan (PO16) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits