ET-2306
Form Active Employee / Local Employer / State Employer

Conversion Information - Life Insurance

If any portion of your group life insurance coverage terminates, you may be able to continue your life insurance protection. Your right to do this is called a conversion privilege, and its features are described here.

ET-4305
Form Active Employee / Retiree

Sick Leave Escrow Application

Apply to escrow your sick leave credits, if eligible. To escrow means to preserve or bank your sick leave credits for use at a later date.

ET-4307
Form Active Employee / Retiree

Medicare Eligibility Statement

You and/or your insured dependents must be enrolled for both portions of Medicare (Hospital Part A and Medical Part B), when first eligible. Provide this information to ETF using this form.

Video
10 minutes
Health Benefits video blank title slide

Dental, Vision, & Accident Plan

During Open Enrollment, you may have the option to enroll in dental, vision, or accident insurance. This video will provide you with an overview of each benefit program and how to access your benefit information. Watch this video at your leisure on demand 24/7.