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Insurance

Learn about the insurances provided by ETF, such as health, dental and vision insurance.

ET-2405

Form Active Employee / Retiree

ETF Insurance Complaint Form

If you filed a grievance with the plan or benefit administrator and are dissatisfied with the final decision, you can request an administrative review from ETF.

ET-2366

Form Active Employee / Local Employer

Income Continuation Insurance Application--Local Employee

Complete and then submit to your employer to apply for income continuation insurance.

ET-5351

Form Local Employer / State Employer

Income Continuation Insurance Employer Statement

Employer report to verify eligibility for an income continuation insurance claim.

Two women sitting at a table going over forms.

Insurance Programs

General and administrative information for employers about insurance benefits.

Terms and conditions wording overlaying laptop

Benefits Terms and Conditions

Review the terms and conditions governing ETF's online services and benefits.

ET-2307

Form Active Employee / State Employer

Income Continuation Insurance Application - State

Complete and then submit to your employer to apply for income continuation insurance.

Insurance Administration System (IAS)

As part of our modernization journey, ETF is partnering with Benefitfocus to implement a best practices-based, fully integrated Insurance Administration System (IAS), known as My Insurance Benefits.

ET-2339

Form Active Employee / Retiree

Supplemental Insurance Application/Change

For UWs use only, as a paper alternative for a member who cannot complete their supplemental insurance enrollments online.

ET-4943

Brochure Active Employee / Retiree / Other Benefit Recipient

Administrative Appeal Process

This brochure is designed to assist you in understanding the administrative appeals process as it relates to ETF. It is not intended to substitute for the legal advice or assistance of an attorney.