ET-8108
Flyer Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

Nondiscrimination and Language Access

ETF complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity.

ET-8945
Form Other Benefit Recipient

Vendor Privacy Incident Report

Use this form to report any possible or confirmed breaches of protected health information (PHI) or personally identifiable information (PII).

Dependent Day Care Account

A Dependent Day Care Account is a pre-tax benefit used to pay for eligible day care expenses for qualified dependents in order for you (or your spouse) to work, look for work, or attend school full-time.

Plan Year
  • 2025
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits

Vaccines at the Pharmacy

Get vaccinated for free at any in-network pharmacy using your pharmacy benefit.

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
ET-7414
Form Active Employee / Retiree / Other Benefit Recipient

Authorization to Disclose Medical Information

This form gives ETF and entities that perform contracted services for ETF permission to release your designated medical information to a person or entity specified by you.

Transit Account

A Transit Account allows you use pre-tax dollars to pay for eligible mass transit expenses related to your commute to and from work.

Plan Year
  • 2025
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Employer News
Sep 12, 2024 8:00am

ETF Updates MEBS Links

The direct links to the online “myETF Benefits” applications on the ETF website are changing due to an application update. Please update your links.

Following Enrollment

You will receive a welcome brochure in the mail from Optum Financial.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025