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.

Flyer Active Employee / Retiree / Local Employer / State Employer

Accessing Your Health Benefits While Out of State

This document for State, UW and Local retirees describes the health plans that offer out-of-state coverage for routine care and what to expect while you're out of network.

Video
4 minutes
Health Benefits video blank title slide.

Accident Plan

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