Find out which documents are required when adding a spouse or dependent to your insurance or making changes due to a qualified life event. Having the correct paperwork will help ensure a smooth update to your coverage.
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
Notice for members where all or a portion of a payment from the WRS is eligible to be rolled over to an individual retirement account (IRA) or an employer plan.
These terms govern a member's use of ETF online service, enrollment in available ETF insurance benefits, and receipt of available ETF insurance benefits.
Report
Active Employee /
Retiree /
Board Member /
Local Employer /
State Employer
This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of December 31, 2019.
ET-4944
Form
Active Employee /
Retiree /
Other Benefit Recipient