Form for the member’s physician to complete if the member cannot manage property, finances or business affairs because of an impairment in the ability to receive and evaluate information or make or communicate decisions even with the use of technological assistance.
ET-4944
Form
Active Employee /
Retiree /
Other Benefit Recipient
If you need to correct or change your personal information, you may be asked to provide acceptable documents for verification. Know the required documents and how to submit them.
ET-8918
Active Employee /
Retiree /
Local Employer /
State Employer
Income Continuation Insurance (ICI) is an optional insurance that provides replacement income for disabilities that are considered short-term in nature, as well as those which may last for extended periods.
Choose from up to four dental plans to get the right coverage for you and/or your family. The dental plans offer coverage for services such as cleanings, exams, fillings, and orthodontia.