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Submit this completed form to ETF to appeal a determination regarding your ETF-administered benefit(s).

Checklist for a new employer agent or an employer’s new retirement/insurance contact with the ETF.

While there are many new features and capabilities that this system will offer when it goes live, we have identified one feature that will not be available for local employers at that time. Specifically, the premium rate display, with a contribution breakout showing the member and employer shares, will not be visible to your employees.

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.

A tool for an employer to confirm information was presented to a new employee, due dates identified and appropriate information and forms supplied for all ETF-administered benefits offered by the employer.

Designate an attorney-in-fact to act in your stead for an appeal to ETF.

A map of the first floor of the Hill Farms building labeled with room numbers and an arrow to the main entrance lobby.