This application is intended for insured employees who are terminating private pension employment, who may qualify to continue life insurance coverage.
Brochure
Active Employee /
Local Employer /
State Employer
This brochure describes your group term life insurance protection and is your certificate of participation, give a valid enrollment form is on file with ETF and premiums are being paid.
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.