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Once an employee returns to work with his or her pre-military leave of absence employer, the employer is required to submit this form along with a copy of the appropriate military paperwork.
A Dependent Day Care Account is a pre-tax benefit used to pay for eligible day care expenses for qualified dependents in order for you (or your spouse) to work, look for work, or attend school full-time.
Plan Year
2025
Program Option
State Employee and Retiree Health Plan & Supplemental Benefits
ET-1110
Manual
Active Employee /
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer
For UWs only: This guide demonstrates procedures to help support the HR administrative duties within My Insurance Benefits and covers a variety of scenarios, such as enrollment, task management, and document management.