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.
ET-2311
Form
Active Employee /
Local Employer /
State Employer
This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed.
Have you ever needed medical care and didn’t know where to turn? In this video you'll learn about your care options and the advantages of each, including which is easiest on the wallet.