ET-2405
Form Active Employee / Retiree

ETF Insurance Complaint Form

If you filed a grievance with the plan or benefit administrator and are dissatisfied with the final decision, you can request an administrative review from ETF.

You Have a New Dependent

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

Program Option
  • Local Annuitant Health Program (LAHP)
  • Local Deductible Health Plan (PO14) & Supplemental Benefits
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan (PO16) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits
Nurse helping support a patient with a cane

Long-Term Care Insurance

Available to state employees and retirees. Long-term care insurance covers medical services, such as nursing care or therapies. It also includes supportive services, such as bathing, dressing, getting in and out of bed, taking medicines, or preparing meals.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits

What Your Agent Can Do

Your financial power of attorney document determines the scope of your agent's authority. You may give your agent the ability to make many changes to your WRS account or limit them to a few actions.

You Are Laid off or Start a Leave of Absence (Active Employees Only)

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

Program Option
  • Local Deductible Health Plan (PO14) & Supplemental Benefits
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan (PO16) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits

What a Guardian Can Do

Each time a guardian makes a request on behalf of a member, ETF will review the Letters of Guardianship of the Estate. The request will be approved or denied based on the authority granted in the letters.

ET-4943
Brochure Active Employee / Retiree / Other Benefit Recipient

Administrative Appeal Process

This brochure is designed to assist you in understanding the administrative appeals process as it relates to ETF. It is not intended to substitute for the legal advice or assistance of an attorney.

ET-2572
Form Local Employer / State Employer

New Employee Benefit Checklist

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.