Employers, use this form to verify that you viewed the employee’s original required document(s) to verify the employee or dependent(s) is eligible for benefit coverage, as administered by ETF.
The new manual provides information about the Sick Leave Conversion Program, including that unused sick leave can be utilized as a retirement benefit that allows eligible employees to convert unused sick leave into credits to pay post-termination health insurance premiums.
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.
ETF has updated the Sick Leave Conversion Program Employer Manual (ET-1170), and has summarized the changes here. Please disregard any previous versions of this manual.
Active Employee /
Retiree /
Board Member /
State Employer