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.
If you are the owner of a WRS account from which a WRS death benefit or life insurance benefit would be payable upon your death, you may file a beneficiary designation.
You and/or your insured dependents must be enrolled for both portions of Medicare (Hospital Part A and Medical Part B), when first eligible. Provide this information to ETF using this form.
ET-7414
Form
Active Employee /
Retiree /
Other Benefit Recipient
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.