If you wish to specify who shall receive a primary beneficiary’s share of a death or life insurance benefit if a primary beneficiary is deceased, you must use this alternate beneficiary designation 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.
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Active Employee /
Retiree /
Other Benefit Recipient /
Board Member /
Local Employer /
State Employer