You or Your Dependent Involuntarily Lose Eligibility or All Employer Contribution for Other Group Medical Coverage 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
ET-6301 Form Other Benefit Recipient Notice of Death Notify the third party administrator of the group life insurance program of a member death.
You Have a Job Change Where You Gain a Greater Share of Employer Contribution Toward Your Coverage (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
You Have a Job Change Where You Lose a Significant Share of Employer Contribution Toward Your Coverage (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
Flyer Active Employee / Retiree / Other Benefit Recipient / Board Member / Local Employer / State Employer Board Meeting Directions - 1st floor
Flyer Active Employee / Retiree / Other Benefit Recipient / Board Member / Local Employer / State Employer Hill Farms 1st Meeting Rooms-Map Only A map of the first floor of the Hill Farms building labeled with room numbers and an arrow to the main entrance lobby.
Submit, Change, or Terminate Letters of Guardianship Learn the steps to submit, change or terminate Letters of Guardianship.
Create, Submit, or Revoke A Financial Power of Attorney Document Find resources for creating a financial power of attorney document, learn how to submit your document to ETF and how to revoke your document.
Changes to Life Insurance Coverage Events happen in life and can affect your coverage. Make sure you know when you lose your coverage and what steps to take to make sure you can keep it.
Enroll or Make Changes to Dental, Vision, and Accident Plan Learn when and how you can enroll or make changes to supplemental benefits, such as dental insurance, vision insurance, and the accident plan.
