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.
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.
ET-4925
Brochure
Active Employee /
Retiree /
Other Benefit Recipient
If you are eligible to enroll in or change plans due to a qualified life change event, you may be asked to provide documents (employees to your employer, retirees to ETF) to confirm your eligibility.
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-2320
Form
Active Employee /
Retiree /
Other Benefit Recipient
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.