ET-4317
Form Active Employee / Retiree

Sick Leave Re-enrollment Application

Re-enroll for group health insurance coverage during the annual It’s Your Choice open enrollment period or after an involuntary loss of your comparable non-state coverage, if eligible.

Decision Guide Cover Image

State Employee and Retiree Health Plan & Supplemental Benefits

Benefits include: Health, Wellness, Dental, Vision, Accidental Death and Dismemberment (AD&D), Long-Term Care and Pre-Tax Savings Accounts. Sign up and learn more about your health benefits.

Plan Year
  • 2024
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Medical technology

Benefits Mentor

Benefits Mentor is the interactive benefits counselor for active state employees and non-Medicare retirees. Powered by ETF’s secure data warehouse, Benefits Mentor will use your claims information (if available) as a basis for personalized plan design recommendations.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits