Pre-Retirees – Required Documents

Required Documents


Required Documents

The following is a list of documents you will need to submit to the EUTF in order to enroll in retiree health and life insurance benefits. After filing your retirement application with the Employees’ Retirement System (ERS), please submit the following:

  • ERS Retirement Estimate Letter
  • EUTF EC-2 Enrollment Form (due within 60 days of retirement date)

If you’re Medicare eligible (age 65+ or qualified disabled), you must also submit:

  • Copy of your and/or your spouse/partner’s Medicare card (indicating enrollment in Medicare Part B)
  • Medicare Part B Reimbursement Direct Deposit Agreement Form
  • Social Security Administration letter for you and/or your dependent indicating the Medicare Part B Premium amounts.

If you will be paying all or a portion of your health benefit premium and would like your premiums deducted from your ERS pension, submit the following:

  • ERS Pension Deduction Form

Optional Forms:

  • Authorization for Release of Protected Health Information
  • Securian Financial Group Inc. Beneficiary Designation Form