BN - Benefits Personal Data


This procedure will cover how to correctly enter benefit personal data, which drives the ETF Health Interface for State Group Health. Benefits Personal Data is where information regarding Medicare, Other Health Insurance, marital status, and ETF Member ID are stored. All of this information should be regularly updated from the ET-2301 Health Insurance Application Form completed by the employee.


  • ETF requires these fields for accurate coordination of benefits. Critical fields include: Medicare, Spouse/Domestic Partner (SP/DP) state employment, marital status, and other insurance information.  Incorrect information will not only be reflected in HRS, but will be transmitted to ETF and the insurance vendors and may cause claim issues and/or delays in payment.  Campus Benefit Administrators will need to do additional follow-up with an employee if information is not provided on the enrollment form.
  • Employees may be enrolled in plans that they actually are not eligible for due to missing other health insurance or medicare information
  • This screen must be updated whenever a new Health Insurance Application form is submitted by an employee.
  • If you do not have security access to update this page in HRS, you will need to work with your HR Department to update specific fields to ensure accurate and timely information is submitted to ETF.


1. Navigate to:  Benefits > Employee/Dependent Information > Benefits Personal Data

2. Enter the Employee's ID and click the Search button.

3. The employee's ETF Member ID is listed here. This ID is ETF's 8 digit unique identifier for the employee in their database.


Coordination of Benefits

a. If applicable, mark if the spouse or domestic partner is also a state employee.

b. Please select 'Yes' or 'No' to Other Health Insurance.

  • If 'Yes', then list all known information regarding the other insurance using the three fields: Insurance Company Name, Insurance Policy Number, Insurance Group Number


This information can be found under the "Complete if you Have Additional Health/Coverage" information section 12, page 4 of the Health Insurance Application ET-2301 form as shown below:


Marital Status

a. If applicable, provide Effective Date and Marital Status. 

Updating the Marital Status here will also automatically update the Marital Status found on the "Modify a Person" HRS page. 


You can obtain the Marital Status information from "Applicant Information" section 1, page 1 of the Health Insurance Application ET-2301 form as shown below.

Marital Status

Benefits Personal Data

a. This box can be ignored


Benefits Personal Data - Date Sensitive

a. If applicable, fill in Medicare information. 

 If employee's Medicare Number ends in an 'A' this means they have Medicare Reason A. If employee's Medicare Number ends in a 'B' this means they have Medicare Reason B.  Employees might have both. 


You can obtain the Medicare information from the "Complete if you are Covered by Medicare, section 11, page 3 of the Health Insurance Application ET-2301 form as shown below.

Medicare App


Related KBs:

Related Links:

Keywords:coordination of benefits, marital status, other insurance, medicare, ETF Member ID, Interface, state group health, add coverage, add dependent, remove dependent, health, enroll domestic partner, marriage, divorce, single, widow, widowed, effective date   Doc ID:17882
Owner:Samantha Q.Group:Human Resource System (HRS)
Created:2011-04-06 19:00 CDTUpdated:2017-02-27 14:13 CDT
Sites:Human Resource System (HRS)
Feedback:  0   0