Vol. 17, No. 4
February 16, 2000
Income Continuation Insurance Claim Process Approved
The Department of Employe Trust Funds (ETF) has been reviewing
its processes in an effort to improve customer service. As a result,
staff recommended revisions to the Income Continuation Insurance
(ICI) Claim Process, and the Group Insurance Board (GIB) approved
these revisions at a recent meeting.
The revisions not only reduce processing time for payment of initial
ICI benefit payments, but also address employe's concerns about
their employer's access to confidential medical records. In
addition, ETF has created new claim packets, which include a copy
of the ICI booklet, an ICI Claim Form and the
ICI Medical Report. Employes can obtain a claim
packet from their employer.
If you have a supply of old claim forms (ET-5301 or ET-5310), please
destroy them and use the new forms. Effective April 1, 2000, ETF
will no longer accept the old claim forms.
New ICI Claim Process
The new claim process allows us to process several steps simultaneously.
This involves the use of three separate ICI forms. They are as follows:
- ICI Claim Form (ET-5352)
Completed by the employe and forwarded directly to ETF.
- ICI Medical Report (ET-5350)
Completed by the employe and given to the employe's physician
to complete. Employe's physician forwards the completed report
directly to ETF.
- ICI Employer Statement (ET-5351)
Sent to the employer by the claims administrator upon receipt
of the claim form from ETF. Employer completes the statement and
mails it to ETF.
Questions about the new claim process should be directed to the
claims administrator, United Wisconsin Insurance Company (UWIC).
Their toll-free telephone number is: (800) 452-4250.
New ICI Claim Form Packets Now Available
Order new claim form packets from ETF. To place an order, please
use one of the following methods. Allow three weeks for delivery.
- Call ETF Supply and Mail Services at (608) 266-3302.
- Complete the order form
and mail to ETF, PO Box 7931, Madison WI 53707-7931.
- Fax a copy of the order form to ETF at (608) 267-4549.
- E-mail ETF by clicking contact us
on our Internet site.