Vol. 22, State B
February 11, 2005
New Supplemental Income Continuation Insurance (ICI) Open
Enrollment Period Begins February 21, 2005
The Department of Employee Trust Funds (ETF) recently announced
an increase of the maximum monthly Income Continuation Insurance
(ICI) benefit levels through the creation of Supplemental ICI coverage
Vol. 22, Local B dated 1/14/2005). Supplemental ICI, effective
April 1, 2005, provides for coverage based on annual earnings between
$64,000 and $120,000.
This bulletin contains supplemental
ICI enrollment and updated premium remittance
instructions for State agencies.
Supplemental ICI Provisions
Currently, the ICI program covers 75% of an individual’s
annual earnings up to $64,000. The new supplemental ICI coverage
allows for coverage up to annual earnings of $120,000 with the employee
paying the entire premium for coverage beyond the $64,000 threshold.
Individuals with annual earnings greater than $120,000 who enroll
in supplemental ICI coverage are limited to a benefit based on earnings
The State ICI plan defines “earnings” as the basic
salary, including permanent add-on pay based on employees holding
certain educational degrees, certifications, licenses or credentials.
Overtime pay, temporary additional pay such as night differential,
weekend differential, and income from any other sources are excluded.
Who is eligible for Supplemental ICI Coverage?
Employees who meet/met the eligibility requirements for ICI
coverage per the State/Faculty plans and whose annual earnings
exceed $64,000. Eligible employees electing supplemental coverage
must insure their entire salary above $64,000 up to a maximum
of $120,000. There is no partial supplemental coverage. Enrollment
in the supplemental coverage is voluntary.
When to apply:
Employees with ICI coverage and annual earnings exceeding
$64,000 may apply during initial open enrollment (see below).
Employees newly eligible for ICI coverage and those employees
applying for ICI coverage during annual deferred enrollment
with annual earnings exceeding $64,000 may apply for Supplemental
ICI at the same time they apply for ICI coverage.
Employees with ICI coverage and earnings exceeding $64,000
who fail to enroll during the initial open enrollment period
may enroll in Supplemental ICI only on an annual basis (concurrent
with the annual deferred enrollment period). These employees may
not apply for Supplemental ICI by furnishing medical evidence
Employees without ICI coverage whose earnings exceed $64,000
may apply for both ICI and supplemental ICI coverage by furnishing
medical evidence of insurability.
Who pays the premium?
The employee pays the entire premium for the supplemental ICI
coverage; there is no employer share. Employers cannot contribute
any portion of the supplemental ICI premium.
How does supplemental coverage affect the potential
Employees with supplemental ICI coverage are eligible for a
maximum benefit of $7,500 per month (75% of maximum monthly earnings
Employees with annual earnings greater than $64,000 who are
not enrolled in supplemental ICI coverage are limited to a maximum
benefit of $4,000 per month.
Supplemental ICI Initial Open Enrollment
The initial open enrollment period for supplemental ICI coverage
runs from February 21 through March 11, 2005. Supplemental ICI coverage
for employees enrolling during this open enrollment is effective
April 1, 2005. Attached to this bulletin is a sample
letter employers may adapt and use to notify employees with
annual earnings greater than $64,000 whose ICI coverage is effective
on or before April 1, 2005. Employers should notify these employees
and ask interested employees to contact the appropriate human resources
or payroll/benefits personnel for an application.
Eligible employees on leaves of absence during the initial open
enrollment period have 30 days from their return to work to apply
for supplemental ICI coverage. Employees currently receiving ICI
benefits may enroll when they return to work and are no longer receiving
Who may apply during the initial open enrollment?
The initial open enrollment opportunity for supplemental coverage
applies only to employees, with earnings exceeding $64,000, currently
participating in ICI with an ICI coverage effective date of April
1, 2005 or earlier.
How to apply:
ETF recently revised the ICI
enrollment application to accommodate supplemental coverage.
There is a separate enrollment application for State employees/UW
faculty (Income Continuation Insurance Application [ET-2307]).
Eligible employees wishing to enroll in supplemental ICI coverage
must complete the 'Employee' section of the application and return
the application to the employer by close of business on March
- Validate that the employee is eligible for Supplemental ICI
- Complete the 'Employer' section of the application and forward
the top copy of the application to ETF. Each application will
be audited and problem applications reviewed with the employer
- Retain the Employer Copy for verification purposes.
- Give the Employee Copy to the employee.
Note: Please utilize the newly revised application,
Income Continuation Insurance Application (ET-2307, rev. 01/2005),
to enroll employees in both ICI and supplemental ICI coverage. Newly
eligible employees, as well as those employees already enrolled
in ICI and electing supplemental coverage during the open enrollment
period, must complete the revised versions of the application. Destroy/discard
all Income Continuation Insurance Applications (ET-2307, rev. 10/1999
or earlier) and begin using the revised forms effective the date
of this bulletin. As of February 21, 2005, applications
received with a revision date prior to 01/2005 will be returned
to the employer; the employee must then complete the appropriate
Employers received instructions for ordering the revised
ICI applications in a recent Employer
Bulletin (Vol. 22, Local B dated January 14, 2005). If you have
not yet ordered revised applications, complete the form attached
to the above bulletin and mail, fax, or e-mail the form to Broadspire,
the ICI third-party administrator. (Contact information is listed
on the form).
Premium Payment and Reporting
ETF revised the Monthly Premium Report Group Income Continuation
for UW only, ET-1612)
to accommodate the new supplemental ICI coverage. The revised report
is attached along with reporting instructions. Copy the report for
future reporting. This form is also available on ETF’s Internet
site at: http://etf.wi.gov.