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October 15, 2015

State Group Health Insurance Opt-Out Incentive Guidelines for State of Wisconsin Employers

2015 Wisconsin Act 55, s. 40.513, Wis. Stats. allows a state employee to receive up to a $2,000 incentive from his/her employer by opting out of state group health insurance coverage for the following calendar use by using an election form (Group Health Insurance Application/Change Form (ET-2301)).

An employee newly hired to state service during the calendar year will be eligible for a pro-rated incentive if an election is made within the first 30 days of state employment. Eligibility for the incentive begins the month in which the employee would have been eligible for the employer contribution towards the premium.
An employee is not eligible for this opt-out incentive, either in 2016 or future years, if:

  • the employee was eligible for a state contribution in 2015 and elected not to receive coverage in that year or;
  • the employee will receive state group health insurance under coverage of a spouse or domestic partner.

Employees may only opt out of state group health insurance coverage during the 2016 It’s Your Choice Open Enrollment period (which may include cancellations of coverage prior to 12/31/2015) or as a new hire.

Additionally, a state employee may lose eligibility for this incentive when enrolling for coverage, as a subscriber or a dependent spouse or domestic partner, due to an eligible life event. Read more on life changes and coverage changes.

More information on the distribution of this incentive can be found in a bulletin issued by the Department of Personnel Management.

Employee and Employer Responsibilities
In order to receive this incentive, the employee must complete two steps:

When filling out the Group Health Insurance Application/Change Form (ET-2301), the employee must:

  • check “Yes” that the employee is eligible for the incentive;
  • complete sections one and two; and
  • sign and date page three of the application. 

The employer must complete the employer section of the Group Health Insurance Application/Change Form (ET-2301). 

The employer must receive this application from the employee prior to January 1, 2016. However, ETF encourages employees to file an application for this incentive during the 2016 It’s Your Choice Open Enrollment period, October 5, 2015 through October 30, 2015.

The employer should maintain a copy of the completed Group Health Insurance Application/Change Form (ET-2301). The employer is not required to send a copy of the application to ETF.

Additionally, the employee or employer must cancel the state group health insurance coverage in the myETF Benefits system, effective 12/31/2015, during the 2016 It’s Your Choice Open Enrollment period. If a cancellation occurs after the 2016 It’s Your Choice Open Enrollment period but prior to 12/31/2015, please contact ETF for assistance in cancelling the coverage.

ETF’s Verification of Eligibility for Employers
To verify an employee’s eligibility for this incentive, send an email to with the following information:

  • employee’s name,
  • date of birth, and
  • ETF member ID (or last 4 digits of SSN if they do not have an ETF member ID).

The information provided by ETF is accurate as of the date and time provided, but is subject to change.

To facilitate employers’ management of the opt-out incentive in the future, ETF will provide a listing of employees who opted out of coverage for 2015 and employees who are covered under a spouse or domestic partner on a state contract as of 1/1/2016 in early January 2016.

ETF plans to work with employers to conduct an audit of those employees who opted-out of coverage for 2016 in the future.

Please direct any employer questions on this this verification process to

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