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Employers

Wisconsin Retirement System

Income Continuation Insurance Administration Manual (State)

ET-1119, REV 10/27/2016


The following chapters are in Adobe Acrobat PDF format.  To view, download or print these chapters, you will need the Acrobat Reader.  If you do not have Acrobat Reader installed on your system, you will need to install/download the free Acrobat Reader


Table of Contents

Preface (REV 4/1/2016)

Chapter 1—General Information (REV 4/1/2016)

  • 100 Introduction
  • 101 Program Features
  • 102 Administration
  • 103 Division of Responsibilities
  • 104 Administrative Offices and Contacts
  • 105 Complaint Resolution
  • 106 ETF Ombudsperson Services
  • 107 Confidentiality of Records
  • 108 Ordering Income Continuation Insurance Forms
  • 109 Internet Address - http://etf.wi.gov

Chapter 2—Eligibility Criteria (REV 4/1/2016)

  • 200 Newly Hired Employee Eligibility Criteria
  • 201 Initial Enrollment Period and Coverage Effective Date
  • 202 WRS Previous Service Check
  • 203 Transfers Between State Agencies
  • 204 Rehired/Returning Employee Eligibility
  • 205 Leaves of Absence (LOA)
  • 206 Change to LTE, Project or Other Employment Status
  • 207 Change to or from UW Faculty/Academic Staff Positions
  • 208 Reinstatement Due to Compromise Agreement

Chapter 3—Enrollment and Application (REV 10/27/2016)

  • 300 Applying for Income Continuation Insurance - New Employee
  • 301 Two Levels of Coverage
  • 302 Three Enrollment Opportunities
  • 303 Employee Completion of Income Continuation Insurance Application (ET-2307)
  • 304 Employer Completion of Income Continuation Insurance Application (ET-2307)
  • 305 Application Due Date and Effective Date of Coverage (Table)
  • 306 Distribution of Copies
  • 307 Instructions for Completing the Evidence of Insurability Application (ET-2308)

Chapter 4—Employee and Employer Premiums (REV 4/1/2016)

  • 400 Basis for Premium Contribution Rates
  • 401 Employee Monthly Premium Rates - State Employees
  • 402 Employee Monthly Premium Rates - UW Faculty
  • 403 Calculating Employer Premium Share
  • 404 Annual Premium Update

Chapter 5—Monthly Premium Report (REV 4/1/2016)

  • 500 Completing the Monthly Premium Report Group Income Continuation Insurance (ET-1611) for State Employee Plan
  • 501 Sample - Monthly Premium Report Group Income Continuation Insurance (ET-1611)
  • 502 Premium Remittance
  • 503 Due Date
  • 504 Late Reporting Interest Charge
  • 505 Permanent Change in Percentage of Appointment

Chapter 6—Termination of Coverage (REV 4/1/2016)

  • 600 Termination of Coverage
  • 601 Lapse in Coverage
  • 602 Cancellation of Coverage

Chapter 7—Benefits (REV 4/1/2016)

  • 700 Introduction
  • 701 Eligibility for Income Continuation Insurance Benefits
  • 702 Determining Dates of the Elimination Period
  • 703 Earnings for Benefit Payment Purposes
  • 704 Benefit Payments
  • 705 Dates of Benefit Payment Checks
  • 706 Continuation of Benefit
  • 707 Maximum Duration of Benefits
  • 708 Offsets From Other Benefit Sources
  • 709 Reduction or Termination of Benefits
  • 710 Rehabilitative Training
  • 711 Social Security Withholding on Income Continuation Insurance Benefits
  • 712 Taxability of Income Continuation Insurance Benefit

Chapter 8—Claim Process (REV 4/1/2016)

  • 800 Filing an Income Continuation Insurance Claim
  • 801 Employer Information Required by the Third Party Administrator
  • 802 Third Party Administrator Claim Review
  • 803 Approval, Denial or Termination Notice
  • 804 Waiver of Premium

Chapter 9—Claimant Change in Work Status (REV 4/1/2016)

  • 900 Change in Work Status
  • 901 Completing the Income Continuation Insurance Report of Employment and Earnings (ET-5901)

Chapter 10—Reinstatement of Coverage Lost Through Employer Error (REV 4/1/2016)

  • 1000 Statutory and Contractual Provisions
  • 1001 Types of Employer Errors that Can be Corrected
  • 1002 How to Correct an Employer Error
  • 1003 Errors Not Eligible for Correction
  • 1004 Deadline for Reporting of Employer Error
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