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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 Local Traditional Health Plan Insurance Program
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2017 It's Your Choice - Local Traditional Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds It's Your Choice 2017


Local Traditional Plan
Insurance for Employees
and Retirees
(PO2, PO12)


Life Changes and Coverage Changes

Did you recently get married, enter into a domestic partnership, have a baby, an eligible move to a new county or another life change event? You may have the opportunity to enroll or change your coverage outside of the open enrollment period. There are various rules related to life change events.

You may be able to change coverage outside of the IYC open enrollment period if any of the below events apply.**

The chart below also applies to the Uniform Dental Benefit, and optional, employee-pay-all plans, including: VSP, *EPIC Benefits+, *EPIC Dental Wisconsin, Anthem Dental, and Zurich AD&D coverage. Please visit our benefits other insurance page or see your payroll/benefits specialist for details.

For more detail see the Frequently Asked Questions. Employees may also contact your payroll/benefit office.  Retirees and continuants may contact ETF.

Once you've reviewed if you are eligible to make a change, see the Make Your Choice tab above to make a change.

Event Enrollment opportunity? Change  coverage (single-family or family-single)? Change Health Plan? Drop a dependent and keep family coverage? Cancel coverage?
You marry or establish a Chapter 40 domestic partnership Yes Yes Yes No Yes
File an application or enroll online within 30 days of the event.  Coverage becomes effective on the date of the marriage or the date ETF receives the Affidavit of Domestic Partnership (ET-2371).  
You divorce or terminate a Chapter 40 domestic partnership;  Yes; for medical, only if losing other medical coverage as a dependent. Yes Yes Yes Yes
File an application or change information online within 30 days of the event.  Coverage becomes effective on the end of the month following the divorce (or the date that the Continuation-Conversion Notice (ET-2311) is provided to the divorced spouse) or the date ETF receives the Affidavit of Termination of Domestic Partnership (ET-2372).  
You have a new dependent due to birth; adoption; placement for adoption; or birth of grandchild from your covered dependent under age of 18.  (Your grandchild becomes ineligible at the end of the month in which the parent, your dependent, turns age 18.) Yes Yes Yes No Yes
File an application or enroll online within 60 days of the event.  Coverage becomes effective on the date of the event.
You have a new dependent due to National Medical Support Notice Yes Yes, single to family.   Yes No Yes
File an application or enroll online within 60 days of the event.  Coverage becomes effective on either 1: the first of the month following receipt of the application by the employer or ETF for retirees/continuants or 2: the date specified in the Medical Support Notice.  
You have a new dependent  due to paternity Yes Yes, single to family.   Yes No Yes
File an application or enroll online within 60 days of the event.  Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgement of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin) or on the date of birth with a birth certificate listing the father's name. The effective date of coverage will be the birth date, if a statement of paternity is filed within 60 days of the birth. If filed more than 60 days after the birth, coverage will be effective on the first of the month following receipt of application.
You have a new dependent due to legal guardianship Yes Yes, single to family.   No No Yes
File an application or enroll online within 60 days of the event.  Coverage becomes effective on the date of the event.
You have a new dependent due to transfer of custody  Yes Yes, single to family.   No No Yes
File an application or enroll online within 30 days of the event.  Coverage becomes effective on the date of the event.
You gain eligibility for other group medical coverage through your spouse or Chapter 40 domestic partner No Yes, family to single.  No Yes Yes
File an application within 30 days of enrollment in other coverage.  Coverage becomes effective on the first of the month following the receipt of application. This coverage ends the end of the month following receipt of application.
You or your dependent involuntarily lose eligibility or all employer contribution for other group medical coverage Yes Yes Yes No No
File an application or enroll online within 30 days of the event.  Coverage becomes effective on the date the other coverage terminates.
You move from your health plan's service area (county) for at least 3 months  No No Yes No No
File an application or enroll online within 30 days after the move.  Coverage becomes effective on the first of the month following the  receipt of application.
You are laid off  or start a  leave of absence  No Yes, family to single.  No No Yes
A change in coverage becomes effective on the first of the month following the  receipt of application.  Coverage ends the month for which premiums have not been paid.
You retire  No, unless uninsured employee chooses to enroll in the IYC Access Plan 30 days prior to retirement.              STATE: (for 1 month of coverage) in order to escrow sick leave upon retirement. LOCAL:  in order to use post-retirement employer premium contributions.  No** No No Yes
Coverage begins the first of the month following receipt of the application.  Coverage must be in effect 30 days prior to retirement.  Coverage ends the month in which the employment terminates.
Your spouse dies  No, unless the employee is losing other group coverage as a dependent. Yes , family to single if you have no other deps No Yes Yes
If you are an employee, please submit an application to your employer removing your spouse.  For retirees, you only need to file an application if you wish to terminate coverage. Coverage ends on the first of the month following receipt of application.
Your unmarried dependent over age 26 becomes disabled and gains eligibility Yes, for the child to be added to your existing coverage.  Yes, single to family coverage. No No No
File an application or enroll online within 30 days of the event.  The health plan determines if the child meets the disabled dependent criteria. Coverage becomes effective on the first of the month following determination that the adult child meets the disabled dependent criteria.

* Please note that EPIC plans different rules for canceling coverage. Please visit http://www.epiclife.com/wi-state-employees/ for more information.

** If you are a retiree, a state employee who has opted out of premium conversion under Section 125, or are a local employee who does not have their health insurance premium contribution deducted pre-tax under a federal Section 125 plan--you may change from family to single coverage at any time.

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 3/27/2017 4:03:09 PM