Insurance Help

Visit Benefits Available to Me to see if health insurance is offered by your current or former employer. Visit the Dental Insurance, Vision Insurance, Accident Plan, Life Insurance, and Income Continuation Insurance pages to learn about eligibility for each program.

Employees: Contact your employer’s human resources office or benefits specialist for eligibility questions.

Retirees: All retirees are eligible for supplemental dental plans (Preventive, Select, and Select Plus) and vision insurance. Contact ETF if you have additional benefits eligibility questions.

Contact your health plan or insurance vendor if you have questions regarding:

• A letter they sent
• Why you received a bill
• Which services are covered
• The amount that was covered
• Why a service was not covered
   

Ombudsperson Services may be able to help if you’re unable to resolve coverage issues with the health plan or insurance vendor.

If you’ve been told you don’t have insurance coverage or incorrect information (such as an incorrect address or wrong last name) is preventing you from receiving services:

• Employees: Contact your employer’s human resources office or benefits specialist. If this is an emergency situation, you may contact ETF.
• Retirees and COBRA continuants: Contact ETF. If you were automatically cut off from coverage due to nonpayment of premium, contact your health plan or insurance vendor to see if they will reinstate your coverage.

There are certain times throughout the year when you may enroll in, or change your coverage:

• When you are first hired
• When you experience certain life events
• During the fall open enrollment period

Employees

Contact your employer’s human resources office or benefits specialist for questions such as:

• When you can enroll
• When coverage starts
• How to enroll or cancel
• When forms are due
• Required documentation
• When your employer starts contributing to your health insurance premium

Retirees

To enroll, change or cancel your health insurance coverage, submit Health Insurance Application/Change for Retirees (ET-2331) form to ETF. Please note Medicare eligibility is not an enrollment opportunity.

You may cancel health and Uniform Dental insurance or change from family to individual coverage at any time. Your Uniform Dental coverage mirrors your health insurance coverage.

• Cancelling health insurance will cancel your Uniform Dental insurance.
• Changing from family to individual coverage, will apply to both health and Uniform Dental insurance.
   

Supplemental benefits can only be cancelled due to a qualifying life event or during open enrollment. See Enroll or Make Changes to Dental, Vision, and Accident Plan page for more information.

Contact ETF if you have additional questions.

Contact the health plan or vendor if you did not receive insurance cards or need new ones.

For enrollments made during the fall open enrollment period, you should receive your new insurance card(s) by January 1 of the following year. When enrolling as a new hire or making changes due to a qualified life event, new cards typically arrive in one to two weeks.

See our New to Medicare video to learn about the different parts of Medicare, how Medicare works with your ETF benefits, how much you’ll pay and the steps you need to take. Medicare is not an enrollment opportunity but you may be able to change your health plan.

Contact the Center for Medicare and Medicaid (CMS) for the following:

• Enrolling in Medicare
• Coordination of benefits issues
• Late enrollment penalties
• Additional premium amount for higher income individuals (IRMAA)
• Low Income Subsidy (LIS)
• Defer enrollment due to active employment
   

Contact ETF for questions about:

• The different Medicare-coordinated plan designs offered through ETF
• Medicare Parts A, B, C, and D, including enrollment timing and deadlines when you retire
• The Medicare Part D pharmacy plan and disenrolling from ETF’s pharmacy benefit
   

Contact your employer's human resources office or benefits specialist if you deferred Medicare coverage as an employee and are planning to retire.

Active Employees: Contact your employer's human resources office or benefits specialists on issues related to premiums deducted from your paycheck.

Retirees: Contact ETF unless your previous employer pays some or all of your premium, then contact your previous employer. If you are paying your health plan directly, contact the health plan.

The Accumulated Sick Leave Credit Conversion Program allows state employees to convert unused sick leave to credits to pay for health insurance during retirement. See the Accumulated Sick Leave Credit Program page to learn about eligibility, how credits work, how to save your credits, and how to re-enroll in health insurance and begin using your credits.

Employees about to retire or newly retired: Contact your employer's human resources office or benefits specialists if you have questions about the initial sick leave credit amount calculated by your employer.

Retirees: Contact ETF for questions on your sick leave balance, coordination of sick leave accounts, escrowing your sick leave, re-enrolling in health insurance after escrowing your credits, and comparable coverage.

Annually you will receive the Form 1095 which provides proof of your individual health insurance information. See the Form 1095: Proof of Health Insurance page to learn when you should receive it, how to request a duplicate, and more.

You will receive a W-2 statement from ETF or your employer if you and/or your dependents received a taxable wellness incentive. See W-2 Wellness Incentive Taxes page to learn when you should receive it, how to request a duplicate, and more.

See the Well Wisconsin for Members page to learn about wellness tools and resources, how to earn the wellness incentive, and contact information for further questions.

Employees, retirees, and their spouses who participate in the Group Health Insurance Program have access to Well Wisconsin. Visit Benefits Available to Me to see if your current or former employer offers health insurance through the program.

While Medicare Advantage members have access to tools and resources through the Well Wisconsin program, they cannot earn the Well Wisconsin incentive. Instead, Medicare Advantage members can earn other incentives through Renew Active.