1. How do I cancel health insurance coverage?
If you are a retiree, you may cancel anytime. You must provide written, signed notification of cancellation to ETF. Note that if you want to keep family coverage but drop a spouse or adult dependent, you must submit an application to ETF along with proof of their other coverage, such as an ID card, within 30 days of the effective date of other coverage. Otherwise, all eligible dependents must be enrolled in family coverage.
An employee's voluntary cancellation (or switch from family to individual coverage, which is deemed voluntary cancellation for all insured dependents) requires notification to the employer of a cancellation of coverage.
If your health insurance premiums are being deducted on a pre-tax basis under Internal Revenue Code Section 125, you may cancel coverage only if one of the following applies:
- You experience a qualifying change or life event and apply in My Benefits to cancel coverage within 30 days of the event.
- You terminate employment.
- You become eligible for and enroll in another group health insurance plan (not for example, Medicare).
- You cancel your coverage during the annual open enrollment period.
If your adult dependent child becomes eligible for and enrolled in other group health insurance coverage, and you want to drop coverage for them, submit an application electronically or via paper to your employer (to ETF for retirees) within 30 days of the effective date of other coverage. In addition, you must submit proof of enrollment such as an ID card from that coverage. If this is your last dependent and you want to change to individual coverage, you must note that on your application.
If your spouse becomes eligible for and enrolled in other group health insurance coverage and you want to change to individual coverage or cancel your family coverage submit an application electronically or via paper to your employer (to ETF for retirees) within 30 days of the effective date of other coverage. You must also submit proof of enrollment, such as an ID card, that lists all individuals covered under that plan. Retirees: For more information, please review the first paragraph of the answer to this Frequently Asked Question.
If your health insurance premiums are being deducted post-tax you may cancel at any time.
Be aware that voluntary cancellation of coverage does not provide an opportunity to continue coverage for previously covered dependents, as described in the COBRA/Continuation of Health Coverage FAQs. Cancellation affects both medical, uniform dental, and prescription drug coverage.
No refunds are made for premiums paid in advance unless your employer (or ETF, if you are no longer an employee) receives your written, signed request on, or before the last day of the month preceding the month for which you request the refund. Under no circumstances are partial month's premiums refunded. Once coverage terminates you will be responsible for any claims inadvertently paid beyond your coverage effective dates.
2. Under what circumstances can my health insurance coverage be terminated?
Your coverage can only be terminated because of one of the following:
- Premiums are not paid by the due date. Coverage is also waived (known as "constructive waiver") when the employee portion of the premium is not deducted for 12 consecutive months.
- Coverage is voluntarily canceled.
- Death of the subscriber.
- Fraud is committed in obtaining benefits or there is an inability to establish a physician/patient relationship. Termination of coverage because of inability to establish a physician/patient relationship requires Group Insurance Board approval.
- State, grad, and local only: Your coverage can be terminated because your eligibility for coverage ceases (for example, termination of employment).
- Locals Only: Your employer (for retirees, former employer) withdraws from the Wisconsin Public Employers Group Health Insurance Program.
- Retirees only: Your coverage can be terminated because you:
- Became ineligible for coverage as an annuitant because of becoming an active Wisconsin Retirement System employee. For more information see the Changes in Employment Status FAQs Question: How are my health benefits and premiums affected if I return to work for an employer who is under the WRS?
- IYC Medicare Advantage enrollees only: You dropped Medicare Part B. Your coverage will change to Medicare Plus. You may also change health plans within 30 days of the change.
The Medicare enrollment requirement is deferred while you or your spouse are employed and covered under a group health insurance plan from that employment. For more information see the Medicare Information FAQs Question: When must I apply for Medicare?
Active employees should contact their benefits/payroll/personnel office (retirees and COBRA continuants should contact ETF) for the date coverage will end.
3. Is it possible to enroll or reenroll in this health insurance program after I terminate employment?
State Retirees only:
- Former employees who have 20 years of WRS-creditable service and who took or are eligible for an immediate annuity may enroll or reenroll, even if the annuity you are eligible for is deferred. This may be done during open enrollment or up to 30 days after the date ETF receives your annuity application.
- Former employees with 20 years of WRS-creditable service who are not eligible for an immediate annuity may enroll or reenroll. This includes those former employees who have passed minimum retirement age but do not take their annuity. This may be done during open enrollment or up to 30 days after the date ETF receives your annuity application. If you have preserved sick leave credits you may use them to pay for coverage upon reenrollment, even if you have not yet taken your annuity.
- Retired state employees with less than 20 years of WRS-creditable service may reenroll during open enrollment if you were insured immediately prior to termination of employment and you are receiving a WRS retirement annuity or received a lump-sum WRS retirement benefit that began within 30 days of termination of employment.
If you are eligible submit an electronic or paper application to enroll and you may select any offered health plan.
Local Retirees only: Contact ETF for eligibility.
Note: This option is for WRS retirees only (a 40.65 disability benefit is not considered a WRS disability annuity under the law). This option is not available to survivors or dependents. You would not be eligible to use any sick leave credits to pay premiums if you enroll under this provision. There are separate enrollment opportunities for those individuals who have escrowed their sick leave. For more information see the Enrolling for Coverage FAQs Retiree Enrollment section, or contact ETF for details.
4. Is there any contribution for health insurance after I terminate coverage?
State only: Yes. Under certain circumstances your accumulated unused sick leave can be converted to credits to pay for health insurance premiums if one of the following is true:
- You are retiring.
- You are terminating after accumulating 20 years of creditable Wisconsin Retirement System service.
- You are surviving dependents who are insured under our program at the time of the active subscriber's death.
The rules governing eligibility are described in ETF publications: Sick Leave Credit Conversion Program (ET-4132), Group Health Insurance (ET-4112), Information for Retirees (ET-4116) and Your Benefit Handbook (ET-2119).
Locals only: Contact your employer for more information.
5. What if my employer's participation ends under the Local Group Health Insurance Program?
Local: When your employer's participation ends in this program coverage will cease for all participants. This includes retirees, survivors, and those who have continuation coverage. If the employer obtains group health insurance from another carrier ask the employer if the new carrier will provide coverage for retirees, survivors, and continuants.
When the employer terminates participation you will not be eligible for continuation of health coverage.