Q: I want to resolve a Wisconsin Retirement System benefit dispute. Where do I begin?
A: First, contact either your health plan, your employer, or the Department of Employee Trust Funds to clearly explain the problem. Many issues are resolved within a few calls or emails. Keep in mind that not every service you either want or need is covered by your health insurance. Contact your plan if you are uncertain about coverage, or to find out whether prior authorization is required for the services you want to receive.
If you are unable to resolve the matter yourself, you can choose to go through a grievance process. Contact your plan or program administrator for information about their grievance process. If your issue is about WRS retirement benefits, contact ETF.
ETF Ombudsperson Services will attempt to resolve questions and issues on your behalf, including trying to resolve your plan issue outside of the grievance process. You may also contact an ombudsperson before or after going through the plan grievance process. In either case, the ombudsperson can assist as a “navigator" by providing guidance, options, and resources. If your complaint cannot be resolved informally by an ombudsperson and you wish to pursue it further, they will explain the appeals process available to all WRS members.
For more information about ETF Ombudsperson Services, review our brochure or visit the Benefits Dispute page.