The Local Employer Health Insurance Standards, Guidelines and Administration Manual (ET-1144) has been revised. Please disregard any previous versions of this manual. You can see a summary of the changes below.

If you have any employer-related questions regarding the group health insurance program, please contact Employer Communication Center at ETFSMBEmployerInsurance@etf.wi.gov or 1-877-533-5020.

Location in Manual Summary of Change
Multiple Revised name for "Life Events Guide" (no longer "Life Change Event Guide").
Multiple Edited "Decision Guide" to be "annual Health Benefits Decision Guide."
Multiple Updated the name for ET-4814 to "Local Employer Verification of Health Insurance Coverage." 
106C, 208 Updated "Staywell" with "WebMD."
202 Clarified that although health plans all use the same Uniform Benefits, they may still process claims differently if they consider a procedure experimental.
203 Clarified that Access in-network benefits are Uniform Benefits.
204 Updated State Maintenance Plan (SMP) information that speaks about plan qualification.
205A Clarified the breakdown of contribution structures.
207 Corrected reference in 207 to link to 205, (not 204 as it was previously).
301A Clarified surcharge for new groups: explains that second year amount can change, annually.
401B Added survivors as eligible members.
402B Removed sentence allowing dual coverage. 
501A Added language to inform employers that new hires must be directed to look at the COBRA notice in the State and Federal Notifications web page, along with their spouse.
503A, 604B Clarified timing of receipt of loss of coverage documentation.
Multiple Clarified that gaining custody (joint or full or transfer of) is a qualifying event.
503A 2 a Clarified that if a member requests coverage following a marriage, other coverage must be terminated in order to enroll.
601 Renamed "Status Changes" to "Life Event Changes."
602 Updated that for a move life event, the member may send in notification of the move within 30 days before or after the move. Effective as of open enrollment for 2022.
Multiple Inserted references to Life Change Events and Documentation Requirements (ET-2846) form.
604A (8) Clarified that involuntary loss of coverage is required in order to change from individual to family coverage.
604B 2), 606B Effective January 1, 2022, currently insured single/divorced employees who request family coverage, or to add dependents to a family contract, must provide documentation, such as birth certificate. This is required even if dependents were previously covered.
604B 3 e Clarified that expiration of COBRA is a voluntary loss of coverage.
607E Clarified documentation required for terminating legal guardianship.
607F Clarified that an adult child can be terminated from coverage when the child experiences open enrollment outside of the program.
607F Added a note that enrollment in Medicare by an adult dependent is not a qualifying life event to remove a dependent.
607H Clarified the provision on when an adult child wants to be dropped but a parent refuses to submit an application.
803C 1 Military leave of absence (LOA) - Clarified that coverage is effective upon the date of re-employment, not return to work as defined in 801 B.
903 Changed directions for employer to leave health insurance active in myETF Benefits when an employee retires. ETF will end the contract when ETF receives the Local Employer Verification of Health Insurance Coverage (ET-4814).
Multiple Corrected the name for ET-4814 as "Local Employer Verification of Health Insurance Coverage."
1002F Clarified that COBRA for SSA disability can be 29 months if the employee notifies ETF within 60 days of the date they are "found to be disabled by SSA."
1004 4 b Clarified that if a COBRA member gains Medicare, only that member must be removed from the contract. 
1101A Clarified that ETF will end the coverage for a retiree after receipt of the Local Employer Verification of Health Insurance Coverage (ET-4814). The employee no longer needs to sign ET-4814 to continue coverage.
1104 Noted that employees no longer need to sign the Local Employer Verification of Health Insurance Coverage (ET-4814) if they want to continue coverage in retirement.
Appendix A Updated name and link to the State of Wisconsin Group Health Insurance Program Agreement (ET-1136).