The Department of Employee Trust Fund has updated the Local Employer Health Insurance Standards, Guidelines, and Administration Employer Manual (ET-1144), and has summarized the changes in the table below. Please disregard any previous versions of this manual.
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.
| Summary of Change | Location in Manual |
|---|---|
| Added clarifying language for employees’ eligibility when working for a non-Wisconsin Retirement System employer covered by the Section 218 agreement with the Social Security Administration | 401C |
| Added language clarifying that uninsured employees who want to use their sick leave to pay for health insurance in retirement must be insured in the Access Plan for a month prior to retirement | 501A 5 |
| Added clarifying language that if employees terminate after taking incomplete action to add a child dependent within 90 days, the child will be deleted and have no effective coverage | 606B |
| Updated links to documents for most current edition | 606B, 606C |
| Clarified the language for removing a dependent that is no longer covered under the National Medical Support Notice (NMSN) | 607I |
| Added clarifying language for the status of late health benefits open enrollment applications: approved requests received prior to 1/31 are retroactively effective 1/1, while requests approved after 1/31 are effective the first of the following month | 704C |
| Renamed terms for consistency throughout manual | 802 OE, 804 |
| Added clarifying language regarding leave of absence for military and non-military employees | 803 |
| Added language clarifying that ACA requires that an employee has at least 30 days of coverage before benefit termination | 901A (5) |
| Added language clarifying that if an employee's spouse is an eligible state or local employee, the couple may change the listed subscriber, but this does not permit changing health plans | 901A (13) |
| Added language clarifying that when an employee is hired, WRS eligible, and elects insurance coverage, but terminates before 30 days of service, their insurance remains and the employee must be offered COBRA | 1002G |
| Added clarifying language that employers should offer COBRA to insured employees even if the employee terminates before 30 days of work have passed | 1002A (1), 1002G |
| Added clarifying language that to reduce timing-related issues with accepting invoices, employers should not accept them between the hours of 5:40 - 8:15 p.m. | 1503A |
| Updated the glossary to align with other ETF glossaries | Chapter 17 |
| Updated Health Plans Carrier Codes table | B-4 |
| Added directions and guidance for how to run reports in MEBS | C-11 |