The State Agency Health Insurance Administration Manual (ET-1118) has been revised. The revision date of each chapter is indicated next to the title of each chapter. Changes are summarized 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 the 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."
106C, 208 Updated "Staywell" with "WebMD."
201A Clarified that although health plans all use the same Uniform Benefits, they may still process claims differently if they consider a procedure experimental.
202 Clarified that Access in-network benefits are Uniform Benefits.
203 Updated State Maintenance Plan (SMP) information that speaks about plan qualification.
205, 206 Added information that craft workers will get employer contribution, HSA contribution, and ability to opt-out effective January 1, 2022.
401A 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.
403A (1), 504B Clarified timing of receipt of loss of coverage documentation.
Multiple Clarified that gaining custody (joint or full or transfer of) is a qualifying event.
403A (2) Clarified that if a member requests coverage following a marriage, other coverage must be terminated in order to enroll.
501 Renamed "Status Changes" to "Life Event Changes."
502 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.
504A (8) Clarified that involuntary loss of coverage is required in order to change from individual to family coverage.
504B 2), 506B 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.
504 B (3) e Clarified that expiration of COBRA is a voluntary loss of coverage.
507E  Clarified documentation required for terminating legal guardianship.
507F Clarified that an adult child can be terminated from coverage when the child experiences open enrollment outside of the program.
507F Added a note that enrollment in Medicare by an adult dependent is not a qualifying life event to remove a dependent.
507H Clarified the provision on when an adult child wants to be dropped but a parent refuses to submit an application.
705B (5) 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.
902F 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."
904 4) Clarified that if a dependent gains Medicare, only that dependent will be removed. If Medicare starts prior to or on the same day as the COBRA contract, they can have COBRA with Medicare.
1201 Added the Accumulated Sick Leave Credit Transfer Between Wisconsin Retirement System Agencies grid.
1203D Added a reminder that if an employee is terminating with sick leave and isn't in the State Group Health Insurance Program (GHIP), the employer must talk to them about losing sick leave unless they enroll in the State GHIP for 30 days to escrow.
1208 7) Clarified that if a member is termed due to gross misconduct, the employer should submit a sick leave certificate for $0. 
1208F 5) Clarified instructions on how to document sick leave time during a layoff.
Appendix A Updated name and link to the State of Wisconsin Group Health Insurance Program Agreement (ET-1136).