The Department of Employee Trust Funds has updated the State Health Insurance Standards, Guidelines, and Administration Employer Manual (ET-1118), 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 |
|---|---|
| Renamed terms for consistency throughout manual | Multiple |
| Clarified that gaining custody of a dependent (joint, full, or transfer of custody) is a qualifying life event | Multiple |
| Clarified that in a life event of moving, a member may send notice of the move within 30 days before or after the event | Multiple |
| Updated email addresses and links to documents for most current edition | Multiple |
| Added example to provide clarity | 401(A)(5) |
| Added language clarifying that when LTE or part-time employee becomes eligible for employer contributions, it counts as new enrollment opportunity | 403 |
| 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 | 506(B) |
| Clarified language for removing a dependent that is no longer covered under the National Medical Support Notice (NMSN) | 507(I) |
| Added clarifying language for 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 | 604(3) |
| Clarified language surrounding coverage during a military leave of absence (continue, lapse, or cancel) | 705(A) |
| Added language clarifying that if an employee's spouse is an eligible state or local employee, the couple may change listed who is the listed subscriber, but this does not permit changing health plans | 801(A)(11) |
| Added language clarifying that when an employee is hired, Wisconsin Retirement System-eligible, and elects insurance coverage, but the employee terminates before reaching 30 days of service, their insurance remains and they must be offered COBRA | 902G |
| Added clarifying language that employers should terminate an employee's health insurance contract using the Retirement option in MEBS to ensure coverage continues automatically in retirement | 1001(A) |
| Updated Health Plans Carrier Codes table | B-4 |