1. How do I cancel health insurance coverage?

If you are a retiree, you may cancel anytime. You must provide written, signed notification of cancellation to ETF. Note that if you want to keep family coverage but drop a spouse or adult dependent, you must submit an application to ETF, along with proof of their other coverage, such as an ID card, within 30 days of the effective date of other coverage. Otherwise, all eligible dependents must be enrolled in family coverage. 

An employee's voluntary cancellation (or switching from family to individual coverage which is deemed voluntary cancellation for all insured dependents) requires written, signed notification to the employer denoting a cancellation of coverage.

If your health insurance premiums are being deducted on a pre-tax basis under Internal Revenue Code Section 125, you may cancel coverage only if:

  • You experience a qualifying change or life event and submit an application to cancel coverage within 30 days of the event;
  • You terminate employment;
  • You become eligible for and enroll in another group health insurance plan (not for example, Medicare); or
  • You cancel your coverage during the annual open enrollment period.

If your adult dependent child becomes eligible for and enrolled in other group health insurance coverage, and you want to drop coverage for him/her, you must submit an application electronically or via paper to your employer (to ETF for retirees) within 30 days of the effective date of other coverage. In addition, you must submit proof of enrollment such as an ID card from that coverage. If this is your last dependent and you want to change to individual coverage, you must note that on your application.

If your spouse becomes eligible for and enrolled in other group health insurance coverage and you want to change to individual coverage or cancel your family coverage, you must submit an application electronically or via paper to your employer (to ETF for retirees) within 30 days of the effective date of other coverage. In addition, you must submit proof of enrollment, such as an ID card, that lists all individuals covered under that plan. (Retirees, please see the first paragraph in this Frequently Asked Question for important information.)

If your health insurance premiums are being deducted post-tax, you may cancel anytime.

Be aware that voluntary cancellation of coverage does not provide an opportunity to continue coverage for previously covered dependents as described in the Continuation of Health Coverage section. Cancellation affects both medical and prescription drug coverage.

No refunds are made for premiums paid in advance unless your employer (or ETF, if you are no longer a state employee) receives your written, signed request on or before the last day of the month preceding the month for which you request the refund. Under no circumstances are partial month's premiums refunded. Once coverage terminates, you will be responsible for any claims inadvertently paid beyond your coverage effective dates.

2. Under what circumstances can my health insurance coverage be terminated?

Your coverage can only be terminated because:

  • Premiums are not paid by the due date. Coverage is also waived (known as "constructive waiver") when the employee portion of the premium is not deducted for 12 consecutive months.
  • Coverage is voluntarily canceled.
  • Death of the subscriber.
  • Fraud is committed in obtaining benefits or there is an inability to establish a physician/patient relationship. Termination of coverage for this second reason requires Group Insurance Board approval.

State and Grad only: Your coverage can be terminated because your eligibility for coverage ceases (for example, termination of employment).

Retirees only: Your coverage can be terminated because you:

  • Became ineligible for coverage as an annuitant because of becoming an active Wisconsin Retirement System employee. (See Changes in Employment Status FAQs Question: How are my health benefits affected by my return to work for an employer who is under the WRS?)
  • IYC Medicare Advantage enrollees only: You dropped Medicare Part B. Your coverage will change to Medicare Plus. You may also change health plans within 30 days of the change.

The Medicare enrollment requirement is deferred while you or your spouse are employed and covered under a group health insurance plan from that employment (See Medicare Information FAQs Question: When must I apply for Medicare?). Active employees should contact their benefits/payroll/personnel office (retirees and continuants should contact ETF) for the date coverage will end.

3. Is it possible to enroll or re-enroll in this health insurance program after I terminate state employment?

State and Retirees only: 

  • Former employees who have 20 years of WRS-creditable service and took or are eligible for an immediate annuity may enroll or re-enroll even if the annuity you are eligible for is deferred. This may be done during open enrollment or up to 30 days after the date ETF receives your annuity application.
  • Former employees with 20 years of WRS-creditable service who are not eligible for an immediate annuity may enroll or re-enroll. This includes those former employees who have passed minimum retirement age, but do not take their annuity. This may be done during open enrollment or up to 30 days after the date ETF receives your annuity application. If you have preserved sick leave credits, you may use them to pay for coverage upon re-enrollment, even if you have not yet taken your annuity.
  • Retired state employees with less than 20 years of WRS-creditable service may re-enroll if you:
    • Were insured immediately prior to termination of employment, and
    • Are receiving a WRS retirement annuity or received a lump-sum WRS retirement benefit that began within 30 days of termination of employment.

If you are eligible, you must submit an electronic or paper application to enroll and may select any offered health plan.

Note: This option is for WRS retirees only (a 40.65 disability benefit is not considered a WRS disability annuity under the law). This option is not available to survivors or dependents. You would not be eligible to use any sick leave credits to pay premiums if you enroll under this provision. There are separate enrollment opportunities for those individuals who have escrowed their sick leave. (See Other Enrollment Opportunities or contact ETF for details.)

4. Is there any state contribution for health insurance after I terminate coverage?

State only: Yes. Under certain circumstances, your accumulated unused sick leave can be converted to credits to pay for health insurance premiums if you are:

  • Retiring,
  • Terminating after accumulating 20 years of creditable Wisconsin Retirement System service, or
  • Surviving dependents who are insured under our program at the time of the active subscriber's death.

The rules governing eligibility are described in ETF publications: Sick Leave Credit Conversion Program (ET-4132), Group Health Insurance (ET-4112), Information for Retirees (ET-4116) and Your Benefit Handbook (ET-2119).