| Number | Title | Description | Audience |
|---|---|---|---|
| Health Care Provider Form | Complete this form using results from your most recent health care provider visit to earn credit for the 2021 Well Wisconsin Program. The form must be submitted by October 8, 2021. |
Active Employee, Local Employer, State Employer | |
| 23ET-1136 | 2023 State of Wisconsin Group Health Insurance Program Agreement | This 2023 State of Wisconsin Health Benefit Program Agreement is for the purposes of administering the health benefit program. |
Local Employer, State Employer |
| 23ET-2107 | It's Your Choice 2023 Decision Guide: State of Wisconsin Group Health Insurance for Employees | 2023 health benefits decision guide for state of Wisconsin employees. |
Active Employee, State Employer |
| 23ET-2107upb | 2023 Uniform Pharmacy Benefits Certificate of Coverage | Uniform Pharmacy Benefits Certificate of Coverage for the 2023 plan year, for all program options. |
Active Employee, Retiree, Local Employer, State Employer |
| 23ET-2108 | It's Your Choice 2023 Decision Guide: State of Wisconsin Group Health Insurance for Retirees | 2023 health benefits decision guide for state of Wisconsin retirees. |
Retiree, State Employer |
| 23ET-2128 | It's Your Choice 2023 Decision Guide: Local Traditional Plan Insurance for Employees and Retirees | 2023 local traditional plan group health benefits decision guide for local employees and retirees |
Active Employee, Retiree, Local Employer |
| 23ET-2131sb | 2023 Schedule of Benefits: Local Traditional Access Plan (PO2/12) | The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services. |
Active Employee, Retiree, Local Employer |
| 23ET-2156 | It's Your Choice 2023 Decision Guide: Local Annuitant Health Program (LAHP) | 2023 Local Annuitant Health Program health benefits decision guide for certain local retirees and surviving dependents. |
Retiree, Local Employer |
| 23ET-2158 | It's Your Choice 2023 Decision Guide: Local Deductible Plan Insurance for Employees and Retirees | 2023 local deductible plan group health benefits decision guide for local employees and retirees. |
Active Employee, Retiree, Local Employer |
| 23ET-2162sb | 2023 Schedule of Benefits: Local Deductible Access Plan (PO4/14) | The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services. |
Active Employee, Retiree, Local Employer |