| Number Sort ascending | Title | Description | Audience |
|---|---|---|---|
| ET-4112 | Group Health Insurance | This brochure includes general information about health insurance through ETF. |
Active Employee, Retiree, Local Employer, State Employer |
| ET-2572a | New Employer Agent/Contact Wisconsin Retirement System Training Checklist | Checklist for a new employer agent or an employer’s new retirement/insurance contact with the ETF. |
Local Employer, State Employer |
| ET-2572 | New Employee Benefit Checklist | A tool for an employer to confirm information was presented to a new employee, due dates identified and appropriate information and forms supplied for all ETF-administered benefits offered by the employer. |
Local Employer, State Employer |
| ET-2340 | Automatic Premium Conversion Waiver/Revocation of Waiver | Complete this form to waive your participation in automatic premium conversion, or to revoke a waiver of premium conversion that you filed previously. |
Active Employee, Local Employer, State Employer |
| ET-2331 | Health Insurance Application/Change for Retirees | Retirees, enroll in health insurance or change your coverage. |
Retiree, Other Benefit Recipient, Local Employer, State Employer |
| ET-2314a | Model COBRA Subsidy Notice | This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed. |
Local Employer, State Employer |
| ET-2314 | Request for Treatment as an Assistance Eligible Individual | The American Rescue Plan Act of 2021 (ARP) subsidizes the full COBRA premium for “Assistance Eligible Individuals” for periods of coverage from April 1, 2021 through September 30, 2021. |
Local Employer, State Employer |
| ET-2311 | COBRA Continuation - Conversion Notice | Under federal law, known as COBRA, you and your qualified beneficiaries may continue group health insurance coverage, if eligible. |
Active Employee, Local Employer, State Employer |
| ET-2301 | Health Insurance Application/Change Form | Enroll in health insurance or change your coverage. |
Active Employee, Local Employer, State Employer |
| ET-2167 | myETF Benefits Quick Start Guide | myETF Benefits provides online tools to enroll and manage your health insurance benefits. |
Active Employee, Local Employer, State Employer |