The State of Wisconsin Group Insurance Board contracts with a Pharmacy Benefit Manager to provide administrative services to State of Wisconsin and Wisconsin Public Employer group health insurance program participants.
ET-4702
Brochure
Active Employee /
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer
Wisconsin law requires the WRS participant to complete this form and submit it ETF when a portion of the participant’s account is awarded to an alternate payee via a Qualified Domestic Relations Order (QDRO).
Under certain circumstances, reciprocity may increase the retirement benefits payable to you if you worked for one or more participating public retirement systems.
File a copy of this form with each of your former retirement systems each time you become covered under a new retirement system, for limited reciprocity between the three public employee retirement systems in Wisconsin.
WRS annuitants who have met all terms and conditions associated with having a valid termination and meeting the minimum break in service requirement may return to work for a WRS employer.
This program allows eligible, retired public safety officers to have medical, vision, dental and long-term care insurance premiums deducted directly from their WRS monthly annuity payments.
Eligible, retired public safety officers receiving a Wisconsin Retirement System annuity may elect to have health and long-term care insurance premiums taken from their monthly WRS annuities.