25ET-2180
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Summary

This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits (UB) offered under the Group Health Insurance Program (GHIP). This certificate applies to all Uniform Benefits for employees, retirees, and COBRA Continuants enrolled in*:  

  • State of Wisconsin Group Health Insurance (PO1)
  • Local Traditional Plan Insurance (PO2, PO12)
  • Local Deductible Plan Insurance (PO4, PO14)
  • Local Health Plan Insurance (PO6, PO16)
  • Local High Deductible Health Plan Insurance (PO7, PO17)

*Includes regional health plans, Access Plans, and Local Annuitant Health Program products.