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Summary
For State Employees With 20 Years of WRS-Creditable Service
This application is intended for insured state employees who are terminating Wisconsin Retirement System employment with 20 or more years of WRS-creditable service, who may qualify to continue health insurance coverage, and who may not begin a WRS retirement benefit immediately.
Employers should complete Parts A, B and C. Then make a copy for your records and give the application to the employee.