Your sick leave credits can only pay for premiums through the State of Wisconsin Group Health Insurance Program. If you have other health insurance, not through the State of Wisconsin Group Health Insurance Program, you may be eligible to save your credits to use later.

Who is Eligible

To save your credits, you must:

  • Have comparable health insurance coverage and
  • Be eligible to use sick leave (see Who is Eligible for more info)

Comparable Coverage

You must have comparable health insurance coverage, if you have coverage outside of the State of Wisconsin Group Health Insurance Program, in order to save your sick leave credits for later use. This means your health insurance plan must have benefits similar to the Access Plan or IYC Medicare Plus. If you aren’t sure, you can send your plan’s Summary of Benefits and Coverage (that includes pharmacy information) to ETF for review. Contact ETF for more information on what and how to provide this information.

  • Generally, if your plan has similar deductibles, out-of-pocket limits, and pharmacy benefits, your coverage may be comparable
  • If you have a Medicare Supplement plan, your coverage must be comparable to the IYC Medicare Plus plan and have similar medical and pharmacy deductibles and coinsurance rates
  • If you are covered through your spouse who is working for the state and has State of Wisconsin Group Health Insurance Program coverage, your coverage is comparable. All plans in the State Group Health Insurance Program are comparable
  • If you or your spouse work for a local employer who participates in the Wisconsin Public Employers Group Health Insurance Program, and have coverage under this program, your coverage is comparable. All Wisconsin Public Employers Group Health Insurance Program plans are comparable
  • If you live outside of the United States in a country with national healthcare coverage that you qualify to use, your coverage is comparable
  • If you are enrolled in Tricare, your coverage is comparable
  • If you have Veteran’s Administration benefits, your coverage is comparable

Non-Comparable Coverage includes:

  • Health plans with no pharmacy benefits
  • Medicare; Medicaid; BadgerCare
  • Health plans that don’t cover pre-existing conditions
  • If you have a Medicare Supplement plan, your coverage is not comparable if you have a deductible for your Part D pharmacy coverage

How to Save Your Sick Leave Credits

Saving your sick leave credits depends on the type of health insurance coverage you have and whether you are covered through the State of Wisconsin Group Health Insurance Program or some other health insurance outside of your employer.

Coverage through a Spouse Who Works for the State

This section applies to you if your spouse works for a state agency, the UW, or UW Hospitals & Clinics. If your spouse works for a local employer, such as a city, school district or local government, see Coverage through a Local Employer.

  • If your spouse is the health insurance subscriber, you don’t have to do anything with your sick leave credits. Your credits will be automatically saved for future use.
  • If your spouse is not the health insurance subscriber, you can designate them as the subscriber by submitting a Group Health Insurance Application/Change Form (ET-2301) to ETF. You should mark that you are cancelling coverage due to a “spouse-to-spouse transfer.” Your spouse should mark that they are adding coverage due to “spouse-to-spouse transfer.” Your credits will be saved for future use.
  • If both you and your spouse are retired, the subscriber will automatically have the premiums deducted from their sick leave credits. The other spouse’s credits will be saved. When the subscriber’s sick leave credits are gone, the other spouse becomes the subscriber. Premiums are then deducted from their account. You don’t need to do anything with your sick leave credits.

Coverage through a Spouse Who Works for a Local Employer

This section applies to you if your spouse works for a local employer who participates in the Wisconsin Public Employers Group Health Insurance Program. If your spouse’s employer does not participate in the group health insurance program, see Coverage Through Another Organization, below.

  • To be eligible to use or save your sick leave credits, you must be covered by the Wisconsin Public Employers Group Health Insurance Program when you terminate employmentIf your spouse is the subscriber, you must be enrolled in the Access Plan for at least one month before you terminate employment.
  • If your spouse is not the subscriber, you can change that. You and your spouse should turn in the Group Health Insurance Application/Change Form (ET-2301). You should mark that you are cancelling coverage due to a “spouse-to-spouse transfer”. Your spouse should mark that they are adding coverage due to a “Loss of Coverage”.
  • In both cases, you must submit the Sick Leave Credit Escrow Application (ET-4305) to ETF. You don’t need to submit a Summary of Benefits and Coverage with your application.

Coverage through Another Organization

This section applies to you if you are covered by a plan outside of Group Health Insurance Program and the sections above don’t apply to you.

  • If you are not enrolled in health insurance through your employer, you should enroll in the Access Plan through your employer by the first of the month in which you retire. Talk to your payroll/benefits office about your specific enrollment deadline. To be eligible to use or save your sick leave credits, you must be covered by the Group Health Insurance Program when you terminate employment.
  • Your health insurance contract will automatically continue after you terminate employment.
  • Submit the Sick Leave Credit Escrow Application (ET-4305) to ETF, along with the Summary of Benefits and Coverage from your non-state health insurance coverage.
    • If approved, you’ll receive a confirmation letter from ETF and your state health insurance will terminate. Your sick leave credits will be saved until you choose to re-enroll in the future.
    • If your coverage is not considered comparable, your coverage will continue and premiums will be deducted from your sick leave credits.
    • If your coverage is not considered comparable and you choose to cancel your state health insurance, you will permanently lose your sick leave credits. Cancellations must be received in writing.

Maintaining Comparable Coverage

After your sick leave credits are saved, you must continue your comparable coverage without any gaps. If you change your coverage, you must send the plan info into ETF for review. If you have any gaps in your coverage or are covered under a non-comparable plan, you will permanently lose your sick leave credits.