Complete this form using results from your most recent health care provider visit to earn credit for the 2021 Well Wisconsin Program. The form must be submitted by October 8, 2021.
This Summary Plan Description is a supplement to the Section 125 Cafeteria Plan Document (ET-1904), for members and employees. This publication summarizes the basic features of the plan.
This plan document provides provisions on the Commuter Fringe Benefits Accounts, such as plan administration, eligibility, participation, and termination.
ET-2331
Form
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer
The Group Insurance Board has approved changes to the Income Continuation Insurance (ICI) Program that will expand coverage to employees aged 70 and over. This change will go into effect May 1, 2023.