ET-1660 Form Local Employer Local Employer Paid Life Insurance Coverage Local employers, please submit this verification if you will be paying for an employee’s life insurance coverage in retirement.
25ET-2180 Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer 2025 Uniform Benefits Certificate of Coverage This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits offered under the Group Health Insurance Program.
26ET-4113 Brochure Retiree / Local Employer / State Employer 2026 Medicare Plus Certificate of Coverage Certificate of Coverage for the Medicare Plus Plan for the 2026 plan year.
26ET-1136 Manual Local Employer / State Employer 2026 State of Wisconsin Group Health Insurance Program Agreement This 2026 State of Wisconsin Health Benefit Program Agreement is for the purposes of administering the health benefit program.
25ET-1136 Manual Local Employer / State Employer 2025 State of Wisconsin Group Health Insurance Program Agreement This 2025 State of Wisconsin Health Benefit Program Agreement is for the purposes of administering the health benefit program.
ET-1325 Form Local Employer Resolution for Inclusion Under the Wisconsin Public Employers’ Group Health Insurance Program-with a request to retain a second group health plan Resolution for employers to join the WPE Group Health Insurance Program with a request to retain a second group health plan.
25ET-4113 Brochure Retiree / Local Employer / State Employer 2025 Medicare Plus Certificate of Coverage Certificate of Coverage for the Medicare Plus Plan for the 2025 plan year.
ET-1140 Manual Local Employer / State Employer How to Become a Participating Employer Under the Wisconsin Public Employers' Group Income Continuation Insurance Program The ICI plan provides replacement income for disabilities which are considered short term in nature as well as those which may last for extended periods.
ET-1318 Form Local Employer Resolution to Withdraw from the Wisconsin Public Employer’s Group Health Insurance Program A resolution for the employer to withdraw from the Wisconsin Public Employers Group Health Insurance program.
25ET-2107upb Brochure Active Employee / Retiree / Local Employer / State Employer 2025 Uniform Pharmacy Benefits Certificate of Coverage Uniform Pharmacy Benefits Certificate of Coverage for the 2025 plan year, for all program options.