Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option Local Deductible Health Plan (PO14) & Supplemental Benefits
Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option State Employee and Retiree Health Plan & Supplemental Benefits
Enrolling For Coverage FAQs Program Option Local Deductible Health Plan (PO14) & Supplemental Benefits Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits Local Health Plan (PO16) & Supplemental Benefits Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits Local High Deductible Health Plan (PO17) & Supplemental Benefits Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits Local Traditional Health Plan (PO12) & Supplemental Benefits Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits State Employee and Retiree Health Plan & Supplemental Benefits
Notice of Creditable Coverage for Medicare Part D Program Option Local Deductible Health Plan (PO14) & Supplemental Benefits Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits Local Health Plan (PO16) & Supplemental Benefits Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits Local High Deductible Health Plan (PO17) & Supplemental Benefits Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits Local Traditional Health Plan (PO12) & Supplemental Benefits Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits State Employee and Retiree Health Plan & Supplemental Benefits
ET-4112 Brochure Active Employee / Retiree / Local Employer / State Employer Group Health Insurance This brochure includes general information about health insurance through ETF.
You or Your Dependent Involuntarily Lose Eligibility or All Employer Contribution for Other Group Medical Coverage Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance. Program Option Local Annuitant Health Program (LAHP) Local Deductible Health Plan (PO14) & Supplemental Benefits Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits Local Health Plan (PO16) & Supplemental Benefits Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits Local High Deductible Health Plan (PO17) & Supplemental Benefits Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits Local Traditional Health Plan (PO12) & Supplemental Benefits Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits State Employee and Retiree Health Plan & Supplemental Benefits
ET-2154 Form Active Employee / Local Employer / State Employer Group Life Insurance Continuation Application This application is intended for insured employees who are terminating Wisconsin Retirement System employment, who may qualify to continue life insurance coverage, and who will not begin a WRS retirement benefit immediately.
ET-4814 Form Active Employee / Retiree / Local Employer Local Employer Verification of Health Insurance Coverage Local employers, complete to submit verification for an employee's or local-paid retiree's health insurance coverage.