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Health & Pharmacy

Information about your health benefits offered through the State of Wisconsin Group Health Insurance Program

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
Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2015

This report presents the results of the Annual Actuarial Valuation of benefit liabilities and costs of the Duty Disability Program as of January 1, 2016.

Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2014

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of January 1, 2015.

ET-2311
Form Active Employee / Local Employer / State Employer

COBRA Continuation - Conversion Notice

Under federal law, known as COBRA, you and your qualified beneficiaries may continue group health insurance coverage, if eligible.

ET-8902
Active Employee / Retiree / Local Employer / State Employer

Group Health Insurance Fact Sheet

The group health insurance program is an employer-sponsored program offering group health coverage to employees of state agencies, UW System, UW Hospital & Clinics Authority and participating local government employers.

You Divorce

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-4305
Form Active Employee / Retiree

Sick Leave Escrow Application

Apply to escrow your sick leave credits, if eligible. To escrow means to preserve or bank your sick leave credits for use at a later date.

Equal Employment Opportunity Commission (EEOC) Notice Regarding Wellness Program

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

Out-Of-Network Health Services for Access Plans

Out-of-network services are only available with the Access Plan and Access HDHP. Learn how much it will cost to visit the doctor, have labs drawn, get an X-ray, and more.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025