ET-2405
Form Active Employee / Retiree

ETF Insurance Complaint Form

If you filed a grievance with the plan or benefit administrator and are dissatisfied with the final decision, you can request an administrative review from ETF.

ET-8947
Active Employee / Retiree / Local Employer / State Employer

Supplemental Insurance Program Fact Sheet

The State of Wisconsin Supplemental Insurance Program is an employee pay-all optional insurance program for state active employees, continuants and retirees.

ET-4307
Form Active Employee / Retiree

Medicare Eligibility Statement

You and/or your insured dependents must be enrolled for both portions of Medicare (Hospital Part A and Medical Part B), when first eligible. Provide this information to ETF using this form.

LAHP Cover Image

Local Annuitant Health Program (LAHP)

Learn more about health, dental and wellness benefits - for certain local retirees and surviving dependents.

Plan Year
  • 2025
Program Option
  • Local Annuitant Health Program (LAHP)