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.

ET-1110
Manual Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

My Insurance Benefits HR Administrator Guide

For UWs only: This guide demonstrates procedures to help support the HR administrative duties within My Insurance Benefits and covers a variety of scenarios, such as enrollment, task management, and document management.

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

Long-Term Disability Insurance Actuarial Valuation 2015

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Long-Term Disability Insurance Plan (LTDI) as of December 31, 2015.