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-8947
Active Employee /
Retiree /
Local Employer /
State Employer
The State of Wisconsin Supplemental Insurance Program is an employee pay-all optional insurance program for state active employees, continuants and retirees.
ET-2331
Form
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer
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.
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.
Learn about all insurance changes for the 2026 plan year. Changes this year include health plan name changes, expanded coverage of the State Maintenace Plan (SMP) for members in the local program, an increase to the deductible for the High Deductible Health Plan (HDHP), and more.
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
