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
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.
ET-2314 Form Local Employer / State Employer Request for Treatment as an Assistance Eligible Individual The American Rescue Plan Act of 2021 (ARP) subsidizes the full COBRA premium for “Assistance Eligible Individuals” for periods of coverage from April 1, 2021 through September 30, 2021.
