ET-1907
Form Local Employer / State Employer

No Taxpayer Identification Number

A tool for an employer to confirm information was presented to a new employee, due dates identified and appropriate information and forms supplied for all ETF-administered benefits offered by the employer.

A parent piggybacks is child, with healthcare workers in the background.

2026 Insurance Changes

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
People kayaking

Well Wisconsin for Members

The Well Wisconsin program, administered by WebMD, provides tools and resources to help participants set health and well-being goals, track progress, stay motivated, and earn incentives.

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-2350
Form Active Employee

Health Insurance Election for Military Service Personnel

Section 40.05 (4g), Wis. Stat., provides additional months of state contribution toward health insurance premiums for certain military service personnel who receive a military leave of absence or are eligible for reemployment under Wis. Stat. § 321.64.

Health and Wellness News
Oct 23, 2024 12:00pm
Doctor listening to heartbeat of child with parent

Open Enrollment Ends This Friday!

Learn about our Insurance Help page, how to contact Health Plan and Vendors, additional benefits from Delta Dental, and other mental health support programs.

Data Analytics and Insights

Data Analytics and Insights (DAISI) is a data warehouse and analytics tool administered by Merative. All the organizations that supply health and wellness products and services as part of the Group Health Insurance Program put data into DAISI through a secure file transfer process. DAISI organizes and protects this data and has tools to help make sense of the data.