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This application is intended for insured employees who are terminating Wisconsin Retirement System employment, who may qualify to continue life insurance coverage, and who will not begin a WRS retirement benefit immediately.

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.

Use this form to request to inspect or copy medical information maintained about you by ETF.

This brochure describes your group term life insurance protection and is your certificate of participation, give a valid enrollment form is on file with ETF and premiums are being paid.

See how much you'll pay each month for vision.