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23ET-2100cc

Brochure Retiree

2023 Medicare Advantage Evidence of Coverage - Non-deductible

This Evidences of Coverage provides details about Medicare health care coverage from January 1, 2023 - December 31, 2023.

23ET-2100ccd

Brochure Retiree

2023 Medicare Advantage Evidence of Coverage - Deductible

Medicare Advantage, with deductible, Evidence of Coverage for the 2023 plan year.

24ET-2100cc

Brochure Retiree

2024 Medicare Advantage Evidence of Coverage - Non-deductible

This Evidences of Coverage provides details about Medicare health care coverage from January 1, 2024 - December 31, 2024.

24ET-2100ccd

Brochure Retiree

2024 Medicare Advantage Evidence of Coverage - Deductible

Medicare Advantage, with deductible, Evidence of Coverage for the 2024 plan year.

ET-4337

Form Active Employee / Retiree / Other Benefit Recipient

Wisconsin Tax Withholding Election for WRS Annuity Payments

Use this form to elect Wisconsin state tax withholding for your WRS annuity payment.

Report Active Employee / Retiree / Board Member / Local Employer

Local Income Continuation Insurance Plan Actuarial Valuation 2018

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Local Income Continuation Insurance Plan as of December 31, 2018.

General Information FAQs

Program Option

State Employee and Retiree Health Plan & Supplemental Benefits

Plan Year

2024

ET-2321

Form Active Employee / Retiree / Other Benefit Recipient

How To Fill Out Beneficiary Designation - Alternate (ET-2321)

If you are the owner of a WRS account from which a WRS death benefit or life insurance benefit would be payable upon your death, you may file a beneficiary designation.

Notice of Creditable Coverage for Medicare Part D

Program Option

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-2319

Form Retiree / Local Employer / State Employer

Rehired Annuitant

WRS annuitants who have met all terms and conditions associated with having a valid termination and meeting the minimum break in service requirement may return to work for a WRS employer.