ET-7414
Form Active Employee / Retiree / Other Benefit Recipient

Authorization to Disclose Medical Information

This form gives ETF and entities that perform contracted services for ETF permission to release your designated medical information to a person or entity specified by you.

How to Sign Up for Benefits Mentor

Before you begin your Benefits Mentor experience you will need to register and verify your identity. Follow our instructions for helpful tips.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Long-Term Disability Insurance Actuarial Valuation 2015

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.

You Divorce

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

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
Health and Wellness News
Oct 19, 2023 12:00pm

Open Enrollment Ends Friday

Open Enrollment Ends Friday, GHC of South Central Wisconsin Members - Action Required, Dental Evidence Based Integrated Care Plan (EBICP), New 2024 Well Wisconsin Resources

Man sitting in therapy session

Mental Health Resources

Mental health is just as important as physical health when it comes to your overall well-being. Learn about mental health resources available through the Group Health Insurance Program and Employee Assistance Programs.