The State of Wisconsin Supplemental Insurance Program is an employee pay-all optional insurance program for state active employees, continuants and retirees.
Employers should submit this form when first aware that an insured employee is unable to work due to illness or injury and will be unable to perform any work or to engage in any occupation for an indefinite period.
Once an employee returns to work with his or her pre-military leave of absence employer, the employer is required to submit this form along with a copy of the appropriate military paperwork.
The Board has extended the ICI premium holiday for 2025, based on the strong financial position of the local ICI plan. This means that employers and employees will not pay premiums for either standard or supplemental ICI coverage.
Report
Active Employee /
Retiree /
Other Benefit Recipient /
Board Member /
Local Employer /
State Employer
Independent Auditor’s Report on the Financial Statements and Other Reporting Required by Government Auditing Standards for the year ended December 31, 2015.
Report
Active Employee /
Retiree /
Other Benefit Recipient /
Board Member /
Local Employer /
State Employer
