Form for the member’s physician to complete if the member cannot manage property, finances or business affairs because of an impairment in the ability to receive and evaluate information or make or communicate decisions even with the use of technological assistance.
Flyer
Active Employee /
Retiree /
Local Employer /
State Employer
This document for State, UW and Local retirees describes the health plans that offer out-of-state coverage for routine care and what to expect while you're out of network.
Learn how the data warehouse securely collects and stores enrollment, claims, and wellness data for all participants of the Group Health Insurance Program.
Spread the word about the regional biometric health screening events, participate in the culture of health assessment and champion contest, and promote upcoming webinars and 5K workshops.
Share new opportunities for your employees to participate in Well Wisconsin activities and get engaged yourself as a Well Wisconsin champion with resources to help you build a culture of well-being at work.
ETF has updated the Local Employer Verification of Health Insurance Coverage (ET-4814) form. This update means that local employers will no longer collect the forms from employees and survivors that want to continue health insurance coverage after the employee retires or dies. Coverage now continues automatically, and employees and survivors only need to complete the form to cancel coverage.