ACA: Marketplace Health Insurance Coverage Options Notice

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-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.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 2012

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 2012 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 2008

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 2008 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 2004

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 2004 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 1999

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 1999 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 1998

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 1998 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 1997

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 1997 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 1996

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 1996 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.