Employees who did not enroll for group life insurance coverage during their initial enrollment period, or insured employees who wish to apply for more insurance for themselves or their spouse or dependents, may apply using this form.
ET-1109g
Manual
Active Employee /
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer
For UWs only: This guide demonstrates procedures to help support the HR administrative duties within My Insurance Benefits and covers a variety of scenarios, such as enrollment, task management, and document management.
The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospitals & Clinics Authority, participating local government employers, and annuitants (and their insured survivors).
The Group Health Insurance Program offers employees of employers who participate in the WRS or are covered by a Section 218
Agreement a uniform medical benefits package. The employer can also choose to offer Uniform Dental Benefits.
