Enrolling For Coverage FAQs

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
Plan Year
  • 2024
ET-5306
Form Local Employer / State Employer

Request for Disability Premium Waiver

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.

ET-4560
Form Active Employee / Local Employer / State Employer

USERRA Certification

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.

Department News
Nov 15, 2023 4:15pm

GIB Focuses on Program Affordability and Sustainability

The Group Insurance Board today discussed initiatives that would support program affordability for members, program innovation, and the overall sustainability of the State of Wisconsin Group Health Insurance Program. The Board also approved the release of several requests for proposal.

Report Active Employee / Retiree / Other Benefit Recipient / Board Member / Local Employer / State Employer

Cost Effective Measurement Report

A report that compares existing pension performance and administration against other pension plans.

ET-8501
Report Other Benefit Recipient

Comprehensive Annual Financial Report 2014

The Comprehensive Annual Financial Report of the Wisconsin Department of Employee Trust Funds for the year ended December 31, 2014 provides comprehensive information about ETF, the Wisconsin Retirement System, and other benefit programs administered by ETF.