ET-1313
Form Local Employer / State Employer

Designation of Agent

Employers, complete to designate an employee as the agent representing the employer in matters pertaining to the programs administered by the Department of Employee Trust Funds.

Cancellation or Termination of Health 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
Employer News
Nov 9, 2023 8:00am

WPE Life, Health Insurance Manuals Updated

ETF has updated How to Join the Wisconsin Public Employers Group Health Insurance Program (ET-1139) and How to Become a Participating Employer Under the Wisconsin Public Employer's Group Life Insurance Program (ET-1107). Please disregard any previous versions.

Employer News
Jul 15, 2022 12:00pm

August 2022 Well Wisconsin Resources Available

Well Wisconsin wants to hear from employers! Please fill out the short survey to share your thoughts on the program and how we can help you. Ans see the latest resources to promote in August, including the Invitational Challenge – Round 2, new Well Wisconsin Radio episode, and Kindness at Work calendar

ET-2314a
Form Local Employer / State Employer

Model COBRA Subsidy Notice

This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed.