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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.

The group health insurance program is an employer-sponsored program offering group health coverage to employees of state agencies, UW System, UW Hospital & Clinics Authority and participating local government employers.

Due to 2023 Wisconsin Act 4, county correctional officers (jailers) who are categorized as general employees will become protective occupation employees under the Wisconsin Retirement System, unless they opt out. Learn about who is affected, decision deadlines, and what this means for a jailer’s WRS benefits.

The employee completes parts A and B of this form and submits it to the employer where the member rendered the service to purchase.

ETF administers benefit programs for current and former public employees, retirees, and their beneficiaries of the Wisconsin Retirement System.

The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services.

The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services.

The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services.

The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services.

The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services.