ET-4303
Form Active Employee / Local Employer / State Employer

Waiver of Part-Time Elected Service

Form for elected officials to irrevocably waive further participation in the WRS for current, and any future, service as an elected official that does not exceed 1,044 hours per year.

ET-4110
Form Retiree

Health Insurance - Integrated with Medicare

The following information is for those retirees who are transitioning into Medicare under the State or the Wisconsin Public Employers Group Health Insurance Programs.

Health and Wellness News
Oct 10, 2024 12:00pm
Icon representing medicine bottle and virus

Preventive Care and Drugs Coverage in 2025

Open enrollment runs until Oct. 25, 2024. Learn about preventive care and drugs coverage in 2025, where to get free vaccines, diabetes management program, and more.

Flyer Active Employee / Retiree

It’s Your Health: Diabetes

Participating in the Well Wisconsin diabetes condition management program lowers your diabetes-related prescription copays.

Notice of Creditable Coverage for Medicare Part D

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-2175
Flyer Active Employee / Retiree / Other Benefit Recipient

Transitioning Care with a New Health Plan

When changing health plans there are many things you have to consider. This handout will help you determine if you can keep your current health care providers with the new plan, if you will need to change providers and how to do so and what steps you should take if you are receiving complex care.

High Deductible Health Plans (HDHPs)

High Deductible Health Plans (HDHPs) cost less per month but won't start paying for your care until you meet your deductible. The one exception is preventive care, which is covered at 100%. Learn how an HDHP differs from the other options, and if it is a good fit for you.

Plan Year
  • 2025
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits