Survivor's certification that a WRS annuity or lump-sum payment made to the survivor of the member named in this form may be eligible for an income tax exemption.
Learn about the key differences between plan designs, such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Program Option
State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
2024
ET-4925
Brochure
Active Employee /
Retiree /
Other Benefit Recipient
Learn about the key differences between plan designs such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Plan Year
2024
Program Option
Local High Deductible Health Plan (PO17) & Supplemental Benefits
Learn about the key differences between plan designs such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Plan Year
2024
Program Option
Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
Learn about the key differences between plan designs such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Learn about the key differences between plan designs such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Plan Year
2024
Program Option
Local Deductible Health Plan (PO14) & Supplemental Benefits
Learn about the key differences between plan designs such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Plan Year
2024
Program Option
Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
Learn about the key differences between plan designs, such as how much you'll pay per month, how much you can expect to pay when you visit the doctor, and if you will have nationwide coverage.
Plan Year
2024
Program Option
Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits