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This application allows you to apply to enroll in the Income Continuation Insurance (ICI) Program if you did not enroll when originally eligible or if coverage was canceled.

Employers, complete this form to notify ETF of a claimant’s change in work status and/or earnings paid to the individual after the elimination period.

When filing claims with ETF’s ICI administrator, The Hartford, employees should advise The Hartford that their employer is the State of Wisconsin—not their actual employer (such as City of ABC or State Agency XYZ).

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the State Income Continuation Insurance Plan as of December 31, 2011.

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the State Income Continuation Insurance Plan as of December 31, 2012.

Designate an attorney-in-fact to act in your stead for an appeal to ETF.

As part of transferring files to SharePoint Online employers will need to use Multi-Factor Authentication (MFA). This page provides guides to setting up common MFA applications.

Employers, complete this form for access to ETF systems.

Premium and contribution payment deadlines for ETF-administered programs.