Document Requirements for Life Events and Dependent Verification

Find out which documents are required when adding a spouse or dependent to your insurance or making changes due to a qualified life event. Having the correct paperwork will help ensure a smooth update to your coverage.

Program Option
  • Local Annuitant Health Program (LAHP)
  • 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
ETI0047 Request for Proposals (RFP)

Third Party Administration of the Wisconsin Public Employers Group Life Insurance Program Request for Proposals for the State of Wisconsin Department of Employee Trust Funds

The purpose of this Request for Proposals (RFP) is to solicit proposals from interested and qualified group life insurance providers that possess the resources and expertise to insure and administer the Wisconsin Public Employers Group Life Insurance Program (Program). Proposals from brokers will not be considered.

Apple sitting next to a stethoscope

Insurance

Learn about the insurances provided by ETF, such as health, dental and vision insurance.

ET-2305
Form Active Employee / Local Employer / State Employer

Evidence of Insurability

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.