ET-2314a
Form Local Employer / State Employer

Model COBRA Subsidy Notice

This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed. 

Breakdown of Your Costs by Plan Design

Learn how much you can expect to pay when you visit the doctor, get an X-ray and more.
Plan Year
    2025
Program Option
    Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits

Breakdown of Your Costs by Plan Design

Learn how much you can expect to pay when you visit the doctor, get an X-ray and more.
Plan Year
    2025
Program Option
    Local Deductible Health Plan (PO14) & Supplemental Benefits

State and Federal Notifications

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

Breakdown of Your Costs by Plan Design

Learn how much you can expect to pay when you visit the doctor, get an X-ray and more.
Plan Year
    2025
Program Option
    Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits

Breakdown of Your Costs by Plan Design

Learn how much you can expect to pay when you visit the doctor, get an X-ray and more.
Plan Year
    2025
Program Option
    Local Traditional Health Plan (PO12) & Supplemental Benefits
ETJ0043 Request for Proposals (RFP)

Third Party Administration of the State of Wisconsin Income Continuation Insurance (ICI) 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 income continuation insurance providers that possess the resources and expertise to administer the Wisconsin Income Continuation Insurance Program (Program). Proposals from brokers will not be considered.

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.