Form Active Employee / Local Employer / State Employer

Health Care Provider Form

Complete this form using results from your most recent health care provider visit to earn credit for the Well Wisconsin Program.

ET-2166
Brochure Active Employee / Retiree / Other Benefit Recipient / Board Member / Local Employer / State Employer

Domestic Partner Benefits

As of Sept. 23, 2017, the State of Wisconsin no longer allows the establishment of new domestic partnerships under Chapter 40 of the Wisconsin statutes. This brochure provides information about the benefit changes for established domestic partnerships.