ET-7414
Form Active Employee / Retiree / Other Benefit Recipient

Authorization to Disclose Medical Information

This form gives ETF and entities that perform contracted services for ETF permission to release your designated medical information to a person or entity specified by you.

ET-2101
Brochure Active Employee / Retiree / Other Benefit Recipient

The Wisconsin Public Employers Group Life Insurance Program

This brochure describes your group term life insurance protection and is your certificate of participation, given a valid enrollment form is on file with ETF and premiums are being paid.

ET-4125
Brochure Active Employee / Retiree / Other Benefit Recipient

Tax Liability on WRS Benefits

This brochure provides general information about the income tax liability on your Wisconsin Retirement System benefits. The tax treatment of WRS benefits is generally similar for federal and Wisconsin income tax purposes.

National Medical Support Notice

Program Option
  • 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

Following Enrollment

You will receive a welcome brochure in the mail from Optum Financial.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025
Man with leg in a cast

Accident Plan

The Accident Plan provides a cash benefit paid directly to you to help cover out-of-pocket expenses regardless of health insurance coverage.