An eligible expense is a health care service, treatment, or item the IRS states can be paid for without taxes. Eligible expenses can be incurred by you, your spouse, or qualified dependents. The Health Savings Account (HSA) can only be used to pay for eligible medical expenses incurred after your HSA was established.
Program Option
State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
2024
ET-2154
Form
Active Employee /
Local Employer /
State Employer
This application is intended for insured employees who are terminating Wisconsin Retirement System employment, who may qualify to continue life insurance coverage, and who will not begin a WRS retirement benefit immediately.
ET-2321
Form
Active Employee /
Retiree /
Other Benefit Recipient
If you are the owner of a WRS account from which a WRS death benefit or life insurance benefit would be payable upon your death, you may file a beneficiary designation.
If you wish to specify who shall receive a primary beneficiary’s share of a death or life insurance benefit if a primary beneficiary is deceased, you must use this alternate beneficiary designation form.
24ET-2180
Brochure
Active Employee /
Retiree /
Other Benefit Recipient /
Local Employer /
State Employer