COBRA/Continuation of Health Coverage FAQs 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
ET-2155 Form State Employer Group Health Insurance Program Continuation Application For State Employees With 20 Years of WRS-Creditable Service. Employers, complete your sections and then give the form to the employee.
ET-4317 Form Active Employee / Retiree Sick Leave Re-enrollment Application Re-enroll for group health insurance coverage during the annual It’s Your Choice open enrollment period or after an involuntary loss of your comparable non-state coverage, if eligible.
ET-2385 Form Active Employee / Local Employer / State Employer Health Savings Account (HSA) Enrollment For UWs use only, as a paper alternative for a member who cannot complete their HSA enrollment online.
Notice of Privacy Practices 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
COBRA: Continuation of Coverage Rights for the Group Health Insurance Program 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
Employer News Sep 19, 2024 8:00am 2025 Employee Reimbursement Account and Health Savings Account Administrative Fees The ERA and HSA employer administrative fees have decreased for the 2025 plan year.
ET-1144 Manual Local Employer Local Employer Health Insurance Standards, Guidelines and Administration Manual This manual is a reference source intended to aid employer administration of and participation in the WPE Group Health Insurance Program.
Employer News Sep 15, 2025 8:00am 2026 Employee Reimbursement Account and Health Savings Account Administrative Fees The ERA and HSA employer administrative fees have changed for the 2026 plan year.
Employer News Jun 4, 2024 11:00am New Local Employer Training: Premium Contributions Part 2 How much do employers contribute toward premiums for health insurance? Is it different than premiums for life or income continuation insurance (ICI)?