Enrolling For 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-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-4305
Form Active Employee / Retiree

Sick Leave Escrow Application

Apply to escrow your sick leave credits, if eligible. To escrow means to preserve or bank your sick leave credits for use at a later date.

ET-9019
Active Employee / Retiree / Local Employer / State Employer

Local Annuitant Health Program Fact Sheet

LAHP is a program that provides group health insurance for retirees whose group health insurance with their former employer does not meet their needs or is not permanently available after retirement.

ET-4109
Form Active Employee / Retiree

Medicare Enrollment for Retiring Employees

The following information is for employees who will retire in the next three months and will be transitioning into Medicare under the State or the Wisconsin Public Employers Group Health Insurance Programs.

Enroll or Make Changes

Made your decision? Learn how to enroll in your benefits.

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
Plan Year
  • 2025
Decision Guide Cover Image

State Employee and Retiree Health Plan & Supplemental Benefits

Benefits include: Health, Wellness, Dental, Vision, Accidental Death and Dismemberment (AD&D), Long-Term Care and Pre-Tax Savings Accounts. Sign up and learn more about your health benefits.

Plan Year
  • 2025
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits

Open Enrollment Quick Reference

A quick reference for what changes you can make to your benefits during open enrollment.

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