ET-1313
Form Local Employer / State Employer

Designation of Agent

Employers, complete to designate an employee as the agent representing the employer in matters pertaining to the programs administered by the Department of Employee Trust Funds.

ET-4307
Form Active Employee / Retiree

Medicare Eligibility Statement

You and/or your insured dependents must be enrolled for both portions of Medicare (Hospital Part A and Medical Part B), when first eligible. Provide this information to ETF using this form.

HIPAA: Special Enrollment Opportunities

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

STAR Employees Enrollment

State of Wisconsin, Legislature, and Wisconsin Court System Employees covered by STAR

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

Non-STAR State Employees Enrollment

Beyond Vision, Fox River Navigation System Authority, WEDC, WHEDA, WHEFA

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025
ET-1113
Manual Local Employer / State Employer

Employer Transaction Application Guide

The UW will have access to the Employer Transaction Application (ETA) user interface to update employee demographic and eligibility information, new employee enrollments, and employee terminations.

Health and Wellness News
May 15, 2025 11:00am
Image: Woman holding a map. Image text: Where You Belong. Find health and closer connection.

Well Wisconsin Program 2025

Subscribers and spouses under the ETF-administered health insurance can earn a $150 prepaid card for completing a quick health assessment, health check, and well-being activity by Oct. 17.

ET-8935
Brochure Active Employee / Retiree

Ombudsperson Services

The ETF ombudsperson staff attempts to resolve questions and issues on behalf of WRS members.

Health and Wellness News
Jan 16, 2025 5:00pm
Collage of photos of people enjoying their activities, with text, "Well Wisconsin News: January Issue"

Thrive in 2025 with Well Wisconsin

What’s your one word for 2025? Survive, jive, thrive... these are just a few you might consider as you look at the year ahead.