Choose from up to four dental plans to get the right coverage for you and/or your family. The dental plans offer coverage for services such as cleanings, exams, fillings, and orthodontia.
Form
Active Employee /
Local Employer /
State Employer
Complete this form using results from your most recent health care provider visit to earn credit for the 2021 Well Wisconsin Program. The form must be submitted by October 8, 2021.
Learn about all insurance changes for the 2024 plan year. Changes this year include a network split for Group Health Cooperative South Central Wisconsin, changes to medical benefits, a decrease in Accident Plan premiums, and more.
Plan Year
2024
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
This Summary Plan Description is a supplement to the Section 125 Cafeteria Plan Document (ET-1904), for members and employees. This publication summarizes the basic features of the plan.
This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed.
This manual is a reference source intended to aid employer administration of and participation in the State of Wisconsin Group Health Insurance Program.
23ET-2107upb
Brochure
Active Employee /
Retiree /
Local Employer /
State Employer