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-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.

Network Health

Major Health Systems
  • Froedtert & the Medical College of Wisconsin Health System
  • Children’s Hospital of Wisconsin - with locations in Milwaukee, Green Bay and Neenah
  • Ascension Wisconsin
  • Prevea Health
  • Bellin Health
  • SSM Health
  • Holy Family Memorial
Full Service Areas
  • Brown County
  • Calumet County
  • Dodge County
  • Door County
  • Fond Du Lac County
  • Green Lake County
  • Kenosha County
  • Kewaunee County
  • Manitowoc County
  • Marinette County
  • Milwaukee County
  • Oconto County
  • Outagamie County
  • Ozaukee County
  • Racine County
  • Shawano County
  • Sheboygan County
  • Washington County
  • Waukesha County
  • Winnebago County
Limited Service Areas
  • Marquette County
  • Menominee County
  • Portage County
  • Waupaca County
  • Waushara County