Employers should submit this form when first aware that an insured employee is unable to work due to illness or injury and will be unable to perform any work or to engage in any occupation for an indefinite period.
Report
Active Employee /
Retiree /
Other Benefit Recipient /
Board Member /
Local Employer /
State Employer
Independent Auditor’s Report on the Financial Statements and Other Reporting Required by Government Auditing Standards for the year ended December 31, 2016.
The Group Insurance Board today examined the cost effectiveness of bariatric surgery and adding coverage of weight-loss drugs in the State of Wisconsin Group Health Insurance Program.
Report
Retiree /
Board Member /
Local Employer /
State Employer
May eAlert: Learn more about mental health resources, join a Well Wisconsin book club discussion, participate in OutWiGo for a free fun weekend, and sign up for other Well Wisconsin activities.
Employers, use this form to verify that you viewed the employee’s original required document(s) to verify the employee or dependent(s) is eligible for benefit coverage, as administered by ETF.
