ET-4560
Form Active Employee / Local Employer / State Employer

USERRA Certification

Once an employee returns to work with his or her pre-military leave of absence employer, the employer is required to submit this form along with a copy of the appropriate military paperwork.

Life Insurance Benefit Payout

A benefit may be paid during your lifetime or upon your death.  You or your beneficiary must make sure to follow the correct steps to receive your benefit.

Robin with HealthPartners Health Plan

Major Health Systems
  • Bellin Health
  • ThedaCare
  • Aurora Health Care
  • BayCare Clinic
  • Froedert & the Medical College of Wisconsin
Full Service Areas
  • Brown County
  • Calumet County
  • Fond Du Lac County
  • Green Lake County
  • Kewaunee County
  • Manitowoc County
  • Marinette County
  • Menominee County
  • Oconto County
  • Outagamie County
  • Shawano County
  • Waupaca County
  • Waushara County
  • Winnebago County
Limited Service Areas
  • Florence County
  • Marquette County