ET-1518
Form State Employer

Flexible Spending Account Continuation Election Form

Employers must issue this notice to employees within 14 days of becoming aware of a qualifying event that will cause an employee to lose eligibility to participate in the FSA or limited purpose FSA program(s).

Form Active Employee / Local Employer / State Employer

Health Care Provider Form

Complete this form using results from your most recent health care provider visit to earn credit for the Well Wisconsin Program.

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.