ET-8945
Form Other Benefit Recipient

Vendor Privacy Incident Report

Use this form to report any possible or confirmed breaches of protected health information (PHI) or personally identifiable information (PII).

Dependent Day Care Account

A Dependent Day Care Account is a pre-tax benefit used to pay for eligible day care expenses for qualified dependents in order for you (or your spouse) to work, look for work, or attend school full-time.

Plan Year
  • 2025
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits

Dependent Day Care Account

A Dependent Day Care Account is a pre-tax benefit used to pay for eligible day care expenses for qualified dependents in order for you (or your spouse) to work, look for work, or attend school full-time.

Plan Year
  • 2026
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
ET-7356
Form Active Employee

Reciprocity: Employee Summary

File a copy of this form with each of your former retirement systems each time you become covered under a new retirement system, for limited reciprocity between the three public employee retirement systems in Wisconsin.