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Find out which documents are required when adding a spouse or dependent to your insurance or making changes due to a qualified life event. Having the correct paperwork will help ensure a smooth update to your coverage.
Program Option
Local Annuitant Health Program (LAHP)
Local Deductible Health Plan (PO14) & Supplemental Benefits
Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
Local Health Plan (PO16) & Supplemental Benefits
Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
Local High Deductible Health Plan (PO17) & Supplemental Benefits
Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
Local Traditional Health Plan (PO12) & Supplemental Benefits
Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
State Employee and Retiree Health Plan & Supplemental Benefits
ET-6101
Brochure
Active Employee /
Retiree /
Other Benefit Recipient
For the 2025 plan year, the health benefits decision guide will continue to be a printed guide, as a companion piece to the collection of web pages found on the ETF website. Please let ETF know by July 12, 2024 how many paper guides you would like.
If you prefer to provide your employees with a paper copy of the guide, we will automatically send you the same number of guides as you received last year. If you would like to change the number of copies, contact name, or mailing address, email ETF.
As a participant in this health insurance program, you have certain rights and responsibilities. By becoming familiar with them, you will be able to make the most of your health care.
Program Option
Local Deductible Health Plan (PO14) & Supplemental Benefits
Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
Local Health Plan (PO16) & Supplemental Benefits
Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
Local High Deductible Health Plan (PO17) & Supplemental Benefits
Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
Local Traditional Health Plan (PO12) & Supplemental Benefits
Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
State Employee and Retiree Health Plan & Supplemental Benefits
This manual is a reference source intended to aid employer administration of and participation in the State of Wisconsin Group Health Insurance Program.