ET-2405 Form Active Employee / Retiree ETF Insurance Complaint Form If you filed a grievance with the plan or benefit administrator and are dissatisfied with the final decision, you can request an administrative review from ETF.
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-1904 Manual Local Employer / State Employer State of Wisconsin Department of Employee Trust Funds Section 125 Cafeteria Plan Document A resource document available for employers to obtain an understanding of the components of all benefits taken as pre-tax.
ET-2301 Form Active Employee / Local Employer / State Employer Health Insurance Application/Change Form Enroll in health insurance or change your coverage.
ET-1109g Manual Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer My Insurance Benefits Glossary of Terms and Definitions This document for employers provides a list of My Insurance Benefits terms and definitions.