Notice of Creditable Coverage for Medicare Part D

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
ET-2321
Form Active Employee / Retiree

Beneficiary Designation - Alternate

If you wish to specify who shall receive a primary beneficiary’s share of a death or life insurance benefit if a primary beneficiary is deceased, you must use this alternate beneficiary designation form.

24ET-2180
Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

2024 Uniform Benefits Certificate of Coverage

This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits offered under the Group Health Insurance Program.

23ET-2180
Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

2023 Uniform Benefits Certificate of Coverage

This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits offered under the Group Health Insurance Program.

Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2004

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of December 31, 2004.

Report Active Employee / Retiree / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2005

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of December 31, 2005.

ACA: Marketplace Health Insurance Coverage Options Notice

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
ET-5108
Brochure Active Employee / Retiree

Long-Term Disability Insurance

LTDI is a disability insurance benefit under the WRS that is meant to provide an income to members who have become totally and permanently disabled. This program was closed to new claims January 1, 2018.