ET-8107
Board Member

ETF - Attached Boards Public Records Notice

The Public Records notice for records pertaining to the Employee Trust Funds board, Teachers Retirement Board, Wisconsin Retirement Board, Group Insurance Board and Deferred Compensation Board.

Uniform Dental Benefits Certificate of Coverage

Program Option
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025
ET-4109
Form Active Employee / Retiree

Medicare Enrollment for Retiring Employees

The following information is for employees who will retire in the next three months and will be transitioning into Medicare under the State or the Wisconsin Public Employers Group Health Insurance Programs.

ET-4111
Form Retiree

Medicare Enrollment for Disability Retirees

If you retired due to a disability, you may be eligible for Medicare benefits. Medicare eligibility related to disability is available to persons who have received Social Security disability benefits for at least 24 months, who have End Stage Renal Disease (ESRD), or Lou Gehrig’s Disease (ALS).

Health Insurance for Retirees with Medicare

Enrolled in Medicare? Learn about the key differences between our Medicare-coordinated plan design options, costs for medical services, available health plans and monthly premium amounts

Plan Year
  • 2025
Program Option
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits

Health Insurance for Retirees with Medicare

Enrolled in Medicare? Learn about the key differences between our Medicare-coordinated plan design options, costs for medical services, available health plans and monthly premium amounts

Plan Year
  • 2025
Program Option
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits