ET-7414
Form Active Employee / Retiree / Other Benefit Recipient

Authorization to Disclose Medical Information

This form gives ETF and entities that perform contracted services for ETF permission to release your designated medical information to a person or entity specified by you.

Department News
Apr 4, 2024 10:00am
Photo of a pair of legs in blue denims and white sneakers hopping into a series of steppingstones in a body of water. The banner above reads, "Your Steppingstones to Retirement"

Webinar: Your Steppingstones to Retirement

Attend this webinar on April 17 to learn how your Social Security, WRS pension, and deferred compensation savings account can bring you closer to a secure financial retirement.

ET-1907
Form Local Employer / State Employer

No Taxpayer Identification Number

A tool for an employer to confirm information was presented to a new employee, due dates identified and appropriate information and forms supplied for all ETF-administered benefits offered by the employer.

COBRA: Continuation of Coverage Rights for the Group Health Insurance Program

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
Employer News
Jan 10, 2023 8:00am

January 2023 Well Wisconsin Updates

Discover what’s included in the 2023 Well Wisconsin program, explore changes to the WebMD One portal, and delve into new resources for creating a culture of well-being across your worksite.

Employer News
Jan 19, 2022 9:00am

2022 Well Wisconsin Program

The Well Wisconsin program is available to subscribers and spouses enrolled in the Group Health Insurance Program via a partnership with WebMD. Participants can earn a taxable $150 gift card by completing a health check, health assessment, and well-being activity.