ET-2314a
Form Local Employer / State Employer

Model COBRA Subsidy Notice

This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed. 

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. The privacy of your information is important to us. Please review it carefully.

Notice of Privacy Practices

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
Apr 5, 2023 12:00am
Statement on computer image

2023 WRS Annual Statement of Benefits Coming Soon

The WRS Annual Statement of Benefits will soon be delivered to active employees with WRS contribution balances as of December 31, 2022. Note: All active employees will receive their statement in the mail.

Employer News
Apr 4, 2024 9:00am
Statement on computer image

2024 WRS Annual Statement of Benefits Coming Soon

The WRS Annual Statement of Benefits will soon be delivered to active employees with WRS contribution balances as of December 31, 2022. Note: All active employees will receive their statement in the mail.

Employer News
Apr 8, 2021 12:00am
Image of interactive statement of Benefits on a computer screen.

2021 WRS Annual Statement of Benefits Coming Soon

The WRS Annual Statement of Benefits will soon be delivered to active employees with WRS contribution balances as of December 31, 2020. Note: All active employees will receive their statement in the mail.

Employer News
Apr 6, 2022 12:00am
Statement on computer image

2022 WRS Annual Statement of Benefits Coming Soon

The WRS Annual Statement of Benefits will soon be delivered to active employees with WRS contribution balances as of December 31, 2021. Note: All active employees will receive their statement in the mail.