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.
The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospitals & Clinics Authority, participating local government employers, and annuitants (and their insured survivors).
ET-4112
Brochure
Active Employee /
Retiree /
Local Employer /
State Employer
The American Rescue Plan of 2021 (ARP) was signed into law by President Biden on March 11, 2021. The bill provides an enrollment opportunity for individuals who would have been eligible for, but did not elect, COBRA at the time of their termination, as well as individuals who had COBRA but let it lapse before their full 18 months of eligibility was complete.
ET-2154
Form
Active Employee /
Local Employer /
State Employer
This application is intended for insured employees who are terminating Wisconsin Retirement System employment, who may qualify to continue life insurance coverage, and who will not begin a WRS retirement benefit immediately.
The group health insurance program is an employer-sponsored program offering group health coverage to employees of state agencies, UW System, UW Hospital & Clinics Authority and participating local government employers.
Understanding COBRA—the Consolidated Omnibus Budget Reconciliation Act—can sometimes be tricky. A new nine-minute training video answers these questions and provides additional information on qualifying events, responsibilities, and timelines.
ETF has updated the Local Employer Verification of Health Insurance Coverage (ET-4814) form. This update means that local employers will no longer collect the forms from employees and survivors that want to continue health insurance coverage after the employee retires or dies. Coverage now continues automatically, and employees and survivors only need to complete the form to cancel coverage.