Brochure Active Employee / Local Employer / State Employer Wisconsin Public Employers Group Life Insurance Policy
National Medical Support 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
Health and Wellness News Nov 19, 2024 1:00pm November is National Diabetes Month Join us this month in learning about diabetes, prediabetes, and Well Wisconsin's diabetes management coaching program.
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
ET-2311 Form Active Employee / Local Employer / State Employer COBRA Continuation - Conversion Notice Under federal law, known as COBRA, you and your qualified beneficiaries may continue group health insurance coverage, if eligible.
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-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.
ET-5350 Form Active Employee Income Continuation Insurance Medical Report Physician report to verify eligibility for an income continuation insurance claim.
2024 Medical Premium Increases Learn why the health insurance premiums increased for the 2024 plan year.
Opt Out of Medical Benefits Employees may be eligible to receive up to $2,000 if opting out of State Group Health Insurance Coverage Program Option State Employee and Retiree Health Plan & Supplemental Benefits
