Events happen in life and can affect your coverage. Make sure you know when you lose your coverage and what steps to take to make sure you can keep it.
ET-4620
Form
Active Employee /
Local Employer /
State Employer
This application is intended for insured employees who are terminating private pension employment, who may qualify to continue life insurance coverage.
You may be able to convert your Basic group life insurance coverage to pay premiums for health insurance or long‑term care insurance. This brochure explains who is eligible and how conversion works.
The Group Insurance Board today reviewed trends in healthcare market consolidation and the impacts on the State of Wisconsin Group Health Insurance Program. The Board also discussed approaches for the coverage of weight-loss drugs.
The program offers term life insurance coverage up to 5 times an employee's yearly pay for State of Wisconsin employees and local government employees whose employer offers the plan. Employees may also insure their spouses and dependent children.
The Board moved forward with the 5% increase to the employee premium rates effective April 1, 2024. For rates effective April 1, 2023 - March 31, 2024, please see Group Life Insurance Plan Monthly Rates (ET-2164).
Local government employers may choose to pay for continued life insurance coverage for their employees in retirement. To do so, local employers must submit the Local Employer Paid Life Insurance Coverage (ET-1660) form.
