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You or Your Dependent Involuntarily Lose Eligibility or All Employer Contribution for Other Group Medical Coverage

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

Program Option

Local Annuitant Health Program (LAHP)
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

You or Your Dependent Gain Eligibility for Other Group Medical Coverage

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

Program Option

Local Annuitant Health Program (LAHP)
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-1140

Manual Local Employer / State Employer

How to Become a Participating Employer Under the Wisconsin Public Employers' Group Income Continuation Insurance Program

The ICI plan provides replacement income for disabilities which are considered short term in nature as well as those which may last for extended periods.

Employer News

Dec 5, 2024 8:00am

Income Continuation Insurance Premium Holiday Continues in 2025 for Local Employers, Employees

The Board has extended the ICI premium holiday for 2025, based on the strong financial position of the local ICI plan. This means that employers and employees will not pay premiums for either standard or supplemental ICI coverage.

You or Your Dependent Has a Medicare Coverage Change (Retirees and Survivors Only)

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

Program Option

Local Annuitant Health Program (LAHP)
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-1119a

Brochure State Employer

State of Wisconsin Income Continuation Insurance Plan Language

This plan language is intended to be used with the state and local income continuation insurance manuals.

ET-2129

Brochure Active Employee

Income Continuation Insurance - Local

The income continuation insurance (ICI) benefit is a voluntary income replacement benefit payable if you become disabled.

ET-2308

Form Active Employee

Evidence of Insurability Instructions—Income Continuation Insurance (ICI)

This application allows you to apply to enroll in the Income Continuation Insurance (ICI) Program if you did not enroll when originally eligible or if coverage was canceled.

ET-2106

Brochure Active Employee / State Employer

Income Continuation Insurance - State

The income continuation insurance ICI benefit is a voluntary “income replacement” benefit payable if you become disabled.

You Have a Job Change Where You Gain a Greater Share of Employer Contribution Toward Your Coverage (Active Employees Only)

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

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