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ET-8928

Form Local Employer / State Employer

ETF Online Access Security Agreement

Employers, complete this form for access to ETF systems.

ET-8928i

Form Local Employer

ETF Online Access Security Agreement – IAS

Employers, complete this form for access to the new Insurance Administration System (IAS).

ET-2178

Flyer Active Employee / Retiree / Other Benefit Recipient

Security Health Plan No Longer Available in 2020

Security Health Plan will not be available for the 2020 plan year. Learn what steps you need to take if you currently have health insurance through Security Health Plan.

ET-8937

Form Other Benefit Recipient

Online Network for Health Plans Security Agreement

Health plans, submit this form to request access to ETF systems.

HIPAA: Privacy, Electronic Transactions Standards and Security

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-1113

Manual Local Employer / State Employer

Employer Transaction Application Guide

The UW will have access to the Employer Transaction Application (ETA) user interface to update employee demographic and eligibility information, new employee enrollments, and employee terminations.

Changes in Employment Status FAQs

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-1145

Manual Local Employer

The Wisconsin Public Employers Income Continuation Insurance Administration Manual

The ICI Program is authorized by Wis. Stat. §§ 40.61 and 40.62, and is administered according to the plan provisions between the Group Insurance Board and the program’s third-party administrator.

STAR Employers

Program Option

State Employee and Retiree Health Plan & Supplemental Benefits

Employer News

Sep 5, 2024 7:00am

Insurance Benefits 2025 Open Enrollment Information for Local Employers in the Program

The annual insurance benefits open enrollment period is September 30-October 25, 2024. The annual insurance benefits open enrollment allows uninsured but eligible employees and retirees to enroll for coverage effective the following January 1.