ET-1319 Form Local Employer / State Employer Resolution of Inclusion Under the Wisconsin Retirement System Resolution for employers to join the Wisconsin Retirement System.
COBRA: Continuation of Coverage Rights for the Group Health Insurance Program 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
COBRA/Continuation of Health Coverage 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-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.
ET-2155 Form State Employer Group Health Insurance Program Continuation Application For State Employees With 20 Years of WRS-Creditable Service. Employers, complete your sections and then give the form to the employee.
Cancellation or Termination of Health Coverage 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
Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option Local Traditional Health Plan (PO12) & Supplemental Benefits
ET-2314a Form Local Employer / State Employer Model COBRA Subsidy Notice 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.
Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option Local High Deductible Health Plan (PO17) & Supplemental Benefits
Health Insurance for Employees, COBRA and Retirees without Medicare Learn about the key differences between your plan design options, costs for medical services, available health plans and monthly premium amounts Plan Year 2025 Program Option Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits