ET-2154
Form Active Employee / Local Employer / State Employer

Group Life Insurance Continuation Application

This application is intended for insured employees who are terminating Wisconsin Retirement System employment, who may qualify to continue life insurance coverage, and who will not begin a WRS retirement benefit immediately.

Life Events Guide

Have you recently had a baby? Gotten married? Divorced? Moved? Throughout the year you may experience life events that allow you to change your benefits outside of the annual open enrollment period. The life events guide explains deadlines, required documentation, and which events allow you to make changes.

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
Webinar
Oct 22, 2025 11:00am Event Open

Meet Your Accident Plan and Life Insurance Administrator: Securian Financial

Join us for a free, 45-minute online session to learn about your Accident Plan and Life Insurance Administrator: Securian Financial during open enrollment. No travel needed. You’ll get the same helpful information you’d find at an in-person benefits fair, right from your home or office. This session is appropriate for all members, regardless of enrollment or employment type.

Document Requirements for Life Events and Dependent Verification

Find out which documents are required when adding a spouse or dependent to your insurance or making changes due to a qualified life event. Having the correct paperwork will help ensure a smooth update to your coverage.

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
Apple sitting next to a stethoscope

Insurance

Learn about the insurances provided by ETF, such as health, dental and vision insurance.