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Brochure Active Employee / Local Employer / State Employer

Wisconsin Public Employers Group Life Insurance Policy

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-1660

Form Local Employer

Local Employer Paid Life Insurance Coverage

Local employers, please submit this verification if you will be paying for an employee’s life insurance coverage in retirement.

Changes to Life Insurance Coverage

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

Employee/Employer Certification Annuitant Continuant Coverage--Private Pension Fund

This application is intended for insured employees who are terminating private pension employment, who may qualify to continue life insurance coverage.

ET-2325

Brochure Active Employee / Retiree

Converting Your Group Life Insurance to Pay Health or Long-Term Care Insurance Premiums

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.

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

Department News

Aug 14, 2024 5:00pm

Graphic design representing the types of insurance under the Group Health Insurance Program

GIB Reviews Healthcare Trends, Drug Coverage

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.

Group Life Insurance

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.