The Wisconsin Public Employers Group Health Insurance Program is authorized by the Group Insurance Board and available to local employers participating in the WRS, and local government employers that do not participate in the WRS and are separate Social Security entities.
Have you considered joining the WPE Group Health Insurance Program? This program is available to local employers participating in the WRS, and local government employers that do not participate in the WRS and are separate Social Security entities.
This information is for finance professionals of local employers who participate in the WPE Group Health Insurance Program and who are accountable for financial reporting under GASB Statement 75, “Accounting and Financial Reporting for Postemployment Benefits Other Than Pensions.”
Employers, use this form to verify that you viewed the employee’s original required document(s) to verify the employee or dependent(s) is eligible for benefit coverage, as administered by ETF.
Employer certification that a WRS annuity or lump-sum payment made to the survivor of the member named in this form may be eligible for an income tax exemption.
ET-4620
Form
Active Employee /
Local Employer /
State Employer
This application is intended for insured employees who are terminating private pension employment, who may qualify to continue life insurance coverage.
