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Employers, complete this form for access to ETF systems.

The ICI plan provides replacement income for disabilities which are considered short term in nature as well as those which may last for extended periods.

ETF requires a member’s ITIN or SSN to administer benefits. What should employers do when you have employees or their dependents without one of these numbers?

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.

Checklist for a new employer agent or an employer’s new retirement/insurance contact with the ETF.

Employer report to verify eligibility for an income continuation insurance claim.

Employers, complete this form to notify ETF of a claimant’s change in work status and/or earnings paid to the individual after the elimination period.

When filing claims with ETF’s ICI administrator, The Hartford, employees should advise The Hartford that their employer is the State of Wisconsin—not their actual employer (such as City of ABC or State Agency XYZ).

ETF has updated the employer Income Continuation Insurance (ICI) Program manuals. Please disregard any previous versions.

Please note a few reminders for employers: check that you are using the most current form revision, watch for ETF Update meeting invites, and read about changes coming to the ICI Program in 2024.