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.
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.
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?
The Basic group life insurance plan became available to state employees in 1958 and to local government employees in 1960. Spouse & Dependent, Supplemental and Additional coverage is also available.
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).
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.