ET-1908
Form Local Employer / State Employer

Employer Attestation For Documentation Received

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.

STAR Employers

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits

Changes in Employment Status FAQs

Program Option
  • 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
Plan Year
  • 2024
Employer News
Feb 13, 2023 8:00am

Employers Recognized for Well-Being in 2022

Nine Wisconsin employers were recognized for well-being through the 2022 Well Wisconsin program. Well-being champions representing these employers were recognized at a recent Well Wisconsin Awards Ceremony held at the Olbrich Botanical Gardens in Madison, WI.