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.
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.
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.
The Wisconsin Public Employers Group Life Insurance Program is a benefit provided under the WRS and is available to employees of the State of Wisconsin and employees of participating Wisconsin local government employers.
Brochure
Active Employee /
Local Employer /
State Employer
This brochure describes your group term life insurance protection and is your certificate of participation, give a valid enrollment form is on file with ETF and premiums are being paid.
The Wisconsin Public Employers Group Life Insurance program provides continuation of your group life insurance after retirement if you meet the eligibility requirements.