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COBRA/Continuation of Health Coverage FAQs

Program Option

State Employee and Retiree Health Plan & Supplemental Benefits

Plan Year

2024

COBRA: Continuation of Coverage Rights for the Group Health Insurance Program

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
State Employee and Retiree Health Plan & Supplemental Benefits

ET-2308

Form Active Employee

Evidence of Insurability Instructions—Income Continuation Insurance (ICI)

This application allows you to apply to enroll in the Income Continuation Insurance (ICI) Program if you did not enroll when originally eligible or if coverage was canceled.

Report Active Employee / Board Member / Local Employer

Local Income Continuation Insurance Plan Actuarial Valuation 2001

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Local Income Continuation Insurance Plan as of December 31, 2001.

Report Active Employee / Board Member / Local Employer

Local Income Continuation Insurance Plan Actuarial Valuation 2002

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Local Income Continuation Insurance Plan as of December 31, 2002.

Report the Death of a WRS Member

Understand the steps to report a death and ETF’s process for paying benefits.

ET-2106

Brochure Active Employee / State Employer

Income Continuation Insurance - State

The income continuation insurance ICI benefit is a voluntary “income replacement” benefit payable if you become disabled.

ET-2307

Form Active Employee / Local Employer / State Employer

Income Continuation Insurance Application - State

Complete and then submit to your employer to apply for income continuation insurance.

ET-2167

Brochure Active Employee / Local Employer / State Employer

myETF Benefits Quick Start Guide

myETF Benefits provides online tools to enroll and manage your health insurance benefits.

Report Active Employee / Board Member / Local Employer

Local Income Continuation Insurance Plan Actuarial Valuation 2014

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Local Income Continuation Insurance Plan as of December 31, 2014.