ET-2321
Form Active Employee / Retiree

Beneficiary Designation - Alternate

If you wish to specify who shall receive a primary beneficiary’s share of a death or life insurance benefit if a primary beneficiary is deceased, you must use this alternate beneficiary designation form.

ET-4110
Form Retiree

Health Insurance - Integrated with Medicare

The following information is for those retirees who are transitioning into Medicare under the State or the Wisconsin Public Employers Group Health Insurance Programs.

ET-4322
Form Active Employee / Retiree

QDRO - Military Service Certification and Affidavit 

Wisconsin law requires the WRS participant to complete this form and submit it ETF when a portion of the participant’s account is awarded to an alternate payee via a Qualified Domestic Relations Order (QDRO).

HSA Eligibility

There are a number of requirements you must meet in order to be eligible for an HSA.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2024
Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2016

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of January 1, 2017.

Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2014

This report presents the results of the annual actuarial valuation of benefit liabilities and costs of the Duty Disability Program as of January 1, 2015.

ET-4307
Form Active Employee / Retiree

Medicare Eligibility Statement

You and/or your insured dependents must be enrolled for both portions of Medicare (Hospital Part A and Medical Part B), when first eligible. Provide this information to ETF using this form.

Report Active Employee / Retiree / Board Member / Local Employer / State Employer

Duty Disability Program Actuarial Valuation 2015

This report presents the results of the Annual Actuarial Valuation of benefit liabilities and costs of the Duty Disability Program as of January 1, 2016.