ET-2101
Brochure Active Employee / Retiree / Other Benefit Recipient

The Wisconsin Public Employers Group Life Insurance Program

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.

ET-7414
Form Active Employee / Retiree / Other Benefit Recipient

Authorization to Disclose Medical Information

This form gives ETF and entities that perform contracted services for ETF permission to release your designated medical information to a person or entity specified by you.

ET-4925
Brochure Active Employee / Retiree / Other Benefit Recipient

How Divorce Can Affect Your WRS Benefits

Information on how a divorce may affect WRS benefits, beneficiary designations as well as information for the alternate payee.

Life Change Events and Documentation Requirements

If you are eligible to enroll in or change plans due to a qualified life change event, you may be asked to provide documents (employees to your employer, retirees to ETF) to confirm your eligibility.

Program Option
  • Local Annuitant Health Program (LAHP)
  • 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-2320
Form Active Employee / Retiree / Other Benefit Recipient

Beneficiary Designation

If you are the owner of a WRS account from which a WRS death benefit or life insurance benefit would be payable upon your death, you may file a beneficiary designation.

ET-6301
Form Other Benefit Recipient

Notice of Death

Notify the third party administrator of the group life insurance program of a member death.