A resolution for the employer to offer the Wisconsin Public Employers Group Health Insurance program to eligible personnel through the program of the State of Wisconsin Group Insurance Board, and agrees to abide by the terms of the program.
ETF has published new recorded webinars for local employers focused on the Group Health Insurance Program and supplemental benefits to help answer employer questions.
Effective immediately, employers must send ETF this form to verify that they have personally viewed their employees’ original required documents to verify benefit coverage eligibility.
For the 2022 plan year, the It’s Your Choice decision guide will continue to be a printed guide, as a companion piece to the collection of It’s Your Choice web pages found on the ETF website. Please let ETF know by July 16, 2021 how many paper guides you would like.
ETF has created a second training video to provide information and answer questions about the program options available in the Wisconsin Public Employers Group Health Insurance Program.
ET-2340
Form
Active Employee /
Local Employer /
State Employer
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.