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

Dependent Information FAQs

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
Plan Year
  • 2024

Quartz - Central

Major Health Systems
  • Aurora Health Care
  • Gundersen Health System
  • ProHealth Medical Group
  • UnityPoint Health - Meriter Hospital & Clinics
  • UW Health Hospitals & Specialty Clinics
Full Service Areas
  • Adams County
  • Columbia County
  • Dodge County
  • Fond Du Lac County
  • Grant County
  • Green County
  • Green Lake County
  • Iowa County
  • Jefferson County
  • Juneau County
  • Lafayette County
  • Marquette County
  • Richland County
  • Rock County
  • Sauk County
  • Walworth County
  • Waukesha County
  • Waushara County
  • Wood County
Limited Service Areas
  • Illinois
  • Iowa
  • Minnesota

Quartz - West

Major Health Systems
  • Black River Memorial 
  • Crossing Rivers Health 
  • Gundersen Health System 
  • HSHS (Sacred Health Hospital and St. Joseph's Chippewa Falls)
  • OakLeaf IPA and Surgical Hospital 
  • Tomah Health
  • UW Health Hospital & Specialty Clinics
  • Vernon Memorial Healthcare 
Full Service Areas
  • Buffalo County
  • Chippewa County
  • Crawford County
  • Eau Claire County
  • Jackson County
  • La Crosse County
  • Monroe County
  • Trempealeau County
  • Vernon County
Limited Service Areas
  • Clark County
  • Pepin County
  • Illinois
  • Iowa
  • Minnesota

Quartz - UW Health

Major Health Systems
  • Access Community Health Centers
  • Associated Physicians, LLP
  • Madison Women's Health, LLP
  • Physicians for Women
  • UnityPoint Health – Meriter Hospital & Clinics
  • UW Health Hospitals & Clinics
  • Wildwood Family Clinic, SC
Full Service Areas
  • Dane County
Employer News
Jun 10, 2022 8:00am

State Health Insurance Manual (ET-1118) Updated June 2022

ETF has updated the State Health Insurance Standards, Guidelines, and Administration Employer Manual (ET-1118), and has summarized the changes in the table below.  Please disregard any previous versions of this manual.

Employer News
Jun 10, 2022 8:00am

Local Health Insurance Manual (ET-1144) Updated June 2022

ETF has updated the Local Employer Health Insurance Standards, Guidelines, and Administration Employer Manual (ET-1144), and has summarized the changes in the table below.  Please disregard any previous versions of this manual.