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-2166
Brochure Active Employee / Retiree / Other Benefit Recipient / Board Member / Local Employer / State Employer

Domestic Partner Benefits

As of Sept. 23, 2017, the State of Wisconsin no longer allows the establishment of new domestic partnerships under Chapter 40 of the Wisconsin statutes. This brochure provides information about the benefit changes for established domestic partnerships.

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

You or Your Dependent Involuntarily Lose Eligibility or All Employer Contribution for Other Group Medical Coverage

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

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

Benefit Enrollment Opportunities

Learn about the times throughout the year when you may enroll in health and supplemental insurance benefits, or change your coverage.

Plan Year
  • 2024
Program Option
  • 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-7423
Manual Other Benefit Recipient

Long-Term Care Insurance Standards

This document, “Long-Term Care Insurance Standards,” serves as a resource for insurers interested in offering state employees and retirees long-term care insurance (LTCI).

24ET-2180
Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

2024 Uniform Benefits Certificate of Coverage

This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits offered under the Group Health Insurance Program.

23ET-2180
Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

2023 Uniform Benefits Certificate of Coverage

This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits offered under the Group Health Insurance Program.