Summary of Benefits and Coverage

A snapshot of a health plan's costs, benefits, covered healthcare services, and other important features.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2024

Summary of Benefits and Coverage

A snapshot of a health plan's costs, benefits, covered healthcare services, and other important features.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025
ET-7406
Form Active Employee / Retiree / Other Benefit Recipient

Authorization to Disclose Non-Medical Information

Wisconsin law allows ETF to release personal information to a third party if the member has first provided ETF with a valid written authorization. Use this form to authorize the release of non-medical information.

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.

My Benefits

With My Benefits, you can securely access your Statement of Benefits or apply for a disability retirement benefit.

WRS News Online for Employees
Jan 30, 2025 12:00pm
ETF Secretary John Voelker

Sec. Voelker: In a Positive Light

Most "words of the year" chosen by publications capture a negative mood in 2024. I prefer to approach things positively. Thankfully, the WRS gives us plenty of material.

ET-2405
Form Active Employee / Retiree

ETF Insurance Complaint Form

If you filed a grievance with the plan or benefit administrator and are dissatisfied with the final decision, you can request an administrative review from ETF.