For state and local government employees
Department of Employee Trust Funds
Wisconsin Retirement System
P.O. Box 7931
Madison, Wisconsin 53707-7931
ET-2101 (Rev 12/2019)
This Brochure is Your Certificate of Participation.
Read this brochure carefully. It provides a description of your group
term life insurance protection and is your certificate of participation,
provided that a valid enrollment form is on file with the Department
of Employee Trust Funds and premiums are being paid. You are
responsible for reviewing your payroll records and statements of
fringe benefits regularly to be sure that premiums are being properly
deducted. Discrepancies should be reported to your employer
immediately. Coverage may lapse if the required premiums go unpaid
for 60 days.
Whenever the insurance program is modified substantially, revised
copies of this brochure will be made available. Keep this brochure in a
safe place with your other important papers.
Every effort has been made to assure that the information in this
booklet is accurate. In the event of conflicting information, state or
federal statutes, state insurance contracts, and the policies and
provisions established by the State of Wisconsin Group Insurance
Board shall be followed. In the event of any discrepancies between the
policy and this booklet, the policy shall be followed.
Please note that the most updated version of this booklet can be
found online at https://etf.wi.gov/publications/et2101/direct.
TABLE OF CONTENTS
1. Introduction .......................................... 1
2. Eligibility ............................................. 1
3. Enrollment............................................ 2
A. Enrollment When First Eligible.......................... 2
B. Enrollment Upon Return from Leave of Absence ........... 2
C. Enrollment for Change in Employment Class .............. 2
D. Enrollment Due to Family Status Change Event ............ 2
E. Enrollment Under Evidence Of Insurability ................ 3
F. Effective Date Of Insurance ............................ 3
4. Amount Of Life Insurance During Active Employment ......... 3
5. Cost Of Insurance ..................................... 5
6. Accidental Death, Dismemberment And Loss Of Use Insurance . 6
A. Benefits ........................................... 6
B. Requirements....................................... 7
C. Limitations ......................................... 8
D. Notice And Proof Of Injury ............................ 8
7. Spouse And Dependent Coverage ........................ 9
8. Benefits Payable During Your Lifetime ......................13
9. Disability Waiver Of Premium Benefit ......................14
10. Coverage During Leave Of Absence .......................17
11. While Appealing A Dismissal .............................18
12. Cancellation ..........................................18
13. Termination Of Your Insurance............................19
14. Maintaining Coverage After You Terminate Employment. .......20
A. Continuation Of Group Coverage .......................20
B. Conversion To An Individual Policy ......................21
15. Beneficiary ...........................................22
16. Payment Of The Benefit At Death .........................23
17. How Your Premiums/Benefits Are Taxed....................23
18. Frequently Asked Questions About Your Group Life Insurance ..24
19. For Additional Information ...............................29
1
INTRODUCTION
The Wisconsin Public Employers Group Life Insurance Program
(the Program) is a benefit provided under the Wisconsin Retirement
System and is available to employees of the State of Wisconsin and
employees of participating Wisconsin local government employers.
The Program is governed under Chapter 40 of the Wisconsin State
Statutes, Wisconsin Administrative Code and the life insurance policy
between the Wisconsin Group Insurance Board and Securian Financial
Group, Inc. (Securian Financial). The Wisconsin Group Insurance
Board is the policyholder and is responsible for Program oversight.
The Wisconsin Department of Employee Trust Funds (ETF) has overall
responsibility for administration of the Program. Securian Financial and
its affiliate, Minnesota Life Insurance Company, underwrite and assist
ETF with administration of the Program.
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ELIGIBILITY
You may enroll if your employer participates in the Program,
you are an eligible employee in accordance with Wisconsin Statutes
40.02(25)(a) or (c), whether full time or part time, and you are under age
70. You may enroll if you are included under a private pension plan
with a participating local government employer.
Any blind employee qualifying under Wisconsin Statutes
40.02(25)(a)(3) is eligible.
Employees who reach age 70 before becoming eligible for
coverage may be insured only under the Additional Plan if their
employer offers the plan, if the employee provides evidence of
insurability satisfactory to Securian Financial.
Rehired annuitants who have continued coverage during
retirement, who subsequently return to employment as a WRS
participating employee in accordance with Wisconsin Statutes
40.02(46), may choose between retaining the annuitant coverage or
enrolling for coverage as an eligible employee for the plans available
through the employee’s employer.
An employee who returns to work as an eligible employee with
the same employer within 30 days after termination of employment or
after a leave of absence without earnings, during which time coverage
lapsed, is eligible to apply for the plans and amounts in effect prior to
termination or leave of absence, except plans that have been cancelled
by the employee.
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ENROLLMENT
A. Enrollment When First Eligible
If you are under age 70, you may obtain coverage by completing an
application provided by your employer. Applications must be submitted
within 30 days of hire.
B. Enrollment Upon Return from Leave of Absence
If you return to employment after a leave of absence without
earnings, during which time coverage lapsed, you may enroll without
evidence of insurability for the plans of insurance in effect prior
to your leave. You also may apply for any new coverage that your
employer made available to all employees for the first time during
your leave. You may not enroll in any plan which you previously
declined or cancelled. Your application must be submitted within 30
days of your return to work.
C. Enrollment for Change in Employment Class
A change in employment class or a change in appointment does
not provide you with an open enrollment unless the change resulted
from a termination of employment. However, if you have a change in
employment class that requires your employer to provide you with
100% employer-paid coverage under its employment contract for an
entire employment class, you will be eligible for an open enrollment
only for the plans that are 100% employer paid. You will have 30
days to enroll from the date you became eligible for 100% employer
paid coverage.
D. Enrollment Due to Family Status Change Event
You may enroll in Basic coverage, or increase your employee
coverage by one level, and enroll in one or two units of Spouse and
Dependent coverage without evidence of insurability if application is
made within 30 days of gaining a dependent as defined in ETF 10.01(2)
due to one of the following:
1. the date of the employee’s marriage or
2. the date of birth, adoption, placement for adoption, or award of
legal guardianship of a dependent child.
You may only enroll in coverage levels offered by your employer;
if you already have all the coverage offered, you do not have an
enrollment opportunity.
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E. Enrollment Under Evidence Of Insurability
If you do not enroll for all available coverage within 30 days of first
becoming eligible, or within 30 days of a family status change event,
as described above, you may obtain coverage by providing Securian
Financial with satisfactory evidence of insurability. The Evidence of
Insurability Application form (ET-2305) must be received by Securian
Financial prior to your 70th birthday for the Basic and Supplemental
Plans of insurance. However, the Evidence of Insurability Application
may be received by Securian Financial at any age for the Additional Plan.
Employees who become an eligible employee at age 70 or later
are not eligible for the Basic or Supplemental Plans. They are eligible
to apply for the Additional Plan but are required to provide evidence
of insurability.
The Evidence of Insurability Application form is available from
your employer and on ETF’s internet site at http://etf.wi.gov. You and
your employer will receive written notice when the coverage becomes
effective or if it is denied. Securian Financial may contest payment of
any benefit for up to two years after coverage begins.
F. Effective Date of Insurance
Your insurance becomes effective, if you are an eligible employee
and have filed an application in accordance with the enrollment
provisions described above, on the first day of the month following 30
days from the date of hire, the first day of the month following 30 days
from return from an approved leave of absence, or the first day of the
month following 30 days from the date of the qualifying family status
change event, whichever is applicable.
For claims purposes, an employee’s election date will be the point
of reference for providing coverage and paying claims. Election date
is the date of online enrollment or the date the paper application is
received by the employer, but not earlier than the date of hire, the date
of the qualifying family status change event, or the return to work date,
whichever is applicable.
Insurance shall not become effective if the applicant is no longer an
employee of a participating employer on the insurance effective date.
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AMOUNT OF LIFE INSURANCE DURING ACTIVE EMPLOYMENT
When you first become insured through your current employer,
your amount of insurance is an estimate determined by your
employer. The estimate is based on the employer’s projection
of your earnings for the next twelve months rounded to the next
higher $1,000 if not already an even $1,000. On the January 1 that
immediately follows the date you became insured, the amount of
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insurance is based on the higher of the estimated earnings or the
actual earnings in the previous calendar year. On each January 1
thereafter your insurance amount will be based on your highest prior
calendar year’s actual earnings with your current employer.
“Earnings” means the total salary or wages paid to you by your
employer during the previous calendar year. This includes deferred
compensation, tax shelter arrangements and allowances provided for
you in lieu of money. For employers that provide employees a private
pension plan, “earnings” has the same meaning as above and are
reported by your employer to Securian Financial.
Each local government employer is a separate employer
and the State of Wisconsin is considered one employer for life
insurance purposes.
If your earnings increase above the current level of coverage, your
insurance coverage will increase January 1 of the following year. If your
earnings decrease, your insurance coverage will not decrease unless
you request a reduction of insurance in writing or unless your calendar
year earnings after one full year of employment are less than the
coverage amount that was based on the prior year’s estimate.
Basic Plan
Except as provided above, under the Basic Plan you will have
insurance equal to the earnings paid to you by your employer during
the previous calendar year rounded to the next higher $1,000.
If you are employed when you reach age 70, your premiums
will be discontinued and the amount of your Basic insurance will be
adjusted as shown in the Continuing Coverage Table in Section 14. The
adjustments shown in the Continuing Coverage Table do not apply to
employees under age 70.
When the governing body of an employer adopts a resolution to
participate in the Program and makes insurance available for the first
time to its employees, eligible employees who are age 70 and older on
the effective date of the Basic Plan, will receive an amount of insurance
equal to the final reduced amount provided in the Continuing Coverage
Table in Section 14.
Supplemental Plan
You must have Basic coverage and your employer must participate
in the Supplemental Plan to be eligible for the Supplemental Plan. This
plan provides life insurance coverage in addition to the Basic Plan at
one times your previous year’s earnings, rounded to the next higher
$1,000. If you are employed when you reach age 70, your premiums
will stop and your Supplemental insurance coverage will terminate.
If you have continued the Supplemental Plan following termination
of employment or retirement, coverage will end at age 65.
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Additional Plan
You must have Basic coverage and your employer must participate
in the Additional Plan to be eligible for the Additional Plan. This plan
provides life insurance in addition to the Basic Plan at up to three times
your prior year’s earnings. If you are employed when you reach age
70, your coverage will continue until you terminate employment, cancel
coverage or stop paying premiums, whichever is earliest. If you have
continued the Additional Plan following termination of employment or
retirement, coverage will end at age 65.
When the governing body of an employer adopts a resolution to
participate in the Additional Plan and makes it available for the first
time to all its employees, eligible employees who are age 70 and older
on the effective date of the Additional Plan are required to provide
evidence of insurability satisfactory to Securian Financial, if they wish
to enroll in the Additional Plan.
The Additional Plan does not include waiver of premium or
accidental death and dismemberment benefits for insureds who are
age 70 and older.
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COST OF INSURANCE
Cost To You
Your monthly premiums are determined as of April 1 of each year
if you are a state employee and as of July 1 of each year if you are a
local government employee, based on your age on that date and your
amount of insurance. The monthly rates for Basic, Supplemental and
Additional insurance are available from your employer, ETF or Securian
Financial. Rates could change annually. You can also find current
premium rates (ET-2164) on ETF’s Internet site at http://etf.wi.gov.
Premiums are due for each month during which your group
coverage is in force beginning on the first day of the month following
30 days from the date of hire. When an insured retiree turns age 65
no premiums will be deducted from the insured’s annuity. If you are
between age 65 and age 69 when you retire, your last premium is due
for the month in which you retire.
Cost To Your Employer
Basic Plan
If you are a state employee, your employer pays an additional
65.25 percent of the employee Basic premium. If you are a local
government employee whose employer has chosen to provide
continued post- retirement coverage at the 50 percent-of-Basic level,
your employer pays an additional 40 percent of the employee Basic
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premium. All other employers pay an additional 20 percent of the
employee Basic premium. This provides post-retirement coverage at
the 25 percent-of-Basic level. The employer’s cost is authorized by the
Group Insurance Board and is subject to change.
Supplemental Plan
If you are a state employee, your employer pays an additional 37.25
percent of the employee Supplemental rate. No employer contribution
is required of local government employers.
Additional and Spouse and Dependent Plans
No employer contribution is required. Employees pay the full cost
of coverage.
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ACCIDENTAL DEATH, DISMEMBERMENT
AND LOSS OF USE INSURANCE
A. Benefits
The amount of Accidental Death, Dismemberment, and Loss of
Use (AD&D) coverage is equal to the total amount of your insurance
under the Basic, Supplemental and Additional coverages. This amount
of coverage is also referred to as the “Principal Sum.” Payment of
benefits under the Accidental Death, Dismemberment and Loss of Use
coverage is in addition to any payment under the Basic, Supplemental
and Additional coverages. If you suffer more than one of the losses
listed below in Coverages A and B because of any one accident,
payment will be made only for the loss for which the largest amount is
payable, but not more than the Principal Sum. If you receive payment
for a loss under this policy and later incur another loss, payment will
be made for that loss regardless of any previous loss. However, under
no circumstances will more than one payment be made for the loss or
loss of use of the same limb(s), or part thereof, or member(s).
This coverage continues while your insurance is in force and you are:
• employed and under age 70, or
• retired and under age 65, or
• on a disability waiver of premium.
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Coverage A – Loss Of Life, Limb Or Sight
Loss Benefit Payment
Life Principal sum
Two or more members Principal sum
One member One-half of principal sum
Thumb and index finger on same hand One-fourth of principal sum
“Member” means hand, foot or eye. Loss of hand or foot means
actual severance through or above the wrist or ankle joint. Loss of
sight means the entire and irrecoverable loss of sight. Loss of thumb
and index finger means actual severance through or above the
metacarpophalangeal (close to the palm of the hand) joint. Above the
wrist and metacarpophalangeal joints means towards the elbow; above
the ankle joint means towards the knee.
Benefits for loss of life will be paid to your beneficiary. Benefits for
any other loss will be paid to you.
Coverage B – Permanent And Total Loss Of Use
Loss Benefit Payment
Each hand or foot from wrist or ankle One-fourth of principal sum
Each arm or leg from shoulder or hip. One-half of principal sum
Permanent and total loss of use means the permanent and
total loss of the ability to function because of incurable paralysis or
stiffening. The requirements of your occupation or profession are not
considered when determining your right to this benefit. Permanent and
total loss of use of arm or leg means the permanent and total loss of
use to the entire arm or leg, including loss of use of the attached hand
or foot.
B. Requirements
For payment of AD&D benefits under Coverages A and B, your
injury and loss must:
1. Result from a bodily injury which was unintended, unexpected
and unforeseen, as shown by a visible contusion or wound on the
exterior of the body (except in the case of drowning).
2. Be suffered through external, violent and accidental means.
3. Be the direct result of that injury.
4. Be independent of all other causes.
5. Occur within one year of the date of the accident.
6. Occur while your coverage is in force.
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C. Limitations
In no event will the AD&D benefit be paid where the loss is caused
directly or indirectly by, results from, or there is contribution from, any
of the following:
1. Self-inflicted injury or self-destruction, whether sane or insane.
2. Suicide or attempted suicide, whether sane or insane.
3. Participation in or attempt to commit a crime, assault, or felony.
4. Bodily or mental infirmity, illness or disease.
5. The use of alcohol, drugs, medications, poisons, gases, fumes or
other substances taken, absorbed, inhaled, ingested or injected,
unless taken upon the advice of a licensed physician in the
verifiable prescribed manner and dosage.
6. Motor vehicle collision or accident where the employee is the
operator of the motor vehicle and the employee’s blood alcohol
level meets or exceeds the level at which intoxication is defined in
the state where the collision or accident occurred, regardless of
the outcome of any legal proceedings connected thereto.
7. Infection, other than infection occurring simultaneously with, and
as a direct result of, the accidental injury.
8. Medical or surgical treatment or diagnostic procedures or any
resulting complications.
9. Travel in or descent from any aircraft, except as a fare-paying
passenger on a regularly scheduled commercial flight on a
licensed passenger aircraft carrier, or except for an employee
who is a pilot, crew member or passenger on an aircraft owned,
operated or leased by a state or local government employer and
being used for business of that employer.
10. War or any act of war, whether declared or undeclared.
D. Notice And Proof Of Injury
A claim form for Accidental Dismemberment Total and Permanent
Loss of Use or Loss of Sight should be requested directly from
Securian Financial.
This form or written notice of an injury on which a claim may
be based, must be given to Securian Financial within 30 days
after the accident causing the loss unless it is shown not to have
been reasonably possible to give such notice prior to the date it is
presented. Instructions for filing a proof of loss will accompany the
claim form. Securian Financial may require a claimant to be examined
at Securian Financial’s expense while a claim is pending.
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SPOUSE AND DEPENDENT COVERAGE
Definitions
“Spouse” means your lawful husband or wife.
“Dependent” means your children, including natural children,
stepchildren, adopted children, legal wards and children in adoptive
placement under Wis. Stats. §48.837(1). Children are eligible from live
birth (stillborn and unborn children are not eligible) to the attainment
of age 26. A child who is age 26 or older is also eligible if he or she
is incapable of self-support because of a physical or mental disability
which is expected to be of a long-continued and indefinite duration.
Eligibility
You must have the Basic Plan or file an application for Basic
coverage at the same time you apply for the Spouse and Dependent
coverage. Also, you must be an eligible employee under age 70 and
your employer must offer this plan as part of its benefits program.
Enrollment for Spouse and Dependent Coverage
An eligible employee may enroll without evidence of insurability for
Spouse and Dependent insurance by filing an application provided by
ETF which must be received by the employer within 30 days after:
1. The date the employee first qualifies with that employer as an
eligible employee under Wisconsin Statutes 40.02(25)(a) or (c)
provided the employee enrolls in the Basic Plan; or
2. One of the following changes:
a. The date of the employee’s marriage,
b. The date of birth, adoption, placement for adoption, or award
of legal guardianship of a dependent child; or
3. The date an employee returns to work as an eligible employee
of a participating employer if within 30 days of terminating
employment or after a leave of absence without earnings, during
which time coverage lapsed. The employee may enroll only for
the plans of coverage that were in effective prior to termination or
leave of absence, unless coverage was previously cancelled by
the employee.
You may only enroll in coverage levels offered by your employer;
if you already have all the coverage offered, you do not have an
enrollment opportunity.
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Evidence of Insurability for Spouse and Dependent
Evidence of insurability is required if you enroll or increase
coverage after the enrollment period ends.
If you cancel your coverage because you no longer have an
eligible spouse or dependent, you may re-enroll without evidence of
insurability within 30 days of a qualifying family status change event.
Effective Date of Insurance
If an eligible employee enrolls for Spouse and Dependent coverage
on an application in accordance with the enrollment provisions in
this section, the effective date of insurance shall be the first day of
the month following 30 days from the date of hire, the first day of
the month following 30 days from return from an approved leave of
absence, or the first day of the month following 30 days from the date
of the qualifying family status change event, whichever is applicable.
For a spouse who is required to submit evidence of insurability the
effective date of insurance is the first of the month following the date
the application is approved by Securian Financial. For claims purposes,
the approval date will be the point of reference for providing coverage
and paying claims.
Insurance shall not become effective if the applicant is no longer
an employee of a participating employer or if the applicant is no longer
a spouse or dependent of an employee on the insurance effective date.
Amount of Coverage
If you meet eligibility requirements, you may apply for one or two
units of Spouse and Dependent term life insurance. You may not
elect more than two units of coverage even if you are employed by
more than one participating employer. However, you and your spouse
may both elect Spouse and Dependent coverage if both employers
offer it. There is no Accidental Death, Dismemberment or Loss of
Use coverage in the Spouse and Dependent Plan. The amounts of
coverage under each unit may be subject to changes made by the
Group Insurance Board.
1 Unit Spouse $10,000
Each Dependent Child 5,000
2 Units Spouse $20,000
Each Dependent Child 10,000
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Cost of Insurance
The monthly cost for each unit of Spouse and Dependent life
insurance is a set dollar amount. The cost is the same for each unit of
coverage regardless of the age or number of family members you have
to insure. Contact ETF, your employer, or Securian Financial for current
premium information. You can also find current premium information on
the Life Insurance Rates form (ET-2164) on ETF’s Internet site at
http://etf.
wi.gov.
Coverage During Disability
If you become disabled as explained in Section 9, “Disability
Waiver of Premium Benefit,” you can continue Spouse and Dependent
life insurance coverage until age 65 without premium payments, as
long as your disability continues and you continue to be covered under
the Basic Plan.
Coverage During An Approved Leave Of Absence, Layoff, Or While
Appealing A Discharge
Spouse and Dependent coverage may be continued during any
approved leave of absence or layoff subject to the conditions specified
in Section 10, “Coverage During Leave of Absence”, or while employee
is appealing a dismissal, subject to the conditions specified in Section
11, “While Appealing A Dismissal”.
Conversion To An Individual Policy
When coverage on your insured spouse or dependent child
terminates, he or she may convert to an individual policy. The
application for conversion and first premium payment must be
received by Securian Financial within 31 days after the insured is no
longer eligible for coverage under the group policy. Failure to obtain
an application for conversion does not extend the conversion period.
In the event of your death, your spouse and dependent(s) will have 90
days from the date of your death to convert. Spouse and Dependent
coverage must have been in effect for the entire six-month period
preceding termination of coverage. You may obtain the conversion
application (ET-2306) from your employer, ETF, Securian Financial,
or ETF’s Internet site at http://etf.wi.gov. Completed applications for
conversion should be sent to Securian Financial.
Termination Of Coverage
Insurance on any spouse or dependent shall terminate
automatically on the earliest of the following dates:
1. The last day of the calendar month in which the employee
terminates employment; or
2. The date the employee meets any of the conditions specified in
Section 13, “Termination of Employee’s Insurance,” or reaches age
70; or
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3. For an individual whose premiums are waived under the section
entitled Section 9, “Disability Waiver of Premium Benefit,” the date
the individual reaches age 65; or
4. The last day of the calendar month in which the employer
receives a written notice of cancellation of this insurance from
the employee. The notice must be on a form provided by ETF. A
notice of cancellation may be withdrawn only by a written request
to the employer or ETF which is received prior to the termination of
coverage; or
5. For a dependent, the date of qualification for insurance as an
eligible employee under Wisconsin Statutes 40.02(25); or
6. For a spouse, the date a divorce decree is entered; or
7. Ninety days after the death of the employee; or
8. For a dependent other than one described in (10) below, upon
reaching age 26; or
9. For a dependent incapable of self-support due to a physical or
mental disability which can be expected to be of long-continued
or indefinite duration who would not otherwise be eligible, the date
disability ceases; or
10. The date this coverage is terminated.
Insurance coverage shall be considered lapsed if an employee who
is receiving earnings fails to make required premium payments during
a consecutive 60-day period, commencing with the first day for which
premiums have not been paid, except where the employer has elected
to pay the entire premium for all its employees. Cancellation under this
provision shall not preclude the employee from obtaining life insurance
coverage after the 60 days have elapsed, if premiums were omitted as
a result of employer payroll deduction error and all past due premiums
are paid.
Cancellation Of Coverage
You should cancel your Spouse and Dependent coverage as soon
as you no longer have a spouse or eligible dependent to insure by
filing a Life Insurance Application/Cancellation/Refusal form (ET-2304)
with your employer. If you delay filing a cancellation, a refund of your
premiums is limited to the current year and the immediately preceding
calendar year.
Beneficiary
You (the employee) are the beneficiary in the event of the death
of your spouse or dependent. In the case of simultaneous deaths of
you and your spouse or dependent child, payment will be made to
your estate.
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Payment Of Benefits At Death
Upon the death of an insured spouse or dependent, contact your
employer’s payroll and benefits office to report the death. They will
assist you in completing the proper form for reporting the death of the
insured and will submit it to Securian Financial.
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BENEFITS PAYABLE DURING YOUR LIFETIME
Living Benefits
If you are an insured person, employee, annuitant, spouse, or
dependent, you may apply to receive all or part of the value of your
life insurance coverage while still living, provided you are diagnosed
with a terminal condition caused by illness or injury and have a life
expectancy of 12 months or less.
The benefit amount must be equal to an amount provided under
a plan of insurance or a multiple of plans. You may request a Living
Benefit more than once, provided you have not exhausted all your
coverage. In no event are you allowed to claim more benefits than
the amount for which you are insured. Any value remaining at death
will be paid to your beneficiary(ies), or to you if the coverage is the
Spouse and Dependent Plan. Living Benefits may be taxable to the
recipient as regular income in the year of payment.
The amount of life insurance eligible for a living benefit payment
shall be the total amount of insurance in force on the life of the insured
on the date Securian Financial receives the application for a living
benefit payment.
An eligible insured may request the payment of a living benefit
by completing the Application for Living Benefits form (ET-2322). The
insured’s life insurance must be in force and all required premiums must
have been fully paid. Medical evidence will be requested by Securian
Financial after you file the application. Securian Financial’s determination
regarding the applicant’s eligibility for the living benefit is final.
The request for a living benefit must be voluntary. A living benefit
is not intended to cause the insured to involuntarily reduce the death
proceeds ultimately payable to the named beneficiary. Therefore:
1. If the insured is required by law to use this option to meet the
claims of creditors, whether in bankruptcy or otherwise, the
insured is not eligible for this benefit.
2. If the insured is required by a government agency to use this
option in order to apply for, obtain or keep a government benefit or
entitlement, the insured is not eligible for this benefit.
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Upon receipt of satisfactory evidence of the insured’s qualifying
condition as defined in this section, Securian Financial will pay the
living benefit to the insured subject to Wisconsin Statutes 40.08 (9) and
(9m) and applicable ETF Wisconsin Administrative Code. If the insured
dies, any remaining life insurance that remains in force will be paid to
the insured’s beneficiary.
For more information about Living Benefits, contact ETF for a
Living Benefits brochure (ET-2327) or contact Securian Financial for an
Application for Living Benefits form (ET-2323). Information can also be
found on ETF’s website at http://etf.wi.gov.
Conversion To Pay Health or Long-Term Care Insurance Premiums
If you have health or long-term care insurance through ETF and
your life insurance has been reduced to its final amount, you may elect
to use the present value of your life insurance to pay premiums for your
health or long-term care insurance. Note: Long term care coverage
through ETF is available to state employees only. To be eligible,
you must be at your final insurance reduction age as shown in the
Continuing Coverage Table in Section 14. If you are a state employee
you must also exhaust your accumulated sick leave before converting
your life insurance to pay for health insurance premiums through the
conversion program.
In exchange for payment of health or long-term care insurance
premiums, you give up the death benefit that would otherwise be
payable to your beneficiaries. You also give up the difference between
the face value and present value of your life insurance coverage. The
election is permanent and cannot be withdrawn.
Contact ETF to receive a brochure (ET-2325) about the program.
You may also obtain one on ETF’s Internet site at http://etf.wi.gov. If
you are eligible for conversion now, or will be eligible within the next 12
months, you may request an application (ET-2324). You will receive an
estimate of the amount available to you under the conversion program
along with your application form.
9
DISABILITY WAIVER OF PREMIUM BENEFIT
This benefit provides for continued coverage without further
payment of premiums for an employee who becomes totally disabled
while insured under this policy and prior to attaining age 70.
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Definition of Disability
An insured employee must be totally disabled if, as a result of
bodily injury or disease, he or she is wholly prevented from performing
any work or engaging in any occupation for remuneration or profit
and is likely to remain so disabled for an indefinite period of time.
The employee is required to submit medical evidence acceptable to
Securian Financial showing the date that total disability began or was
diagnosed and that the employee is totally disabled from any gainful
occupation and is likely to remain disabled for an indefinite period.
An employee shall also be deemed to be disabled for the purposes
of this policy if the employee has qualified for a disability annuity under
Wis. Stats. §40.63 for as long as the insured qualifies for a disability
annuity. Further proof of disability shall not be required while the
insured qualifies for disability annuity benefits.
An employee is ineligible for a waiver of premium if employment
was terminated for reasons other than disability.
Filing a Disability Waiver of Premium Claim
A claim for waiver of premium must be submitted to Securian
Financial on a form provided by ETF within 36 calendar months after the
last day for which earnings are paid. Insured employees who are on a
leave of absence are eligible to submit a claim if they become disabled
as defined in this section during the leave of absence and insurance is
in force.
If the claim is approved, the effective date of the premium waiver
will be the first of the month following the date the disability began, or
the date the employee is no longer receiving earnings or other earned
income from any gainful occupation, whichever is later.
An insured employee will be granted a waiver of premium only if
he or she becomes totally disabled as defined above while coverage
is in force at the time the disability commences and prior to age 70.
Coverage must have been in force continuously from the date of onset
of the disability to the date the waiver of premium is approved.
The employer must continue to remit premiums for employer-paid
coverage and the employee must continue to remit premium payments
for all amounts of employee-paid coverage until Securian Financial
approves the claim. Premiums that were paid after the effective date
of the premium waiver will be refunded. The insurance shall remain in
force while the premiums are waived. Insurance shall continue during
the continuance of disability even if the person insured ceases to be an
employee of a participating employer.
Except for those who qualified for a disability annuity benefit as
described above, the employee shall submit proof of disability to
Securian Financial at Securian Financial’s request. Securian Financial
shall also have the right and opportunity to have medical examiners
15
designated by Securian Financial examine the employee when and as
often as it may reasonably require during the employee’s disability,
but not more than once each year after insurance has been extended
under this section.
Amount of Insurance
During the period of disability in which premiums are waived, the
amount of insurance shall be the same as the amount of insurance
at the date of onset of the disability. If an employee’s insurance is
continued in force under this section, any Spouse and Dependent life
insurance shall also continue in force without payment of premium.
For purposes of determining the amount of post-retirement
coverage, it shall be assumed that a person insured under a waiver
or premium retires upon attainment of age 65. The amount of Basic
Insurance shall then be reduced according to the “Continuing
Coverage Table” in section 14 entitled “Maintaining Coverage After You
Terminate Employment” and in accordance with Wis. Stats. §40.72(2)
and (3). All other insurance will terminate upon the date the insured
reaches age 65 if it has not already terminated or been cancelled.
If the insured dies while waiver of premium is In effect and while
remaining continuously disabled, then upon due proof of death, Securian
Financial will pay the amount of insurance in force to the beneficiary.
Termination of a Disability Waiver of Premium Benefit
If the insured employee is receiving a disability annuity benefit
as provided under Wis. Stats. §40.63, premiums shall be waived for
all insurance under this section until the date the insured’s disability
annuity is terminated, unless the insured submits proof of disability to
Securian Financial.
However, if the insured employee attains age 65 while receiving a
disability annuity benefit, the waiver of premium ends and the insured
may qualify to be covered as provided in Section 14, “Maintaining
Coverage After You Terminate Employment”.
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If the insured is not receiving a disability annuity benefit, then
premiums shall be waived for all insurance under this section until the
earliest of:
1. The date the insured is able to return to gainful occupation; or
2. 60 days after a request by Securian Financial for an examination
or proof of disability if the insured refuses to be examined as
required above or fails to furnish proof of continued total disability,
unless it can be shown conclusively not to have been reasonably
possible to undergo such examination or to provide such proof
and Securian Financial’s request for an examination or proof is
complied with as soon as reasonably possible; or
3. The end of the month in which the employee’s insurance reduces
in accordance with the Program. If eligible, the insured may then
be covered under the Basic insurance as provided under the
Continuing Coverage Table in Section 14, “Maintaining Coverage
After You Terminate Employment.”
If the extension of insurance without payment of premiums under
this section is terminated because disability ceases, the employee
shall be entitled to the rights and benefits under the section entitled
“Conversion Privilege,” together with insurance protection during
the 31-day period allowed for conversion as if employment had then
terminated, unless during that period the insured returns to work,
continues to be on an approved leave of absence or qualifies for
continuation of insurance as provided in Wis. Stats. §40.72(4).
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COVERAGE DURING LEAVE OF ABSENCE
An insured employee may continue insurance coverage during
any approved unpaid leave of absence for up to 36 months. Insurance
coverage may be continued beyond 36 months if the approved leave is a
union service leave as provided under Wisconsin Statutes Chapter 40.
In order to continue the insurance in force during an approved
unpaid leave of absence, the employee must contact the employer
to make premium payments during the leave of absence. Premium
contributions must be paid in advance and each payment must be
received by the employer at least 31 days prior to the end of the period
for which premiums had previously been paid.
The amount of insurance for an employee on an approved unpaid
leave of absence shall be the same as that in effect immediately
preceding the approved unpaid leave of absence. Initial coverage or
increased coverage will not be available during the unpaid leave of
absence. Premium may increase due to changes in the employee’s age
or premium rates during the unpaid leave of absence.
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Insurance will lapse for employees who do not wish to continue
insurance in force or who do not make arrangements to pay premiums
during an unpaid leave of absence.
An employee who returns from a leave of absence, during which
time coverage lapsed, as an eligible employee will have 30 days to apply
for the plans and amounts in effect prior to the leave of absence except
those plans that were cancelled.
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WHILE APPEALING A DISMISSAL
You may continue your coverage after being involuntarily
discharged from your employment if you:
1. Exercise a right of appeal of your removal or discharge within 30
days after it occurs; and
2. Pay premiums to your employer during the appeal process. The
first premium payment must be made within 31 days of the date of
the removal or discharge, and must include both the employee’s
and employer’s share of the premium for a three-month period.
You must continue to pay both parts of the premium in quarterly
payments, which are due within 31 days of the last date for which
premiums have been paid.
If your appeal is successful, your employer will refund the
payments you made for the employer’s share of the premium. If the
appeal determination is adverse to you, coverage will terminate on the
last day of the month in which the determination becomes final. Any
premiums you paid for coverage after that date will be refunded to you.
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CANCELLATION
You may cancel your coverage at any time by submitting a Life
Insurance Application/Cancellation/Refusal form (ET-2304) to your
employer. Coverage will cease at the end of the month in which your
employer receives your application to cancel. You may cancel one plan
and keep the others, but if you cancel your Basic coverage, all other
coverages are automatically canceled.
Annuitants who wish to cancel coverage should contact ETF
to obtain a Life Insurance Application/Cancellation/Refusal form
(ET-2304). The form is also available on ETF’s Internet site
at http://etf.wi.gov.
If you cancel your coverage you will not be able to reinstate your
coverage. To reenroll you will need to provide evidence of insurability.
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13
TERMINATION OF YOUR INSURANCE
Your insurance will terminate on the earliest of the following dates:
1. The last day of the calendar month in which you terminate
employment with the state or a participating local government
employer if this occurs before you become entitled to a disability
waiver of premium benefit as provided under Section 9 or before
you qualify for continuation of insurance as a retiree as provided in
Section 14.
2. Thirty days after the date of expiration of an authorized leave of
absence for the period permitted in Section 10 of this booklet.
3. The last day of the calendar month in which you file a cancellation
of insurance with your employer, or ETF, if you are an annuitant.
4. The date to which your premiums are paid if you fail to pay the
required premiums within 30 days of such date while you are on
unpaid leave as provided in Section 10, or while your coverage has
continued as provided in Section 14.
5. The date to which premiums are paid for continuing coverage
provided in Section 14 after you have again become employed
by a participating employer and enroll for coverage as an
eligible employee.
6. Your 70th birthday for the Supplemental and Spouse and
Dependent Plans.
7. The effective date of termination of the group policy by
your employer.
Insurance coverage shall be considered lapsed if you fail to make
the required premium payments during a 60-day period which begins
on the day following the last day for which premiums were paid.
Unless cancelled or terminated as provided above, Supplemental
and Additional Plans shall automatically terminate on the date the
retired employee attains age 65.
Accidental Death, Dismemberment and Loss of Use coverage
will automatically terminate when an insured employee terminates
employment or attains age 70, whichever is earlier. For insureds who
retiree prior to age 65, coverage will automatically terminate at age 65.
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14
MAINTAINING COVERAGE AFTER YOU TERMINATE EMPLOYMENT
A. Continuation Of Group Coverage
You may continue your group life insurance after terminating
employment, provided you meet the following requirements:
1. Your WRS coverage began before January 1, 1990, or you have
been covered by the group life insurance plan in five calendar
years beginning January 1, 1990; and
2. You qualify under one of the following situations:
a. You are receiving an immediate WRS annuity or meet all of the
requirements for receiving an immediate WRS annuity except
the filing of an application; or
b. The sum of the years of your creditable service in the WRS on
January 1, 1990 plus your years of group life insurance coverage
after 1989 equals 20 years; or
c. You have 20 years of service on payroll with your last employer.
If you begin a WRS annuity within 31 days after your coverage
terminates, your insurance will be continued for you automatically.
Premiums will be deducted from your annuity. If you do not begin an
annuity, you must file a Continuation Application (ET-2154) with ETF
within 31 days of the date coverage terminates. Securian Financial will
bill you directly for your premiums.
If you participate in your employer’s private pension plan, you may
continue your group insurance after terminating employment provided
you have 20 years of service with your last employer.
If You Terminate Before Age 65
The amount of your insurance will be the same as prior to
termination or retirement. Premiums are calculated in the same manner
as before and will automatically be deducted from your retirement
annuity check, or you will be billed directly by Securian Financial.
The Basic insurance will continue after age 65 without cost to
you, subject to the Continuing Coverage Table below. However, the
Accidental Death, Dismemberment and Loss of Use coverage as well
as any Supplemental and Additional insurance coverage will terminate
at age 65. Spouse & Dependent coverage will terminate at the end of
the month that your employment ends.
If You Terminate At Age 65 Or Later
Your Basic insurance coverage will continue in a reduced amount
for life, without cost to you, if you retire at age 65 or later.
The amount of Basic insurance is shown on the Continuing
Coverage Table below. Your Supplemental, Spouse & Dependent, and
Accidental Death, Dismemberment and Loss of Use coverages will
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terminate at the end of the month in which you retire, or attain age 70,
whichever is earlier. Your Additional insurance will terminate when you
terminate employment, cancel coverage, or stop paying premiums,
whichever is earliest.
Continuing Coverage Table
Age Percent of Basic Coverage Continuing
Before age 65 100%
While age 65 75%
While age 66 50%
While age 67 and after 25%*
* Applies only to employees of local government employers. Local government
employers may, however, elect a continuation of 50 percent of the Basic coverage if
they agree to make the increased employer contributions. State employee coverage
continues at the 50 percent rate from age 66 and after.
B. Conversion To An Individual Policy
If your insurance is terminated under (1) or (2) of Section 13,
“Termination Of Your Insurance,” and you are not eligible to continue
group coverage, you may apply for an individual policy with Securian
Financial. However, you must have been insured for the entire six
months preceding termination of coverage.
No evidence of insurability is required if the following terms are met:
1. You apply for individual coverage that is less than or equal to the
amount of group insurance coverage you had.
2. You apply for the individual policy on a form provided by Securian
Financial and pay the first premium within 31 days after your group
insurance coverage terminates.
Any spouse or dependent who is insured continuously for the
entire six months preceding termination of coverage may apply to
convert coverage to an individual policy with Securian Financial. The
individual policy will be issued without evidence of insurability subject
to the terms of this section. When termination of coverage is due to the
death of the insured employee, written application and payment of the
first premium must be received by Securian Financial within 90 days of
the employee’s death.
Insurance under the individual policy shall become effective at the
end of the 31-day period during which application for the individual
insurance may be made, provided the above terms are met. If the
insured dies during that 31-day period, Securian Financial will pay your
beneficiary the maximum amount of insurance for which the individual
policy could have been issued, regardless of whether or not you
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actually applied for conversion or paid the first premium.
The individual policy is a type currently issued by Securian
Financial but cannot be term insurance. This policy will not include a
Waiver of Premium or Accidental Death and Dismemberment benefit.
Application forms for this conversion (ET-2306) are available from
your employer, on ETF’s internet site at http://etf.wi.gov, or Securian
Financial. Failure to obtain an application for conversion does not
extend the conversion period.
15
BENEFICIARY
Beneficiaries shall be determined in accordance with Wisconsin
Statutes §40.02(8) and §40.74. You may designate a beneficiary or
change your beneficiary at any time by completing a form provided by
ETF. Separate Beneficiary Designation forms (ET-2320) may be filed
for WRS retirement and life insurance benefits. Benefits will be paid
according to the last Beneficiary Designation on file with ETF at the
time of your death. It is important to keep a copy of your Beneficiary
Designation form and review it periodically. It is your responsibility
to maintain a current and accurate Beneficiary Designation on file
with ETF. If you do not designate a beneficiary or if the designated
beneficiaries are not living at the time of your death, the sequence of
beneficiaries will be as follows:
1. Surviving spouse or surviving domestic partner. (“Domestic Partner”
means a person who meets the definition of domestic partner in
Wis. Stats. §40.02(21d) and for whom the employee has submitted
an Affidavit for Domestic Partnership form (ET-2371) with the
Department of Employee Trust Funds before September 23, 2017.)
2. Children of the deceased participant, employee, or annuitant, in
equal shares, with the share of any deceased child payable to the
issue of the child or, if there is no surviving issue of a deceased
child, to the other eligible children in this group or, if deceased,
their issue.
3. Parent, in equal shares if both survive.
4. Brother and sister in equal shares, and the issue of any deceased
brother or sister. No payment may be made to a person included
in any group if there is a living person in a preceding group.
5. Estate.
Contact ETF to obtain a Beneficiary Designation form (ET-2320). A
Beneficiary Designation form can also be found on ETF’s Internet site,
at http://etf.wi.gov.
See Section 7 for beneficiary information for Spouse and
Dependent coverage.
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16
PAYMENT OF THE BENEFIT AT DEATH
Notify ETF at the time of an insured member’s death. That
information will be forwarded to Securian Financial so that the
appropriate claim forms can be sent. Securian Financial will send claim
forms to the beneficiary(ies) and will request a death certificate and
other documents Securian Financial deems necessary to consider a
claim for payment. Benefits will be paid as shown under Section 15.
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HOW YOUR BENEFITS ARE TAXED
Group Term Life Insurance
Under section 79 of the Internal Revenue Code, if the total value of
your group life insurance provided through your employer(s) exceeds
$50,000, you may be liable for income tax on “imputed income.” The
imputed income should be reported by your employer on your W-2 and
is equal to:
the total “uniform premium” set by the IRS for all group term
life insurance in excess of $50,000, which is provided through
your employer(s),
minus
the total premiums for all group life insurance coverage that
you paid with after-tax dollars (i.e., not through a tax-sheltered
or cafeteria plan).
Death Benefits
Death benefits paid by your life insurance are not taxable by the
State of Wisconsin. For federal tax purposes, you should consult with a
tax advisor.
Life insurance proceeds that you receive as a result of the death of
your spouse or dependent are not taxable to you and are not included
in the deceased person’s estate.
For more information about tax treatment of group term life
insurance and death benefits, please consult with a tax professional.
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18
FREQUENTLY ASKED QUESTIONS ABOUT YOUR
GROUP LIFE INSURANCE
How much coverage is available?
State employees may apply for insurance coverage on their own
lives from the plans below. The maximum amount of insurance is 5
times their prior year earnings. For local government employees,
the insurance coverage available depends on which plans the
employer offers.
• The Basic Plan = 1 times earnings.
• The Supplemental Plan = 1 times earnings.
• The Additional Plan = 1, 2, or 3 times earnings.
Employees may also apply for 1 or 2 units of coverage for
their spouse and dependents, if your employer offers Spouse and
Dependent coverage. Each unit provides $10,000 of coverage for a
spouse and $5,000 for each dependent child.
All employees (both state and local government) must elect Basic
coverage in order to elect Supplemental, Additional, or Spouse and
Dependent coverage. Coverage on the life of an employee includes
Accidental Death, Dismemberment and Loss of Use benefit.
How are earnings determined?
Earnings are your wages and salary paid to you by your employer
who participates in this life insurance program as provided in Wis.
Stats. §40.02(22). For employees covered by a private pension plan,
earnings means taxable compensation as reported to the Internal
Revenue Service.
What are the requirements for coverage to be in effect?
There are two requirements for coverage to be in effect: 1) a valid
application must be on file with the Department of Employee Trust
Funds; and 2) premiums must be paid when due.
What coverage do I have?
If you are an eligible insured employee, your employer can tell you
what coverage you have. You are responsible for checking your payroll
deductions and statements of benefits to be sure that appropriate
premiums are being deducted, because coverage lapses after 60 days
if premiums are not paid. Inactive or retired employees may contact the
Department of Employee Trust Funds (ETF) with questions regarding
coverage or premiums.
24
How can I add more coverage?
If you do not enroll for all available coverage when you were
eligible, you can apply for any of the remaining coverage offered by
your employer by submitting an evidence of insurability form. You
must be an eligible employee in order to apply for insurance and for
insurance to take effect.
Does the policy build cash value?
This is term insurance that does not accumulate cash value.
Persons with terminal medical conditions may qualify for Living
Benefits. Retired employees who have an ETF-sponsored health
insurance plan may convert the value of their life insurance coverage
to pay premiums for health insurance. Retired state employees may
also convert the value of their life insurance coverage to pay for ETF-
sponsored long-term care insurance. See Section 8.
Can I increase coverage if I have a family status change?
You may enroll for Basic coverage, increase your coverage by one
level, or enroll in one or two units of Spouse & Dependent coverage
(subject to the plans that are made available by your employer) if
you have a qualifying family status change due to marriage, or birth,
adoption, placement for adoption, or award of legal guardianship of a
dependent child. See the Enrollment Section of this booklet for more
information.
What if I take a leave of absence without pay from my job?
You may continue your coverage during an approved leave of
absence by paying premiums to your employer in advance. Otherwise,
coverage will lapse and you will only be eligible to reapply for coverage
if and when you return to work. Upon return to work, you may enroll
without evidence of insurability for the plans you had prior to your
leave, if you apply within 30 days of your return to work.
Leave of absence means the same as “leave of absence” as
prescribed in Wis. Stats. §40.02(40) but excluding the group health
insurance portion of the definition. This also includes temporary layoffs
as defined under the applicable collective bargaining agreement or
Wisconsin Administrative Code.
What are my options for reinstating coverage or reenrolling in coverage
that I cancelled?
If you cancel your coverage, you will not be able to reinstate or
reenroll without evidence of insurability. There are no exceptions.
25
What if I become disabled?
If you go on unpaid medical leave or terminate employment due to
a disability which is total and permanent or of unknown duration, you
may file a claim to continue your coverage without making premium
payments. Contact your employer to obtain more information about
submitting a Request for Disability Premium Waiver form (ET-5306).
Can I keep this insurance if I change jobs or retire?
If you move to a different participating Wisconsin public
employer, you will be eligible to enroll for coverage at your new job.
If you meet certain service requirements, you may keep your group
coverage after you retire or terminate employment. For purposes
of this life insurance program, termination of employment means
the same as prescribed under ETF 10.08 (2) and (3). Most coverage
terminates when you reach age 65 (or age 70 if you are still working),
but a reduced amount of Basic coverage will continue for your
lifetime if you meet the service requirements.
Even if you do not meet the requirements to continue group
coverage, you will be eligible to convert your coverage to an individual
policy with Securian Financial, if you are insured for the six full months
before group coverage ends. Coverage for your spouse or dependent
child can also be converted.
What is an example of the insurance coverage?
Previous calendar year earnings = $53,200
Coverage Doubles
Coverage In Case of Accidental Death
Basic Plan coverage
for the current year $54,000 $108,000
Supplemental Plan $54,000 $108,000
Additional Plan - Unit 1 $54,000 $108,000
Additional Plan - Unit 2 $54,000 $108,000
Additional Plan - Unit 3 $54,000 $108,000
TOTAL COVERAGE $270,000 $540,000
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How is the insurance premium calculated?
Premiums for coverage are set annually by the Group Insurance
Board and are based on your age. Contact ETF, your employer or
Securian Financial for current premium rates. Rates (ET-2164) may also
be found on ETF’s Internet site at http://etf.wi.gov.
Note:
• The cost of Spouse and Dependent coverage is a dollar amount for
each unit of coverage, regardless of the age or number of family
members you have to insure.
• Your employer contributes premium for the Basic Plan, and in
some cases, the Supplemental Plan.
• No premiums are required for retired employees over age 65.
Example: A state employee is age 36 and earned $53,200 last
year. She is enrolled for Basic, Supplemental and 3
units of Additional coverage, plus two units of Spouse
and Dependent coverage. Her coverage is $54,000 x 5
= $270,000.
Her monthly premium is:
Basic 54 x $0.04* = $2.16
Supplemental 54 x 0.04 = 2.16
Additional – Unit 1 54 x 0.06 = 3.24
Additional – Unit 2 54 x 0.06 = 3.24
Additional – Unit 3 54 x 0.06 = 3.24
Spouse and Dependent 5.00
Total Employee Premium $19.04
Her employer pays:
Basic 65.25%** x $2.16 = $1.41
Supplemental 37.25% x 2.16 = 0.80
Total Employer Premium $2.21
*Premium rates used in the example are for illustrative purposes only
and may not be actual.
**The percentage of the employer contribution used in the example is
for illustrative purposes only and may not be actual. See section 5 for
more information about the employer’s cost.
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When will the policy pay benefits?
Death benefits for Basic, Supplemental and Additional Plans are
payable to your beneficiary upon your death if coverage is in force on
the date of death.
Death benefits from the Spouse and Dependent Plan are payable
to you upon the death of the person insured under the Spouse and
Dependent Plan.
Accidental Death, Dismemberment and Loss of Use benefits apply
to the Basic, Supplemental and Additional Plans during employment
They are payable upon your death or covered accident. Some
exclusions may apply. See Section 6 for more information.
For benefits payable during your lifetime, including Living Benefits,
see Section 8 for more information.
You or your beneficiary must file a claim with Securian Financial to
claim any benefits under the Program and the claim must be approved
by Securian Financial before payment is made.
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Contact ETF
etf.wi.gov
Find ETF-administered benets information, forms,
brochures, benet calculators, educational offerings
and other online resources. Stay connected with:
1-877-533-5020
608-266-3285 (local Madison)
7:00 a.m. to 5:00 p.m. (CST), Monday-Friday
Benet specialists are available to answer questions.
Wisconsin Relay: 711
P.O. Box 7931
Madison, WI 53707-7931
Write ETF or return forms.
@wi_etf
ETF E-Mail Updates
29
F57185 Rev 12-2019
