BenefitsETF - Wisconsin Department of Employee Trust FundsWisconsin Department of Employee Trust FundsETFDOR Estates, Trusts and FiduciariesReference 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with the Applicant Information section. Fill in your name, contact details, and check if any information has changed. Ensure all fields are completed clearly.
3. If applicable, provide Spouse Information by entering their details. Check for any changes in their information as well.
4. In the Dependent Information section, list any dependents you wish to add or cover under your plan. Include their primary care physician if necessary.
5. Select the reason for application in Section 4. This could be due to open enrollment or a life event change. Make sure to specify dates where required.
6. Choose your health plan options in Section 5 and ensure you understand the coverage levels and benefits available.
7. Complete the signature section at the end of the form, confirming that all information is accurate before submitting it back to your employer.

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