WISCONSIN STATE EMPLOYEES GROUP ENROLLMENT FORM: Fill out & sign online

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out WISCONSIN STATE EMPLOYEES GROUP ENROLLMENT FORM with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the WISCONSIN STATE EMPLOYEES GROUP ENROLLMENT FORM in the editor.
Begin by filling out the 'Reason for Submitting Application' section. Select the appropriate option such as '30 DAYS' or 'TRANSFER' and provide your Customer Number.
In the 'Information about You' section, enter your last name, first name, middle initial, address, date of birth, sex, home phone number, and social security number.
Next, complete the 'Information about Your Family' section if applicable. Indicate coverage requested for yourself, spouse/domestic partner, or children.
For each dependent listed, provide their date of birth, gender, social security number, relationship to you, disability indicator, taxable dependent status, and student status.
Fill out the 'Information about Other Coverage' section by indicating any existing health insurance plans and Medicare coverage details.
Finally, review all information for accuracy before signing and dating the application at the bottom of the form.

Start using our platform today to easily fill out your WISCONSIN STATE EMPLOYEES GROUP ENROLLMENT FORM online for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Contact us

What is the major disadvantage of group health insurance?

A docHub drawback of group insurance plans is the limited flexibility they offer employees. Because group plans are designed to cover a broad range of individuals with varying healthcare needs, they may not meet each employees specific requirements.

What health insurance plan do state employees have in Wisconsin?

State Employees. Active state employees have a choice of either the Its Your Choice (IYC) Health Plan or High Deductible Health Plan (HDHP). No matter which plan design option you choose, the same in-network services are covered. The main difference are the premiums and how much you pay when you visit a provider.

Is group health insurance worth it?

Group benefits are usually the best deal, because everyone has to pay in, even the low risk ones. If everyone has to pay, the premiums are usually very low, because the few who end up costing the system a lot of money are more than balanced out by the vast majority who cost the system next to nothing.