Retirees who were employed by an employer that participates in the State of Wisconsin Employee Trust Fund may be eligible for additional retiree health insurance coverage options. The Wisconsin Department of Employee Trust Funds (ETF) provides retirement, insurance, disability, and other Wisconsin Retirement System benefits for current and former public employees, retirees, and their beneficiaries. Questions about your benefits from ETF qualified employment can be directed to ETF (Contact).
Accumulated Sick Leave Credit Program
The Wisconsin Employee Trust Fund's (ETF) Accumulated Sick Leave Credit Conversion Program allows state employees to convert unused sick leave to credits to pay for health insurance during their retirement. Along with health insurance premiums, these credits can be used to help pay for pharmacy and optional Uniform Dental benefits. Sick leave credits can only be used to pay for health insurance premiums in the State of Wisconsin Group Health Insurance Program. Credits cannot be cashed out or otherwise converted to pay for other benefits.
If eligible, unused sick leave credits can be used to pay post-termination state group health insurance premiums for the former state employee, their spouse and/or dependents. The premiums will automatically be paid from your sick leave credit account.
What Accumulated Sick Leave Credits Cannot Do:
Be cashed out,
Pay for Medicare Part B premiums,
Be split into two accounts if you get divorced,
Transfer to another person (unless you pass away),
Pay for health insurance that is not part of the State Group Health Insurance Program,
Pay for supplemental benefits, or
Earn interest
Considerations When Leaving Retiree Group Coverage
Leaving ETF Retiree Group Coverage to elect different Medicare coverage, including a Medicare Supplement Policy, Medicare Advantage Plan, and/or Medicare Prescription Drug Plan may present challenges to beneficiaries. The first important consideration that a beneficiary and ETF annuitant should consider is their ability to choose between a Medicare Advantage Plan and a Medicare Supplement policy. Depending on an annuitant's situation, they may not have guaranteed issue rights to purchase a Medicare Supplement Policy without health underwriting due to leaving ETF Retiree Group Coverage. An annuitant should also consider the out-of-pocket cost differences between ETF Retiree Group Coverage and a "marketplace" Medicare Advantage Plan.
Medicare Supplement Guaranteed Issue Implications:
Leaving an ETF Retiree Group Plan (RGP) voluntarily does not qualify as a guaranteed issue period to purchase a Medicare Supplement Policy without health underwriting. An ETF annuitant using up all of their sick leave credits and choosing to leave an ETF RGP is not considered an involuntary loss of employer-sponsored coverage. However, there may be other ways to obtain guaranteed issue protections to purchase a Medicare Supplement Policy without health underwriting.
Loss of Creditable Coverage Special Enrollment Period (Medicare Advantage and Part D):
Beneficiaries who end their employer-sponsored coverage (including an ETF Retiree Group Plan) have a special enrollment period to enroll in a Medicare Advantage or Medicare Prescription Drug Plan. This special enrollment period ends two months after the month the employer-sponsored coverage ends. The loss of employer-sponsored coverage can be either voluntary or involuntary to qualify for this special enrollment period.
Resources
A webpage that includes an overview of health benefit for applicable ETF retirees.
ETF Accumulated Sick Leave Credit Program EligibilityA webpage that provides an overview of the sick leave credit program at ETF and the eligibility requirements.