Employer Forms

Employees initiate an appeal/rescind for their benefit plans electronically by following the steps provided in the Appeals Guide. The deadlines for 2022 Annual Benefits Enrollment appeals/rescinds are as follows:

  • Rescinds (for all plans listed in the next three bullet points): December 31, 2021
  • Flexible Spending Accounts (Health Care and Dependent Day Care): January 31, 2022
  • Supplemental Insurance Plans (Dental, Vision, Accident): February 28, 2022
  • State Group Health Insurance, Uniform Dental Insurance, and Health Savings Accounts: April 15, 2022

Employees may appeal only if they were actively employed with the UW System during the ABE period.

  • Notice of Eligibility and Rights & Responsibilities (UWS 81) pdf - This form must be provided to an employee within 5 business days of an employee’s request for a WFMLA and/or FMLA-protected leave; or within 5 business days of learning an employee is eligible for coverage by WFMLA and/or FMLA.
  • Designation Notice (UWS 86) pdf - This form must be provided to the employee who has requested a WFMLA and/or FMLA-protected leave to let the employee know if the leave is approved and/or if the employee needs to submit any additional information before the leave can be approved.
  • HIPPA Authorization pdf - Complete this form if you (the employer) needs to obtain medical information directly from the health care provider.

ETF requires online submission of Sick Leave Conversion Credits through the online Accumulated Sick Leave System in the 'myETF Benefits Administrator' system. The online sick leave certification process provided through ETF’s system must be used for all employees. To request access review ETF Online Tools - Requesting Access pdf .

Additional Information and Tools



  • Sick Leave Credit Conversion Program Training - Webinar series available for viewing anytime. Registration required. Published by ETF.
    • Module 1 - Provides an overview of the sick leave program, eligibility requirements and sick leave conversion credit calculations.
    • Module 2 - Discusses employer and employee responsibilities, and when employers are to certify sick leave for their employees.
    • Module 3 - Explains rehired annuitants, sick leave escrow, the sick leave re-enrollment process and what happens to a member’s sick leave in the event of death.
    • Module 4 - Resources to assist employers helping employees considering terminating employment and the Q & A from the Sick Leave Credit Conversion Program in-person employer training.

Information including a list of frequently asked questions and the application can be found on the WRS-Single Payroll Transition Program web page.

Review the WRS-Single Payroll Transition Program - HR Administrative Processes pdf for information on program responsibilities.

To schedule an Edvest workshop on your campus, contact the Wisconsin Department of Financial Institutions (DFI) College Savings Program Representatives:

Updated: 08/27/2020