{"id":378,"date":"2014-11-06T14:56:44","date_gmt":"2014-11-06T20:56:44","guid":{"rendered":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/?page_id=378"},"modified":"2026-04-13T15:03:09","modified_gmt":"2026-04-13T20:03:09","slug":"guideline-documents","status":"publish","type":"page","link":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/guideline-documents\/","title":{"rendered":"Guideline Documents"},"content":{"rendered":"\n\t\t\t\t\t<div id=\"cfct-build-378\" class=\"cfct-build grid\">\n\t\t\t\t\t\t<div class=\"row\"><div class=\"col-md-3 cfct-block\">\n\t\t\t<div class=\"cfct-module cfct-supplemental\">\n\t\t\t\t    <div class=\"cfct-mod-content\">\n    <nav class=\"widget widget_meta\" >\n\n        <div class=\"menu-cfct-module-8328c2643cb9484d5f3038fff0a623dd-container\"><ul id = \"menu-benefits-administration\" class = \"menu nav\"><li id=\"menu-item-418\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-418\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/\">Overview<\/a><\/li>\n<li id=\"menu-item-400\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-400\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/administration-manuals\/\">Administration Manuals<\/a><\/li>\n<li id=\"menu-item-1752\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1752\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/abeinfo\/\">Benefits Open Enrollment Information<\/a><\/li>\n<li id=\"menu-item-402\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-402\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/contacts\/\">Contacts<\/a><\/li>\n<li id=\"menu-item-3425\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3425\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/formpubs\/\">Employer Forms<\/a><\/li>\n<li id=\"menu-item-404\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-404\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/employment-changes\/\">Employment Changes<\/a><\/li>\n<li id=\"menu-item-405\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-405\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/family-changes\/\">Family Changes<\/a><\/li>\n<li id=\"menu-item-409\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-409\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/guideline-documents\/\">Guideline Documents<\/a><\/li>\n<li id=\"menu-item-417\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-417\"><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/benefits\/newemp\/\">New Employees<\/a><\/li>\n<\/ul><\/div>    <\/nav>\n<\/div>\n\n\t\t\t<\/div><\/div><div class=\"col-md-9 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><div id=\"toc\" class=\"uwsa-toc callout hidden-print\"><\/div><style>@media (min-width: 768px) {#toc { max-width: 40%} <\/style><script>jQuery(document).ready(function() {\n \t\t\t\t\tgenerateTOC(\"Guideline Documents\", \"\", \"div.entry-content\" ,1 ,\"true\", \"toc\");\n \t\t\t\t\t });<\/script>\n<h2>Overview<\/h2>\n<p>Below are resources for benefits administrators to use when counseling employees.<\/p>\n<h2>Administrator Resources<\/h2>\n<ul>\n<li>Benefits Billing\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/benbillcoveragelapse.pdf\" target=\"_blank\">Benefit Billing - Process with Coverage Lapse Contract Provisions Chart (UWS-300)<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/li>\n<li>Employer Error\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/employererror.pdf\" target=\"_blank\">Employer Error - Institution Process & Form<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/li>\n<li>Graduate Assistant \/ Short-Term Academic Staff Benefits Package\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/gradhealth.pdf\" target=\"_blank\">Graduate Assistant \/ Short-Term Academic Staff Benefits Package Decision Tree<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/li>\n<li>\u00a0Leave\/Disability\n<ul>\n<li>Enrollment Verification &#8211; To verify enrollment in the Income Continuation Insurance Program before submitting a claim, employees can sign into My Insurance Benefits to review their benefit enrollments or reach out to their benefits contact. The Hartford (plan administrator) does not maintain ICI enrollment information.<\/li>\n<li><a href=\"http:\/\/etf.wi.gov\/members\/benefits_disability_ins.htm\" target=\"_blank\" rel=\"noopener\">Disability Benefits Overview<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/disability.pdf\" target=\"_blank\">Disability Chart<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/40.63-Instructions.pdf\" target=\"_blank\">Disability Retirement Program (40.63) Employer Statement (ET-5607) Instructions<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/et11190pdf\/download?inline=\" target=\"_blank\" rel=\"noopener\">Income Continuation Insurance (ICI) Eligibility &amp; Premium Rules Table<\/a> (Refer to Appendix A)<\/li>\n<li><a href=\"https:\/\/uwservice.wisconsin.edu\/administration\/ici\/\" target=\"_blank\" rel=\"noopener noreferrer\">Income Continuation Insurance (ICI) Administrator Landing Page<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/ici-summerbreak.pdf\" target=\"_blank\">Income Continuation Insurance (ICI) Elimination Period for Employees during Summer Break<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/attendee.gototraining.com\/r\/6577508738374317826\" target=\"_blank\" rel=\"noopener\">Income Continuation Insurance webinar<\/a>\u00a0(<span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/ICI-webinar.pdf\" target=\"_blank\">Income Continuation Insurance (ICI) Presentation<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n)<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/LTDI-webinar.pdf\" target=\"_blank\">Long Term Disability (LTDI) Presentation<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/li>\n<li>Opt-Out Incentive\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/ben\/resources\/optoutprocess.pdf\" target=\"_blank\">Opt-Out Incentive Business Process<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/li>\n<li>Spending &amp; Savings Accounts\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/fsachart.pdf\" target=\"_blank\">Flexible Spending Accounts Chart by Life Event<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/download\/CIPguideUWS.pdf\" target=\"_blank\">HSA Customer Identification Program (CIP) Process Guide - UW System<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>Plan Group or Policy Numbers<\/h2>\n<table style=\"width: 1092.08px\">\n<tbody>\n<tr>\n<td style=\"width: 545px\"><strong>Plan<\/strong><\/td>\n<td style=\"width: 545.078px\"><strong>Group or Policy Number<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">ETF Employer ID Number<\/td>\n<td style=\"width: 545.078px\">0001-131<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">State Group Health Insurance<\/td>\n<td style=\"width: 545.078px\">differs based on insurance carrier<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">Pharmacy Benefits<\/td>\n<td style=\"width: 545.078px\">83445<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">Dental Insurance<\/td>\n<td style=\"width: 545.078px\">50316-001 (Uniform Dental) OR 50120-003 (Preventive)<\/p>\n<p>50119-003 (Select Plan) OR 50319-003 (Select Plus Plan)<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">Vision Insurance<\/td>\n<td style=\"width: 545.078px\">2025: 1029058<\/p>\n<p>2026: 268973-1-G<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">State Group Life Insurance<\/td>\n<td style=\"width: 545.078px\">2832-G\/ Billing Unit #: 285<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">Individual\u00a0&amp; Family Life Insurance<\/td>\n<td style=\"width: 545.078px\">32871-G<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">Accidental Death &amp; Dismemberment Insurance<\/td>\n<td style=\"width: 545.078px\">GTU 8364005<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 545px\">Accident Insurance Plan<\/td>\n<td style=\"width: 545.078px\">76038<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><strong>Lump Sum Default Hourly Rate<\/strong><\/h2>\n<p>To track creditable service, hours are reported to the Wisconsin Retirement System (WRS). If an employee is paid on a lump sum basis, WRS creditable hours need to be determined.<\/p>\n<p>If an employee receiving a lump sum payment has another position in the same employment category (not job title), the rate from that similar position is divided into the lump sum payment to determine the number of WRS creditable hours. If there are multiple positions in the same employment category, the lowest hourly rate will be used. Hourly rates are calculated by dividing the annual rate by 2080 hours, regardless of the employment category and pay basis. If the employee <strong>does not<\/strong> have a position in a similar employment category, then the WRS lump sum default hourly rate will be divided into the lump sum payment to determine the number of WRS creditable hours.<\/p>\n<p>At the beginning of each fiscal year, an hourly rate is determined which is used when there is not an active similar position. Below the lump sum default hourly rates for the last five years are listed. For more information on calculating WRS credit review section I of <a href=\"https:\/\/www.wisconsin.edu\/uw-policies\/uw-system-administrative-policies\/salary-fringe-benefit-calculations-2\/\" target=\"_blank\" rel=\"noopener\">UW System Administrative Policy 230 (formerly F29) Salary &amp; Fringe Benefit Calculations<\/a>.<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>Effective Date<\/strong><\/td>\n<td><strong>Lump Sum Default Hourly Rate (for WRS Purposes)<\/strong><\/td>\n<\/tr>\n<tr>\n<td>July 1, 2025<\/td>\n<td>$36.28<\/td>\n<\/tr>\n<tr>\n<td>July 1, 2024<\/td>\n<td>$34.14<\/td>\n<\/tr>\n<tr>\n<td>July 1, 2023<\/td>\n<td>$32.91<\/td>\n<\/tr>\n<tr>\n<td>July 1, 2022<\/td>\n<td>$31.81<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module cfct-lastupdate\">\n\t\t\t\t<div class=\"listing-module\"><p><span class=\"item-date\">Updated: 04\/13\/2026<\/span><\/p><\/div>\n\t\t\t<\/div><\/div><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":20,"featured_media":0,"parent":161,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-378","page","type-page","status-publish","hentry","cfct-can-haz-build"],"_links":{"self":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/pages\/378","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/comments?post=378"}],"version-history":[{"count":7,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/pages\/378\/revisions"}],"predecessor-version":[{"id":3628,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/pages\/378\/revisions\/3628"}],"up":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/pages\/161"}],"wp:attachment":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/admin\/wp-json\/wp\/v2\/media?parent=378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}