You have thirty days from the date of divorce decree to remove a dependent from your insurance. Forms must be completed and submitted to HR via fax: (608) 263-5778 or attached to an Ask HR case in ServiceNow.
If you are losing insurance coverage through your former spouse’s plan, you will need to submit proof of loss of coverage and provide a copy of your member ID card, along with the applicable insurance enrollment forms.
In order to enroll in a benefit as a result of loss of coverage from your former spouse, you will need to have lost similar coverage through their plan. Any questions regarding this can be directed to (608) 263-6500.
Health and Uniform Dental Insurance
To change your health insurance from family to single and/or remove a dependent, you must submit a completed Health Insurance Application/Change Form to make that change.
- Health Insurance Application/Change Form
- More information on Health and Uniform Dental Insurance, including premiums, coverage, etc.
The form needs to be completed and submitted to HR within 30 days from the date of divorce decree. Your spouse is removed from your insurance at the end of the month in which HR sends them out a COBRA offering.
There are other benefits an employee can change due to a qualifying life event. Below is a list of benefits an employee could change, if eligible. Refer to Employee Self Service to review your benefit eligibility. If interested in changing, please complete the appropriate form and contact Human Resources at (608) 263-6500.
These forms need to be completed and submitted to HR within 30 days from the date of divorce decree. If you are removing a dependent as a result of the divorce, benefits will be terminated the first of the month following the date of divorce decree. If you are newly enrolling in coverage as a result of this qualifying event, your benefits will begin the date current coverage ends.
State Group Life Insurance
If removing your spouse will change your life insurance coverage (cancel spouse/dependent coverage), you will need to submit a new State Group Life application indicating the change. If you have other dependents covered by State Group Life Insurance, you do not want to cancel your Spouse/Dependent coverage. The form must be received by Human Resources within 30 days from the date of divorce decree.
Supplemental Life Insurance
If removing your spouse will change your life insurance coverage (cancel spouse/domestic partner coverage) for any of the following life insurances, you should submit an application to cancel that coverage. The form(s) must be received by Human Resources within 30 days from the date of divorce decree.
If you wish to change your beneficiary on file for your life insurance and/or retirement plan savings account, you will need to complete the required beneficiary forms:
- Wisconsin Retirement System
- This form also updates your State Group Life beneficiaries and should be submitted directly to ETF
- Accidental Death and Dismemberment
- Wisconsin Deferred Compensation
- This form should be submitted directly to WDC
- Tax Sheltered Annuity – 403(b) Plan
- To update your beneficiary with your 403(b) plan, contact the provider of your plan directly to make the update
For UW Employees, Inc. and Supplemental Life Insurance, call Securian at (608) 277-8690.
Please note: In the State of Wisconsin, your spouse must be listed as your 100% primary beneficiary, unless you submit a completed spousal consent form.
Often when employees go through a divorce, they are required to separate the balance of their retirement accounts through a Qualified Domestic Relations Order (QDRO). If there is a QDRO applicable to your retirement account through the Wisconsin Retirement System (WRS), contact ETF directly at (608) 266-3285. For your Tax Sheltered Annuity (TSA) account, contact the vendor that your account is currently through. For the Wisconsin Deferred Compensation Program (WDC), call (877) 457-9327 and ask to be transferred to the QDRO department.