Plan Overview

Description: The plan provides up to 75% of gross wages as replacement income if you become disabled.  Benefits begin after a selected waiting period (minimum of 30 consecutive calendar days) or use of accumulated sick leave (up to 130 days), whichever is longer.  There are two coverage levels: Standard ICI covers earnings up to $64,000; Supplemental ICI covers earnings from $64,001 to $120,000.

Premiums

• Premiums for Standard and Supplemental Coverage by Employee Category

Learn More

• Income Continuation Insurance
• Income Continuation Insurance (ICI) - ETF Overview
• Filing for ICI Benefits, ET-5106
• Sick Leave Use During Summer & Income Continuation, UW1050

Administered by

WI Department of Employee Trust Funds (ETF)

Vendor

Aetna

Send questions to: benefits@ohr.wisc.edu

Publications

Income Continuation Insurance, ET-2106

Forms

Note: Use Adobe Reader to open and complete PDF forms.
MAC Users: Do not use "Preview", a PDF reader.

Application | Submit to your Payroll & Benefits Office

Evidence of Insurability | Submit to ETF

Evidence of Insurability, ET-2308
If you do not enroll for ICI coverage when you are first eligible, you can enroll only by completing an Evidence of Insurability application.

Sick Leave Usage | Submit to the Office of Human Resources, 21 N. Park St., Suite 5101

Sick Leave Usage Election at Time of Claim, UW1456
Complete this form only if you are applying for a WRS Disability annuity, an LTDI benefit, or a § 40.65 Duty Disability benefit from the Department of Employee Trust Funds at the same time that you are applying for Income Continuation Insurance benefits.