Documents & Forms

General Information

• View documents on the Wisconsin Department of Employee Trust Funds (ETF) website
• It's Your Choice Insurance Publications
• HealthSense Rewards™ Member Discount Program
• WPS Referral Authorization Request
• Letter on SMP Referral Process
• Home Attendance Care Claim Form

Preauthorization Forms

• Inpatient Pre-Certification Guidelines
• Outpatient Preauthorization Guidelines
• Medical Preauthorization Request Form

2010 Network Materials

Network Tip Sheets: Plan Year 2010

• SMP Network Tip Sheet - Plan Year 2010
• SMP Network Tip Sheet Wisconsin Public Employers(WPE) - Plan Year 2010
• Metro Choice Tip Sheet - Plan Year 2010

Dental

• State of Wisconsin Metro Choice Network Dental Plan for Plan Year 2010

WPS Provider Directories: Plan Year 2010

• State Maintenance Plan (SMP) - 2010 Directory
  
• State PPO Directory Statewide - Eastern - 2010 Directory
  
• State PPO Directory Statewide - Western - 2010 Directory
• Metro Choice Provider - 2010 Directory
  

Optional Plans

• Plan Year 2010
  EPIC Supplemental Benefit Plan Designed Exclusively for State of Wisconsin Employees (Dental, Excess Medical, and AD&D)