Wisconsin Administrative Code › Department of Employee Trust Funds › Chapter ETF 11 - Appeals › Section ETF 11.02 - Definitions

Current through June 24, 2024
Words, phrases and terms used in this chapter have the same
				meanings as set forth in s.
				40.02, Stats., and s.
				ETF
				10.01, except as defined in this chapter or where the
				context clearly indicates a different meaning. In this chapter:
(2) "Administrative agent" means a person who
			 has entered a contract with a board or the department to provide administrative
			 services to a program administered by that board or the department under ch.
			 40, Stats. The term includes the administrative agent of the group insurance
			 board or department who assists in the administration of a group insurance plan
			 under ch. 40, Stats., for which the public employee trust fund is the
			 insurer.
(3) "Appeal" means the
			 review of a written finding, notification or decision specifically set forth in
			 a determination made by the department conducted by a board under s.
			 40.03(1) (j), (6) (i), (7) (f),
			 or (8) (f), Stats.
(3m) "Appeals coordinator" means the
			 department staff responsible for receiving appeals, forwarding appeals to the
			 hearing examiner, and working directly with the hearing examiner and board on
			 administrative matters regarding an appeal.
(4) "Appellant" means the person, including a
			 participant, annuitant, beneficiary, employer, insured, insurer or deferrer who
			 initiates an appeal to the board. "Appellant" also includes a person appealing
			 an adverse determination of participating employee status.
(5) "Board" means the employee trust funds
			 board, deferred compensation board, group insurance board, teachers retirement
			 board or Wisconsin retirement board according to the context of its
			 application.
(6) "Board staff"
			 means the department employees assigned by the secretary to perform tasks in
			 support of the board.
(7)
			 "Deferrer" means an employee who participates in the deferred compensation
			 program under ch. 40, Stats.
(8)
			 "Determination made by the department" means a written finding, notification or
			 decision of the department, which includes a notice of appeal rights and
			 applies law or contract terms to actual facts to determine a benefit, right,
			 obligation or interest under ch. 40, Stats., including contracts authorized by
			 ch. 40, Stats., of a person who is, or claims the status of, a participant,
			 annuitant, beneficiary, employer, insured, insurer or deferrer.
(9) "E-mail" means to send via electronic
			 mail over a computer network.
(10)
			 "Hearing examiner" means the person who presides over each appeal of a
			 determination made by the department of employee trust funds including an
			 administrative law judge employed by the division of hearings and
			 appeals.
(11) "Insured" means a
			 person covered under a group insurance plan provided under ch. 40,
			 Stats.
(12) "Insurer" means the
			 person bearing the financial risk and liability for payment of claims under a
			 group insurance plan provided under ch. 40, Stats., including where applicable
			 the public employee trust fund.
(13) "Mail" means to send via the U.S. mails
			 as at least first class mail, and includes sending by express mail, special or
			 overnight delivery, certified or registered mail.
(14) "Respondent" with respect to an appeal
			 means the department of employee trust funds. In addition:
(a) The employer is a respondent in the
			 appeal of a department determination which was based on the employer's
			 determination that a person is not a participating employee or protective
			 occupation participant or based on the employer's certification, or failure to
			 certify, under s.
			 40.63(1)
			 (c), Stats.
(b) The insurer and administrative agent are
			 respondents in the appeal of a department determination affecting any right or
			 benefit under any group insurance plan provided under ch. 40, Stats., except
			 that the department shall represent the interests of the public employee trust
			 fund as insurer.