Continuation of Benefits Coverage (COBRA) - Wisconsin

Summary of differences between federal and state regulations

Federal COBRA applies to employers who offer group health plans, and have 20 or more employees, but state laws may also apply. Under Wisconsin law, all employers are covered and continuation coverage applies to hospital or medical coverage. Self-insured plans covered by ERISA are covered only under federal COBRA, unless they are eligible for an exemption. Only participants who have been continuously covered under a group policy for at least three months may elect to continue group policy coverage. Coverage may continue for up to 18 months.

In October 2009, an emergency rule was issued that will make federally subsidized health insurance available for employees and their families who are laid off when their employers go out of business. The Wisconsin Office of the Commissioner of Insurance ("OCI") issued an emergency rule to require insurers to continue group health insurance coverage for laid-off employees, and their families, even when their former employer goes out of business or otherwise discontinues group health coverage.

Under both federal and state law a laid-off employee may elect to continue group health insurance coverage. However if the employer discontinues its business the group health insurance coverage for former employees is dropped. The federal American Recovery and Reinvestment Act of 2009 (ARRA) gave certain laid off employees a 65 percent health insurance premium subsidy to help pay for their former employer's group health insurance coverage.

State

Contact

Office of the Commissioner of Insurance

Regulations

Wisconsin Statutes

Chapter 632 Insurance Contracts in Specific Lines

§632.897 Hospital and medical coverage for persons insured under individual and group policies

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

26 CFR 54.4980B-1 et seq.