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COBRA Laws in Wisconsin

After leaving a job, either voluntarily or as the result of termination, many individuals find themselves in need of health insurance coverage. The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows employees and their dependents to continue receiving health coverage after leaving a job. Like many states, Wisconsin allows consumers to receive COBRA benefits under federal law; the state also has its own mini-COBRA laws that are separate from the federal guidelines.

  1. Coverage Eligibility

    • Under Wisconsin state law, individuals who have received continuous insurance coverage for a minimum of three months have the right to continue receiving benefits if they meet one of three guidelines. Individuals must either be a former spouse who has lost coverage due to a divorce or annulment; a covered spouse or dependent of an employee who has passed away; or an employee and his dependents who have lost coverage due to a loss of employment except for cases involving a termination for misconduct. Under federal law, individuals qualify for coverage if they were employed by a business with at least 20 full-time employees; however Wisconsin law also allows for COBRA coverage for those who were employed at a business with between two and 19 full-time employees.

    Continuing Coverage

    • Residents of Wisconsin are eligible for COBRA coverage for 18 months after losing employment. During the 18 months of coverage, the insurance company reserves the right to cancel coverage if payments are missed. Those who establish a permanent residence outside of the state will also lose coverage, but are eligible to convert their plan from a group policy to an individual policy. Wisconsin law also requires that the insurance company not charge the individual more than the group rate for coverage while receiving COBRA benefits. The fee is determined by calculating the amount the employee paid toward health insurance plus the amount contributed to the coverage by the employer.

    Available Policies

    • Wisconsin law requires that an insurance company offer the same group policy that the individual received while employed. However, at the end of the allowed COBRA time frame, the company must offer an individual conversion policy that consists of one of three requirements. The policy must offer coverage similar to that which was offered under the previous plan; be a high-limit comprehensive policy; or the company must give the individual a choice between three plans that include one basic coverage plan and two major medical-expense plans.

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