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Wisconsin COBRA Regulations

The Consolidated Omnibus Budget Reconciliation Act, more commonly known as COBRA, is a federal law providing employees, their spouses and dependents with group health insurance coverage after employment termination. This coverage must be paid for at the employee's expense. COBRA has many rules and regulations, and each state has its own COBRA laws, including Wisconsin.

  1. Who Is Eligible?

    • Wisconsin law stipulates that spouses who lose their coverage due to a divorce or annulment, employees--and their spouses and dependents--who lose their job for any reason other than misconduct as well as spouses and/or dependents of an employee who has died are all eligible to continue group coverage or coverage under a converted individual health insurance policy for at least three months. Eligible persons must have received continuous coverage prior to the separation of employment or other qualifying event.

    Discharge for Misconduct

    • Under Wisconsin COBRA law, there is no legal definition of discharge with regard to misconduct. If the nature of the termination comes into question, it is typically decided by the courts when handling other unemployment benefits questions or issues. The Office of the Commissioner of Insurance cannot make determinations regarding discharge by misconduct; persons who have lost their coverage in this manner are not eligible for continuation under Wisconsin COBRA law.

    Loss of Coverage

    • Factors that will end a person's COBRA coverage include moving outside of Wisconsin or a former spouse losing group coverage--though, in either case, individuals should be able to convert from a group policy to an individual policy. Other ways to lose COBRA coverage include non-payment of premiums or eligibility under another plan. Generally, all persons are likely to lose COBRA coverage after 18 months.

    Policy Types

    • Insurance companies must provide individuals eligible for COBRA with health insurance coverage similar to their previous policy or a high limit comprehensive policy. Another option may involve selecting from among three plans, two of which are major medical expense plans and one that offers basic coverage.

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