COBRA coverage

What you need to know about COBRA

COBRA coverage

Groups with 20 or more employees

COBRA stands for Consolidated Omnibus Budget Reconciliation, a federal law enacted in 1985. This law requires most insured and self-insured group health plans to provide continuation of coverage to employees, spouses and dependents who lose coverage under the plan for certain reasons.

State continuation

Groups with 19 or fewer employees

State Continuation (Wis. Stat. § 632.897) is the Wisconsin legislation similar to the federal COBRA. All employers and insurers within the state of Wisconsin must comply with State Continuation, regardless of size (except for self-insured plans).

Since both laws apply for many employers, the employer must comply with the law that is most beneficial for the employee. Therefore, it is important for employers to be familiar with both COBRA and State Continuation requirements.

 Hereafter, COBRA and State Continuation may be referred to as “group continuation,” which means either COBRA and/or State Continuation depending on which law will apply.

Helpful references

Employer knowledge

Employers are responsible for:

• Providing written notification to your employees and their dependents of their rights to group continuation coverage.
• Knowing which events qualify the employee/dependents for continuation.

Employers must:

• Terminate the employee from your active group coverage segment.
• Obtain written documentation for the election of continuation from the eligible employee/dependent(s) for their continuation coverage.
• Enroll the terminated employee into the COBRA segment of your group coverage.
• Know the guidelines for terminating participants for non-payment.

Those who elect COBRA coverage are responsible for sending you the monthly premium payments. You will make payment to us.

COBRA/State Continuation is an employer-administrated benefit. We have provided this information for reference purposes only. Consult with your attorney or COBRA administrator (if applicable) regarding specific situations or concerns regarding the administration of group continuation.

For more detailed information, contact:

COBRA contact

U.S. Department of Labor
Phone – 202-219-8776 
dol.gov

State continuation contact

State of WI Office of the Commissioner of Insurance
 

• 800-236-8517 – Toll-Free
• 608-266-3585 – Phone
• oci.wi.gov