Health Insurance Considerations

Most employer-sponsored group health plans must comply with the Employee Retirement Income Security Act of 1974 (ERISA) which is Federal law that sets standards to protect certain employee benefits. One protection contained in ERISA is the right to COBRA continuation coverage – i.e., temporary continuation of group health coverage following a qualifying event such as termination of employment. More detailed information about COBRA and compliance requirements may be found on the Department of Labor’s website.

Employer-sponsored group health plans may also have to comply with Wisconsin’s continuation law, Wisconsin Statutes section 632.897. The law applies to group policies issued to employers of any size; it does not apply to employer self-funded health plans or policies that limit coverage to specified diseases or accidental injuries. Questions about this law and compliance requirements may be directed to the Wisconsin Office of the Commissioner of Insurance via phone 608-266-3585 / 800-236-8517 or email ocicomplaints@wisconsin.gov.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) offers certain protections to people who lose their health insurance. Under HIPAA, the health plan must provide an individual who loses coverage with a certificate of creditable coverage. This must be provided free of charge. More information may be found on the Department of Labor’s website.