Both Wisconsin law and the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) permit employees to continue their group health coverage if they leave the group for certain specified reasons. According to federal law, employees may utilize the law that is most favorable to their situation.
Wisconsin's continuation law applies to most group health insurance policies that provide hospital or medical coverage. The law applies to group policies issued to employers of any size. The law does not apply to employer self-insured plans or policies that cover only specified diseases or accidental injuries. The state law gives the following Wisconsin residents who have been continuously covered under a group health insurance policy for at least 3 months the right to continue the group coverage or to convert to an individual policy providing similar benefits:
• A former spouse whose coverage ends because of divorce or annulment
• An employee whose coverage ends because of a reduction in hours or because he or she voluntarily or involuntarily terminates employment for any reason other than discharge for misconduct, along with the employee's spouse and dependents, if covered
• A covered spouse and/or dependents of an employee who has died
“Discharge for misconduct” is not defined by the law. The courts have decided cases involving the question of misconduct in connection with unemployment compensation cases and might use the same parameters when determining your eligibility for continuation/conversion.
Continuation of group coverage must be provided to an eligible individual for 18 months unless one of the following events occurs earlier: