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  • Wisconsin State Continuation Sample Form

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85 TO BE COMPLETED BY EMPLOYER ONLY Employee Name First Middle Initial Last Date of Hire - STATE CONTINUATION OF COVERAGE Applicable to employers with less than 20 employees and church and federal government groups COBRA Applicable to employer with 20 or more employees FOR STATE CONTINUATION OF COVERAGE OR WHEN THE EMPLOYER DOES COBRA BILLING IF YOU ELECT TO CONTINUE COVERAGE PAYMENT MUST BE SENT TO PAYABLE ON OR BEFORE THE DAY OF EACH MONTH COMM.

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Related content

Fact Sheet on Continuation Rights in Health...
632.897, Wis. Stat.) Wisconsin's continuation law applies to most group health insurance...
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Department of Employe Trust Funds - Wisconsin...
Items 1 - 8 — You are eligible for continuation (COBRA) coverage. Your health insurance...
Learn more
University of Wisconsin Law School - Wikipedia
The University of Wisconsin Law School is the professional school for the study of law at...
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Federal Law (COBRA) Under federal law, employees who have a reduction in work hours or terminate employment for any reason other than gross misconduct may continue their group coverage for up to 18 months. (A spouse and dependents are also covered.)

Federal Law (COBRA) Under federal law, employees who have a reduction in work hours or terminate employment for any reason other than gross misconduct may continue their group coverage for up to 18 months. (A spouse and dependents are also covered.)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, ...

By law, small employers don't have to offer health insurance as a benefit to their employees. Many do offer health insurance to help attract and keep good workers. The Wisconsin Office of the Commissioner of Insurance has a guide with details on the Small Employer Health Insurance Law, terms, and possible costs.

Losing COBRA Benefits Here's the good news: Rolling off of COBRA coverage is a qualifying event that opens a special enrollment period for you to purchase your own health coverage. And you'll have more options, flexibility and control of your health plan outside of COBRA with an individual health insurance plan.

Health Insurance Requirement: The Individual Shared Responsibility provision of the law, or Individual Mandate, requires most people to obtain qualified health insurance or pay a penalty (effective January 1, 2019 the Individual Mandate penalty has been reduced to $0).

It's for people who lose health insurance that was part of their employer's group plan. COBRA allows workers, spouses, and dependents to stay on their former employer's health plan. This is at their own expense, for a set time.

Health Insurance Requirement: The Individual Shared Responsibility provision of the law, or Individual Mandate, requires most people to obtain qualified health insurance or pay a penalty (effective January 1, 2019 the Individual Mandate penalty has been reduced to $0).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232