This is the Model Notice for COBRA Continuation Subsidy under the American Rescue Plan [ARP] Act of 2021. Employers please note that information for qualified beneficiaries must be completed.
ET-2311
Form
Active Employee /
Local Employer /
State Employer
The State of Wisconsin Group Insurance Board contracts with a Pharmacy Benefit Manager to provide administrative services to State of Wisconsin and Wisconsin Public Employer group health insurance program participants.
The American Rescue Plan Act of 2021 (ARP) subsidizes the full COBRA premium for “Assistance Eligible Individuals” for periods of coverage from April 1, 2021 through September 30, 2021.