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.
The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospitals & Clinics Authority, participating local government employers, and annuitants (and their insured survivors).
The American Rescue Plan of 2021 (ARP) was signed into law by President Biden on March 11, 2021. The bill provides an enrollment opportunity for individuals who would have been eligible for, but did not elect, COBRA at the time of their termination, as well as individuals who had COBRA but let it lapse before their full 18 months of eligibility was complete.
The American Rescue Plan Act (ARP) provides for temporary 100% COBRA premium subsidies for eligible former employees who suffered an involuntary job loss, and for current or former employees who have suffered a reduction in hours that made them COBRA-eligible. A member might qualify both to use their sick leave in retirement and for the COBRA subsidy.
ET-2154
Form
Active Employee /
Local Employer /
State Employer
This application is intended for insured employees who are terminating Wisconsin Retirement System employment, who may qualify to continue life insurance coverage, and who will not begin a WRS retirement benefit immediately.
ET-8902
Active Employee /
Retiree /
Local Employer /
State Employer
The group health insurance program is an employer-sponsored program offering group health coverage to employees of state agencies, UW System, UW Hospital & Clinics Authority and participating local government employers.
The Wisconsin Public Employers Group Health Insurance Program offers employees of local government employers the opportunity to choose between two or more health insurance plans.