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Wisconsin Healthcare Stability Plan

Last Updated: March 4, 2026

Wisconsin's 1332 Waiver for State Innovation: Wisconsin Healthcare Stability Plan

Under the Affordable Care Act, pursuant to the 2017 Wisconsin Act 138 - opens in new window, OCI developed a 1332 Waiver for State Innovation Application allowing Wisconsin to leverage federal funding for a state-based reinsurance plan: the Healthcare Stability Plan (WIHSP).

A 1332 Waiver permits states to pursue innovative strategies to ensure residents have access to affordable health insurance options and to control costs.

On July 29, 2018, the U.S. Department of Health and Human Services and the U.S. Department of the Treasury approved Wisconsin's 1332 Waiver application. The approval was effective as of January 1, 2019 and has been extended through December 31, 2028.

Below are links to the quarterly and annual reports, reinsurance amounts, application and approval letters, and other important materials related to the Wisconsin Healthcare Stability Plan.

Reinsurance Waiver Quarterly Reporting and Final Reports

2025

2024

FFE EXP-2024 SLCSP Data - opens in new window

2023

FFE EXP-2023 SLCSP Data - opens in new window

2022

* This final federal report also satisfies the state reporting requirement under Wis. Stat. s.601.85 (2).** Data for the fourth quarter is compiled in the annual report.

2017 Wisconsin Act 138: Required Recommendation Report

The law that established the Wisconsin Healthcare Stability Plan also requires by December 31, 2018, the Office of the Commissioner of Insurance to submit to the governor recommendations on implementing a waiver under s. 601.83 (1) (b).

The table below provides aggregate reinsurance amounts for claims paid through each quarter based on insurer responses to OCI's order for information under Wis. Stat. 601.42 in accordance with Wis. Stat. 601.83.

Each quarter is cumulative; the estimated reinsurance amount reported in Quarter 1 is included in the amount reported in Quarter 2.

2025 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$26,071,625.83
Quarter 2	$90,426,700.71
Quarter 3	$166,609,518.51
Quarter 4	$241,113,212.57

2024 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$27,419,689.13
Quarter 2	$85,467,942.84
Quarter 3	$157,185,911.90
Quarter 4	$239,541,347.35
Final Aggregate	$256,782,968.83*

*Payments must be adjusted so the PY 2024 WIHSP total meets the statutory limit of $230 million.

2023 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$18,239,293.54
Quarter 2	$68,793,621.13
Quarter 3	$127,638,895.00
Quarter 4	$193,128,562.00
Final Aggregate	$209,956,706.21

2022 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$19,688,746.74
Quarter 2	$73,642,017.81
Quarter 3	$138,533,110.25
Quarter 4	$212,417,056.43
Final Aggregate	$230,704,180.66*

*Individual insurer payments were reduced so that the total PY 2022 WIHSP claim total meets the statutory limit of $230 million.

2021 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$16,391,781.56
Quarter 2	$62,680,237.44
Quarter 3	$113,662,303.36
Quarter 4	$185,083,494.55
Final Aggregate	$202,811,341.37

2020 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$18,903,769.00
Quarter 2	$58,044,758.00
Quarter 3	$109,759,180.85
Quarter 4	$171,504,526.72
Final Aggregate	$183,483,625.85

2019 Estimated Reinsurance Amounts

Quarter	Amount
Quarter 1	$14,765,951.00
Quarter 2	$53,989,888.59
Quarter 3	$100,842,381.94
Quarter 4	$159,087,831.04
Final Aggregate	$174,254,353.91

The Commissioner of Insurance engaged a consulting and actuarial firm to assist OCI in developing its preliminary payment parameters consistent with Wis. Stat. 601.83 (2). After considering the data received by insurers and best estimates for enrollment, the Commissioner proposed the following payment parameters.

Year	Attachment Point	Coinsurance Rate	Reinsurance Cap
2026	$50,000	50%	$214,738
2025	$50,000	43%	$157,471
2024	$45,000	48%	$142,000
2023	$45,000	50%	$141,685
2022	$40,000	50%	$175,000
2021	$40,000	48%	$175,000
2020	$40,000	50%	$175,000
2019	$50,000	50%	$250,000

Public Notices

2026 Plan Year: Final Payment Parameters - opens in new window | Preliminary - opens in new window
2025 Plan Year: Final Payment Parameters - opens in new window | Preliminary - opens in new window
2024 Plan Year: Final Payment Parameters - opens in new window | Preliminary - opens in new window
2023 Plan Year: Final Payment Parameters - opens in new window | Preliminary - opens in new window | Public Hearing Audio - opens in new window
2022 Plan Year: Revised Final Payment Parameters - opens in new window | Final - Prior to Revision - opens in new window | Preliminary - opens in new window
2021 Plan Year: Preliminary Payment Parameters - opens in new window
2020 Plan Year: Final Payment Parameters - opens in new window | Preliminary - opens in new window

Letter of Approval

The Center for Consumer Information & Insurance Oversight:

Section 1332: State Innovation Waivers - opens in new window - opens in new window

Wisconsin Approval - opens in new window(Click the link and scroll through the states for the Wisconsin section.)