Wisconsin Healthcare Stability Plan

Last updated November 23, 2020

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

OCI developed a 1332 Waiver for State Innovation Application under the Affordable Care Act pursuant to the  2017 Wisconsin Act 138 allowing Wisconsin to leverage federal funding for the operation of a state-based reinsurance plan: the Healthcare Stability Plan.

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

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 is effective January 1, 2019, through December 31, 2023.

Below are links to the letter of approval, application, and materials highlighting key information about the Wisconsin individual market and the Healthcare Stability Plan.


Letter of Approval

The Center for Consumer Information & Insurance Oversight:

  • Section 1332: State Innovation Waivers
  • Wisconsin Approval (Click the link and scroll through the states for the Wisconsin section.)
    • Fact Sheet
    • Notice of Preliminary Determination of Completeness
    • Wisconsin Approval Letter and STC
    • Frequently Asked Questions about the 1332 State Innovation Waivers

Materials

Reports

Application

Wisconsin 1332 Waiver Application:

Wisconsin 1332 Draft Waiver Application:  


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).


Estimated Reinsurance Amounts

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.

Note that each quarter is cumulative.  For example, the estimated reinsurance amount reported in Quarter 1 is included in the amount reported in Quarter 2.

2020 Estimated Reinsurance Amounts
Quarter 1​​
​​$18,903,769
​Quarter 2​
​$58,044,758​


 

2019 Estimated Reinsurance Amounts
​Quarter 1
​$14,765,951
​Quarter 2
​$53,989,888.59
Quarter 3​$100,842,381.94
Quarter 4​$159,087,831.04
2019 ​Final Aggregate​ $174,254,353.91

​​Payment Parameters

The Commissioner of Insurance engaged a consulting and actuarial firm to assist OCI in developing its preliminary payment parameters for plan yea​r 2020 consistent with Wis. Stat. 601.83 (2). After considering the data received by insurers and best estimates for 2020 enrollment, the Commissioner proposed the following payment parameters.

​Rei​nsurance​ Parameters 2019 2020 2021
Attachment Point$50,000$40,000​$40,000
Coinsurance Rate50%50%​48%
Reinsurance Cap
$250,000$175,000$175,000


Reinsurance Waiver Quarterly Reporting and Final Reports

​2020

2019​

*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.


Post Award Public Forum (5-7-2019)


Wisconsin Healthcare Stability Plan Questions and Answers