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Wisconsin Healthcare Stability Plan

Last Updated: April 11, 2024

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

Under the Affordable Care Act, pursuant to the 2017 Wisconsin Act 138 , 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.

Reports - Quarterly and Annual

Reinsurance Waiver Quarterly Reporting and Final Reports

2023

Reinsurance Waiver Draft Annual Report**

FFE EXP-2023 SLCSP Data

2022

2021

State Premium Pass Through Calculations
Attendee Report
Letter from Anthem
Letter from CGHC
Correspondence from Wisconsin Association of Health Plans

2020

Reinsurance Waiver Final Report *

Reinsurance Waiver Draft Annual Report **

2019

Draft Annual Reporting Data Template

* 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).

Estimated Reinsurance Amounts and Payment Parameters

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.

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

2023 Estimated Reinsurance Amounts
Quarter 1	$18,239,293.54
Quarter 2	$68,793,621.13
Quarter 3	$127,638,895.00
Quarter 4	$193,128,562.00

2022 Estimated Reinsurance Amounts
Quarter 1	$19,688,746.74
Quarter 2	$73,642,017.81
Quarter 3	$138,533,110.25
Quarter 4	$212,417,056.43
2022 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 1	$16,391,781.56
Quarter 2	$62,680,237.44
Quarter 3	$113,662,303.36
Quarter 4	$185,083,494.55
2021 Final Aggregate	$202,811,341.37

2020 Estimated Reinsurance Amounts
Quarter 1	$18,903,769.00
Quarter 2	$58,044,758.00
Quarter 3	$109,759,180.85
Quarter 4	$171,504,526.72
2020 Final Aggregate	$183,483,625.85

2019 Estimated Reinsurance Amounts
Quarter 1	$14,765,951.00
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 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.

Reinsurance Parameters	2019	2020	2021	2022	2023	2024
Attachment Point	$50,000	$40,000	$40,000	$40,000	$45,000	$45,000
Coinsurance Rate	50%	50%	48%	50%	50%	48.28%
Reinsurance Cap	$250,000	$175,000	$175,000	$175,000	$141,685	$142,000