Payroll Client AccessWhat are the Requirements for Providing Health Insurance to Employees in Wisconsin?
BenHR > Employee Health Insurance Requirements
Wisconsin employers with fewer than 50 full-time equivalent employees are not legally required to provide health insurance. Under the federal Affordable Care Act (ACA), employers with 50 or more FTEs must offer affordable coverage meeting minimum essential standards or face potential penalties. Smaller businesses can still choose to offer coverage to stay competitive, improve retention and qualify for potential federal tax credits.
BenHR works with Wisconsin employers of all sizes to interpret coverage laws, evaluate benefit options and design compliant health insurance programs tailored to workforce needs.
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Health Insurance Laws for Wisconsin Employers
There is no Wisconsin state mandate requiring private employers to provide health insurance. Coverage requirements come from the federal ACA, which defines:
- Small Employers (2–50 employees): Not required to offer health insurance under state or federal law.
- Large Employers (50+ FTEs): Must offer affordable, minimum essential coverage to full-time employees and dependents or face ACA penalties.
Employers offering group health insurance must follow nondiscrimination rules, apply participation requirements consistently and provide employees with plan certificates upon request.
Small Business Options and Tax Incentives
Small employers offering health insurance can purchase plans through the Small Business Health Options Program (SHOP) Marketplace. Businesses with fewer than 25 FTEs, average wages below approximately $56,000 and employer-paid premiums covering at least 50% of employee costs may qualify for the Small Business Health Care Tax Credit.
Offering benefits through SHOP gives small businesses access to competitive plan categories (Bronze, Silver, Gold, Platinum) and helps balance premiums and coverage.
Why Offer Coverage Voluntarily
Even without a legal requirement, many Wisconsin employers provide health insurance to:
- Compete for skilled employees
- Improve retention and morale
- Promote preventive care and workplace productivity
- Access tax-deductible premium contributions
BenHR helps businesses assess whether group coverage makes sense financially and strategically for their organization.
Partner With BenHR for Employee Benefits Compliance
From determining ACA thresholds to comparing small-group plan options, BenHR provides Wisconsin employers with clear guidance on health insurance obligations and voluntary benefits. Our consultants help you stay compliant, competitive and informed.