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Dhs wisconsin medicaidMedicaid in WisconsinWisconsin Department of Health Services 2026
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- Click ‘Get Form’ to open the Employer Health Insurance Verification form in the editor.
- Begin by filling out the 'Individual Information' section. Enter the name, date of birth, and request number of the individual for whom you are verifying health insurance.
- In the 'Current Information' section, indicate whether the employee is currently employed by your company. Select 'Yes' or 'No'.
- Next, specify if this employee has coverage through your company or can sign up within three months. Choose from options like 'Employee Only', 'Employee and Child(ren)', etc., and fill in the total monthly cost along with employee and company shares.
- Proceed to the 'Past Information' section. Answer whether this employee could have signed up for health insurance within the last 12 months and provide similar details as in step 4.
- Finally, list any relevant comments and ensure all fields are completed before submitting.
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