Covering Wisconsin

What Covering Wisconsin does

Covering Wisconsin is a non-profit health insurance navigator program operating as a unit within the University of Wisconsin-Madison Division of Extension. Founded in 2014 under the Affordable Care Act, the organization delivers free, federally-certified enrollment assistance to Wisconsin residents across all 72 counties through a team of approximately 42 navigators, including 11 bilingual Spanish-speakers and 2 bilingual Hmong-speakers, with interpreter services available in 15+ additional languages. Its core offering is one-on-one navigation through ACA Marketplace, BadgerCare Plus, and Medicaid enrollment — delivered via in-person appointments, phone, video, and an online scheduling platform called GetCovered Connector — supplemented by community outreach (44,963+ individuals contacted at events in 2025), an annual Wisconsin Health Insurance Enrollment Conference (362 registrants, 122 organizations in 2025), and Regional and Affinity Networks coordinating 2,250 participants across agencies, carriers, and community organizations.

The business model is grant-funded rather than revenue-generating: all services to consumers are provided free of charge, and the operating budget of approximately $3.1-3.2 million annually has historically been supported by federal CMS/HHS Navigator grants (roughly 75%), with supplementary funding from UW Health, Wisconsin DHS, Dane County, Milwaukee Shared Community Investment Fund, Molina Healthcare, Dean Health Plan, UnitedHealthcare, Wisconsin Hospital Association, Evjue Foundation, and other foundations. In February 2025, CMS announced a 90% reduction in national Navigator program funding effective for plan year 2026, dropping Covering Wisconsin's federal award from approximately $3.1 million to approximately $300,000 — a structural shock that has already triggered navigator headcount reductions from 50 to roughly 44 and a scaling-back of outreach and professional training programs. The organization recorded a 97% navigator satisfaction rating and facilitated enrollment of 291,336 Wisconsin residents in ACA Marketplace plans during the 2025-26 Open Enrollment period.

Name

Covering Wisconsin

Legal name

Covering Wisconsin

Website

https://coveringwi.org

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

11–50 employees

Short description

Covering Wisconsin is a UW-Madison Division of Extension non-profit program that provides free, federally-certified health insurance enrollment assistance to Wisconsin residents across all 72 counties via approximately 42 multilingual navigators.

Ownership category

akta.pro rank

Product category

Health Insurance Navigation Services

NAICS

Insurance Agencies and Brokerages (52421), Agencies, Brokerages, and Other Insurance Related Activities (5242)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO)

akta.pro secondary industry

Off-Exchange Individual & Family Plans (HLAEABAB)

Keywords

• Health insurance navigation
• ACA enrollment assistance
• Medicaid enrollment support
• Federally-certified navigators
• Community health outreach

Headquarters

HQ city

Milwaukee

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure

Revenue model

1. Federal Navigator Grants: Primary funding from federal CMS/HHS Navigator program grants, representing approximately three-quarters of budget. Award of $1,976,369 with 16% from CMS/HHS and $373,805 (19%) from non-governmental sources. Previous grants of $3.1-3.2 million annually.
2. Contributions and Donations: Individual and organizational contributions from supporters including healthcare providers, insurers, and foundations. Promotional materials indicate contributions help advance health and well-being of Wisconsin residents.
3. Healthcare System ROI: Indirect value generated through reduced uncompensated care when Wisconsinites are enrolled in coverage. Adding 1,000 consumers to subsidized ACA coverage yields estimated $6.8 million in annual federal subsidy support (10:1 return).

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels8 records

Core offering

Covering Wisconsin provides free, federally-certified health insurance navigation and enrollment assistance to Wisconsin residents. Approximately 42 trained navigators help consumers compare plans, submit applications for ACA Marketplace coverage (Healthcare.gov) and BadgerCare Plus/Medicaid, resolve billing and coverage issues, file eligibility appeals, and provide year-round multilingual support in 15+ languages. Services are delivered in person, by phone, video, and via the GetCovered Connector online scheduling tool.

Product overview

Covering Wisconsin is a program of the University of Wisconsin-Madison Division of Extension that provides free health insurance navigation services to Wisconsin residents. The core offering consists of Navigator Services (federally-certified enrollment assisters who help consumers understand and sign up for ACA Marketplace, BadgerCare Plus, and Medicaid), supported by the GetCovered Connector scheduling tool. The program also provides Educational Resources, runs the annual Wisconsin Health Insurance Enrollment Conference for professional development, facilitates Regional Enrollment Networks for statewide coordination, and offers Language Access Services to serve non-English speaking residents.

Differentiator

Problem solved

Functional benefit

Quantifiable outcome

• 291,336 Wisconsin residents enrolled in ACA Marketplace plans during 2025-26 Open Enrollment
• +4 more outcomes

Named customers5 records

Segments5 records

Ideal customer profiles3 records

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature2 records

Partnerships

16 partnerships are on record, tiered core, major and minor.

• ABC for Rural HealthcoreStrategic or Co-development PartnerPartnership for delivering enrollment services and conducting local outreach across Wisconsin's rural communities. ABC for Rural Health is one of multiple community organizations collaborating with Covering Wisconsin for statewide coverage assistance.
• Allied Wellness CentercoreStrategic or Co-development PartnerCollaboration for community-based health insurance enrollment assistance and outreach coordination in local communities.
• Bread of Healing CliniccoreStrategic or Co-development PartnerPartnership providing enrollment assistance to patients and community members seeking health coverage.
• Centro Hispano of Dane CountycoreStrategic or Co-development PartnerCollaboration providing bilingual Spanish-language enrollment assistance and culturally appropriate outreach to Latino communities in Dane County.
• Sixteenth Street Community Health CenterscoreStrategic or Co-development PartnerPartnership delivering enrollment services at community health center locations serving diverse Milwaukee populations.
• Northlakes Community CliniccoreStrategic or Co-development PartnerFederally Qualified Health Center partnership for comprehensive enrollment assistance services.
• Family Health Center of MarshfieldcoreStrategic or Co-development PartnerPartnership providing enrollment assistance and health coverage navigation for patients and community members.
• UW HealthmajorStrategic or Co-development PartnerMajor healthcare system partner providing financial support and community relations collaboration for health coverage outreach programs. UW Health contributes to Covering Wisconsin's navigator funding.
• Wisconsin Department of Health ServicescoreStrategic or Co-development PartnerState agency partnership for Medicaid/BadgerCare enrollment coordination and policy alignment. Covering Wisconsin receives state funding support and collaborates on enrollment initiatives.
• Public Health Madison & Dane CountycoreStrategic or Co-development PartnerLocal public health department partnership for coordinated health coverage outreach and enrollment assistance.
• Common Ground Healthcare CooperativeminorStrategic or Co-development PartnerHealthcare cooperative providing sponsorship support and community partnership for enrollment initiatives.
• Dean Health Plan by MedicaminorStrategic or Co-development PartnerHealth insurer providing sponsorship support for enrollment education programs and conference.
• Molina HealthcareminorStrategic or Co-development PartnerHealth insurer providing sponsorship support for enrollment education and professional development.
• United Healthcare Community PlanminorStrategic or Co-development PartnerHealth insurer providing sponsorship and community support for coverage outreach programs.
• Wisconsin Hospital AssociationminorStrategic or Co-development PartnerHealthcare industry association providing sponsorship support for enrollment education initiatives.
• Milwaukee Enrollment NetworkcoreStrategic or Co-development PartnerCollaborative enrollment network coordinating ACA enrollment efforts across Milwaukee County with Covering Wisconsin leadership.

Scale indicators13 records

Recent moves6 records

Expansion highlights5 records

Others

• Wisconsin Department of Health Services (DHS): Wisconsin's state Medicaid agency administering BadgerCare Plus and Medicaid, with which Covering Wisconsin partners for enrollment coordination. An ecosystem partner rather than a competitor; shares the Medicaid enrollment mission and is a major Covering Wisconsin partner and funder.

Emerging players

• HealthSherpa: Private online ACA Marketplace enrollment platform and broker network that competes with navigator programs by offering free enrollment assistance backed by carrier commissions. Comparable target market and product (Marketplace enrollment) but distinct commercial business model.
• United Way 211: National 211 referral service that, in many states including Wisconsin, helps connect residents with health insurance and social service resources including navigator programs. Overlapping mission in connecting consumers to coverage assistance, with broader social service scope.

Direct peers

• MNsure: Minnesota's state-based health insurance marketplace and navigator program, providing free enrollment assistance to residents in ACA Marketplace and MinnesotaCare plans. Directly comparable in mission, structure as a state-level navigator entity, and reliance on federal/state funding.
• Pennie: Pennsylvania's state-based health insurance marketplace and navigator program, providing free enrollment assistance to state residents for ACA Marketplace and Medicaid coverage. Directly comparable in operating model, target population, and federal grant funding structure.
• Get Covered Illinois: Illinois's official health insurance marketplace and navigator assistance program serving residents seeking ACA Marketplace and Medicaid coverage. Comparable as a state-based navigator entity with similar community outreach and consumer education focus.
• Washington Healthplanfinder: Washington state's health insurance exchange and navigator program, providing free enrollment assistance for QHP and Apple Health (Medicaid) coverage. Comparable in mission, statewide navigator network, and community-based partner model.
• NY State of Health: New York's official health insurance marketplace, including its navigator and enrollment assistance programs serving individuals, families, and small businesses. Comparable as a state-based navigator entity providing free enrollment help across Marketplace, Medicaid, and Child Health Plus.
• BeWell New Mexico: New Mexico's state-based health insurance marketplace and navigator program providing free enrollment assistance for QHP and Medicaid coverage. Comparable in operating as a state-orchestrated navigator entity serving a mix of Marketplace and Medicaid populations.
• Maryland Health Connection: Maryland's state-based health insurance marketplace with navigator and connector entities providing free enrollment assistance for individuals and small businesses. Comparable in structure, multilingual support, and partnership with FQHCs and community organizations.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/coveringwi

Revenue estimate

Valuation estimate

Number of profiles

Profiles12 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Covering Wisconsin