SB1,26 11Section 26. 2013 Wisconsin Act 20, section 9122 (1L) (b) 4. is amended to read:
SB1,14,1812[2013 Wisconsin Act 20] Section 9122 (1L) (b) 4. `Payment of plan costs.' The
13To the extent possible, the authority shall pay plan costs incurred in 2013 and all
14other costs associated with dissolving the plan that are incurred before
15administrative responsibility for the dissolution of the plan is transferred to the
16office under subdivision 8. The authority and the office shall make every effort to pay
17plan costs in accordance with, or as closely as possible to, the manner provided in
18section 149.143 of the statutes.
SB1,27 19Section 27. 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. (intro.) is repealed
20and recreated to read:
SB1,14,2221[2013 Wisconsin Act 20] Section 9122 (1L) (b) 8. `Transfer to the office.' (intro.)
22On February 28, 2014, all of the following shall occur:
SB1,28 23Section 28. 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. a., 9. a., 10. a. and
24b. and 11. b. are amended to read:
SB1,15,9
1[2013 Wisconsin Act 20] Section 9122 (1L) (b) 8. a. Administrative
2responsibility for the operations and dissolution of the plan is transferred to the
3office. The commissioner shall take any action necessary or advisable to manage and
4wind up the affairs of the plan and shall notify the legislative audit bureau when the
5windup is completed and provide to the legislative audit bureau the final financial
6statements of the plan. For purposes of chapter 177 of the statutes, as affected by
7this act, the dissolution, and winding up of the affairs, of the plan shall be considered
8a dissolution of an insurer in accordance with section 645.44 of the statutes, except
9that a court order of dissolution is not required to effect the dissolution of the plan.
SB1,15,1410 9. a. There is created, 60 days after the date coverage under the plan terminates
11under subdivision 1. b.
on March 1, 2014, a Health Insurance Risk-Sharing Plan
12advisory committee consisting of the commissioner, or his or her designee, and the
13other 13 members of the board holding office on the date the advisory committee is
14created.
SB1,15,2515 10. a. On behalf of the commissioner, the authority shall provide notice of the
16plan's dissolution to all persons known, or reasonably expected from the plan's
17records, to have claims against the plan, including all covered persons. The notice
18shall be sent by first class mail to the last-known addresses at least 60 days before
19the date on which coverage terminates under subdivision 1. b. Notice to potential
20claimants of the plan shall require the claimants to file their claims, together with
21proofs of claims, within 90 days after the date on which coverage terminates under
22subdivision 1. b.
by June 1, 2014. The notice shall be consistent with any relevant
23terms of the policies under the plan and contracts and with section 645.47 (1) (a) of
24the statutes. The notice shall serve as final notice consistent with section 645.47 (3)
25of the statutes.
SB1,16,12
1b. Proofs of all claims must be filed with the office in the form provided by the
2office consistent with the proof of claim, as applicable, under section 645.62 of the
3statutes, on or before the last day for filing specified in the notice. For good cause
4shown, the office shall permit a claimant to make a late filing if the existence of the
5claim was not known to the claimant and the claimant files the claim within 30 days
6after learning of the claim, but not more than 210 days after the date on which
7coverage terminates under subdivision 1. b.
later than September 1, 2014. Any such
8late claim that would have been payable under the policy under the plan if it had been
9filed timely and that was not covered by a succeeding insurer shall be permitted
10unless the claimant had actual notice of the termination of the plan or the notice was
11mailed to the claimant by first class mail at least 10 days before the insured event
12occurred.
SB1,16,1513 11. b. Complete a final audit of the plan, after the termination of the plan in
142014, within 90 days after the office provides the final financial statements of the
15plan under subdivision 8. a.
by June 30, 2015.
SB1,29 16Section 29. 2013 Wisconsin Act 20, section 9418 (7) is amended to read:
SB1,16,2417[2013 Wisconsin Act 20] Section 9418 (7) Patient protection and affordable
18care act changes
. The treatment of sections 49.45 (23) (a) (by Section 1046), (b) (by
19Section 1048), and (e), 49.46 (1) (a) 15., 49.47 (4) (a) 1. and (c) 1. and 3., 49.471 (1)
20(f), (2), (3) (a) 1. and 3., (4) (a) 4. a., b., and c., and 5. and (b) (intro.), 1., 1m., 2., 3., and
214., (6) (d), (7) (a), (b) 1. and 2. and (e), (8) (d) 1. b., (9) (a) 2. b., and (10) (b) 1. (by Section
221143) and 4. b., 49.84 (6) (c) 1. d., and 66.0137 (3) of the statutes, the repeal of section
2349.471 (7) (c) of the statutes, and Section 9318 (14) of this act take effect on January
24April 1, 2014.
SB1,30 25Section 30. 2013 Wisconsin Act 20, section 9418 (7m) is created to read:
SB1,17,4
1[2013 Wisconsin Act 20] Section 9418 (7m) Childless adult waiver; Medical
2Assistance for the medically indigent; eligibility for those leaving foster care.

3The treatment of sections 49.45 (23) (b) (by Section 1048), 49.47 (4) (c) 1. and 3., and
449.471 (2) and (4) (a) 5. of the statutes takes effect on January 1, 2014.
SB1,31 5Section 31. 2013 Wisconsin Act 20, section 9418 (9) is amended to read:
SB1,17,106[2013 Wisconsin Act 20] Section 9418 (9) BadgerCare Plus Benchmark
7eligibility; Badger Rx Gold; BadgerCare Basic.
The treatment of sections 20.435
8(4) (a), (bm), (jw), and (jz), 49.471 (4) (c), (10) (b) 5. (by Section 1152), and (11) (a),
949.67, 146.45, 227.01 (13) (ur), and 227.42 (7) of the statutes takes effect on January
10April 1, 2014.
SB1,32 11Section 32 . Nonstatutory provisions.
SB1,17,1312 (1) Coverage extension of the Health Insurance Risk-Sharing Plan;
13issuance of Medicare supplement and replacement policies.
SB1,17,1414 (a) Definitions. In this subsection:
SB1,17,16 151. "Authority" means the Health Insurance Risk-Sharing Plan Authority
16under subchapter III of chapter 149 of the statutes.
SB1,17,17 172. "Commissioner" means the commissioner of insurance.
SB1,17,18 183. "Covered person" means a person who has coverage under the plan.
SB1,17,19 194. "Medicare" has the meaning given in section 149.10 (7) of the statutes.
SB1,17,21 205. "Medicare Advantage" has the meaning given in section INS 3.39 (3) (r),
21Wisconsin Administrative Code.
SB1,17,23 226. "Medicare replacement policy" has the meaning given in section 600.03 (28p)
23of the statutes.
SB1,17,25 247. "Medicare supplement policy" has the meaning given in section 600.03 (28r)
25of the statutes.
SB1,18,1
18. "Office" means the office of the commissioner of insurance.
SB1,18,3 29. "Plan" means the Health Insurance Risk-Sharing Plan under subchapter II
3of chapter 149 of the statutes.
SB1,18,74 (b) Extension of the plan and authority. Notwithstanding any statute,
5administrative rule, or provision of a policy or contract or of the plan to the contrary,
6the dissolution of the plan and the authority as provided in 2013 Wisconsin Act 20,
7section 9122 (1L), is modified as follows:
SB1,18,9 81. `Coverage provisions.' Notwithstanding 2013 Wisconsin Act 20, section 9122
9(1L) (b)
1. b., all of the following apply:
SB1,18,22 10a. A covered person whose coverage under the plan was in effect on December
111, 2013, who paid his or her December premium, and who, if eligible for Medicare,
12had not enrolled in Medicare Advantage during the federal open enrollment period
13in 2013 may elect to obtain a policy under the plan by making a timely payment of
14the January 2014 premium. The covered person must maintain the same policy
15benefits, including the same deductible amount, that were in effect on December 1,
162013. A new deductible period will commence on January 1, 2014. The premium for
17January 2014 must be paid no later than February 1, 2014. Thereafter, the covered
18person must pay premiums in accordance with the terms of the contract for coverage,
19which may not extend beyond 11:59 p.m. on March 31, 2014. Any medical claims that
20the covered person incurs after December 31, 2013, and before the plan receives the
21premium payment for January 2014 shall be held in abeyance and the plan shall not
22be responsible for payment until the premium payment is received.
SB1,19,5 23b. If a covered person's coverage under the plan is funded under a contract with
24the federal department of health and human services, the covered person's coverage
25will end as provided in 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. b., unless the

1federal department of health and human services issues a contract amendment that
2extends the contract and coverage to a date later than December 31, 2013, and the
3terms of the contract amendment are such that the federal government will be
4financially liable for all costs related to the operation of the contract that exceed
5member premium collections.
SB1,19,20 6c. If the requirements under subdivision 1 . b. are satisfied, a covered person
7whose coverage is funded under a contract with the federal department of health and
8human services, whose coverage under the plan was in effect on December 1, 2013,
9who paid his or her December premium, and who had not enrolled in Medicare
10Advantage during the federal open enrollment period in 2013 may elect to obtain a
11policy under the plan by making a timely payment of the January 2014 premium.
12The covered person must maintain the same policy benefits, including the same
13deductible amount, that were in effect on December 1, 2013. A new deductible period
14will commence on January 1, 2014. The premium for January 2014 must be paid no
15later than February 1, 2014. Thereafter, the covered person must pay premiums in
16accordance with the terms of the contract for coverage, which may not extend beyond
1711:59 p.m. on March 31, 2014. Any medical claims that the covered person incurs
18after December 31, 2013, and before the plan receives the premium payment for
19January 2014 shall be held in abeyance and the plan shall not be responsible for
20payment until the premium payment is received.
SB1,19,24 21d. No later than February 1, 2014, the authority shall provide notice that
22coverage shall terminate on March 31, 2014, to all covered persons, all insurers and
23providers that are affected by the termination of the coverage, the office, the
24legislative audit bureau, and the insurers described in paragraph (c) 1 .
SB1,20,9
12. `Provider claims.' Providers of medical services and devices and prescription
2drugs to covered persons whose coverage is extended as provided in this paragraph
3must file claims for payment no later than June 1, 2014. Any claim filed after that
4date is not payable and may not be charged to the covered person who received the
5service, device, or drug. Except for copayments, coinsurance, or deductibles required
6under the plan, consistent with sections 149.14 (3) and 149.142 (2m) of the statutes,
7a provider may not bill a covered person who receives a covered service or article and
8shall accept as payment in full the payment rate determined under section 149.142
9(1) of the statutes.
SB1,20,10 103. `Grievances and review.'
SB1,20,13 11a. Any grievance by a covered person whose coverage is extended as provided
12in this paragraph must be in writing and received no later than July 1, 2014, or be
13barred.
SB1,20,17 14b. A covered person whose coverage is extended as provided in this paragraph
15who submits a grievance after March 31, 2014, must request an independent review,
16if any, with respect to the grievance no later than August 1, 2014, or be barred from
17requesting an independent review with respect to the grievance.
SB1,20,18 184. `Payment of plan costs.'
SB1,20,22 19a. To the extent possible, the authority shall pay plan costs incurred in 2013
20and 2014 and all other costs associated with operating and dissolving the plan that
21are incurred before administrative responsibility for the dissolution of the plan is
22transferred to the office on February 28, 2014.
SB1,21,3 23b. Notwithstanding 2013 Wisconsin Act 20, section 9122 (1L) (b) 4., the
24authority, before March 1, 2014, and the office, on and after March 1, 2014, shall pay
25plan costs in the manner provided in section 149.143 of the statutes, except that the

1authority or office may use all available surplus before imposing an assessment
2against insurers, as described in subdivision 4 . c. All provider claims shall be
3adjudicated by September 30, 2014.
SB1,21,8 4c. The authority, before March 1, 2014, and the office, on and after March 1,
52014, but no later than July 1, 2014, shall determine whether an assessment of
6insurers under section 149.13 of the statutes is necessary to cover in full the plan's
7expenses related to operations, winding up operations, and dissolution of the plan.
8Any such assessment shall be based on the 2013 filed plan assessment form.
SB1,21,9 95. `Dissolution notice, claims, and updates.'
SB1,21,19 10a. On behalf of the commissioner, the authority shall provide notice of the plan's
11dissolution to all persons known, or reasonably expected from the plan's records, to
12have claims against the plan, including all covered persons. Notwithstanding 2013
13Wisconsin Act 20
, section 9122 (1L) (b) 10. a., the notice shall be sent by 1st class mail
14to the last-known addresses no later than February 1, 2014. Notice to potential
15claimants of the plan shall require the claimants to file their claims, together with
16proofs of claims, by June 1, 2014. The notice shall be consistent with any relevant
17terms of the policies under the plan and contracts and with section 645.47 (1) (a) of
18the statutes. The notice shall serve as final notice consistent with section 645.47 (3)
19of the statutes.
SB1,22,4 20b. Proofs of all claims must be filed with the office in the form provided by the
21office consistent with the proof of claim, as applicable, under section 645.62 of the
22statutes, on or before the last day for filing specified in the notice. For good cause
23shown, the office shall permit a claimant to make a late filing if the existence of the
24claim was not known to the claimant and the claimant files the claim within 30 days
25after learning of the claim, but not later than September 1, 2014. Any such late claim

1that would have been payable under the policy under the plan if it had been filed
2timely and that was not covered by a succeeding insurer shall be permitted unless
3the claimant had actual notice of the termination of the plan or the notice was mailed
4to the claimant by 1st class mail at least 10 days before the insured event occurred.
SB1,22,55 (c) Medicare supplement and replacement policy issuance.
SB1,22,9 61. In addition to the requirement under 2013 Wisconsin Act 20, section 9122
7(1m)
, an insurer offering a Medicare supplement policy or a Medicare replacement
8policy in this state shall provide coverage under the policy to any individual who
9satisfies all of the following:
SB1,22,10 10a. The individual is eligible for Medicare.
SB1,22,11 11b. The individual had coverage under the plan.
SB1,22,12 12c. The individual's coverage under the plan terminated on March 31, 2014.
SB1,22,14 13d. The individual applies for coverage under the policy before 63 days after the
14date specified in subdivision 1 . c.
SB1,22,15 15e. The individual pays the premium for the coverage under the policy.
SB1,22,18 162. An insurer under subdivision 1. may not deny coverage to any individual who
17satisfies the criteria under subdivision 1 . a. to e . on the basis of health status, receipt
18of health care, claims experience, or medical condition including disability.
SB1,22,21 193. In addition to any other notice requirements to insurers, no later than
20February 1, 2014, the authority shall provide notice to the insurers described in
21subdivision 1. of the requirements under this paragraph.
SB1,33 22Section 33. Effective dates. This act takes effect on the day after publication,
23except as follows:
SB1,22,2524 (1) Health Insurance Risk-Sharing Plan. The treatment of section 895.514
25(2) and (3) (a) and (b) of the statutes takes effect on January 1, 2015.
SB1,23,2
1(2) Medical Assistance eligibility. The treatment of sections 49.45 (23) (a) (by
2Section 2) and 49.471 (4) (a) 4. b. of the statutes takes effect on April 1, 2014.
SB1,23,43 (3) Reconciliation with 2011 Wisconsin Act 32. The treatment of section 49.45
4(23) (a) (by Section 3 ) of the statutes takes effect on January 1, 2015.
SB1,23,55 (End)
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