2019 - 2020 LEGISLATURE
September 18, 2019 - Introduced by Representatives Sanfelippo, Kuglitsch,
Allen, Knodl, Pronschinske, Quinn, Ramthun, Thiesfeldt, Tusler and
Dittrich, cosponsored by Senators Kooyenga, Craig and Wanggaard.
Referred to Committee on Insurance.
1An Act to amend
632.745 (5) (a) of the statutes; relating to: adjusting group
2health plan requirements to account for the normal work week of fire fighters.
Analysis by the Legislative Reference Bureau
Under current law, the applicability of certain requirements related to group
health plan coverage depends on whether an individual is an “eligible employee.” For
example, an insurer that offers a group health plan to an employer or health benefit
purchasing cooperative is generally required to offer coverage to all of the employer's
or cooperative member's eligible employees and their dependents. Similarly, if the
state or a county, city, village, town, or school district offers coverage under a
self-insured health plan, the coverage must generally be offered to all eligible
employees and their dependents. Another example is that small employers with less
than ten eligible employees are exempt from the requirement to cover the treatment
of mental and substance use disorders under their group health plans. For all of
these purposes, an “eligible employee” is an individual who works on a permanent
basis and has a normal work week of at least 30 hours.
This bill amends the definition of “eligible employee” to account for the normal
work week of fire fighters. Under the bill, an individual who is employed as a
member or officer of a fire department and whose duties include fire fighting or fire
fighting training is an “eligible employee” if the individual works on a permanent
basis and has a normal work week of at least 42 hours.
For further information see the local fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
632.745 (5) (a) of the statutes is amended to read:
(a) Except as provided in par. (b), “eligible employee" means an 3
employee who works on a permanent basis and has either
a normal work week of 30 4
or more hours or, in the case of an individual who is employed by a county, city, village,
5or town as a member or officer of a fire department and whose duties include fire
6fighting or fire fighting training, a normal work week of 42 or more hours
. The term 7
includes a sole proprietor, a business owner, including the owner of a farm business, 8
a partner of a partnership and a member of a limited liability company if the sole 9
proprietor, business owner, partner or member is included as an employee under a 10
health benefit plan of an employer, but the term does not include an employee who 11
works on a temporary or substitute basis.
This act takes effect on the first day of the 4th month beginning after 14