AB16-ASA1,4,1514 4. "Self-insured health plan" means a self-insured health plan of the state or
15a county, city, village, town, or school district.
AB16-ASA1,4,1716 5. "Treatment" means services, diagnoses, procedures, surgery, and therapy
17provided by a health care professional.
AB16-ASA1,4,2018 (b) 1. Subject to par. (c) and except as provided in par. (d), every disability
19insurance policy and every self-insured health plan shall provide the following
20coverages:
AB16-ASA1,5,221 a. Coverage of the cost of hearing aids and cochlear implants that are
22prescribed by a physician, or by an audiologist licensed under subch. II of ch. 459, in
23accordance with accepted professional medical or audiological standards, for a child
24covered under the policy or plan who is under 18 years of age and who is certified as

1deaf or hearing impaired by a physician or by an audiologist licensed under subch.
2II of ch. 459.
AB16-ASA1,5,53 b. Coverage of the cost of treatment related to hearing aids and cochlear
4implants, including procedures for the implantation of cochlear devices, for a child
5specified in subd. 1. a.
AB16-ASA1,5,76 2. Coverage of the cost of hearing aids under this subsection is not required to
7exceed the cost of one hearing aid per ear per child more often than once every 3 years.
AB16-ASA1,5,118 3. The coverage required under this subsection may be subject to any
9cost-sharing provisions, limitations, or exclusions, other than a preexisting
10condition exclusion, that apply generally under the disability insurance policy or
11self-insured health plan.
AB16-ASA1,5,1512 (c) 1. Notwithstanding par. (b) 3. and subject to subd. 2., an individual disability
13insurance policy may impose a preexisting condition exclusion that does not exceed
14one year with respect to the coverage required under this subsection for cochlear
15implants and related treatment.
AB16-ASA1,5,2116 2. An individual disability insurance policy that imposes a preexisting
17condition exclusion as authorized under subd. 1. shall nevertheless cover the cost of
18cochlear implants and related treatment for a child during the preexisting condition
19exclusion period if time is of the essence for the child to receive cochlear implants and
20related treatment as a result of the occurrence during that period of any of the
21following conditions:
AB16-ASA1,5,2222 a. Vestibular aqueduct syndrome.
AB16-ASA1,5,2323 b. Viral infection.
AB16-ASA1,5,2424 c. Ototoxicity.
AB16-ASA1,5,2525 d. Autoimmune inner ear disease.
AB16-ASA1,6,2
1e. Any other condition with respect to which a failure to intervene would likely
2negatively impact the child's outcome.
AB16-ASA1,6,33 (d) This subsection does not apply to any of the following:
AB16-ASA1,6,44 1. A disability insurance policy that covers only certain specified diseases.
AB16-ASA1,6,75 2. A health care plan offered by a limited service health organization, as defined
6in s. 609.01 (3), or by a preferred provider plan, as defined in s. 609.01 (4), that is not
7a defined network plan, as defined in s. 609.01 (1b).
AB16-ASA1,6,88 3. A long-term care insurance policy.
AB16-ASA1,6,99 4. A medicare replacement policy or a medicare supplement policy.
AB16-ASA1, s. 10 10Section 10. Initial applicability.
AB16-ASA1,6,1111 (1) This act first applies to all of the following:
AB16-ASA1,6,1412 (a) Except as provided in paragraphs (b) and (c ), disability insurance policies
13that are issued or renewed, and governmental self-insured health plans that are
14established, extended, modified, or renewed, on the effective date of this paragraph.
AB16-ASA1,6,1715 (b) Disability insurance policies covering employees who are affected by a
16collective bargaining agreement containing provisions inconsistent with this act
17that are issued or renewed on the earlier of the following:
AB16-ASA1,6,18 181. The day on which the collective bargaining agreement expires.
AB16-ASA1,6,20 192. The day on which the collective bargaining agreement is extended, modified,
20or renewed.
AB16-ASA1,6,2421 (c) Governmental self-insured health plans covering employees who are
22affected by a collective bargaining agreement containing provisions inconsistent
23with this act that are established, extended, modified, or renewed on the earlier of
24the following:
AB16-ASA1,6,25 251. The day on which the collective bargaining agreement expires.
AB16-ASA1,7,2
12. The day on which the collective bargaining agreement is extended, modified,
2or renewed.
AB16-ASA1, s. 11 3Section 11. Effective date.
AB16-ASA1,7,54 (1) This act takes effect on the first day of the 7th month beginning after
5publication.
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