2. Any employer that participates in the plan must offer health care coverage
to all of its permanent employes who have a normal work week of 30 or more hours
and may offer coverage under the plan to any of its other employes.
3. Any employer that participates in the plan must provide health care
coverage to at least 50% of its permanent employes who have a normal work week
of 30 or more hours and who do not otherwise receive health care coverage as a
dependent under any other plan that is not offered by the employer. The employer
is also required to pay for each employe insured under the plan at least 50% of the
lowest premium rate that would be available to the employer for the employe's
coverage under the plan.
4. Any employer that provides coverage under the plan and that voluntarily
terminates coverage under the plan is not eligible to participate in the plan for at
least 3 years from the date that coverage is terminated.
5. Any insurer that submits a bid to offer health care coverage for state
employes is required to submit a bid to offer health care coverage under the plan in
those counties in which the insurer bids to provide health care coverage to state
employes.
6. Any insurer that offers the plan must provide coverage under the plan to any
employer that applies for coverage, without regard to the health condition or claims
experience of any individual who would have coverage, as long as the employer pays
the premium and agrees to comply with plan requirements.
7. The health care coverage plan is subject to all provisions of the state
insurance code to the same extent as any other group health benefit plan that is
offered in the private sector.
8. The plan may only be sold by licensed insurance agents in this state, but an
insurance agent may not sell coverage under the plan on behalf of an insurer unless
he or she is employed by the insurer or has a contract with the insurer to sell the
coverage on behalf of the insurer.
9. DETF is prohibited from selling any health care coverage under the plan or
enrolling any employe under the plan, but DETF may publicize the availability of the
health care coverage plan for employers.
10. DETF is authorized to contract with any person to provide services relating
to the administration of the health care coverage plan.

11. The commission rate at which an insurer must compensate insurance
agents for the sale of the plan is set by the PEHCCB.
12. DETF is required to charge employers who participate in the plan a fee to
cover the costs of designing, establishing and administering the plan.
13. The plan is sunset on January 1, 2007.
Under the bill, the PEHCCB is required to report annually to the governor and
the legislature on the operation of the plan. In addition, no later than August 1, 2005,
the PEHCCB must submit a report to the governor and the legislature that offers
recommendations as to whether DETF should continue to administer the plan,
whether a different state agency should administer the plan or whether the plan
should be administered by a private nonprofit organization. If the PEHCCB
recommends that a different state agency administer the health care coverage plan
or that the health care coverage plan be administered by a private nonprofit
organization, the PEHCCB shall submit proposed legislation relating to the
recommendation at the time that the PEHCCB submits its report.
For further information see the state 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:
AB662, s. 1 1Section 1. 13.94 (1) (p) of the statutes is created to read:
AB662,3,52 13.94 (1) (p) No later than January 1, 2004, prepare a program evaluation audit
3of the private employer health care coverage plan established under subch. X of ch.
440. The legislative audit bureau shall file a copy of the audit report under this
5paragraph with the distributees specified in par. (b).
AB662, s. 2 6Section 2. 13.94 (1) (p) of the statutes, as created by 1997 Wisconsin Act ....
7(this act), is repealed.
AB662, s. 3 8Section 3. 15.07 (1) (b) 21. of the statutes is created to read:
AB662,3,99 15.07 (1) (b) 21. Private employer health care coverage board.
AB662, s. 4 10Section 4. 15.07 (1) (b) 21. of the statutes, as created by 1997 Wisconsin Act
11.... (this act), is repealed.
AB662, s. 5 12Section 5. 15.165 (5) of the statutes is created to read:
AB662,4,5
115.165 (5) Private employer health care coverage board. (a) There is created
2in the department of employe trust funds a private employer health care coverage
3board consisting of the secretary of employe trust funds or his or her designee, the
4secretary of health and family services or his or her designee and the following
5members appointed for 3-year terms:
AB662,4,66 1. One member who represents health maintenance organizations.
AB662,4,77 2. One member who represents hospitals.
AB662,4,88 3. One member who represents insurance agents, as defined in s. 628.02 (4).
AB662,4,109 4. Two members who are employes eligible to receive health care coverage
10under subch. X of ch. 40 and whose employer employs not more than 50 employes.
AB662,4,1111 5. One member who represents insurers.
AB662,4,1412 6. Two members who are, or who represent, employers that employ not more
13than 50 employes and who are eligible to offer health care coverage under subch. X
14of ch. 40.
AB662,4,1515 7. One member who is a physician, as defined in s. 448.01 (5).
AB662,4,1616 8. Two members who represent the public interest.
AB662,4,1817 (b) The secretary of employe trust funds or his or her designee and the secretary
18of health and family services or his or her designee shall be nonvoting members.
AB662, s. 6 19Section 6. 15.165 (5) of the statutes, as created by 1997 Wisconsin Act .... (this
20act), is repealed.
AB662, s. 7 21Section 7. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
22the following amounts for the purposes indicated: - See PDF for table PDF
AB662, s. 8 1Section 8. 20.515 (2) (title) of the statutes is created to read:
AB662,5,22 20.515 (2) (title) Private employer health care coverage plan.
AB662, s. 9 3Section 9. 20.515 (2) (title) of the statutes, as created by 1997 Wisconsin Act
4.... (this act), is repealed.
AB662, s. 10 5Section 10. 20.515 (2) (a) of the statutes is created to read:
AB662,5,96 20.515 (2) (a) Private employer health care coverage plan; start-up costs. The
7amounts in the schedule for the start-up costs for designing, establishing and
8administering the private employer health care coverage plan under subch. X of ch.
940.
AB662, s. 11 10Section 11. 20.515 (2) (a) of the statutes, as created by 1997 Wisconsin Act ....
11(this act), is repealed.
AB662, s. 12 12Section 12. 20.515 (2) (g) of the statutes is created to read:
AB662,5,1613 20.515 (2) (g) Private employer health care coverage plan. All moneys received
14under subch. X of ch. 40 from employers who elect to participate in the private
15employer health care coverage plan under subch. X of ch. 40, for the costs of
16designing, establishing and administering the plan.
AB662, s. 13 17Section 13. 20.515 (2) (g) of the statutes, as created by 1997 Wisconsin Act ....
18(this act), is repealed.
AB662, s. 14 19Section 14 . 40.02 (26) (intro.) of the statutes is amended to read:
AB662,6,8
140.02 (26) (intro.) "Employe" means any person who receives earnings as
2payment for personal services rendered for the benefit of any employer including
3officers of the employer, except as provided in subch. X. An employe is deemed to
4have separated from the service of an employer at the end of the day on which the
5employe last performed services for the employer, or, if later, the day on which the
6employe-employer relationship is terminated because of the expiration or
7termination of leave without pay, sick leave, vacation or other leave of absence. A
8person shall not be considered an employe if a person:
AB662, s. 15 9Section 15. 40.02 (26) (intro.) of the statutes, as affected by 1997 Wisconsin
10Act .... (this act), is amended to read:
AB662,6,1811 40.02 (26) (intro.) "Employe" means any person who receives earnings as
12payment for personal services rendered for the benefit of any employer including
13officers of the employer, except as provided in subch. X. An employe is deemed to
14have separated from the service of an employer at the end of the day on which the
15employe last performed services for the employer, or, if later, the day on which the
16employe-employer relationship is terminated because of the expiration or
17termination of leave without pay, sick leave, vacation or other leave of absence. A
18person shall not be considered an employe if a person:
AB662, s. 16 19Section 16 . 40.02 (28) of the statutes is amended to read:
AB662,7,320 40.02 (28) "Employer" means the state, including each state agency, any
21county, city, village, town, school district, other governmental unit or
22instrumentality of 2 or more units of government now existing or hereafter created
23within the state and, any federated public library system established under s. 43.19
24whose territory lies within a single county with a population of 500,000 or more and
25a local exposition district created under subch. II of ch. 229
, except as provided under

1ss. 40.51 (7) and 40.61 (3), or a local exposition district created under subch. II of ch.
2229
and subch. X. Each employer shall be a separate legal jurisdiction for OASDHI
3purposes.
AB662, s. 17 4Section 17. 40.02 (28) of the statutes, as affected by 1997 Wisconsin Act ....
5(this act), is amended to read:
AB662,7,136 40.02 (28) "Employer" means the state, including each state agency, any
7county, city, village, town, school district, other governmental unit or
8instrumentality of 2 or more units of government now existing or hereafter created
9within the state, any federated public library system established under s. 43.19
10whose territory lies within a single county with a population of 500,000 or more and
11a local exposition district created under subch. II of ch. 229, except as provided under
12ss. 40.51 (7) and 40.61 (3) and subch. X. Each employer shall be a separate legal
13jurisdiction for OASDHI purposes.
AB662, s. 18 14Section 18. Subchapter X of chapter 40 [precedes 40.98] of the statutes is
15created to read:
AB662,7,1616 Chapter 40
AB662,7,1917 Subchapter X
18 Private employer health
19 Care coverage
AB662,7,20 2040.98 Health care coverage. (1) In this subchapter:
AB662,7,2121 (a) "Board" means the private employer health care coverage board.
AB662,7,2522 (b) "Dependent" means a spouse, an unmarried child under the age of 19 years,
23an unmarried child who is a full-time student under the age of 21 years and who is
24financially dependent upon the parent, or an unmarried child of any age who is
25medically certified as disabled and who is dependent upon the parent.
AB662,8,8
1(c) "Employe" means any person who receives earnings as payment for personal
2services rendered for the benefit of any employer including officers of the employer.
3An employe is considered to have separated from the service of an employer at the
4end of the day on which the employe last performed services for the employer, or, if
5later, the day on which the employe-employer relationship is terminated because of
6the expiration or termination of leave without pay, sick leave, vacation or other leave
7of absence. A person shall not be considered an employe if any of the following
8applies:
AB662,8,109 1. The person is employed under a contract involving the furnishing of more
10than personal services.
AB662,8,1411 2. The person is customarily engaged in an independently established trade,
12business or profession providing the same type of services to more than one employer
13and the person's services to an employer are not compensated for on a payroll of that
14employer.
AB662,8,1615 3. The person is a patient or inmate of a hospital, home or institution and
16performs services in the hospital, home or institution.
AB662,8,1917 (d) "Employer" means any person who is doing business or operating an
18organization in this state and who employs at least 2 employes, but who is not an
19employer, as defined in s. 40.02 (28).
AB662,8,2120 (e) "Health care coverage plan" means the health care coverage plan
21established under sub. (2) (a).
AB662,8,2222 (f) "Insurer" has the meaning given in s. 600.03 (27).
AB662,9,6 23(2) (a) The department shall design, establish and administer a health care
24coverage plan for employers that provides coverage beginning not later than January
251, 2000. In establishing the health care coverage plan, the department shall solicit

1and accept bids and enter into contracts with insurers who are to provide health care
2coverage under the health care coverage plan. The health care coverage plan is
3subject to the provisions of chs. 600 to 646 that apply to group health benefit plans,
4as defined in s. 632.745 (9), to the same extent as any other group health benefit plan,
5as defined in s. 632.745 (9). Before the health care coverage plan may be
6implemented, the board must approve the plan.
AB662,9,107 (b) The health care coverage plan shall require that all insurance rates under
8the plan be published annually in a single publication that is made available to
9employers and employes. The rates shall be listed by county and by any other factor
10that the department considers appropriate.
AB662,9,1311 (c) The health care coverage plan shall have an enrollment period that is
12identical to that provided to state employes who receive health care coverage under
13s. 40.51 (6).
AB662,9,1714 (d) The department shall charge employers who participate in the health care
15coverage plan a fee to cover the department's cost in designing, establishing and
16administering the health care coverage plan. All moneys received under this
17paragraph shall be credited to the appropriation account under s. 20.515 (2) (g).
AB662,9,2018 (e) The department may not sell any health care coverage plan to an employer
19or enroll any employe in the health care coverage plan, but the department may
20publicize the availability of the health care coverage plan for employers.
AB662,9,2221 (f) The department may enter into a contract with any person to provide
22services relating to the administration of the health care coverage plan.
AB662,9,24 23(3) Any employer who participates in the health care coverage plan shall do all
24of the following:
AB662,10,3
1(a) Offer health care coverage under the plan to all of its permanent employes
2who have a normal work week of 30 or more hours and may offer health care coverage
3under the plan to any of its other employes.
AB662,10,74 (b) Provide health care coverage under the plan to at least 50% of its permanent
5employes who have a normal work week of 30 or more hours and who do not otherwise
6receive health care coverage as a dependent under any other plan that is not offered
7by the employer.
AB662,10,108 (c) Pay for each employe at least 50% of the lowest premium rate that would
9be available to the employer for that employe's coverage under the health care
10coverage plan.
AB662,10,1211 (d) Make premium payments for the health care coverage of its employes
12directly to the insurer providing the health care coverage.
AB662,10,15 13(4) Any employer that provides health care coverage for its employes under the
14plan and that voluntarily terminates coverage under the plan is not eligible to
15participate in the plan for at least 3 years from the date that coverage is terminated.
AB662,10,19 16(5) (a) Any insurer that submits a bid to offer health care coverage under s.
1740.51 (6) is required to submit a bid to offer the health care coverage plan established
18under sub. (2) in those counties in which the insurer bids to provide health care
19coverage under s. 40.51 (6).
AB662,10,2420 (b) Any insurer that offers the health care coverage plan shall provide coverage
21under the plan to any employer that applies for coverage, and to all of the employer's
22employes who elect coverage under the health care coverage plan, without regard to
23the health condition or claims experience of any individual who would be covered
24under the health care coverage plan if all of the following apply:
AB662,11,2
11. The employer agrees to pay the premium required for coverage under the
2health care coverage plan.
AB662,11,53 2. The employer agrees to comply with all provisions of the health care coverage
4plan that apply generally to a policyholder or an insured without regard to health
5condition or claims experience.
AB662,11,7 6(6) (a) The health care coverage plan may only be sold by insurance agents
7licensed under ch. 628.
AB662,11,118 (b) An insurance agent may not sell any health care coverage under the health
9care coverage plan on behalf of an insurer unless he or she is employed by the insurer
10or has a contract with the insurer to sell the health care coverage on behalf of the
11insurer.
AB662,11,1612 (c) The board shall set, and may adjust as often as semiannually, the
13commission rate at which an insurer shall compensate an insurance agent for the
14sale of a policy under the health care coverage plan. The rate shall be based on the
15average commission rate that insurance agents are paid in the state for the sale of
16comparable health insurance policies at the time that the rate is set or adjusted.
AB662,11,1817 (d) An insurer shall specify on the first page of any policy sold under the health
18care coverage plan the amount of the commission paid to the insurance agent.
AB662,11,24 19(7) (a) Annually, on or before December 31, the board shall submit a report to
20the appropriate standing committees under s. 13.172 (3) and to the governor on the
21operation of the health care coverage plan. The report shall specify the number of
22employers participating in the health care coverage plan, calculate the costs of the
23health care coverage plan to employers and their employes and include
24recommendations for improving the health care coverage plan.
AB662,12,10
1(b) No later than August 1, 2005, the board shall submit a report to the
2appropriate standing committees under s. 13.172 (3) and to the governor that offers
3recommendations as to whether the department should continue to administer the
4health care coverage plan, whether a different state agency should administer the
5health care coverage plan or whether the health care coverage plan should be
6administered by a private nonprofit organization. If the board recommends that a
7different state agency administer the health care coverage plan or that the health
8care coverage plan be administered by a private nonprofit organization, the board
9shall submit proposed legislation to the appropriate standing committees under s.
1013.172 (3) at the time that the board submits its report.
AB662, s. 19 11Section 19. Subchapter X of chapter 40 [precedes 40.98] of the statutes, as
12created by 1997 Wisconsin Act .... (this act), is repealed.
AB662, s. 20 13Section 20. Nonstatutory provisions.
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