LRB-0096/2
PJK:kmg&jlg:jlb
1997 - 1998 LEGISLATURE
January 6, 1998 - Introduced by Representatives R. Young, Notestein, Bock,
Boyle, L. Young, Coggs and Wasserman, cosponsored by Senator Moore.
Referred to Committee on Insurance, Securities and Corporate Policy.
AB693,1,4
1An Act to amend 40.51 (8), 40.51 (8m), 60.23 (25), 66.184, 120.13 (2) (g), 185.981
2(4t) and 185.983 (1) (intro.); and
to create 111.91 (2) (n) and 632.895 (11) of the
3statutes;
relating to: requiring disability insurance policies to cover
4contraceptive articles and services.
Analysis by the Legislative Reference Bureau
This bill requires every health insurance policy (called "disability insurance
policy" in the statutes), including health care plans offered by health maintenance
organizations, preferred provider plans and the state, and every self-insured health
plan of a school district, county, city or village, to provide coverage for contraceptive
articles and services if the policy or plan covers outpatient health care services.
Contraceptive articles include any drug or device that is approved by the federal food
and drug administration (FDA) and prescribed by a licensed health care provider for
use to prevent a pregnancy and any hormonal compound that is taken orally and
approved by the FDA for use to prevent a pregnancy. A contraceptive article,
however, does not include any drug or device that is prescribed for use in terminating
a pregnancy of a woman who is known to be pregnant by the prescribing health care
provider. Contraceptive services include medical procedures performed to prevent
a pregnancy and physical examinations and medical counseling for the prescription
or use of a contraceptive article. Specifically excluded from this coverage
requirement are health insurance policies that cover only certain specified diseases,
health care plans offered by limited service health organizations, medicare
replacement and supplement policies and long-term care insurance policies.
Deductibles and copayments that apply generally to the policy or plan may apply to
contraceptive articles and services.
For further information see the state and 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:
AB693,2,53
40.51
(8) Every health care coverage plan offered by the state under sub. (6)
4shall comply with ss. 631.89, 631.90, 631.93 (2), 632.72 (2), 632.745 (1) to (3) and (5),
5632.747, 632.87 (3) to (5), 632.895 (5m) and (8) to
(10) (11) and 632.896.
AB693,2,108
40.51
(8m) Every health care coverage plan offered by the group insurance
9board under sub. (7) shall comply with ss. 632.745 (1) to (3) and (5)
and, 632.747
and
10632.895 (11).
AB693,2,1613
60.23
(25) Self-insured health plans. Provide health care benefits to its
14officers and employes on a self-insured basis if the self-insured plan complies with
15ss. 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3),
16632.87 (4) and (5), 632.895 (9)
and (11) and 632.896.
AB693,3,4
1966.184 Self-insured health plans. If a city, including a 1st class city, or a
20village provides health care benefits under its home rule power, or if a town provides
1health care benefits, to its officers and employes on a self-insured basis, the
2self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
3632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3), 632.87 (4) and (5), 632.895 (9)
and
4(10) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).
AB693, s. 5
5Section
5. 111.91 (2) (n) of the statutes is created to read:
AB693,3,76
111.91
(2) (n) The provision to employes of the health insurance coverage
7required under s. 632.895 (11).
AB693,3,1310
120.13
(2) (g) Every self-insured plan under par. (b) shall comply with ss.
1149.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2.,
12632.747 (3), 632.87 (4) and (5), 632.895 (9)
and (10)
to (11), 632.896, 767.25 (4m) (d)
13and 767.51 (3m) (d).
AB693,3,1816
185.981
(4t) A sickness care plan operated by a cooperative association is
17subject to ss. 252.14, 631.89, 632.72 (2), 632.745, 632.747, 632.749, 632.87 (2m), (3),
18(4) and (5), 632.895 (10)
and (11) and 632.897 (10) and ch. 155.
AB693,4,221
185.983
(1) (intro.) Every such voluntary nonprofit sickness care plan shall be
22exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
23601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72
24(2), 632.745, 632.747, 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5),
1632.895 (5)
, (9) and (10) and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619
2and chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:
AB693, s. 9
3Section
9. 632.895 (11) of the statutes is created to read:
AB693,4,134
632.895
(11) Contraceptive articles and services. (a) In this subsection,
5"contraceptive article" means any drug, medicine, mixture, preparation, instrument,
6article or device of any nature that is approved by the federal food and drug
7administration for use to prevent a pregnancy and that is prescribed by a licensed
8health care provider for use to prevent a pregnancy, or any hormonal compound that
9is taken orally and that is approved by the federal food and drug administration for
10use to prevent a pregnancy. "Contraceptive article" does not include any drug,
11medicine, mixture, preparation, instrument, article or device of any nature
12prescribed for use in terminating the pregnancy of a woman who is known by the
13prescribing licensed health care provider to be pregnant.
AB693,4,1614
(b) Every disability insurance policy, and every self-insured health plan of a
15county, city, village or school district, that provides coverage of outpatient health care
16services shall provide coverage for all of the following:
AB693,4,1717
1. Contraceptive articles.
AB693,4,1918
2. Medical services, including counseling and physical examinations, for the
19prescription or use of a contraceptive article or of a procedure to prevent a pregnancy.
AB693,4,2020
3. Medical procedures performed to prevent a pregnancy.
AB693,4,2321
(c) Coverage under this subsection may be subject to exclusions or limitations,
22including copayments and deductibles, that apply generally to the benefits that are
23provided under the policy or plan.
AB693,4,2424
(d) This subsection does not apply to any of the following:
AB693,4,2525
1. A disability insurance policy that covers only certain specified diseases.
AB693,5,2
12. A health care plan offered by a limited service health organization, as defined
2in s. 609.01 (3).
AB693,5,43
3. A medicare replacement policy, a medicare supplement policy or a long-term
4care insurance policy.
AB693,5,66
(1) This act first applies to all of the following:
AB693,5,97
(a) Except as provided in paragraphs (b) and (c
), disability insurance policies
8that are issued or renewed, and self-insured health plans that are established,
9extended, modified or renewed, on the effective date of this paragraph.
AB693,5,1210
(b) Disability insurance policies covering employes who are affected by a
11collective bargaining agreement containing provisions inconsistent with this act
12that are issued or renewed on the earlier of the following:
AB693,5,13
131. The day on which the collective bargaining agreement expires.
AB693,5,15
142. The day on which the collective bargaining agreement is extended, modified
15or renewed.
AB693,5,1816
(c) Self-insured health plans covering employes who are affected by a collective
17bargaining agreement containing provisions inconsistent with this act that are
18established, extended, modified or renewed on the earlier of the following:
AB693,5,19
191. The day on which the collective bargaining agreement expires.
AB693,5,21
202. The day on which the collective bargaining agreement is extended, modified
21or renewed.
AB693,5,2423
(1)
This act takes effect on the first day of the 5th month beginning after
24publication.
