LRB-0434/1
PJK:lmk&jld:rs
2005 - 2006 LEGISLATURE
October 31, 2005 - Introduced by Representative Black. Referred to Committee
on Insurance.
AB799,1,4 1An Act to amend 40.51 (8), 40.51 (8m), 66.0137 (4), 111.91 (2) (n), 120.13 (2) (g),
2185.981 (4t) and 185.983 (1) (intro.); and to create 609.87 and 632.895 (15) of
3the statutes; relating to: health insurance coverage of smoking cessation
4treatment and medications.
Analysis by the Legislative Reference Bureau
This bill requires a health care plan to provide coverage of smoking cessation
treatment that is provided in conformity with recommendations set forth in a
publication of the federal Agency for Healthcare Research and Quality, as well as
coverage of certain specified smoking cessation medications. The coverage
requirement applies to both individual and group health insurance policies and
plans, including defined network plans and plans offered by cooperative sickness
care associations; to health care plans offered by the state to its employees, including
a self-insured plan; and to self-insured health plans of counties, cities, towns,
villages, and school districts. The requirement does not apply to health care plans
that are offered by limited service health organizations or to health care plans that
cover only specified diseases. The requirement may be subject to any limitations,
exclusions, or cost-sharing provisions that apply generally under the policy or plan.

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:
AB799, s. 1 1Section 1. 40.51 (8) of the statutes is amended to read:
AB799,2,52 40.51 (8) Every health care coverage plan offered by the state under sub. (6)
3shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.746 (1) to (8)
4and (10), 632.747, 632.748, 632.83, 632.835, 632.85, 632.853, 632.855, 632.87 (3) to
5(5), 632.895 (5m) and (8) to (14) (15), and 632.896.
AB799, s. 2 6Section 2. 40.51 (8m) of the statutes is amended to read:
AB799,2,97 40.51 (8m) Every health care coverage plan offered by the group insurance
8board under sub. (7) shall comply with ss. 631.95, 632.746 (1) to (8) and (10), 632.747,
9632.748, 632.83, 632.835, 632.85, 632.853, 632.855, and 632.895 (11) to (14) (15).
AB799, s. 3 10Section 3. 66.0137 (4) of the statutes is amended to read:
AB799,2,1611 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or
12a village provides health care benefits under its home rule power, or if a town
13provides health care benefits, to its officers and employees on a self-insured basis,
14the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
15632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.85, 632.853, 632.855, 632.87 (4) and (5),
16632.895 (9) to (14) (15), 632.896 , and 767.25 (4m) (d).
AB799, s. 4 17Section 4. 111.91 (2) (n) of the statutes is amended to read:
AB799,2,1918 111.91 (2) (n) The provision to employees of the health insurance coverage
19required under s. 632.895 (11) to (14) (15).
AB799, s. 5 20Section 5. 120.13 (2) (g) of the statutes is amended to read:
AB799,3,4
1120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
249.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
3632.85, 632.853, 632.855, 632.87 (4) and (5), 632.895 (9) to (14) (15), 632.896, and
4767.25 (4m) (d).
AB799, s. 6 5Section 6. 185.981 (4t) of the statutes is amended to read:
AB799,3,96 185.981 (4t) A sickness care plan operated by a cooperative association is
7subject to ss. 252.14, 631.17, 631.89, 631.95, 632.72 (2), 632.745 to 632.749, 632.85,
8632.853, 632.855, 632.87 (2m), (3), (4), and (5), 632.895 (10) to (14) (15), and 632.897
9(10) and chs. 149 and 155.
AB799, s. 7 10Section 7. 185.983 (1) (intro.) of the statutes is amended to read:
AB799,3,1711 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be
12exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
13601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.17, 631.89, 631.93,
14631.95, 632.72 (2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.85, 632.853,
15632.855, 632.87 (2m), (3), (4), and (5), 632.895 (5) and (9) to (14) (15), 632.896 , and
16632.897 (10) and chs. 609, 630, 635, 645, and 646, but the sponsoring association
17shall:
AB799, s. 8 18Section 8. 609.87 of the statutes is created to read:
AB799,3,20 19609.87 Coverage of smoking cessation treatment. Defined network plans
20are subject to s. 632.895 (15).
AB799, s. 9 21Section 9. 632.895 (15) of the statutes is created to read:
AB799,3,2422 632.895 (15) Smoking cessation treatment and medication. (a) In this
23subsection, "self-insured health plan" means a self-insured health plan of the state
24or a county, city, village, town, or school district.
AB799,4,6
1(b) 1. Subject to subd. 2. and except as provided in par. (e), every disability
2insurance policy and every self-insured health plan shall provide coverage of
3smoking cessation treatment that is provided in conformity with the
4recommendations set forth in Tobacco Cessation Guideline, released on June 27,
52000, by the federal department of health and human services, agency for healthcare
6research and quality.
AB799,4,87 2. A disability insurance policy or self-insured health plan is not required to
8cover smoking cessation treatment more than 3 times for any insured individual.
AB799,4,129 (c) Except as provided in par. (e), every disability insurance policy and every
10self-insured health plan shall provide coverage of all of the following medications if
11approved for use by the federal food and drug administration and if prescribed for
12smoking cessation:
AB799,4,1313 1. Nicotine gum.
AB799,4,1414 2. Nicotine patch.
AB799,4,1515 3. Nicotine nasal spray.
AB799,4,1616 4. Nicotine inhaler.
AB799,4,1717 5. Zyban or its generic equivalent.
AB799,4,2018 (d) The coverage required under pars. (b) and (c) may be subject to any
19limitations, exclusions, or cost-sharing provisions that apply generally under the
20disability insurance policy or self-insured health plan.
AB799,4,2121 (e) This subsection does not apply to any of the following:
AB799,4,2222 1. A limited service health organization, as defined in s. 609.01 (3).
AB799,4,2423 2. A preferred provider plan, as defined in s. 609.01 (4), that is not a defined
24network plan, as defined in s. 609.01 (1b).
AB799,4,2525 3. A disability insurance policy that covers only certain specified diseases.
AB799, s. 10
1Section 10. Initial applicability.
AB799,5,22 (1) This act first applies to all of the following:
AB799,5,53 (a) Except as provided in paragraphs (b) and (c ), disability insurance policies
4that are issued or renewed, and self-insured health plans that are established,
5extended, modified, or renewed, on the effective date of this paragraph.
AB799,5,86 (b) Disability insurance policies covering employees who are affected by a
7collective bargaining agreement containing provisions inconsistent with this act
8that are issued or renewed on the earlier of the following:
AB799,5,9 91. The day on which the collective bargaining agreement expires.
AB799,5,11 102. The day on which the collective bargaining agreement is extended, modified,
11or renewed.
AB799,5,1412 (c) Self-insured health plans covering employees who are affected by a
13collective bargaining agreement containing provisions inconsistent with this act
14that are established, extended, modified, or renewed on the earlier of the following:
AB799,5,15 151. The day on which the collective bargaining agreement expires.
Loading...
Loading...