214 Ill. Comp. Stat. Ann 5/370c, SB 1341, and HB 2190 provide minimum mandated benefits affecting group health policies having more than 50 enrolled employees. Covered conditions include serious mental illness, including pervasive developmental disorders and post-traumatic stress disorders. Benefits include a minimum of 45 inpatient days and 35 outpatient visits benefits for serious mental illness; other mental health conditions may be subject to 50% co-pays and the lesser of the annual limit of $10,000.00 or 25% of the lifetime policy limit. Mental illness resulting from the use of controlled substances or cannabis and addictions to controlled substances and cannabis are not required to be covered.
Iowa:
Iowa code 514c.22 and HF420 provide minimum mandated benefits affecting group health policies having more than 50 enrolled employees. There is a 50-employee exemption if no coverage of mental illness is provided. Serious mental illness including pervasive developmental disorders and autistic disorders are covered; the minimum benefits include 30 inpatient days and 52 outpatient visits per plan year.
Michigan:
SB 1209/Act 252 provides a minimum mandated benefit affecting Health Maintenance Organizations (HMOs) that covers broad-based mental health disorders and substance use disorders. Minimum coverage levels include a 3% cost exemption and no fewer than 20 outpatient mental health visits per plan year.
Minnesota:
Minn. Stat. Sec. 62A.152, Minn. Stat. Sec. 62Q.47, and SB 845 provide comprehensive parity for HMOs and Community Integrated Service Networks. Benefits are mandated if offered for individual and group policies. Broad-based mental health disorders and substance use disorders are covered at minimum coverage levels.
Summary of factual data and analytical methodologies
The commissioner appointed a 20-member advisory council that met two times to discuss implementation advice to the commissioner on the parity law, content and delivery of notices to employees and components of the actuarial study. The council membership includes Sen. Hansen and Rep. Pasch, the sponsors of Wisconsin's law as well as representatives from the insurance industry, mental health and hospital providers, consumer mental health and substance use disorder advocates, large and small businesses. The commissioner's staff also met with the Department of Health Services to ensure citations and coverage description reflects current transitional treatment provisions and updated regulations. The proposed rule reflects the results of the council's deliberations and advice.
Analysis and supporting documents used to determine effect on small business
Upon review of insurers affected by the regulation, the office identified no small businesses that would be affected by the regulation.
Effect on Small Business
No significant effect will be imposed on regulated small businesses. No additional technology requirements are necessary to comply with the regulation.
Initial regulatory flexibility analysis
Pursuant to s.
227.14(2g), Stats., the proposed rule may have a significant economic impact on small businesses.
Small business regulatory coordinator
The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266-7843 or at email address
eileen.mallow@wisconsin.gov.
Fiscal Estimate
There will be no state or local government fiscal effect.
Private sector fiscal effect
This rule change will have no significant effect on the private sector regulated by OCI.
Agency Contact Person
A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the Web site at:
http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, OCI Services Section, at:
Phone: (608) 264-8110
Address: 125 South Webster St – 2nd Floor, Madison WI
Mail: PO Box 7873, Madison, WI 53707-7873
Notice of Hearing
Insurance
NOTICE IS HEREBY GIVEN that pursuant to the authority granted under section
601.41 (3), Stats., and the procedures set forth in under section
227.18, Stats., OCI will hold a public hearing to consider the adoption of the attached proposed rulemaking order affecting sections
Ins 2.18,
7.02,
7.04,
28.06, Wis. Adm. Code, relating to life settlements and affecting small business.
Hearing Information
Date and Time:
|
Location:
|
March 17, 2011
Thursday
10:00am
|
OCI
2nd Floor, Room 227
125 S. Webster St.
Madison, WI 53703
|
Submittal of Written Comments
Written comments can be mailed to:
James W. Harris
Legal Unit - OCI Rule Comment for Rule Ins
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Written comments can be hand delivered to:
James W. Harris
Legal Unit - OCI Rule Comment for Rule Ins
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53703-3474
Comments can be emailed to:
James W. Harris
The deadline for submitting comments is 4:00 p.m. on the 14th day after the date for the hearing stated in this Notice of Hearing.
Copies of Proposed Rule
A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the OCI internet Web site at
http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, Public Information and Communications, OCI, at:
inger.williams@wisconsin.gov, (608) 264-8110, 125 South Webster Street – 2
nd Floor, Madison WI or PO Box 7873, Madison WI 53707-7873.
Analysis Prepared by the Office fo the Commissioner of Insurance (OCI)
Statute(s) interpreted
Statutory authority
Explanation of agency authority
2009 Wisconsin Act 344 created s.
632.69, Stats., replacing Wisconsin's viatical settlement statute with comprehensive regulation of life settlement transactions. The statute replaces licensing requirements for brokers and providers and establishes pre-licensing and continuing education standards. The statute provides the commissioner with authority to adopt rules implementing and administering the law including appropriate licensing requirements and standards for continuing licensure for providers and brokers, financial accountability for providers and brokers, and the adoption of rules governing the relationship and responsibilities of insurers, providers and brokers during settlement of a life insurance policy.
Related statute(s) or rule(s)
See the statutes interpreted in paragraph 1, above.
Plain language analysis
The proposed rule will assist in implementation of the requirements of s.
632.69, Stat. including those provisions relating to licensure, training, disclosures, reporting, examinations and conduct of licensees. The proposed rule sets forth initial and renewal license application deadlines, fees and requirements, including financial accountability, training, and information to be submitted. The rule lists criteria that may be used in assessing qualification of an applicant for licensure. The proposed rule provides for notification to the commissioner of administrative actions, criminal proceedings and lawsuits that may affect licensure, and reporting of cessation of business activity or change of business address or location of business records. The proposed rule provides detail for fulfilling the form filing and approval requirements of s.
632.69 (5), Stat. as well as providing formats for notices to policyholders, owners and purchasers. The proposed rule incorporates license application forms in to ch.
Ins 7, Wis. Adm. Code, and add certain categories of approved training to s.
Ins 28.06, Wis. Adm. Code.
Summary of, and comparison with, existing or proposed federal regulations
There are no federal regulations which are intended to address life settlement activities to be regulated by the proposed rule.
Comparison with rules in adjacent states
Illinois:
215 ILCS 159/1, et. Seq., effective 7/01/2010, amended Illinois viatical settlement law. To date there has been no formal adoption of language similar to the proposed rule.
Iowa:
IAC 191-48, effective 4/03/2009, contains provisions for viatical and life settlements comparable to the proposed rule.
Michigan:
Michigan General Insurance Laws, Chapter
550 contains viatical settlement contract regulations. To date there has been no formal adoption of language similar to the proposed rule.
Minnesota:
Minnesota Laws, Chapter 60A.957, et. Seq., effective 8/01/2009, contains viatical settlement contract regulations. To date there has been no formal adoption of language similar to the proposed rule.
Summary of factual data and analytical methodologies
The proposed rule is based upon reference to a model regulation and analysis of the proposed provisions by a working group consisting of representatives of the insurance industry, the life settlement industry, an institutional investment group, life insurance agents, regulators and consumer and senior interest associations. The proposed rule will address regulatory needs of the expanding life settlement industry, add procedures for administrative oversight of licensees operating within the state and provide important disclosures to consumers.
Analysis and supporting documents used to determine effect on small business
The proposed rule continues, and expands existing licensing, reporting and disclosure requirements relating to viatical settlements and life settlements. The rule should have little effect on small businesses.
Effect on Small Business
This rule will have little or no effect on small businesses.
Initial regulatory flexibility analysis
Notice is hereby further given that pursuant to s.
227.114, Stats., the proposed rule may have an effect on small businesses. The initial regulatory flexibility analysis is as follows:
a. Types of small businesses affected:
Insurance agents, Small Agencies
b. Description of reporting and bookkeeping procedures required:
None beyond those currently required.
c. Description of professional skills required:
None beyond those currently required.
Small business regulatory coordinator
