Amendment SSA1-AB416

AB416-SSA1, s. 110 Section 110. 635.29 (title) of the statutes is repealed and recreated to read:

AB416-SSA1,56,19 635.29 (title) Applicability of health insurance mandates.

AB416-SSA1, s. 111 Section 111. Nonstatutory provisions.

AB416-SSA1,57,2 (1)  Risk adjustment committee. The commissioner of insurance shall appoint a committee on risk adjustment under section 15.04 (1) (c) of the statutes, consisting of 5 to 8 members, to advise the commissioner on, and to assist the commissioner in developing rules for, the group risk adjustment mechanism under section 635.07 (4) of the statutes, as affected by this act. The commissioner shall appoint at least 5 representatives of insurers to be members of the committee.

AB416-SSA1,57,10 (2)  Risk adjustment mechanism emergency rule-making authority. Using the procedure under section 227.24 of the statutes, the commissioner of insurance may promulgate rules under section 635.07 (4) (e) of the statutes, as affected by this act, for the period before the effective date of the permanent rules promulgated under section 635.07 (4) (e) of the statutes, as affected by this act, but not to exceed the period authorized under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24 (1) and (3) of the statutes, the commissioner is not required to make a finding of emergency.

AB416-SSA1,57,11 (3)  Health insurance risk-sharing plan board member terms.

AB416-SSA1,57,15 (a)  Notwithstanding section 15.07 (1) (c) of the statutes and section 619.15 (1) of the statutes, as affected by this act, the terms of the 7 appointed members currently serving on the board of governors of the health insurance risk-sharing plan shall expire on July 1, 1996.

AB416-SSA1,57,18 (b)  Notwithstanding section 619.15 (1) of the statutes, as affected by this act, the new members of the board of governors of the health insurance risk-sharing plan shall be appointed for the following terms:

AB416-SSA1,57,21 1. One representative of an insurer, one representative of a health care provider and one public member, to be determined by the commissioner, for terms expiring on May 1, 1997.

AB416-SSA1,57,24 2. One representative of an insurer, one representative of a health care provider and one public member, to be determined by the commissioner, for terms expiring on May 1, 1998.

AB416-SSA1,58,3 3. One representative of an insurer, one representative of a health care provider and one public member, to be determined by the commissioner, for terms expiring on May 1, 1999.

AB416-SSA1,58,4 (4)  Study by health insurance risk-sharing plan board.

AB416-SSA1,58,7 (a)  The board of governors of the health insurance risk-sharing plan shall study alternatives for reducing costs under the plan through the use of managed care plans. The board shall study at least all of the following:

AB416-SSA1,58,10 1.  The feasibility of including plan enrollees in the program administered by the department of health and social services that provides health care services to medical assistance recipients through managed care providers.

AB416-SSA1,58,13 2.  The development of a competitive bid process for the provision of covered services to plan enrollees. As part of this requirement, the board shall consider all of the following competitive bidding and pricing alternatives:

AB416-SSA1,58,14 a.  Fully capitated bids.

AB416-SSA1,58,18 b.  Bids under which the health insurance risk-sharing plan and the health care plan providing the covered services share the risk that costs will exceed a predetermined amount and the savings when costs are below a predetermined amount.

AB416-SSA1,58,19 c.  Bids under which only specified services are provided on a capitated basis.

AB416-SSA1,58,21 d.  Bids under which only identified groups of plan enrollees are covered on a capitated basis.

AB416-SSA1,58,24 (b)  The board shall submit a report of the results of the study and its recommendations to the legislature under section 13.172 (2) of the statutes no later than July 1, 1996.

AB416-SSA1,59,5 (5)  Rules on health insurance risk-sharing plan managed care initiative. The board of governors of the health insurance risk-sharing plan shall submit in proposed form the rules required under section 619.145 (1m) of the statutes, as created by this act, to the legislative council staff under section 227.15 (1) of the statutes no later than January 1, 1997.

AB416-SSA1,59,6 (6)  Study on establishing a basic health insurance plan.

AB416-SSA1,59,9 (a)  The department of health and social services and the office of the commissioner of insurance shall jointly study the establishment of a basic health insurance plan. The study shall include consideration of all of the following:

AB416-SSA1,59,13 1. The feasibility of including coverage under the basic health insurance plan for different groups of people, including low-income persons, persons with coverage under the health insurance risk-sharing plan and recipients of medical assistance or health care benefits under another public assistance program.

AB416-SSA1,59,14 2.  The benefits to be provided under the basic health insurance plan.

AB416-SSA1,59,18 3.  A plan and a timetable for phasing out the imposition of surcharges under section 619.13 of the statutes, as affected by this act, for the health insurance risk-sharing plan and for replacing the lost revenues with other funds, including premiums collected for the basic health insurance plan or state or federal funds.

AB416-SSA1,59,22 (b)  The department of health and social services and the office of the commissioner of insurance shall submit a report of the study with their recommendations, addressing each of the items under paragraph (a), to the legislature under section 13.172 (2) of the statutes no later than January 1, 1997.

AB416-SSA1,59,23 (7)  Evaluation of market reforms.

AB416-SSA1,60,3 (a) The commissioner of insurance shall evaluate the effectiveness of the health insurance market reforms under chapter 635 of the statutes, as affected by this act, including the effectiveness of the reforms with respect to all of the following:

AB416-SSA1,60,5 1. Accessibility of health insurance coverage, including such accessibility for persons who reside in rural areas of the state.

AB416-SSA1,60,6 2.  Availability of health insurance coverage for uninsured persons.

AB416-SSA1,60,7 3.  Affordability of health insurance coverage.

AB416-SSA1,60,10 (b) The commissioner shall submit a report of the results of the evaluation and any recommendations to the legislature under section 13.172 (2) of the statutes no later than the first day of the 24th month beginning after publication.

AB416-SSA1, s. 112 Section 112 . Initial applicability.

AB416-SSA1,60,22 (1) Health insurance market reform. The treatment of sections 40.51 (8) and (8m), 111.70 (4) (o), 111.91 (2) (L), 120.13 (2) (g), 185.983 (1g), 625.12 (2), 628.34 (3) (a) and (b), 632.76 (2) (a), 632.896 (4), 635.01, 635.02, 635.03, 635.04, 635.05, 635.07, 635.09, 635.11 (intro.), (1) and (4), 635.13, 635.15, 635.16, 635.17, 635.18 (title), (1) (a) and (b), (2), (3), (4), (5), (6), (7) and (8), 635.20 (1c), (1m), (2) and (13), 635.23 (1) (a), (d), (dp), (dr) and (e) (intro.), 1., 2. and 3., (4) and (5), 635.25 (1) (a) (intro.) and (b), (1m) and (2), 635.254, 635.26, 635.272 (1) and 635.28 of the statutes, the renumbering of section 635.18 (1) of the statutes, the amendment of section 66.184 (1) of the statutes, the repeal and recreation of section 111.70 (1) (a) (by Section 14 of the statutes and the creation of section 60.23 (25) (h) and (i) of the statutes first apply to all of the following:

AB416-SSA1,60,25 (a)  Except as provided in paragraphs (b) and (c), health benefit plans that are issued or renewed, and self-insured health plans that are established, extended, modified or renewed, on the effective date of this paragraph.

AB416-SSA1,61,3 (b) Health benefit plans covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are issued or renewed on the earlier of the following:

AB416-SSA1,61,4 1.  The day on which the collective bargaining agreement expires.

AB416-SSA1,61,6 2.  The day on which the collective bargaining agreement is extended, modified or renewed.

AB416-SSA1,61,9 (c) Self-insured health plans covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are established, extended, modified or renewed on the earlier of the following:

AB416-SSA1,61,10 1.  The day on which the collective bargaining agreement expires.

AB416-SSA1,61,12 2.  The day on which the collective bargaining agreement is extended, modified or renewed.

AB416-SSA1, s. 113 Section 113. Effective dates. This act takes effect on the day after publication, except as follows:

AB416-SSA1,62,2 (1)  Health insurance market reform. The treatment of sections 40.51 (8) and (8m), 111.70 (4) (o), 111.91 (2) (L), 120.13 (2) (g), 185.983 (1g), 625.12 (2), 628.34 (3) (a) and (b), 632.76 (2) (a), 632.896 (4), 635.01, 635.02, 635.03, 635.04, 635.05, 635.07, 635.09, 635.11 (intro.), (1) and (4), 635.13, 635.15, 635.16, 635.17, 635.18 (title), (1) (a) and (b), (2), (3), (4), (5), (6), (7) and (8), 635.20 (1c), (1m), (2) and (13), 635.23 (1) (a), (d), (dp), (dr) and (e) (intro.), 1., 2. and 3., (4) and (5), 635.25 (title), (1) (a) (intro.) and (b), (1m) and (2), 635.254, 635.26, 635.272 (1), 635.28 and 635.29 (title) and chapter 635 (title) of the statutes, the renumbering of section 635.18 (1) of the statutes, the amendment of section 66.184 (1) of the statutes, the repeal and recreation of section 111.70 (1) (a) (by Section 15) of the statutes, the creation of section 60.23 (25) (h) and (i) of the statutes and Section 112 of this act take effect on the first day of the 12th month beginning after publication.

AB416-SSA1,62,12 (2) Health insurance risk-sharing plan surcharge. The treatment of sections 619.14 (5) (d), 619.145 (1) and (1m), 619.15 (1) and 619.165 (1) (a) and (2) of the statutes, the repeal of sections 619.145 (3) (e) and (4) and 619.15 (4) (e) of the statutes, the renumbering of section 66.184 of the statutes, the renumbering and amendment of section 60.23 (25) of the statutes, the amendment of sections 111.70 (1) (a), 619.135 (2) and (3), 619.15 (3) (c) and 619.175 of the statutes, the repeal and recreation of sections 619.10 (3m) (by Section 27 ), 619.13 (by Section 29 ) and 619.15 (4) (c) (by Section 53) of the statutes and the creation of sections 40.51 (8c), 60.23 (25) (a), 66.184 (2), 111.70 (4) (n), 111.91 (2) (k), 120.13 (2) (gm) and 619.15 (3) (bc) and (bm) of the statutes take effect on July 1, 1996.

AB416-SSA1,62,22 (3)  Invalid surcharge and insurer assessment. The repeal of sections 40.51 (8c), 60.23 (25) (a), 66.184 (2), 111.70 (4) (n), 111.91 (2) (k), 120.13 (2) (gm) and 619.15 (3) (bc) and (bm) of the statutes, the repeal and recreation of sections 111.70 (1) (a) (by Section 16), 619.10 (3m) (by Section 28 ), 619.13 (by Section 30 ), 619.135 (2) (by Section 32) and (3) (by Section 35 ), 619.15 (3) (c) and (4) (c) (by Section 54) and 619.175 (by Section 62 ) of the statutes and the creation of sections 619.145 (3) (e) and (4) and 619.15 (4) (e) of the statutes take effect on the date on which the commissioner of insurance certifies to the revisor of statutes under section 619.13 (6) (b) of the statutes, as affected by this act, that the surcharge or its application is invalid with respect to all persons.

AB416-SSA1,63,3 (4)  Health insurance risk-sharing plan waiver or exemption. The repeal and recreation of sections 619.135 (2) (by Section 33) and (3) (by Section 36) and 619.175 (by Section 63) of the statutes takes effect on the day after 2 years after the date on which the commissioner of insurance certifies to the revisor of statutes under section 619.13 (6) (b) of the statutes, as affected by this act, that the surcharge or its application is invalid with respect to all persons.

AB416-SSA1,63,4 (End)