AB591-ASA2,129,322 (a) 1. Except as provided in subd. 2., "eligible employe" means an employe who
23works on a permanent basis and has a normal work week of 30 or more hours. The
24term includes a sole proprietor, a business owner, including the owner of a farm
25business, a partner of a partnership and a member of a limited liability company if

1the sole proprietor, business owner, partner or member is included as an employe
2under a health benefit plan of an employer, but the term does not include an employe
3who works on a temporary or substitute basis.
AB591-ASA2,129,64 2. For purposes of a group health benefit plan, or a self-insured health plan,
5that is offered by the state under s. 40.51 (6) or by the group insurance board under
6s. 40.51 (7), "eligible employe" has the meaning given in s. 40.02 (25).
AB591-ASA2,129,77 (b) "Employer" means any of the following:
AB591-ASA2,129,108 1. An individual, firm, corporation, partnership, limited liability company or
9association that is actively engaged in a business enterprise in this state, including
10a farm business.
AB591-ASA2,129,1111 2. A municipality, as defined in s. 16.70 (8).
AB591-ASA2,129,1212 3. The state.
AB591-ASA2,129,1613 (c) "Group health benefit plan" means a health benefit plan that is issued by
14an insurer to an employer on behalf of a group consisting of eligible employes of the
15employer. The term includes individual health benefit plans covering eligible
16employes when 3 or more are sold to an employer.
AB591-ASA2,129,2517 (d) "Health benefit plan" means any hospital or medical policy or certificate.
18"Health benefit plan" does not include accident-only, credit accident or health,
19dental, vision, medicare supplement, medicare replacement, long-term care,
20disability income or short-term insurance, coverage issued as a supplement to
21liability insurance, worker's compensation or similar insurance, automobile medical
22payment insurance, individual conversion policies, specified disease policies,
23hospital indemnity policies, as defined in s. 632.895 (1) (c), policies or certificates
24issued under the health insurance risk-sharing plan or an alternative plan under
25subch. II of ch. 619 or other insurance exempted by rule of the commissioner.
AB591-ASA2,130,7
1(e) "Insurer" means an insurer that is authorized to do business in this state,
2in one or more lines of insurance that includes health insurance, and that offers
3group health benefit plans covering eligible employes of one or more employers in
4this state. The term includes a health maintenance organization, as defined in s.
5609.01 (2), a preferred provider plan, as defined in s. 609.01 (4), an insurer operating
6as a cooperative association organized under ss. 185.981 to 185.985 and a limited
7service health organization, as defined in s. 609.01 (3).
AB591-ASA2,130,98 (f) "Qualifying coverage" means benefits or coverage provided under any of the
9following:
AB591-ASA2,130,1010 1. Medicare or medicaid.
AB591-ASA2,130,1311 2. A group health benefit plan or an employer-based health benefit
12arrangement that provides benefits similar to or exceeding benefits provided under
13a basic health benefit plan under subch. II of ch. 635.
AB591-ASA2,130,1614 3. An individual health benefit plan that provides benefits similar to or
15exceeding benefits provided under a basic health benefit plan under subch. II of ch.
16635, if the individual health benefit plan has been in effect for at least one year.
AB591-ASA2,130,1817 (g) "Self-insured health plan" means a self-insured health plan of the state or
18a county, city, village, town or school district.
AB591-ASA2,130,22 19(2) Preexisting conditions. (a) A group health benefit plan, or a self-insured
20health plan, may not deny, exclude or limit benefits for a covered individual for losses
21incurred more than 12 months after the effective date of the individual's coverage
22due to a preexisting condition.
AB591-ASA2,130,2523 (b) Except as provided in par. (c), a group health benefit plan, or a self-insured
24health plan, may not define a preexisting condition more restrictively than any of the
25following:
AB591-ASA2,131,4
11. A condition that would have caused an ordinarily prudent person to seek
2medical advice, diagnosis, care or treatment during the 6 months immediately
3preceding the effective date of coverage and for which the individual did not seek
4medical advice, diagnosis, care or treatment.
AB591-ASA2,131,75 2. A condition for which medical advice, diagnosis, care or treatment was
6recommended or received during the 6 months immediately preceding the effective
7date of coverage.
AB591-ASA2,131,118 (c) Notwithstanding par. (b) 1. and 2., a group health benefit plan, or a
9self-insured health plan, shall exclude pregnancy from the definition of a preexisting
10condition for the purpose of coverage of expenses related to prenatal and postnatal
11care, delivery and any complications of pregnancy.
AB591-ASA2,131,18 12(3) Portability. (a) A group health benefit plan, or a self-insured health plan,
13shall waive any period applicable to a preexisting condition exclusion or limitation
14period with respect to particular services for the period that an individual was
15previously covered by qualifying coverage that was not sponsored by the employer
16sponsoring the group health benefit plan or the self-insured health plan and that
17provided benefits with respect to such services, if the qualifying coverage terminated
18not more than 60 days before the effective date of the new coverage.
AB591-ASA2,131,2319 (b) Paragraph (a) does not prohibit the application of a waiting period to all new
20enrollees under a group health benefit plan or a self-insured health plan; however,
21a waiting period may not be applied when determining whether the qualifying
22coverage terminated not more than 60 days before the effective date of the new
23coverage.
AB591-ASA2,132,4 24(4) Minimum participation of employes. (a) Except as provided in par. (d),
25requirements used by an insurer in determining whether to provide coverage under

1a group health benefit plan to an employer, including requirements for minimum
2participation of eligible employes and minimum employer contributions, shall be
3applied uniformly among all employers that apply for or receive coverage from the
4insurer.
AB591-ASA2,132,75 (b) An insurer may vary its minimum participation requirements and
6minimum employer contribution requirements only by the size of the employer group
7based on the number of eligible employes.
AB591-ASA2,132,138 (c) In applying minimum participation requirements with respect to an
9employer, an insurer may not count eligible employes who have other coverage that
10is qualifying coverage in determining whether the applicable percentage of
11participation is met, except that an insurer may count eligible employes who have
12coverage under another health benefit plan that is sponsored by that employer and
13that is qualifying coverage.
AB591-ASA2,132,1614 (d) An insurer may not increase a requirement for minimum employe
15participation or a requirement for minimum employer contribution that applies to
16an employer after the employer has been accepted for coverage.
AB591-ASA2,132,1817 (e) This subsection does not apply to a group health benefit plan offered by the
18state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7).
AB591-ASA2,132,25 19(5) Prohibited coverage practices. (a) 1. Except as provided in rules
20promulgated under subd. 3., if an insurer offers a group health benefit plan to an
21employer, the insurer shall offer coverage to all of the eligible employes of the
22employer and their dependents. Except as provided in rules promulgated under
23subd. 3., an insurer may not offer coverage to only certain individuals in an employer
24group or to only part of the group, except for an eligible employe who has not yet
25satisfied an applicable waiting period, if any.
AB591-ASA2,133,7
12. Except as provided in rules promulgated under subd. 3., if the state or a
2county, city, village, town or school district offers coverage under a self-insured
3health plan, it shall offer coverage to all of its eligible employes and their dependents.
4Except as provided in rules promulgated under subd. 3., the state or a county, city,
5village, town or school district may not offer coverage to only certain individuals in
6the employer group or to only part of the group, except for an eligible employe who
7has not yet satisfied an applicable waiting period, if any.
AB591-ASA2,133,148 3. The secretary of employe trust funds, with the approval of the group
9insurance board, shall promulgate rules related to offering coverage to eligible
10employes under a group health benefit plan, or a self-insured health plan, offered
11by the state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7). The
12rules shall conform to the intent of subds. 1. and 2. and may not allow the state or
13the group insurance board to refuse to offer coverage to an eligible employe or
14dependent for reasons related to health condition.
AB591-ASA2,133,1815 (b) 1. An insurer may not modify a group health benefit plan with respect to
16an employer or an eligible employe or dependent, through riders, endorsements or
17otherwise, to restrict or exclude coverage for certain diseases or medical conditions
18otherwise covered by the group health benefit plan.
AB591-ASA2,133,2219 2. The state or a county, city, village, town or school district may not modify a
20self-insured health plan with respect to an eligible employe or dependent, through
21riders, endorsements or otherwise, to restrict or exclude coverage for certain diseases
22or medical conditions otherwise covered by the self-insured health plan.
AB591-ASA2,134,223 3. Nothing in this paragraph limits the authority of the group insurance board
24to fulfill its obligations as trustee under s. 40.03 (6) (d) or to design or modify

1procedures or provisions pertaining to enrollment, premium transmitted or coverage
2of eligible employes for health care benefits under s. 40.51 (1).
AB591-ASA2, s. 251 3Section 251. 632.747 of the statutes is created to read:
AB591-ASA2,134,9 4632.747 Guaranteed acceptance. (1) Employe becomes eligible after
5commencement of coverage.
If an insurer provides coverage under a group health
6benefit plan, the insurer shall provide coverage under the group health benefit plan
7to an eligible employe who becomes eligible for coverage after the commencement of
8the employer's coverage, and to the eligible employe's dependents, regardless of
9health condition or claims experience, if all of the following apply:
AB591-ASA2,134,1010 (a) The employe has satisfied any applicable waiting period.
AB591-ASA2,134,1211 (b) The employer agrees to pay the premium required for coverage of the
12employe under the group health benefit plan.
AB591-ASA2,134,18 13(2) Employe waived coverage previously. If an insurer provides coverage
14under a group health benefit plan, the insurer shall provide coverage under the
15group health benefit plan to an eligible employe who waived coverage during an
16enrollment period during which the employe was entitled to enroll in the group
17health benefit plan, regardless of health condition or claims experience, if all of the
18following apply:
AB591-ASA2,134,2019 (a) The eligible employe was covered as a dependent under qualifying coverage
20when he or she waived coverage under the group health benefit plan.
AB591-ASA2,134,2521 (b) The eligible employe's coverage under the qualifying coverage has
22terminated or will terminate due to a divorce from the insured under the qualifying
23coverage, the death of the insured under the qualifying coverage, loss of employment
24by the insured under the qualifying coverage or involuntary loss of coverage under
25the qualifying coverage by the insured under the qualifying coverage.
AB591-ASA2,135,3
1(c) The eligible employe applies for coverage under the group health benefit
2plan not more than 30 days after termination of his or her coverage under the
3qualifying coverage.
AB591-ASA2,135,54 (d) The employer agrees to pay the premium required for coverage of the
5employe under the group health benefit plan.
AB591-ASA2,135,11 6(3) State or municipal self-insured plans. If the state or a county, city, village,
7town or school district provides coverage under a self-insured health plan, it shall
8provide coverage under the self-insured health plan to an eligible employe who
9waived coverage during an enrollment period during which the employe was entitled
10to enroll in the self-insured health plan, regardless of health condition or claims
11experience, if all of the following apply:
AB591-ASA2,135,1312 (a) The eligible employe was covered as a dependent under qualifying coverage
13when he or she waived coverage under the self-insured health plan.
AB591-ASA2,135,1814 (b) The eligible employe's coverage under the qualifying coverage has
15terminated or will terminate due to a divorce from the insured under the qualifying
16coverage, the death of the insured under the qualifying coverage, loss of employment
17by the insured under the qualifying coverage or involuntary loss of coverage under
18the qualifying coverage by the insured under the qualifying coverage.
AB591-ASA2,135,2119 (c) The eligible employe applies for coverage under the self-insured health plan
20not more than 30 days after termination of his or her coverage under the qualifying
21coverage.
AB591-ASA2, s. 252 22Section 252. 632.749 of the statutes is created to read:
AB591-ASA2,136,3 23632.749 Contract termination and renewability. (1) Midterm
24cancellation.
Notwithstanding s. 631.36 (2) to (4m), a group health benefit plan
25may not be canceled by an insurer before the expiration of the agreed term, and shall

1be renewable to the policyholder and all insureds and dependents eligible under the
2terms of the group health benefit plan at the expiration of the agreed term at the
3option of the policyholder, except for any of the following reasons:
AB591-ASA2,136,44 (a) Failure to pay a premium when due.
AB591-ASA2,136,65 (b) Fraud or misrepresentation by the policyholder, or, with respect to coverage
6for an insured individual, fraud or misrepresentation by that insured individual.
AB591-ASA2,136,77 (c) Substantial breaches of contractual duties, conditions or warranties.
AB591-ASA2,136,98 (d) The number of individuals covered under the group health benefit plan is
9less than the number required by the group health benefit plan.
AB591-ASA2,136,1110 (e) The employer to which the group health benefit plan is issued is no longer
11actively engaged in a business enterprise.
AB591-ASA2,136,13 12(2) Nonrenewal. Notwithstanding sub. (1), an insurer may elect not to renew
13a group health benefit plan if the insurer complies with all of the following:
AB591-ASA2,136,1514 (a) The insurer ceases to renew all other group health benefit plans issued by
15the insurer.
AB591-ASA2,136,1816 (b) The insurer provides notice to all affected policyholders and to the
17commissioner in each state in which an affected insured individual resides at least
18one year before termination of coverage.
AB591-ASA2,136,2019 (c) The insurer does not issue a group health benefit plan before 5 years after
20the nonrenewal of the group health benefit plans.
AB591-ASA2,136,2421 (d) The insurer does not transfer or otherwise provide coverage to a
22policyholder from the nonrenewed business unless the insurer offers to transfer or
23provide coverage to all affected policyholders from the nonrenewed business without
24regard to claims experience, health condition or duration of coverage.
AB591-ASA2,137,2
1(3) Insurer in liquidation. This section does not apply to a group health benefit
2plan if the insurer that issued the group health benefit plan is in liquidation.
AB591-ASA2,137,5 3(4) Applicability to certain government plans. This section does not apply to
4a group health benefit plan offered by the state under s. 40.51 (6) or by the group
5insurance board under s. 40.51 (7).
AB591-ASA2, s. 253 6Section 253. 632.76 (2) (a) of the statutes is amended to read:
AB591-ASA2,137,127 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years
8from the date of issue of the policy may be reduced or denied on the ground that a
9disease or physical condition existed prior to the effective date of coverage, unless the
10condition was excluded from coverage by name or specific description by a provision
11effective on the date of loss. This paragraph does not apply to a group health benefit
12plan, as defined in s. 632.745 (1) (c), which is subject to s. 632.745 (2).
AB591-ASA2, s. 254 13Section 254. 632.896 (4) of the statutes is amended to read:
AB591-ASA2,137,1914 632.896 (4) Preexisting conditions. Notwithstanding s. ss. 632.745 (2) and
15632.76 (2) (a), a disability insurance policy that is subject to sub. (2) and that is in
16effect when a court makes a final order granting adoption or when the child is placed
17for adoption may not exclude or limit coverage of a disease or physical condition of
18the child on the ground that the disease or physical condition existed before coverage
19is required to begin under sub. (3).
AB591-ASA2, s. 255 20Section 255. 635.02 (5m) of the statutes is repealed.
AB591-ASA2, s. 256 21Section 256. 635.07 of the statutes is repealed.
AB591-ASA2, s. 257 22Section 257. 635.17 of the statutes is repealed.
AB591-ASA2, s. 258 23Section 258. 635.26 (1) (a) of the statutes is renumbered 635.26 (1).
AB591-ASA2, s. 259 24Section 259. 635.26 (1) (b) of the statutes is repealed.
AB591-ASA2, s. 260 25Section 260. 767.045 (1) (c) 1. of the statutes is amended to read:
AB591-ASA2,138,4
1767.045 (1) (c) 1. Aid is provided under s. 48.57 (3m), 49.19 or 49.45 on behalf
2of the child, or benefits are provided to the child's custodial parent under ss. 49.141
3to 49.161,
but the state and its delegate under s. 46.25 (7) are barred by a statute of
4limitations from commencing an action under s. 767.45 on behalf of the child.
AB591-ASA2, s. 261 5Section 261. 767.075 (1) (c) of the statutes is amended to read:
AB591-ASA2,138,76 767.075 (1) (c) Whenever aid under s. 48.57 (3m), 49.19 or 49.45 or a benefit
7under s. 49.153
is provided to on behalf of a dependent child.
AB591-ASA2, s. 262 8Section 262. 767.075 (1) (cm) of the statutes is created to read:
AB591-ASA2,138,119 767.075 (1) (cm) Whenever aid under s. 48.57 (3m), 49.19 or 49.45 or a benefit
10under s. 49.153 has, in the past, been provided on behalf of a dependent child and the
11child's family is eligible for continuing child support services under 45 CFR 302.33.
AB591-ASA2, s. 263 12Section 263. 767.077 (intro.) of the statutes is amended to read:
AB591-ASA2,138,17 13767.077 Support for dependent child. (intro.) The state or its delegate
14under s. 46.25 (7) shall bring an action for support of a minor child under s. 767.02
15(1) (f) or, if appropriate, for paternity determination and child support under s.
16767.45 whenever the child's right to support is assigned to the state under s. 48.57
17(3m) (b) 2. or
49.19 (4) (h) 1. b. if all of the following apply:
AB591-ASA2, s. 264 18Section 264. 767.078 (1) (a) 2. of the statutes is amended to read:
AB591-ASA2,138,2019 767.078 (1) (a) 2. The child's right to support is assigned to the state under s.
2048.57 (3m) (b) 2. or 49.19 (4) (h) 1. b.
AB591-ASA2, s. 265 21Section 265. 767.15 (1) of the statutes is amended to read:
AB591-ASA2,139,422 767.15 (1) In any action affecting the family in which either party is a recipient
23of benefits under ss. 49.141 to 49.161 or aid under s. 49.19 or 49.45, each party shall,
24either within 20 days after making service on the opposite party of any motion or
25pleading requesting the court or family court commissioner to order, or to modify a

1previous order, relating to child support, maintenance or family support, or before
2filing the motion or pleading in court, serve a copy of the motion or pleading upon the
3child support program designee under s. 59.07 (97) of the county in which the action
4is begun.
AB591-ASA2, s. 266 5Section 266. 767.24 (6) (c) of the statutes is amended to read:
AB591-ASA2,139,106 767.24 (6) (c) In making an order of joint legal custody and periods of physical
7placement, the court may specify one parent as the primary caretaker of the child and
8one home as the primary home of the child, for the purpose of determining eligibility
9for aid under s. 49.19 or benefits under ss. 49.141 to 49.161 or for any other purpose
10the court considers appropriate.
AB591-ASA2, s. 267 11Section 267. 767.29 (1m) (c) of the statutes is amended to read:
AB591-ASA2,139,1512 767.29 (1m) (c) The party entitled to the support or maintenance money has
13applied for or is receiving aid to families with dependent children and there is an
14assignment to the state under s. 48.57 (3m) (b) 2. or 49.19 (4) (h) 1. b. of the party's
15right to the support or maintenance money.
AB591-ASA2, s. 268 16Section 268. 767.29 (2) of the statutes, as affected by 1995 Wisconsin Act 27,
17is amended to read:
AB591-ASA2,140,1018 767.29 (2) If any party entitled to maintenance payments or support money,
19or both, is receiving public assistance under ch. 49, the party may assign the party's
20right thereto to the county department under s. 46.215, 46.22 or 46.23 granting such
21assistance. Such assignment shall be approved by order of the court granting the
22maintenance payments or support money, and may be terminated in like manner;
23except that it shall not be terminated in cases where there is any delinquency in the
24amount of maintenance payments and support money previously ordered or
25adjudged to be paid to the assignee without the written consent of the assignee or

1upon notice to the assignee and hearing. When an assignment of maintenance
2payments or support money, or both, has been approved by the order, the assignee
3shall be deemed a real party in interest within s. 803.01 but solely for the purpose
4of securing payment of unpaid maintenance payments or support money adjudged
5or ordered to be paid, by participating in proceedings to secure the payment thereof.
6Notwithstanding assignment under this subsection, and without further order of the
7court, the clerk of court, upon receiving notice that a party or a minor child of the
8parties is receiving aid under s. 49.19, shall forward all support assigned under s.
948.57 (3m) (b) 2., 49.19 (4) (h) 1. or 49.45 (19) to the department of industry, labor and
10human relations.
AB591-ASA2, s. 269 11Section 269. 767.29 (4) of the statutes is amended to read:
AB591-ASA2,140,1812 767.29 (4) If an order or judgment providing for the support of one or more
13children not receiving aid under s. 48.57 (3m) or 49.19 includes support for a minor
14who is the beneficiary of aid under s. 48.57 (3m) or 49.19, any support payment made
15under the order or judgment is assigned to the state under s. 48.57 (3m) (b) 2. or 49.19
16(4) (h) 1. b. in the amount that is the proportionate share of the minor receiving aid
17under s. 48.57 (3m) or 49.19, except as otherwise ordered by the court on the motion
18of a party.
AB591-ASA2, s. 270 19Section 270. 767.32 (1) (a) of the statutes is amended to read:
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