Amendment ASA2-AB591

AB591-ASA2,131,23 (b) Paragraph (a) does not prohibit the application of a waiting period to all new enrollees under a group health benefit plan or a self-insured health plan; however, a waiting period may not be applied when determining whether the qualifying coverage terminated not more than 60 days before the effective date of the new coverage.

AB591-ASA2,132,4 (4) Minimum participation of employes. (a) Except as provided in par. (d), requirements used by an insurer in determining whether to provide coverage under a group health benefit plan to an employer, including requirements for minimum participation of eligible employes and minimum employer contributions, shall be applied uniformly among all employers that apply for or receive coverage from the insurer.

AB591-ASA2,132,7 (b) An insurer may vary its minimum participation requirements and minimum employer contribution requirements only by the size of the employer group based on the number of eligible employes.

AB591-ASA2,132,13 (c) In applying minimum participation requirements with respect to an employer, an insurer may not count eligible employes who have other coverage that is qualifying coverage in determining whether the applicable percentage of participation is met, except that an insurer may count eligible employes who have coverage under another health benefit plan that is sponsored by that employer and that is qualifying coverage.

AB591-ASA2,132,16 (d) An insurer may not increase a requirement for minimum employe participation or a requirement for minimum employer contribution that applies to an employer after the employer has been accepted for coverage.

AB591-ASA2,132,18 (e) This subsection does not apply to a group health benefit plan offered by the state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7).

AB591-ASA2,132,25 (5) Prohibited coverage practices. (a) 1. Except as provided in rules promulgated under subd. 3., if an insurer offers a group health benefit plan to an employer, the insurer shall offer coverage to all of the eligible employes of the employer and their dependents. Except as provided in rules promulgated under subd. 3., an insurer may not offer coverage to only certain individuals in an employer group or to only part of the group, except for an eligible employe who has not yet satisfied an applicable waiting period, if any.

AB591-ASA2,133,7 2. Except as provided in rules promulgated under subd. 3., if the state or a county, city, village, town or school district offers coverage under a self-insured health plan, it shall offer coverage to all of its eligible employes and their dependents. Except as provided in rules promulgated under subd. 3., the state or a county, city, village, town or school district may not offer coverage to only certain individuals in the employer group or to only part of the group, except for an eligible employe who has not yet satisfied an applicable waiting period, if any.

AB591-ASA2,133,14 3. The secretary of employe trust funds, with the approval of the group insurance board, shall promulgate rules related to offering coverage to eligible employes under a group health benefit plan, or a self-insured health plan, offered by the state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7). The rules shall conform to the intent of subds. 1. and 2. and may not allow the state or the group insurance board to refuse to offer coverage to an eligible employe or dependent for reasons related to health condition.

AB591-ASA2,133,18 (b) 1. An insurer may not modify a group health benefit plan with respect to an employer or an eligible employe or dependent, through riders, endorsements or otherwise, to restrict or exclude coverage for certain diseases or medical conditions otherwise covered by the group health benefit plan.

AB591-ASA2,133,22 2. The state or a county, city, village, town or school district may not modify a self-insured health plan with respect to an eligible employe or dependent, through riders, endorsements or otherwise, to restrict or exclude coverage for certain diseases or medical conditions otherwise covered by the self-insured health plan.

AB591-ASA2,134,2 3. Nothing in this paragraph limits the authority of the group insurance board to fulfill its obligations as trustee under s. 40.03 (6) (d) or to design or modify procedures or provisions pertaining to enrollment, premium transmitted or coverage of eligible employes for health care benefits under s. 40.51 (1).

AB591-ASA2, s. 251 Section 251. 632.747 of the statutes is created to read:

AB591-ASA2,134,9 632.747 Guaranteed acceptance. (1) Employe becomes eligible after commencement of coverage. If an insurer provides coverage under a group health benefit plan, the insurer shall provide coverage under the group health benefit plan to an eligible employe who becomes eligible for coverage after the commencement of the employer's coverage, and to the eligible employe's dependents, regardless of health condition or claims experience, if all of the following apply:

AB591-ASA2,134,10 (a) The employe has satisfied any applicable waiting period.

AB591-ASA2,134,12 (b) The employer agrees to pay the premium required for coverage of the employe under the group health benefit plan.

AB591-ASA2,134,18 (2) Employe waived coverage previously. If an insurer provides coverage under a group health benefit plan, the insurer shall provide coverage under the group health benefit plan to an eligible employe who waived coverage during an enrollment period during which the employe was entitled to enroll in the group health benefit plan, regardless of health condition or claims experience, if all of the following apply:

AB591-ASA2,134,20 (a) The eligible employe was covered as a dependent under qualifying coverage when he or she waived coverage under the group health benefit plan.

AB591-ASA2,134,25 (b) The eligible employe's coverage under the qualifying coverage has terminated or will terminate due to a divorce from the insured under the qualifying coverage, the death of the insured under the qualifying coverage, loss of employment by the insured under the qualifying coverage or involuntary loss of coverage under the qualifying coverage by the insured under the qualifying coverage.

AB591-ASA2,135,3 (c) The eligible employe applies for coverage under the group health benefit plan not more than 30 days after termination of his or her coverage under the qualifying coverage.

AB591-ASA2,135,5 (d) The employer agrees to pay the premium required for coverage of the employe under the group health benefit plan.

AB591-ASA2,135,11 (3) State or municipal self-insured plans. If the state or a county, city, village, town or school district provides coverage under a self-insured health plan, it shall provide coverage under the self-insured health plan to an eligible employe who waived coverage during an enrollment period during which the employe was entitled to enroll in the self-insured health plan, regardless of health condition or claims experience, if all of the following apply:

AB591-ASA2,135,13 (a) The eligible employe was covered as a dependent under qualifying coverage when he or she waived coverage under the self-insured health plan.

AB591-ASA2,135,18 (b) The eligible employe's coverage under the qualifying coverage has terminated or will terminate due to a divorce from the insured under the qualifying coverage, the death of the insured under the qualifying coverage, loss of employment by the insured under the qualifying coverage or involuntary loss of coverage under the qualifying coverage by the insured under the qualifying coverage.

AB591-ASA2,135,21 (c) The eligible employe applies for coverage under the self-insured health plan not more than 30 days after termination of his or her coverage under the qualifying coverage.

AB591-ASA2, s. 252 Section 252. 632.749 of the statutes is created to read:

AB591-ASA2,136,3 632.749 Contract termination and renewability. (1) Midterm cancellation. Notwithstanding s. 631.36 (2) to (4m), a group health benefit plan may not be canceled by an insurer before the expiration of the agreed term, and shall be renewable to the policyholder and all insureds and dependents eligible under the terms of the group health benefit plan at the expiration of the agreed term at the option of the policyholder, except for any of the following reasons:

AB591-ASA2,136,4 (a) Failure to pay a premium when due.

AB591-ASA2,136,6 (b) Fraud or misrepresentation by the policyholder, or, with respect to coverage for an insured individual, fraud or misrepresentation by that insured individual.

AB591-ASA2,136,7 (c) Substantial breaches of contractual duties, conditions or warranties.

AB591-ASA2,136,9 (d) The number of individuals covered under the group health benefit plan is less than the number required by the group health benefit plan.

AB591-ASA2,136,11 (e) The employer to which the group health benefit plan is issued is no longer actively engaged in a business enterprise.

AB591-ASA2,136,13 (2) Nonrenewal. Notwithstanding sub. (1), an insurer may elect not to renew a group health benefit plan if the insurer complies with all of the following:

AB591-ASA2,136,15 (a) The insurer ceases to renew all other group health benefit plans issued by the insurer.

AB591-ASA2,136,18 (b) The insurer provides notice to all affected policyholders and to the commissioner in each state in which an affected insured individual resides at least one year before termination of coverage.

AB591-ASA2,136,20 (c) The insurer does not issue a group health benefit plan before 5 years after the nonrenewal of the group health benefit plans.

AB591-ASA2,136,24 (d) The insurer does not transfer or otherwise provide coverage to a policyholder from the nonrenewed business unless the insurer offers to transfer or provide coverage to all affected policyholders from the nonrenewed business without regard to claims experience, health condition or duration of coverage.

AB591-ASA2,137,2 (3) Insurer in liquidation. This section does not apply to a group health benefit plan if the insurer that issued the group health benefit plan is in liquidation.

AB591-ASA2,137,5 (4) Applicability to certain government plans. This section does not apply to a group health benefit plan offered by the state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7).

AB591-ASA2, s. 253 Section 253. 632.76 (2) (a) of the statutes is amended to read:

AB591-ASA2,137,12 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years from the date of issue of the policy may be reduced or denied on the ground that a disease or physical condition existed prior to the effective date of coverage, unless the condition was excluded from coverage by name or specific description by a provision effective on the date of loss. This paragraph does not apply to a group health benefit plan, as defined in s. 632.745 (1) (c), which is subject to s. 632.745 (2).

AB591-ASA2, s. 254 Section 254. 632.896 (4) of the statutes is amended to read:

AB591-ASA2,137,19 632.896 (4) Preexisting conditions. Notwithstanding s. ss. 632.745 (2) and 632.76 (2) (a), a disability insurance policy that is subject to sub. (2) and that is in effect when a court makes a final order granting adoption or when the child is placed for adoption may not exclude or limit coverage of a disease or physical condition of the child on the ground that the disease or physical condition existed before coverage is required to begin under sub. (3).

AB591-ASA2, s. 255 Section 255. 635.02 (5m) of the statutes is repealed.

AB591-ASA2, s. 256 Section 256. 635.07 of the statutes is repealed.

AB591-ASA2, s. 257 Section 257. 635.17 of the statutes is repealed.

AB591-ASA2, s. 258 Section 258. 635.26 (1) (a) of the statutes is renumbered 635.26 (1).

AB591-ASA2, s. 259 Section 259. 635.26 (1) (b) of the statutes is repealed.

AB591-ASA2, s. 260 Section 260. 767.045 (1) (c) 1. of the statutes is amended to read:

AB591-ASA2,138,4 767.045 (1) (c) 1. Aid is provided under s. 48.57 (3m), 49.19 or 49.45 on behalf of the child, or benefits are provided to the child's custodial parent under ss. 49.141 to 49.161, but the state and its delegate under s. 46.25 (7) are barred by a statute of limitations from commencing an action under s. 767.45 on behalf of the child.

AB591-ASA2, s. 261 Section 261. 767.075 (1) (c) of the statutes is amended to read:

AB591-ASA2,138,7 767.075 (1) (c) Whenever aid under s. 48.57 (3m), 49.19 or 49.45 or a benefit under s. 49.153 is provided to on behalf of a dependent child.

AB591-ASA2, s. 262 Section 262. 767.075 (1) (cm) of the statutes is created to read:

AB591-ASA2,138,11 767.075 (1) (cm) Whenever aid under s. 48.57 (3m), 49.19 or 49.45 or a benefit under s. 49.153 has, in the past, been provided on behalf of a dependent child and the child's family is eligible for continuing child support services under 45 CFR 302.33.

AB591-ASA2, s. 263 Section 263. 767.077 (intro.) of the statutes is amended to read:

AB591-ASA2,138,17 767.077 Support for dependent child. (intro.) The state or its delegate under s. 46.25 (7) shall bring an action for support of a minor child under s. 767.02 (1) (f) or, if appropriate, for paternity determination and child support under s. 767.45 whenever the child's right to support is assigned to the state under s. 48.57 (3m) (b) 2. or 49.19 (4) (h) 1. b. if all of the following apply:

AB591-ASA2, s. 264 Section 264. 767.078 (1) (a) 2. of the statutes is amended to read:

AB591-ASA2,138,20 767.078 (1) (a) 2. The child's right to support is assigned to the state under s. 48.57 (3m) (b) 2. or 49.19 (4) (h) 1. b.

AB591-ASA2, s. 265 Section 265. 767.15 (1) of the statutes is amended to read:

AB591-ASA2,139,4 767.15 (1) In any action affecting the family in which either party is a recipient of benefits under ss. 49.141 to 49.161 or aid under s. 49.19 or 49.45, each party shall, either within 20 days after making service on the opposite party of any motion or pleading requesting the court or family court commissioner to order, or to modify a previous order, relating to child support, maintenance or family support, or before filing the motion or pleading in court, serve a copy of the motion or pleading upon the child support program designee under s. 59.07 (97) of the county in which the action is begun.

AB591-ASA2, s. 266 Section 266. 767.24 (6) (c) of the statutes is amended to read:

AB591-ASA2,139,10 767.24 (6) (c) In making an order of joint legal custody and periods of physical placement, the court may specify one parent as the primary caretaker of the child and one home as the primary home of the child, for the purpose of determining eligibility for aid under s. 49.19 or benefits under ss. 49.141 to 49.161 or for any other purpose the court considers appropriate.

AB591-ASA2, s. 267 Section 267. 767.29 (1m) (c) of the statutes is amended to read:

AB591-ASA2,139,15 767.29 (1m) (c) The party entitled to the support or maintenance money has applied for or is receiving aid to families with dependent children and there is an assignment to the state under s. 48.57 (3m) (b) 2. or 49.19 (4) (h) 1. b. of the party's right to the support or maintenance money.

AB591-ASA2, s. 268 Section 268. 767.29 (2) of the statutes, as affected by 1995 Wisconsin Act 27, is amended to read:

AB591-ASA2,140,10 767.29 (2) If any party entitled to maintenance payments or support money, or both, is receiving public assistance under ch. 49, the party may assign the party's right thereto to the county department under s. 46.215, 46.22 or 46.23 granting such assistance. Such assignment shall be approved by order of the court granting the maintenance payments or support money, and may be terminated in like manner; except that it shall not be terminated in cases where there is any delinquency in the amount of maintenance payments and support money previously ordered or adjudged to be paid to the assignee without the written consent of the assignee or upon notice to the assignee and hearing. When an assignment of maintenance payments or support money, or both, has been approved by the order, the assignee shall be deemed a real party in interest within s. 803.01 but solely for the purpose of securing payment of unpaid maintenance payments or support money adjudged or ordered to be paid, by participating in proceedings to secure the payment thereof. Notwithstanding assignment under this subsection, and without further order of the court, the clerk of court, upon receiving notice that a party or a minor child of the parties is receiving aid under s. 49.19, shall forward all support assigned under s. 48.57 (3m) (b) 2., 49.19 (4) (h) 1. or 49.45 (19) to the department of industry, labor and human relations.

AB591-ASA2, s. 269 Section 269. 767.29 (4) of the statutes is amended to read:

AB591-ASA2,140,18 767.29 (4) If an order or judgment providing for the support of one or more children not receiving aid under s. 48.57 (3m) or 49.19 includes support for a minor who is the beneficiary of aid under s. 48.57 (3m) or 49.19, any support payment made under the order or judgment is assigned to the state under s. 48.57 (3m) (b) 2. or 49.19 (4) (h) 1. b. in the amount that is the proportionate share of the minor receiving aid under s. 48.57 (3m) or 49.19, except as otherwise ordered by the court on the motion of a party.

AB591-ASA2, s. 270 Section 270. 767.32 (1) (a) of the statutes is amended to read:

AB591-ASA2,141,20 767.32 (1) (a) After a judgment or order providing for child support under this chapter or s. 48.355 (2) (b) 4., 48.357 (5m), 48.363 (2) or 948.22 (7), maintenance payments under s. 767.26 or family support payments under this chapter, or for the appointment of trustees under s. 767.31, the court may, from time to time, on the petition, motion or order to show cause of either of the parties, or upon the petition, motion or order to show cause of the department of health and social services, a county department under s. 46.215, 46.22 or 46.23 or a child support program designee under s. 59.07 (97) if an assignment has been made under s. 48.57 (3m) (b) 2., 49.19 (4) (h) or, 49.153 (3) or 49.45 (19) or if either party or their minor children receive aid under s. 48.57 (3m) or ch. 49, and upon notice to the family court commissioner, revise and alter such judgment or order respecting the amount of such maintenance or child support and the payment thereof, and also respecting the appropriation and payment of the principal and income of the property so held in trust, and may make any judgment or order respecting any of the matters that such court might have made in the original action, except that a judgment or order that waives maintenance payments for either party shall not thereafter be revised or altered in that respect nor shall the provisions of a judgment or order with respect to final division of property be subject to revision or modification. A revision, under this section, of a judgment or order with respect to an amount of child or family support may be made only upon a finding of a substantial change in circumstances. In any action under this section to revise a judgment or order with respect to maintenance payments, a substantial change in the cost of living by either party or as measured by the federal bureau of labor statistics may be sufficient to justify a revision of judgment or order with respect to the amount of maintenance, except that a change in an obligor's cost of living is not in itself sufficient if payments are expressed as a percentage of income.

AB591-ASA2, s. 271 Section 271. 767.32 (1) (b) 1. of the statutes is amended to read:

AB591-ASA2,141,25 767.32 (1) (b) 1. Commencement of receipt of aid to families with dependent children under s. 49.19 or participation in Wisconsin works under ss. 49.141 to 49.161 by either parent since the entry of the last child support order, including a revision of a child support order under this section.

AB591-ASA2, s. 272 Section 272. 767.47 (6) (a) and (b) of the statutes are amended to read:

AB591-ASA2,142,11 767.47 (6) (a) Whenever the state brings the action to determine paternity pursuant to an assignment under s. 48.57 (3m) (b) 2., 49.153 (3) (a), 49.19 (4) (h) 1. or 49.45 (19), or receipt of benefits under s. 49.148, 49.155, 49.157 or 49.159, the natural mother of the child may not be compelled to testify about the paternity of the child if it has been determined that the mother has good cause for refusing to cooperate in establishing paternity as provided in 42 USC 602 (a) (26) (B) and the federal regulations promulgated pursuant to this statute, as of July 1, 1981, and pursuant to any rules promulgated by the department of health and social services which define good cause in accordance with the federal regulations, as authorized by 42 USC 602 (a) (26) (B) in effect on July 1, 1981.

AB591-ASA2,142,16 (b) Nothing in par. (a) prevents the state from bringing an action to determine paternity pursuant to an assignment under s. 48.57 (3m) (b) 2., 49.153 (3) (a), 49.19 (4) (h) 1. or 49.45 (19), or receipt of benefits under s. 49.148, 49.155, 49.157 or 49.159, where evidence other than the testimony of the mother may establish the paternity of the child.

AB591-ASA2, s. 273 Section 273. 814.61 (13) of the statutes, as affected by 1995 Wisconsin Act 27, is amended to read:

AB591-ASA2,142,24 814.61 (13) Support or maintenance petition. For the cost of court services, whenever a person not receiving benefits under s. 49.148, 49.153 or 49.155 or aid under s. 49.19, 49.46, 49.465, 49.468 or 49.47 files a petition requesting child support, maintenance or family support payments, $10 in addition to any other fee required under this section. This subsection does not apply to a petition filed by the state or its delegate.

AB591-ASA2, s. 274 Section 274. 948.22 (4) (b) of the statutes is amended to read:

AB591-ASA2,143,7 948.22 (4) (b) For a person not subject to a court order requiring child, grandchild or spousal support payments, when the person knows or reasonably should have known that he or she has a dependent, failure to provide support equal to at least the amount set forth established by rule by the department of health and family services under s. 49.19 (11) (a) 46.25 (9) (a) or causing a spouse, grandchild or child to become a dependent person, or continue to be a dependent person, as defined in s. 49.01 (2).

AB591-ASA2, s. 275 Section 275 . Nonstatutory provisions; industry, labor and job development.

AB591-ASA2,143,14 (1)   Wisconsin works administration. The authorized FTE positions for the department of industry, labor and job development are increased by 18.0 GPR positions on July 1, 1996, to be funded from the appropriation under section 20.445 (3) (dz) of the statutes, as affected by this act, for the purpose of administering the Wisconsin works program under sections 49.141 to 49.161 of the statutes, as created by this act.

AB591-ASA2,143,23 (2)   Rules relating to public assistance. Using the procedure under section 227.24 of the statutes, the department of health and social services shall promulgate rules required under chapters 46, 48 and 49 of the statutes, as affected by the acts of 1995, before July 1, 1996, for the period before permanent rules take effect, but not to exceed the period authorized under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24 (1) (a) and (2) (b) of the statutes, the department of health and social services need not provide evidence of the necessity of preservation of the public peace, health, safety or welfare in promulgating rules under this subsection.

AB591-ASA2,144,9 (3)  Rules on qualification criteria for the administration of Wisconsin works. Using the procedure under section 227.24 of the statutes, the department of industry, labor and job development shall promulgate rules required under sections 49.143 to 49.157 of the statutes, as created by this act, for the period before permanent rules take effect, but not to exceed the period authorized under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24 (1) (a) and (2) (b) of the statutes, the department need not provide evidence of the necessity of preservation of the public peace, health, safety or welfare in promulgating rules under this subsection.

AB591-ASA2,144,18 (4)  Rules for the administration of the Wisconsin works health plan. Using the procedure under section 227.24 of the statutes, the department of health and family services shall promulgate rules required under section 49.153 of the statutes, as created by this act, for the period before permanent rules take effect, but not to exceed the period authorized under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24 (1) (a) and (2) (b) of the statutes, the department of health and family services need not provide evidence of the necessity of preservation of the public peace, health, safety or welfare in promulgating rules under this subsection.

AB591-ASA2,144,22 (5)   Low-income and at-risk child care. The treatment of section 46.98 (4) (a) 2. and (b) of the statutes does not apply to ny person who is receiving aid under section 46.98 (4) on the effective of this subsection until the first day of the 4th month beginning after the effective date of this subsection.

AB591-ASA2,145,9 (6)   Kinship care assessments and background investigations. Beginning on July 1, 1996, each county department of human services or social services under sections 46.215, 46.22 and 46.23 of the statutes shall assess and conduct a background investigation of each nonlegally responsible relative who is providing care for a dependent child, as defined in section 49.19 (1) (a) of the statutes, under a program administered by that county department to determine if the relative is eligible to receive kinship care payments under section 48.57 (3m) (a) of the statues, as created by this act. Each county department of human services or social services under sections 46.215, 46.22 and 46.23 shall complete all of the assessments and background investigations required under this subsection and shall end income maintenance payments under section 49.33 of the statutes to those relatives by July 1, 1997.

AB591-ASA2, s. 276 Section 276 . Appropriation changes; health and social services.

AB591-ASA2,145,20 (1)   Health and social services. In the schedule under section 20.005 (3) of the statutes for the appropriation to the department of health and social services under section 20.435 (4) (dz) of the statutes, as affected by the acts of 1995, the dollar amount is decreased by the amounts encumbered from the appropriations under section 20.435 (4) (cn), (d), (dc), (de), (df) and (dg) of the statutes, immediately before the repeal of section 20.435 (4) (cn), (d), (dc), (de), (df) and (dg) of the statutes and by the amounts encumbered under section 20.435 (7) (b) of the statutes for low-income and at-risk child care immediately before the effective date of this paragraph to transfer funding for the purposes of these appropriations to the appropriation accounts under section 20.435 (4) (dz) of the statutes.

AB591-ASA2,146,2 (2)   Community aids. In the schedule under section 20.005 (3) of the statutes for the appropriation to the department of health and social services under section 20.435 (7) (b) of the statutes, as affected by the acts of 1995, the dollar amount is decreased by $5,576,100 for fiscal year 1995-96, less any amount encumbered in fiscal year 1995-96 for low-income and at-risk child care, and the dollar amount is decreased by $5,576,100 for fiscal year 1996-97 to reflect the deletion of low-income and at-risk child care from community aids funding.