AB591-ASA3,151,214 120.13 (14) Day care programs. Establish and provide or contract for the
15provision of day care programs for children. The school board may receive federal
16or state funds for this purpose. The school board may charge a fee for all or part of
17the cost of the service for participation in a day care program established under this
18subsection. Costs associated with a day care program under this subsection may not
19be included in shared costs under s. 121.07 (6). Day care programs established under
20this subsection shall meet the standards for licensed day care centers established by
21the department of health and family services. If a school board proposes to contract
22for or renew a contract for the provision of a day care program under this subsection
23or if on the effective date of this subsection .... [revisor inserts date], a school board
24is a party to a contract for the provision of a day care program under this subsection,
25the school board shall refer the contractor or proposed contractor to the department

1of health and family services for the background investigations required under s.
248.65 (1m).
AB591-ASA3, s. 235 3Section 235. 120.13 (27m) of the statutes is amended to read:
AB591-ASA3,151,164 120.13 (27m) Transportation of indigent pupils. Provide transportation to
5and from school for indigent pupils who reside in the school district and who are not
6required to be transported under s. 121.54. In this subsection, "indigent pupils"
7means pupils eligible for free lunches or reduced-price lunches under 42 USC 1758
8or aid to 18-year-old students under s. 49.20 or for whom aid to families with
9dependent children is being received under s. 49.19 or who are members of a
10Wisconsin works group, as defined in s. 49.141 (1) (s), with a member who is
11participating in Wisconsin works under s. 49.147 (3) to (5)
or any combination
12thereof, as determined by the school board. If a school board determines to provide
13transportation under this subsection, there shall be reasonable uniformity in the
14transportation furnished such pupils whether they attend public or private schools.
15The cost of transporting pupils under this subsection may not be included in the
16school district's shared cost under s. 121.07 (6) (a).
AB591-ASA3, s. 236 17Section 236. 185.981 (4t) of the statutes is amended to read:
AB591-ASA3,151,2018 185.981 (4t) A sickness care plan operated by a cooperative association is
19subject to ss. 252.14, 631.89, 632.72 (2), 632.745, 632.747, 632.749, 632.87 (2m), (3),
20(4) and (5), 632.895 (10) and 632.897 (10) and ch. 155.
AB591-ASA3, s. 237 21Section 237. 185.983 (1) (intro.) of the statutes is amended to read:
AB591-ASA3,152,222 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be
23exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
24601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72
25(2), 632.745, 632.747, 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5),

1632.895 (5), (9) and (10), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609,
2630, 635, 645 and 646, but the sponsoring association shall:
AB591-ASA3, s. 239 3Section 239. 227.01 (13) (zs) of the statutes is created to read:
AB591-ASA3,152,54 227.01 (13) (zs) Establishes geographical areas under s. 49.143 for the
5administration of Wisconsin works under ss. 49.141 to 49.161.
AB591-ASA3, s. 241 6Section 241. 230.04 (13) (a) and (e) 1. and 2. of the statutes are amended to
7read:
AB591-ASA3,152,118 230.04 (13) (a) Establish standards for plans to increase state employment of
9recipients of aid under s. 49.19 or benefits under s. 49.147 (3) to (5) prepared by
10agencies under s. 230.147 (1). The standards shall state the time periods within
11which these plans shall be prepared.
AB591-ASA3,152,1412 (e) 1. A description of each agency's effort during that fiscal year to employ
13under s. 230.147 persons who received aid under s. 49.19 or benefits under s. 49.147
14(3) to (5)
.
AB591-ASA3,152,1715 2. The number of persons receiving aid under s. 49.19 or benefits under s.
1649.147 (3) to (5)
who were employed by each agency under s. 230.147 during that
17fiscal year and the job title or classification of each position filled under s. 230.147.
AB591-ASA3, s. 242 18Section 242. 230.147 (1) of the statutes, as affected by 1995 Wisconsin Act 27,
19is amended to read:
AB591-ASA3,153,420 230.147 (1) Each appointing authority of an agency with more than 100
21authorized permanent full-time equivalent positions shall prepare and implement
22a plan of action to employ persons who, at the time determined under sub. (4), receive
23aid under s. 49.19, or benefits under s. 49.147 (3) to (5), with the goal of making the
24ratio of those persons occupying permanent positions in the agency to the total
25number of persons occupying permanent positions in the agency equal to the ratio

1of the average case load receiving aid under s. 49.19, or benefits under s. 49.147 (3)
2to (5),
in this state in the previous fiscal year to the average number of persons in the
3state civilian labor force in the preceding fiscal year, as determined by the
4department of industry, labor and human relations.
AB591-ASA3, s. 243 5Section 243. 230.147 (2) of the statutes, as affected by 1995 Wisconsin Act 27,
6is amended to read:
AB591-ASA3,153,167 230.147 (2) Each appointing authority of an agency with 100 or fewer
8authorized permanent full-time equivalent positions is encouraged to employ
9persons who, at the time determined under sub. (4), receive aid under s. 49.19, or
10benefits under s. 49.147 (3) to (5),
to attempt to make the ratio of those persons
11occupying permanent positions in the agency to the total number of persons
12occupying permanent positions in the agency equal to the ratio of the average case
13load receiving aid under s. 49.19, or benefits under s. 49.147 (3) to (5) in this state
14in the previous fiscal year to the average number of persons in the state civilian labor
15force in the preceding fiscal year, as determined by the department of industry, labor
16and human relations.
AB591-ASA3, s. 244 17Section 244. 230.147 (3) of the statutes is amended to read:
AB591-ASA3,153,2318 230.147 (3) Notwithstanding subs. (1) and (2), the state fair park board shall
19make every reasonable effort to employ in permanent full-time equivalent positions
20persons who, at the time determined under sub. (4), receive aid under s. 49.19 or
21benefits under s. 49.147 (3) to (5)
. The state fair park board shall consult with the
22department of employment relations to assure that its efforts under this subsection
23comply with ch. 230.
AB591-ASA3, s. 245 24Section 245. 560.14 (1) (a) (intro.) and 1. of the statutes are consolidated,
25renumbered 560.14 (1) (a) and amended to read:
AB591-ASA3,154,4
1560.14 (1) (a) "Applicable median household income" means the greater of the
2following: 1. The
median family income for the county where the household is
3located, as determined annually by the U.S. department of housing and urban
4development.
AB591-ASA3, s. 246 5Section 246. 560.14 (1) (a) 2. of the statutes is repealed.
AB591-ASA3, s. 247 6Section 247. 600.01 (2) (b) of the statutes is amended to read:
AB591-ASA3,154,87 600.01 (2) (b) Group or blanket insurance described in sub. (1) (b) 3. and 4. is
8not exempt from s. 632.745, 632.747 or 632.749 or ch. 633 or 635.
AB591-ASA3, s. 248 9Section 248. 628.34 (3) (a) of the statutes is amended to read:
AB591-ASA3,154,1610 628.34 (3) (a) No insurer may unfairly discriminate among policyholders by
11charging different premiums or by offering different terms of coverage except on the
12basis of classifications related to the nature and the degree of the risk covered or the
13expenses involved, subject to s. ss. 632.365 and 632.745. Rates are not unfairly
14discriminatory if they are averaged broadly among persons insured under a group,
15blanket or franchise policy, and terms are not unfairly discriminatory merely
16because they are more favorable than in a similar individual policy.
AB591-ASA3, s. 249 17Section 249. 628.34 (3) (b) of the statutes is amended to read:
AB591-ASA3,154,2318 628.34 (3) (b) No insurer may refuse to insure or refuse to continue to insure,
19or limit the amount, extent or kind of coverage available to an individual, or charge
20an individual a different rate for the same coverage because of a mental or physical
21disability except when the refusal, limitation or rate differential is based on either
22sound actuarial principles supported by reliable data or actual or reasonably
23anticipated experience, subject to ss. 632.745, 632.747, 632.749, 635.09 and 635.26.
AB591-ASA3, s. 250 24Section 250. 632.745 of the statutes is created to read:
AB591-ASA3,155,3
1632.745 Coverage requirements for group health benefit plans. (1)
2Group health insurance market reform; definitions. In this section and ss. 632.747
3and 632.749:
AB591-ASA3,155,104 (a) 1. Except as provided in subd. 2., "eligible employe" means an employe who
5works on a permanent basis and has a normal work week of 30 or more hours. The
6term includes a sole proprietor, a business owner, including the owner of a farm
7business, a partner of a partnership and a member of a limited liability company if
8the sole proprietor, business owner, partner or member is included as an employe
9under a health benefit plan of an employer, but the term does not include an employe
10who works on a temporary or substitute basis.
AB591-ASA3,155,1311 2. For purposes of a group health benefit plan, or a self-insured health plan,
12that is offered by the state under s. 40.51 (6) or by the group insurance board under
13s. 40.51 (7), "eligible employe" has the meaning given in s. 40.02 (25).
AB591-ASA3,155,1414 (b) "Employer" means any of the following:
AB591-ASA3,155,1715 1. An individual, firm, corporation, partnership, limited liability company or
16association that is actively engaged in a business enterprise in this state, including
17a farm business.
AB591-ASA3,155,1818 2. A municipality, as defined in s. 16.70 (8).
AB591-ASA3,155,1919 3. The state.
AB591-ASA3,155,2320 (c) "Group health benefit plan" means a health benefit plan that is issued by
21an insurer to an employer on behalf of a group consisting of eligible employes of the
22employer. The term includes individual health benefit plans covering eligible
23employes when 3 or more are sold to an employer.
AB591-ASA3,156,724 (d) "Health benefit plan" means any hospital or medical policy or certificate.
25"Health benefit plan" does not include accident-only, credit accident or health,

1dental, vision, medicare supplement, medicare replacement, long-term care,
2disability income or short-term insurance, coverage issued as a supplement to
3liability insurance, worker's compensation or similar insurance, automobile medical
4payment insurance, individual conversion policies, specified disease policies,
5hospital indemnity policies, as defined in s. 632.895 (1) (c), policies or certificates
6issued under the health insurance risk-sharing plan or an alternative plan under
7subch. II of ch. 619 or other insurance exempted by rule of the commissioner.
AB591-ASA3,156,148 (e) "Insurer" means an insurer that is authorized to do business in this state,
9in one or more lines of insurance that includes health insurance, and that offers
10group health benefit plans covering eligible employes of one or more employers in
11this state. The term includes a health maintenance organization, as defined in s.
12609.01 (2), a preferred provider plan, as defined in s. 609.01 (4), an insurer operating
13as a cooperative association organized under ss. 185.981 to 185.985 and a limited
14service health organization, as defined in s. 609.01 (3).
AB591-ASA3,156,1615 (f) 1. "Qualifying coverage" means benefits or coverage provided under any of
16the following:
AB591-ASA3,156,1717 a. Medicare, medicaid or the Wisconsin works healthplan.
AB591-ASA3,156,2018 b. A group health benefit plan or an employer-based health benefit
19arrangement that provides benefits similar to or exceeding benefits provided under
20a basic health benefit plan under subch. II of ch. 635.
AB591-ASA3,156,2321 c. An individual health benefit plan that provides benefits similar to or
22exceeding benefits provided under a basic health benefit plan under subch. II of ch.
23635, if the individual health benefit plan has been in effect for at least one year.
AB591-ASA3,157,524 2. Notwithstanding subd. 1. b. and c., "qualifying coverage" does not include a
25high cost-share health benefit plan that is linked to a tax-preferred savings plan for

1payment of medical expenses if the employer that provides the individual's new
2coverage offers its eligible employes a choice of health benefit plan options that
3includes a high cost-share health benefit plan that may be linked to a tax-preferred
4savings plan for payment of medical expenses and the individual's new coverage is
5not such a high cost-share health benefit plan.
AB591-ASA3,157,76 (g) "Self-insured health plan" means a self-insured health plan of the state or
7a county, city, village, town or school district.
AB591-ASA3,157,11 8(2) Preexisting conditions. (a) A group health benefit plan, or a self-insured
9health plan, may not deny, exclude or limit benefits for a covered individual for losses
10incurred more than 12 months after the effective date of the individual's coverage
11due to a preexisting condition.
AB591-ASA3,157,1412 (b) Except as provided in par. (c), a group health benefit plan, or a self-insured
13health plan, may not define a preexisting condition more restrictively than any of the
14following:
AB591-ASA3,157,1815 1. A condition that would have caused an ordinarily prudent person to seek
16medical advice, diagnosis, care or treatment during the 6 months immediately
17preceding the effective date of coverage and for which the individual did not seek
18medical advice, diagnosis, care or treatment.
AB591-ASA3,157,2119 2. A condition for which medical advice, diagnosis, care or treatment was
20recommended or received during the 6 months immediately preceding the effective
21date of coverage.
AB591-ASA3,157,2522 (c) Notwithstanding par. (b) 1. and 2., a group health benefit plan, or a
23self-insured health plan, shall exclude pregnancy from the definition of a preexisting
24condition for the purpose of coverage of expenses related to prenatal and postnatal
25care, delivery and any complications of pregnancy.
AB591-ASA3,158,7
1(3) Portability. (a) A group health benefit plan, or a self-insured health plan,
2shall waive any period applicable to a preexisting condition exclusion or limitation
3period with respect to particular services for the period that an individual was
4previously covered by qualifying coverage that was not sponsored by the employer
5sponsoring the group health benefit plan or the self-insured health plan and that
6provided benefits with respect to such services, if the qualifying coverage terminated
7not more than 60 days before the effective date of the new coverage.
AB591-ASA3,158,128 (b) Paragraph (a) does not prohibit the application of a waiting period to all new
9enrollees under a group health benefit plan or a self-insured health plan; however,
10a waiting period may not be applied when determining whether the qualifying
11coverage terminated not more than 60 days before the effective date of the new
12coverage.
AB591-ASA3,159,213 (c) If the federal government enacts legislation providing for a federal income
14tax exemption for amounts deposited in a savings plan for payment of medical
15expenses that is linked to a high cost-share health benefit plan, and for any interest,
16dividends or other gain that accrues in the savings plan if redeposited in the savings
17plan, 6 years after the enactment of the federal legislation the commissioner shall
18conduct a study of individuals and groups that had coverage under a high cost-share
19health benefit plan linked to a tax-preferred savings plan for payment of medical
20expenses and that terminated that coverage in order to enroll in a health benefit plan
21that was not such a high cost-share health plan. If as a result of the study the
22commissioner determines that s. 632.745 (1) (f) 2. is not necessary for the purpose for
23which it was intended, the commissioner shall certify that determination to the
24revisor of statutes. Upon the certification, the revisor of statutes shall publish notice
25in the Wisconsin administrative register of the determination, the date of the

1certification and that after 30 days after the date of the certification s. 632.745 (1)
2(f) 2. is not effective.
AB591-ASA3,159,8 3(4) Minimum participation of employes. (a) Except as provided in par. (d),
4requirements used by an insurer in determining whether to provide coverage under
5a group health benefit plan to an employer, including requirements for minimum
6participation of eligible employes and minimum employer contributions, shall be
7applied uniformly among all employers that apply for or receive coverage from the
8insurer.
AB591-ASA3,159,119 (b) An insurer may vary its minimum participation requirements and
10minimum employer contribution requirements only by the size of the employer group
11based on the number of eligible employes.
AB591-ASA3,159,1712 (c) In applying minimum participation requirements with respect to an
13employer, an insurer may not count eligible employes who have other coverage that
14is qualifying coverage in determining whether the applicable percentage of
15participation is met, except that an insurer may count eligible employes who have
16coverage under another health benefit plan that is sponsored by that employer and
17that is qualifying coverage.
AB591-ASA3,159,2018 (d) An insurer may not increase a requirement for minimum employe
19participation or a requirement for minimum employer contribution that applies to
20an employer after the employer has been accepted for coverage.
AB591-ASA3,159,2221 (e) This subsection does not apply to a group health benefit plan offered by the
22state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7).
AB591-ASA3,160,4 23(5) Prohibited coverage practices. (a) 1. Except as provided in rules
24promulgated under subd. 3., if an insurer offers a group health benefit plan to an
25employer, the insurer shall offer coverage to all of the eligible employes of the

1employer and their dependents. Except as provided in rules promulgated under
2subd. 3., an insurer may not offer coverage to only certain individuals in an employer
3group or to only part of the group, except for an eligible employe who has not yet
4satisfied an applicable waiting period, if any.
AB591-ASA3,160,115 2. Except as provided in rules promulgated under subd. 3., if the state or a
6county, city, village, town or school district offers coverage under a self-insured
7health plan, it shall offer coverage to all of its eligible employes and their dependents.
8Except as provided in rules promulgated under subd. 3., the state or a county, city,
9village, town or school district may not offer coverage to only certain individuals in
10the employer group or to only part of the group, except for an eligible employe who
11has not yet satisfied an applicable waiting period, if any.
AB591-ASA3,160,1812 3. The secretary of employe trust funds, with the approval of the group
13insurance board, shall promulgate rules related to offering coverage to eligible
14employes under a group health benefit plan, or a self-insured health plan, offered
15by the state under s. 40.51 (6) or by the group insurance board under s. 40.51 (7). The
16rules shall conform to the intent of subds. 1. and 2. and may not allow the state or
17the group insurance board to refuse to offer coverage to an eligible employe or
18dependent for reasons related to health condition.
AB591-ASA3,160,2219 (b) 1. An insurer may not modify a group health benefit plan with respect to
20an employer or an eligible employe or dependent, through riders, endorsements or
21otherwise, to restrict or exclude coverage for certain diseases or medical conditions
22otherwise covered by the group health benefit plan.
AB591-ASA3,161,223 2. The state or a county, city, village, town or school district may not modify a
24self-insured health plan with respect to an eligible employe or dependent, through

1riders, endorsements or otherwise, to restrict or exclude coverage for certain diseases
2or medical conditions otherwise covered by the self-insured health plan.
AB591-ASA3,161,63 3. Nothing in this paragraph limits the authority of the group insurance board
4to fulfill its obligations as trustee under s. 40.03 (6) (d) or to design or modify
5procedures or provisions pertaining to enrollment, premium transmitted or coverage
6of eligible employes for health care benefits under s. 40.51 (1).
AB591-ASA3, s. 250m 7Section 250m. 632.745 (1) (f) 2. of the statutes, as created by 1995 Wisconsin
8Act .... (this act), is repealed.
AB591-ASA3, s. 251 9Section 251. 632.747 of the statutes is created to read:
AB591-ASA3,161,15 10632.747 Guaranteed acceptance. (1) Employe becomes eligible after
11commencement of coverage.
If an insurer provides coverage under a group health
12benefit plan, the insurer shall provide coverage under the group health benefit plan
13to an eligible employe who becomes eligible for coverage after the commencement of
14the employer's coverage, and to the eligible employe's dependents, regardless of
15health condition or claims experience, if all of the following apply:
AB591-ASA3,161,1616 (a) The employe has satisfied any applicable waiting period.
AB591-ASA3,161,1817 (b) The employer agrees to pay the premium required for coverage of the
18employe under the group health benefit plan.
AB591-ASA3,161,24 19(2) Employe waived coverage previously. If an insurer provides coverage
20under a group health benefit plan, the insurer shall provide coverage under the
21group health benefit plan to an eligible employe who waived coverage during an
22enrollment period during which the employe was entitled to enroll in the group
23health benefit plan, regardless of health condition or claims experience, if all of the
24following apply:
AB591-ASA3,162,2
1(a) The eligible employe was covered as a dependent under qualifying coverage
2when he or she waived coverage under the group health benefit plan.
AB591-ASA3,162,73 (b) The eligible employe's coverage under the qualifying coverage has
4terminated or will terminate due to a divorce from the insured under the qualifying
5coverage, the death of the insured under the qualifying coverage, loss of employment
6by the insured under the qualifying coverage or involuntary loss of coverage under
7the qualifying coverage by the insured under the qualifying coverage.
AB591-ASA3,162,108 (c) The eligible employe applies for coverage under the group health benefit
9plan not more than 30 days after termination of his or her coverage under the
10qualifying coverage.
AB591-ASA3,162,1211 (d) The employer agrees to pay the premium required for coverage of the
12employe under the group health benefit plan.
AB591-ASA3,162,18 13(3) State or municipal self-insured plans. If the state or a county, city, village,
14town or school district provides coverage under a self-insured health plan, it shall
15provide coverage under the self-insured health plan to an eligible employe who
16waived coverage during an enrollment period during which the employe was entitled
17to enroll in the self-insured health plan, regardless of health condition or claims
18experience, if all of the following apply:
AB591-ASA3,162,2019 (a) The eligible employe was covered as a dependent under qualifying coverage
20when he or she waived coverage under the self-insured health plan.
AB591-ASA3,162,2521 (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-ASA3,163,3
1(c) The eligible employe applies for coverage under the self-insured health plan
2not more than 30 days after termination of his or her coverage under the qualifying
3coverage.
AB591-ASA3, s. 252 4Section 252. 632.749 of the statutes is created to read:
AB591-ASA3,163,10 5632.749 Contract termination and renewability. (1) Midterm
6cancellation.
Notwithstanding s. 631.36 (2) to (4m), a group health benefit plan
7may not be canceled by an insurer before the expiration of the agreed term, and shall
8be renewable to the policyholder and all insureds and dependents eligible under the
9terms of the group health benefit plan at the expiration of the agreed term at the
10option of the policyholder, except for any of the following reasons:
AB591-ASA3,163,1111 (a) Failure to pay a premium when due.
AB591-ASA3,163,1312 (b) Fraud or misrepresentation by the policyholder, or, with respect to coverage
13for an insured individual, fraud or misrepresentation by that insured individual.
AB591-ASA3,163,1414 (c) Substantial breaches of contractual duties, conditions or warranties.
AB591-ASA3,163,1615 (d) The number of individuals covered under the group health benefit plan is
16less than the number required by the group health benefit plan.
AB591-ASA3,163,1817 (e) The employer to which the group health benefit plan is issued is no longer
18actively engaged in a business enterprise.
AB591-ASA3,163,20 19(2) Nonrenewal. Notwithstanding sub. (1), an insurer may elect not to renew
20a group health benefit plan if the insurer complies with all of the following:
AB591-ASA3,163,2221 (a) The insurer ceases to renew all other group health benefit plans issued by
22the insurer.
AB591-ASA3,163,2523 (b) The insurer provides notice to all affected policyholders and to the
24commissioner in each state in which an affected insured individual resides at least
25one year before termination of coverage.
AB591-ASA3,164,2
1(c) The insurer does not issue a group health benefit plan before 5 years after
2the nonrenewal of the group health benefit plans.
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