AB100-ASA1-AA1,401,53
565.02
(1) (b) (intro.) Notwithstanding
s. ss. 111.321
, 111.322 and 111.335, no
4person may serve as the administrator if he or she has been convicted of, or entered
5a plea of guilty or no contest to, any of the following:".
AB100-ASA1-AA1,401,108
565.02
(2) (c) (intro.) Notwithstanding
s. ss. 111.321
, 111.322 and 111.335, no
9person may be employed under par. (b) if he or she has been convicted of, or entered
10a plea of guilty or no contest to, any of the following:".
AB100-ASA1-AA1,401,1613
565.10
(3) (a) (intro.) Notwithstanding
s. ss. 111.321
, 111.322 and 111.335, no
14lottery retailer contract may be entered into with a person if, during the immediately
15preceding 10 years, the person has been convicted of, or entered a plea of guilty or
16no contest to, any of the following, unless the person has been pardoned:".
AB100-ASA1-AA1,401,2120
600.01
(2) (b) Group or blanket insurance described in sub. (1) (b) 3. and 4. is
21not exempt from
s. ss. 632.745
, 632.747 or to 632.749 or ch. 633 or 635.".
AB100-ASA1-AA1,402,4
1600.01
(1) (b) 9. The publication and clearinghouse activities described in subd.
29. c., the association undertaking those activities, with respect to those activities, and
3the association's periodic publication resulting from and furthering those activities
4if all of the following apply:
AB100-ASA1-AA1,402,65
a. The publication and clearinghouse activities are undertaken by an
6association that is organized not for profit for religious and charitable purposes.
AB100-ASA1-AA1,402,87
b. The publication activities of the association are limited to subscribers who
8are members of the same church or religious denomination.
AB100-ASA1-AA1,402,139
c. The publication activities of the association function as an organizational
10clearinghouse that matches subscribers to the publications of the association who
11have financial, physical or medical needs and subscribers to the publications of the
12association who desire to financially assist with those needs and who have a present
13ability to pay.
AB100-ASA1-AA1,402,1714
d. Although the association, through its publications, may suggest voluntary
15payment levels between subscribers described in subd. 9. c., the association and the
16subscribers do not assume any risk or make any promise of payment by the
17association or any subscribers.
AB100-ASA1-AA1,402,2118
e. The association provides to each subscriber a written monthly statement
19that lists the total dollar amount of qualified needs submitted for publication in the
20previous month and the total dollar amount of qualified needs submitted that were
21actually published and assigned for payment.
AB100-ASA1-AA1,402,2522
f. On or accompanying all written materials distributed by or on behalf of the
23association, including applications, guidelines, promotional or informational
24materials and periodic publications, the association provides the following written
25disclaimer:
AB100-ASA1-AA1,403,82
This publication is not issued by an insurance company, nor is it offered through
3an insurance company. This publication does not guarantee or promise that your
4medical bills will be published or assigned to others for payment. Whether anyone
5chooses to pay your medical bills is entirely voluntary. This publication should never
6be considered a substitute for an insurance policy. Whether or not you receive any
7payments for medical expenses, and whether or not this publication continues to
8operate, you are responsible for the payment of your own medical bills.
AB100-ASA1-AA1,403,109
g. No payments between subscribers described in subd. 9. c. are made through
10the association.".
AB100-ASA1-AA1,403,17
15609.77 Coverage of breast reconstruction. Health maintenance
16organizations, limited service health organizations and preferred provider plans are
17subject to s. 632.895 (13).".
AB100-ASA1-AA1,403,20
19"
609.78 Coverage of treatment for the correction of
20temporomandibular disorders. Health maintenance organizations,".
AB100-ASA1-AA1,404,2
1"
Section 4830ec. 619.12 (2) (e) of the statutes, as affected by 1997 Wisconsin
2Act .... (this act), is renumbered 149.12 (2) (e) and amended to read:
AB100-ASA1-AA1,404,63
149.12
(2) (e) No person who is eligible for
health care benefits creditable
4coverage, other than those benefits specified in s. 632.745 (11) (b) 1. to 12., that
are
5is provided by an employer on a self-insured basis or through health insurance is
6eligible for coverage under the plan.
AB100-ASA1-AA1, s. 4830em
7Section 4830em. 619.12 (2) (e) 1. of the statutes is renumbered 619.12 (2) (e)
8and amended to read:
AB100-ASA1-AA1,404,129
619.12
(2) (e)
Except as provided in subd. 2., no No person who is eligible for
10health care benefits
, other than those benefits specified in s. 632.745 (11) (b) 1. to 12.,
11that are provided by an employer on a self-insured basis or through health insurance
12is eligible for coverage under the plan.".
AB100-ASA1-AA1,404,16
15"
149.144 (title)
Insurer
Adjustments to insurer assessments and
16provider payment rates for".
AB100-ASA1-AA1,405,9
71194. Page 1813, line 25: after "state" insert "
and who is certified under s.
849.45 (2) (a) 11. and if the service or article is provided by a provider certified under
9s. 49.45 (2) (a) 11.".
AB100-ASA1-AA1,405,14
12"(a) Any charge for treatment for cosmetic purposes other than surgery for the
13repair or treatment of an injury or a congenital bodily defect.
Breast reconstruction
14incident to a mastectomy shall not be considered treatment for cosmetic purposes.".
AB100-ASA1-AA1,405,20
19"
Section 4869m. 619.15 (3) (f) of the statutes, as created by 1997 Wisconsin
20Act .... (this act), is repealed.".
AB100-ASA1-AA1,405,23
22"
Section 4891c. 619.165 (1) (d) of the statutes is renumbered 619.165 (1) (d)
231. and amended to read:
AB100-ASA1-AA1,406,3
1619.165
(1) (d) 1.
The Subject to subd. 2., the board shall establish and
2implement the method for determining the household income of an eligible person
3under par. (b).
AB100-ASA1-AA1,406,75
619.165
(1) (d) 2. In determining household income under par. (b), the board
6shall consider information submitted by an eligible person on a completed federal
7profit or loss from farming form, schedule F, if all of the following apply:
AB100-ASA1-AA1,406,88
a. The person is a farmer, as defined in s. 102.04 (3).
AB100-ASA1-AA1,406,109
b. The person was not eligible to claim the homestead credit under subch. VIII
10of ch. 71 in the preceding taxable year.
AB100-ASA1-AA1, s. 4891r
11Section 4891r. 619.165 (1) (d) of the statutes, as affected by 1997 Wisconsin
12Act .... (this act), is renumbered 149.165 (3), and 149.165 (3) (a) and (b) (intro.), as
13renumbered, are amended to read:
AB100-ASA1-AA1,406,1614
149.165
(3) (a) Subject to
subd. 2., the board par. (b), the department shall
15establish and implement the method for determining the household income of an
16eligible person under
par. (b) sub. (2).
AB100-ASA1-AA1,406,2017
(b) (intro.) In determining household income under
par. (b), the board sub. (2),
18the department shall consider information submitted by an eligible person on a
19completed federal profit or loss from farming form, schedule F, if all of the following
20apply:".
AB100-ASA1-AA1,407,7
1628.34
(3) (a) No insurer may unfairly discriminate among policyholders by
2charging different premiums or by offering different terms of coverage except on the
3basis of classifications related to the nature and the degree of the risk covered or the
4expenses involved, subject to ss. 632.365
and, 632.745
and 632.748. Rates are not
5unfairly discriminatory if they are averaged broadly among persons insured under
6a group, blanket or franchise policy, and terms are not unfairly discriminatory
7merely because they are more favorable than in a similar individual policy.
AB100-ASA1-AA1,407,1610
628.34
(3) (b) No insurer may refuse to insure or refuse to continue to insure,
11or limit the amount, extent or kind of coverage available to an individual, or charge
12an individual a different rate for the same coverage because of a mental or physical
13disability except when the refusal, limitation or rate differential is based on either
14sound actuarial principles supported by reliable data or actual or reasonably
15anticipated experience, subject to ss.
632.745, 632.747, 632.749, 635.09 and 635.26 16632.746 to 632.7495.
AB100-ASA1-AA1,407,2318
628.36
(2) (b) 1. Except for health maintenance organizations, preferred
19provider plans
, and limited service health organizations
and the small employer
20health insurance plan under subch. II of ch. 635, no health care plan may prevent
21any person covered under the plan from choosing freely among providers who have
22agreed to participate in the plan and abide by its terms, except by requiring the
23person covered to select primary providers to be used when reasonably possible.
AB100-ASA1-AA1,408,5
1628.36
(2) (b) 3. Except as provided in subd. 4., no provider may be denied the
2opportunity to participate in a health care plan, other than a health maintenance
3organization, a limited service health organization
,
or a preferred provider plan
or
4the small employer health insurance plan under subch. II of ch. 635, under the terms
5of the plan.
AB100-ASA1-AA1,408,117
628.36
(2) (b) 5.
Except for the small employer health insurance plan under
8subch. II of ch. 635 to the extent determined by the small employer insurance board
9under s. 635.23 (1) (b), all All health care plans, including health maintenance
10organizations, limited service health organizations and preferred provider plans are
11subject to s. 632.87 (3).
AB100-ASA1-AA1,408,2313
631.01
(4) Annuities and group policies for eleemosynary institutions. This
14chapter
, and ch. 632
and the health insurance mandates under ch. 632 that apply to
15the plan under subch. II of ch. 635 do not apply to annuities or group policies that
16are provided on a basis as uniform nationally as state statutes permit to educational,
17scientific research, religious or charitable institutions organized without profit to
18any person, for the benefit of employes of such institutions. The commissioner may
19by order subject such contracts issued by a particular insurer to this chapter
, or ch.
20632
or the health insurance mandates under ch. 632 that apply to the plan under
21subch. II of ch. 635 or any portion of those provisions upon a finding, after a hearing,
22that the interests of Wisconsin insureds or creditors or the public of this state so
23require.".
AB100-ASA1-AA1,409,5
4632.745 Coverage requirements for group and individual health
5benefit plans; definitions. In this section and ss. 632.746 to 632.7495:
AB100-ASA1-AA1,409,8
6(1) "Affiliation period" means the period which, under the terms of health
7insurance coverage offered by a health maintenance organization, must expire
8before the health insurance coverage becomes effective.
AB100-ASA1-AA1,409,10
9(2) "Beneficiary" has the meaning given in section 3 (8) of the federal Employee
10Retirement Income Security Act of 1974.
AB100-ASA1-AA1,409,12
11(3) "Bona fide association" means an association that satisfies all of the
12following:
AB100-ASA1-AA1,409,1313
(a) The association has been actively in existence for at least 5 years.
AB100-ASA1-AA1,409,1514
(b) The association has been formed and maintained in good faith for purposes
15other than obtaining insurance.
