Amendment ASA1-SB332

LRBs0504/1

RAC&PJK:kmg:lp

1997 - 1998 LEGISLATURE

ASSEMBLY SUBSTITUTE AMENDMENT 1, TO 1997 SENATE BILL 332

March 5, 1998 - Offered by Committee on Small Business and Economic Development.

SB332-ASA1,1,9 An Act to repeal 13.94 (1) (p), 15.07 (1) (b) 21., 15.165 (5), 20.515 (2) (title), 20.515 (2) (a), 20.515 (2) (g) and subchapter X of chapter 40 [precedes 40.98]; to amend 40.02 (26) (intro.), 40.02 (26) (intro.), 40.02 (28) and 40.02 (28); and to create 13.94 (1) (p), 15.07 (1) (b) 21., 15.165 (5), 20.515 (2) (title), 20.515 (2) (a), 20.515 (2) (g) and subchapter X of chapter 40 [precedes 40.98] of the statutes; relating to: requiring the department of employe trust funds to establish a health care coverage plan for employers in the private sector, creating a private employer health care coverage board and making an appropriation.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB332-ASA1, s. 1 Section 1. 13.94 (1) (p) of the statutes is created to read:

SB332-ASA1,2,2 13.94 (1) (p) No later than January 1, 2004, prepare a program evaluation audit of the private employer health care coverage plan established under subch. X of ch. 40. The legislative audit bureau shall file a copy of the audit report under this paragraph with the distributees specified in par. (b).

SB332-ASA1, s. 2 Section 2. 13.94 (1) (p) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

SB332-ASA1, s. 3 Section 3. 15.07 (1) (b) 21. of the statutes is created to read:

SB332-ASA1,2,6 15.07 (1) (b) 21. Private employer health care coverage board.

SB332-ASA1, s. 4 Section 4. 15.07 (1) (b) 21. of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

SB332-ASA1, s. 5 Section 5. 15.165 (5) of the statutes is created to read:

SB332-ASA1,2,14 15.165 (5) Private employer health care coverage board. (a) There is created in the department of employe trust funds a private employer health care coverage board consisting of the secretary of employe trust funds or his or her designee, the secretary of health and family services or his or her designee and the following members appointed for 3-year terms:

SB332-ASA1,2,15 1. One member who represents health maintenance organizations.

SB332-ASA1,2,16 2. One member who represents hospitals.

SB332-ASA1,2,17 3. One member who represents insurance agents, as defined in s. 628.02 (4).

SB332-ASA1,2,19 4. Two members who are employes eligible to receive health care coverage under subch. X of ch. 40 and whose employer employs not more than 50 employes.

SB332-ASA1,2,20 5. One member who represents insurers.

SB332-ASA1,2,23 6. Two members who are, or who represent, employers that employ not more than 50 employes and who are eligible to offer health care coverage under subch. X of ch. 40.

SB332-ASA1,2,24 7. One member who is a physician, as defined in s. 448.01 (5).

SB332-ASA1,2,25 8. Two members who represent the public interest.

SB332-ASA1,3,2 (b) The secretary of employe trust funds or his or her designee and the secretary of health and family services or his or her designee shall be nonvoting members.

SB332-ASA1, s. 6 Section 6. 15.165 (5) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

SB332-ASA1, s. 7 Section 7. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table

SB332-ASA1, s. 8 Section 8. 20.515 (2) (title) of the statutes is created to read:

SB332-ASA1,3,8 20.515 (2) (title) Private employer health care coverage plan.

SB332-ASA1, s. 9 Section 9. 20.515 (2) (title) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

SB332-ASA1, s. 10 Section 10. 20.515 (2) (a) of the statutes is created to read:

SB332-ASA1,3,15 20.515 (2) (a) Private employer health care coverage plan; start-up costs. The amounts in the schedule for the start-up costs for designing, establishing and administering the private employer health care coverage plan under subch. X of ch. 40.

SB332-ASA1, s. 11 Section 11. 20.515 (2) (a) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

SB332-ASA1, s. 12 Section 12. 20.515 (2) (g) of the statutes is created to read:

SB332-ASA1,4,4 20.515 (2) (g) Private employer health care coverage plan. All moneys received under subch. X of ch. 40 from employers who elect to participate in the private employer health care coverage plan under subch. X of ch. 40, for the costs of designing, establishing and administering the plan.

SB332-ASA1, s. 13 Section 13. 20.515 (2) (g) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

SB332-ASA1, s. 14 Section 14 . 40.02 (26) (intro.) of the statutes is amended to read:

SB332-ASA1,4,15 40.02 (26) (intro.) "Employe" means any person who receives earnings as payment for personal services rendered for the benefit of any employer including officers of the employer, except as provided in subch. X. An employe is deemed to have separated from the service of an employer at the end of the day on which the employe last performed services for the employer, or, if later, the day on which the employe-employer relationship is terminated because of the expiration or termination of leave without pay, sick leave, vacation or other leave of absence. A person shall not be considered an employe if a person:

SB332-ASA1, s. 15 Section 15 . 40.02 (26) (intro.) of the statutes, as affected by 1997 Wisconsin Act .... (this act), is amended to read:

SB332-ASA1,4,25 40.02 (26) (intro.) "Employe" means any person who receives earnings as payment for personal services rendered for the benefit of any employer including officers of the employer, except as provided in subch. X. An employe is deemed to have separated from the service of an employer at the end of the day on which the employe last performed services for the employer, or, if later, the day on which the employe-employer relationship is terminated because of the expiration or termination of leave without pay, sick leave, vacation or other leave of absence. A person shall not be considered an employe if a person:

SB332-ASA1, s. 16 Section 16 . 40.02 (28) of the statutes is amended to read:

SB332-ASA1,5,10 40.02 (28) "Employer" means the state, including each state agency, any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government now existing or hereafter created within the state and, any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more and a local exposition district created under subch. II of ch. 229, except as provided under ss. 40.51 (7) and 40.61 (3), or a local exposition district created under subch. II of ch. 229 and subch. X. Each employer shall be a separate legal jurisdiction for OASDHI purposes.

SB332-ASA1, s. 17 Section 17 . 40.02 (28) of the statutes, as affected by 1997 Wisconsin Act .... (this act), is amended to read:

SB332-ASA1,5,20 40.02 (28) "Employer" means the state, including each state agency, any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government now existing or hereafter created within the state, any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more and a local exposition district created under subch. II of ch. 229, except as provided under ss. 40.51 (7) and 40.61 (3) and subch. X. Each employer shall be a separate legal jurisdiction for OASDHI purposes.

SB332-ASA1, s. 18 Section 18. Subchapter X of chapter 40 [precedes 40.98] of the statutes is created to read:

SB332-ASA1,5,23 Chapter 40

SB332-ASA1,6,3 Subchapter X Private employer health Care coverage

SB332-ASA1,6,4 40.98 Health care coverage. (1) In this subchapter:

SB332-ASA1,6,5 (a) "Board" means the private employer health care coverage board.

SB332-ASA1,6,9 (b) "Dependent" means a spouse, an unmarried child under the age of 19 years, an unmarried child who is a full-time student under the age of 21 years and who is financially dependent upon the parent, or an unmarried child of any age who is medically certified as disabled and who is dependent upon the parent.

SB332-ASA1,6,17 (c) "Employe" means any person who receives earnings as payment for personal services rendered for the benefit of any employer including officers of the employer. An employe is considered to have separated from the service of an employer at the end of the day on which the employe last performed services for the employer, or, if later, the day on which the employe-employer relationship is terminated because of the expiration or termination of leave without pay, sick leave, vacation or other leave of absence. A person shall not be considered an employe if any of the following applies:

SB332-ASA1,6,19 1. The person is employed under a contract involving the furnishing of more than personal services.

SB332-ASA1,6,23 2. The person is customarily engaged in an independently established trade, business or profession providing the same type of services to more than one employer and the person's services to an employer are not compensated for on a payroll of that employer.

SB332-ASA1,6,25 3. The person is a patient or inmate of a hospital, home or institution and performs services in the hospital, home or institution.

SB332-ASA1,7,3 (d) "Employer" means any person who is doing business or operating an organization in this state and who employs at least 2 employes, but who is not an employer, as defined in s. 40.02 (28).

SB332-ASA1,7,5 (e) "Health care coverage plan" means the health care coverage plan established under sub. (2) (a).

SB332-ASA1,7,6 (f) "Insurer" has the meaning given in s. 600.03 (27).

SB332-ASA1,7,18 (2) (a) The department shall design, establish and administer an actuarially sound health care coverage plan for employers that provides coverage beginning not later than January 1, 2000. In designing the health care coverage plan, the department shall consult with the departments of commerce and health and family services and the office of the commissioner of insurance. In establishing the health care coverage plan, the department shall solicit and accept bids and enter into contracts with insurers who are to provide health care coverage under the health care coverage plan. The health care coverage plan is subject to the provisions of chs. 600 to 646 that apply to group health benefit plans, as defined in s. 632.745 (9), to the same extent as any other group health benefit plan, as defined in s. 632.745 (9). Before the health care coverage plan may be implemented, the board must approve the plan.

SB332-ASA1,7,20 (am) The health care coverage plan established under par. (a) may not be combined with any health care coverage plan under subch. IV.

SB332-ASA1,7,24 (b) The health care coverage plan shall require that all insurance rates under the plan be published annually in a single publication that is made available to employers and employes. The rates shall be listed by county and by any other factor that the department considers appropriate.