,57497 Wis. Act , s. 574
Section 574.
628.10 (2) (cm) of the statutes is created to read:
97 Wis. Act , s. 574 - continued
628.10 (2) (cm) For liability for delinquent taxes. The commissioner shall revoke the license of an intermediary, including a temporary license under s. 628.09, if the department of revenue certifies under s. 73.0301 that the intermediary is liable for delinquent taxes.
,575b97 Wis. Act , s. 575b
Section 575b.
628.10 (2) (d) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is amended to read:
97 Wis. Act , s. 575b - continued
628.10 (2) (d) (title) For failure to provide social security or federal employer identification number. If an intermediary who is a natural person fails to provide a social security number or federal employer identification number as required under s. 628.095 (3), the commissioner shall suspend or limit the license of the intermediary, effective the day following the last day on which the annual fee under s. 601.31 (1) (m) may be paid, if the commissioner has given the intermediary reasonable notice of when the fee must be paid to avoid suspension or limitation. If the intermediary provides the social security number or federal employer identification number within 60 days from the effective date of the suspension, the commissioner shall reinstate the intermediary's license effective as of the date of suspension.
,575m97 Wis. Act , s. 575m
Section 575m.
628.34 (3) (a) of the statutes, as affected by 1997 Wisconsin Act 27, is amended to read:
97 Wis. Act , s. 575m - continued
628.34 (3) (a) No insurer may unfairly discriminate among policyholders by charging different premiums or by offering different terms of coverage except on the basis of classifications related to the nature and the degree of the risk covered or the expenses involved, subject to ss. 632.365, 632.745 632.746 and 632.748. Rates are not unfairly discriminatory if they are averaged broadly among persons insured under a group, blanket or franchise policy, and terms are not unfairly discriminatory merely because they are more favorable than in a similar individual policy.
,576b97 Wis. Act , s. 576b
Section 576b.
632.68 (2) (b) (intro.) of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
97 Wis. Act , s. 576b - continued
632.68 (2) (b) (intro.) A person may apply to the commissioner for a viatical settlement provider license on a form prescribed by the commissioner for that purpose. The application form shall require the applicant to provide the applicant's social security number, if the applicant is a natural person, or the applicant's federal employer identification number, if the applicant is not a natural person. The fee specified in s. 601.31 (1) (mm) shall accompany the application. After any investigation of the applicant that the commissioner determines is sufficient, the commissioner shall issue a viatical settlement provider license to an applicant that satisfies all of the following:
,577b97 Wis. Act , s. 577b
Section 577b.
632.68 (2) (b) 2. of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
97 Wis. Act , s. 577b - continued
632.68 (2) (b) 2. Provides complete information on the application, including the applicant's social security number or federal employer identification number.
,577m97 Wis. Act , s. 577m
Section 577m.
632.68 (2) (bc) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (2) (bc) 1.
,57897 Wis. Act , s. 578
Section 578.
632.68 (2) (bc) 2. of the statutes is created to read:
97 Wis. Act , s. 578 - continued
632.68 (2) (bc) 2. The commissioner may disclose a social security number or federal employer identification number received under par. (b) or (e) to the department of revenue for the purpose of requesting certifications under s. 73.0301.
,578m97 Wis. Act , s. 578m
Section 578m.
632.68 (2) (bm) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (2) (bm) 1.
,57997 Wis. Act , s. 579
Section 579.
632.68 (2) (bm) 2. of the statutes is created to read:
97 Wis. Act , s. 579 - continued
632.68 (2) (bm) 2. Notwithstanding par. (b), the commissioner may not issue a license under this subsection if the department of revenue certifies under s. 73.0301 that the applicant is liable for delinquent taxes.
,580m97 Wis. Act , s. 580m
Section 580m.
632.68 (2) (cm) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (2) (cm) 1.
,58197 Wis. Act , s. 581
Section 581.
632.68 (2) (cm) 2. of the statutes is created to read:
97 Wis. Act , s. 581 - continued
632.68 (2) (cm) 2. If the commissioner denies an application for a license under this subsection for delinquent taxes, the applicant is entitled to a hearing under s. 73.0301 (5) (a) but is not entitled to a hearing under par. (c).
,582b97 Wis. Act , s. 582b
Section 582b.
632.68 (2) (e) of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
97 Wis. Act , s. 582b - continued
632.68 (2) (e) Except as provided in sub. (3), a license issued under this subsection shall be renewed annually on the anniversary date upon payment of the fee specified in s. 601.31 (1) (mp) and upon providing the licensee's social security number or federal employer identification number, as applicable, if not previously provided on the application for the license or at a previous renewal of the license.
,584m97 Wis. Act , s. 584m
Section 584m.
632.68 (3) (b) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (3) (b) 1.
,58597 Wis. Act , s. 585
Section 585.
632.68 (3) (b) 2. of the statutes is created to read:
97 Wis. Act , s. 585 - continued
632.68 (3) (b) 2. The commissioner shall revoke or refuse to renew a viatical settlement provider license if the department of revenue certifies under s. 73.0301 that the licensee is liable for delinquent taxes.
,586b97 Wis. Act , s. 586b
Section 586b.
632.68 (4) (b) of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
97 Wis. Act , s. 586b - continued
632.68 (4) (b) A person may apply to the commissioner for a viatical settlement broker license on a form prescribed by the commissioner for that purpose. The application form shall require the applicant to provide the applicant's social security number, if the applicant is a natural person, or the applicant's federal employer identification number, if the applicant is not a natural person. The fee specified in s. 601.31 (1) (mr) shall accompany the application. The commissioner may not issue a license under this subsection unless the applicant provides his or her social security number or its federal employer identification number, whichever is applicable.
,586m97 Wis. Act , s. 586m
Section 586m.
632.68 (4) (bc) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (4) (bc) 1.
,58797 Wis. Act , s. 587
Section 587.
632.68 (4) (bc) 2. of the statutes is created to read:
97 Wis. Act , s. 587 - continued
632.68 (4) (bc) 2. The commissioner may disclose a social security number or federal employer identification number received under par. (b) or (c) to the department of revenue for the purpose of requesting certifications under s. 73.0301.
,587m97 Wis. Act , s. 587m
Section 587m.
632.68 (4) (bm) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (4) (bm) 1.
,58897 Wis. Act , s. 588
Section 588.
632.68 (4) (bm) 2. of the statutes is created to read:
97 Wis. Act , s. 588 - continued
632.68 (4) (bm) 2. The commissioner may not issue a license under this subsection if the department of revenue certifies under s. 73.0301 that the applicant is liable for delinquent taxes.
,589c97 Wis. Act , s. 589c
Section 589c.
632.68 (4) (c) of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
97 Wis. Act , s. 589c - continued
632.68 (4) (c) Except as provided in sub. (5), a license issued under this subsection shall be renewed annually on the anniversary date upon payment of the fee specified in s. 601.31 (1) (ms) and upon providing the licensee's social security number or federal employer identification number, as applicable, if not previously provided on the application for the license or at a previous renewal of the license.
,591m97 Wis. Act , s. 591m
Section 591m.
632.68 (5) (b) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 632.68 (5) (b) 1.
,59297 Wis. Act , s. 592
Section 592.
632.68 (5) (b) 2. of the statutes is created to read:
97 Wis. Act , s. 592 - continued
632.68 (5) (b) 2. The commissioner shall revoke or refuse to renew a viatical settlement broker license if the department of revenue certifies under s. 73.0301 that the licensee is liable for delinquent taxes.
,59397 Wis. Act , s. 593
Section 593.
632.7495 (1) (a) of the statutes, as created by 1997 Wisconsin Act 27, is amended to read:
97 Wis. Act , s. 593 - continued
632.7495 (1) (a) Except as provided in subs. (2) and (3) to (4) and notwithstanding s. 631.36 (2) to (4m), an insurer that provides individual health benefit plan coverage shall renew such coverage or continue such coverage in force at the option of the insured individual and, if applicable, the association through which the individual has coverage.
,59497 Wis. Act , s. 594
Section 594.
632.7495 (4) of the statutes is created to read:
97 Wis. Act , s. 594 - continued
632.7495 (4) Notwithstanding subs. (1) and (2) and s. 631.36 (4), an insurer is not required to renew individual health benefit plan coverage that is marketed and designed to provide short-term coverage as a bridge between coverages.
,594c97 Wis. Act , s. 594c
Section 594c.
632.853 of the statutes is created to read:
97 Wis. Act , s. 594c - continued
632.853 Coverage of drugs and devices. A health care plan, as defined in s. 628.36 (2) (a) 1., or a self-insured health plan, as defined in s. 632.85 (1) (c), that provides coverage of only certain specified prescription drugs or devices shall develop a process through which a physician may present medical evidence to obtain an individual patient exception for coverage of a prescription drug or device not routinely covered by the plan. The process shall include timelines for both urgent and nonurgent review.
,594d97 Wis. Act , s. 594d
Section 594d.
632.855 of the statutes is created to read:
97 Wis. Act , s. 594d - continued
632.855 Requirements if experimental treatment limited. (1) DEFINITIONS. In this section:
97 Wis. Act , s. 594d - continued
(a) "Health care plan" has the meaning given in s. 628.36 (2) (a) 1.
97 Wis. Act , s. 594d - continued
(b) "Self-insured health plan" has the meaning given in s. 632.85 (1) (c).
97 Wis. Act , s. 594d - continued
(2) DISCLOSURE OF LIMITATIONS. A health care plan or a self-insured health plan that limits coverage of experimental treatment shall define the limitation and disclose the limits in any agreement, policy or certificate of coverage. This disclosure shall include the following information:
97 Wis. Act , s. 594d - continued
(a) Who is authorized to make a determination on the limitation.
97 Wis. Act , s. 594d - continued
(b) The criteria the plan uses to determine whether a treatment, procedure, drug or device is experimental.
97 Wis. Act , s. 594d - continued
(3) DENIAL OF TREATMENT. A health care plan or a self-insured health plan that receives a request for prior authorization of an experimental procedure that includes all of the required information upon which to make a decision shall, within 5 working days after receiving the request, issue a coverage decision. If the health care plan or self-insured health plan denies coverage of an experimental treatment, procedure, drug or device for an insured who has a terminal condition or illness, the health care plan or self-insured health plan shall, as part of its coverage decision, provide the insured with a denial letter that includes all of the following:
97 Wis. Act , s. 594d - continued
(a) A statement setting forth the specific medical and scientific reasons for denying coverage.
97 Wis. Act , s. 594d - continued
(b) Notice of the insured's right to appeal and a description of the appeal procedure.
,594m97 Wis. Act , s. 594m
Section 594m.
632.895 (11) (a) (intro.) of the statutes, as created by 1997 Wisconsin Act 27, is amended to read:
97 Wis. Act , s. 594m - continued
632.895 (11) (a) (intro.) Every Except as provided in par. (e), every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, that provides coverage of any diagnostic or surgical procedure involving a bone, joint, muscle or tissue shall provide coverage for diagnostic procedures and medically necessary surgical or nonsurgical treatment for the correction of temporomandibular disorders if all of the following apply:
,594n97 Wis. Act , s. 594n
Section 594n.
632.895 (11) (c) of the statutes, as created by 1997 Wisconsin Act 27, is renumbered 632.895 (11) (c) 1.
,594nm97 Wis. Act , s. 594nm
Section 594nm.
632.895 (11) (c) 2. of the statutes is created to read:
97 Wis. Act , s. 594nm - continued
632.895 (11) (c) 2. Notwithstanding subd. 1., the coverage required under this subsection for diagnostic procedures and medically necessary nonsurgical treatment for the correction of temporomandibular disorders may not exceed $1,250 annually.
,594p97 Wis. Act , s. 594p
Section 594p.
632.895 (11) (d) of the statutes is created to read:
97 Wis. Act , s. 594p - continued
632.895 (11) (d) Notwithstanding par. (c) 1., an insurer or a self-insured health plan of the state or a county, city, village, town or school district may require that an insured obtain prior authorization for any diagnostic procedures or medically necessary surgical or nonsurgical treatment for the correction of temporomandibular disorders.
,594q97 Wis. Act , s. 594q
Section 594q.
632.895 (11) (e) of the statutes is created to read:
97 Wis. Act , s. 594q - continued
632.895 (11) (e) This subsection does not apply to any of the following:
97 Wis. Act , s. 594q - continued
1. A disability insurance policy that covers only dental care.
97 Wis. Act , s. 594q - continued
2. A medicare supplement policy, as defined in s. 600.03 (28r).
,594r97 Wis. Act , s. 594r
Section 594r.
632.895 (12) (b) (intro.) of the statutes, as created by 1997 Wisconsin Act 27, is amended to read:
97 Wis. Act , s. 594r - continued
632.895 (12) (b) (intro.) Every Except as provided in par. (d), every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, shall cover hospital or ambulatory surgery center charges incurred, and anesthetics provided, in conjunction with dental care that is provided to a covered individual in a hospital or ambulatory surgery center, if any of the following applies:
,594s97 Wis. Act , s. 594s
Section 594s.
632.895 (12) (d) of the statutes is created to read:
97 Wis. Act , s. 594s - continued
632.895 (12) (d) This subsection does not apply to a disability insurance policy that covers only dental care.
,59597 Wis. Act , s. 595
Section 595.
632.897 (4) (d) (intro.) of the statutes is amended to read:
97 Wis. Act , s. 595 - continued
632.897 (4) (d) (intro.) This subsection does not require individual coverage to be offered by an insurer offering group policies only. This subsection does not require an insurer to issue, or continue in force, an individual conversion policy covering a terminated insured or his or her spouse or dependent if benefits provided or available to the covered person under subds. 1. to 3., together with the converted policy's benefits, would result in overinsurance according to the insurer's standards for overinsurance, and these standards have been filed with and approved by the commissioner prior to use:
,59797 Wis. Act , s. 597
Section 597.
633.14 (2) (d) of the statutes is created to read:
97 Wis. Act , s. 597 - continued
633.14 (2) (d) Provides its federal employer identification number.
,597m97 Wis. Act , s. 597m
Section 597m.
633.14 (2c) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 633.14 (2c) (a).
,59897 Wis. Act , s. 598
Section 598.
633.14 (2c) (b) of the statutes is created to read:
97 Wis. Act , s. 598 - continued
633.14 (2c) (b) The commissioner may disclose any information received under sub. (1) (d) or (2) (d) or s. 633.15 (1m) to the department of revenue for the purpose of requesting certifications under s. 73.0301.
,598m97 Wis. Act , s. 598m
Section 598m.
633.14 (2m) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is renumbered 633.14 (2m) (a).
,59997 Wis. Act , s. 599
Section 599.
633.14 (2m) (b) of the statutes is created to read:
97 Wis. Act , s. 599 - continued
633.14 (2m) (b) Notwithstanding subs. (1) and (2), the commissioner may not issue a license under this section if the department of revenue certifies under s. 73.0301 that the applicant is liable for delinquent taxes.
,60097 Wis. Act , s. 600
Section 600.
633.15 (1m) of the statutes, as created by 1997 Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
97 Wis. Act , s. 600 - continued
633.15 (1m) SOCIAL SECURITY OR FEDERAL EMPLOYER IDENTIFICATION NUMBER. At an annual renewal, an administrator shall provide his or her social security number, if the administrator is an individual, or its federal employer identification number, if the administrator is a corporation, limited liability company or partnership, if the social security number or federal employer identification number was not previously provided on the application for the license or at a previous renewal of the license.
,600c97 Wis. Act , s. 600c
Section 600c.
633.15 (2) (a) (title) of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is amended to read:
97 Wis. Act , s. 600c - continued
633.15 (2) (a) (title) Nonpayment of annual renewal fee or failure to provide social security number or federal employer identification number.
,600d97 Wis. Act , s. 600d
Section 600d.
633.15 (2) (a) 1. of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is amended to read:
97 Wis. Act , s. 600d - continued
633.15 (2) (a) 1. If an administrator fails to pay the annual renewal fee as provided under sub. (1) or fails to provide a social security number or federal employer identification number as required under sub. (1m), the commissioner shall suspend the administrator's license effective the day following the last day when the annual renewal fee may be paid, if the commissioner has given the administrator reasonable notice of when the fee must be paid to avoid suspension.
,600e97 Wis. Act , s. 600e
Section 600e.
633.15 (2) (a) 2. of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is amended to read:
97 Wis. Act , s. 600e - continued
633.15 (2) (a) 2. If, within 60 days from the effective date of suspension under subd. 1., an administrator pays the annual renewal fee or provides the social security number or federal employer identification number, or both if the suspension was based upon a failure to do both, the commissioner shall reinstate the administrator's license effective as of the date of suspension.
,600f97 Wis. Act , s. 600f
Section 600f.
633.15 (2) (a) 3. of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is amended to read:
97 Wis. Act , s. 600f - continued
633.15 (2) (a) 3. If payment is not made or the social security number or federal employer identification number is not provided within 60 days from the effective date of suspension under subd. 1., the commissioner shall revoke the administrator's license.
,60197 Wis. Act , s. 601
Section 601.
633.15 (2) (b) 1. (intro.) of the statutes, as affected by 1997 Wisconsin Act .... (Senate Bill 494), is amended to read: