SB308,4,2421
120.13
(2) (g) Every self-insured plan under par. (b) shall comply with ss.
2249.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
23632.85, 632.853, 632.855, 632.87 (4) and (5),
632.89, 632.895 (9) to (13), 632.896,
24767.25 (4m) (d), 767.51 (3m) (d) and 767.62 (4) (b) 4.
SB308, s. 9
25Section
9. 185.981 (4t) of the statutes is amended to read:
SB308,5,4
1185.981
(4t) A sickness care plan operated by a cooperative association is
2subject to ss. 252.14, 631.89, 632.72 (2), 632.745 to 632.749, 632.85, 632.853, 632.855,
3632.87 (2m), (3), (4) and (5),
632.89, 632.895 (10) to (13) and 632.897 (10) and chs. 149
4and 155.
SB308, s. 10
5Section
10. 185.983 (1) (intro.) of the statutes is amended to read:
SB308,5,116
185.983
(1) (intro.) Every such voluntary nonprofit sickness care plan shall be
7exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
8601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72
9(2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.85, 632.853, 632.855, 632.87
10(2m), (3), (4) and (5),
632.89, 632.895 (5) and (9) to (13), 632.896 and 632.897 (10) and
11chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:
SB308, s. 11
12Section
11. 301.12 (8) (d) of the statutes is amended to read:
SB308,5,1713
301.12
(8) (d) After due regard to the case and to a spouse and minor children
14who are lawfully dependent on the property for support, compromise or waive any
15portion of any claim of the state or county for which a person specified under sub. (2)
16is liable, but not any claim payable by an insurer under s. 632.89 (2) or
(2m) (4m) or
17by any other 3rd party.
SB308, s. 12
18Section
12. 301.12 (14) (a) of the statutes is amended to read:
SB308,6,419
301.12
(14) (a) Except as provided in pars. (b) and (c), liability of a person
20specified in sub. (2) or s. 301.03 (18) for care and maintenance of persons under 17
21years of age in residential, nonmedical facilities such as group homes, foster homes,
22treatment foster homes, child caring institutions and juvenile correctional
23institutions is determined in accordance with the cost-based fee established under
24s. 301.03 (18). The department shall bill the liable person up to any amount of
25liability not paid by an insurer under s. 632.89 (2) or
(2m) (4m) or by other 3rd-party
1benefits, subject to rules which include formulas governing ability to pay
2promulgated by the department under s. 301.03 (18). Any liability of the resident not
3payable by any other person terminates when the resident reaches age 17, unless the
4liable person has prevented payment by any act or omission.
SB308, s. 13
5Section
13. 609.86 of the statutes is created to read:
SB308,6,7
6609.86 Coverage of alcoholism and other diseases. Managed care plans
7are subject to s. 632.89.
SB308, s. 14
8Section
14. 632.89 (title) of the statutes is amended to read:
SB308,6,10
9632.89 (title)
Required coverage of Coverage of mental disorders,
10alcoholism and other diseases.
SB308, s. 15
11Section
15. 632.89 (1) (b) of the statutes is created to read:
SB308,6,1212
632.89
(1) (b) "Health benefit plan" has the meaning given in s. 632.745 (11).
SB308, s. 16
13Section
16. 632.89 (1) (em) of the statutes is repealed.
SB308, s. 17
14Section
17. 632.89 (1) (er) of the statutes is created to read:
SB308,6,1615
632.89
(1) (er) "Self-insured health plan" has the meaning given in s. 632.745
16(24).
SB308, s. 18
17Section
18. 632.89 (2) (title) of the statutes is amended to read:
SB308,6,1818
632.89
(2) (title)
Required coverage
for group plans.
SB308, s. 19
19Section
19. 632.89 (2) (a) 1. of the statutes is renumbered 632.89 (2) (a) and
20amended to read:
SB308,6,2421
632.89
(2) (a) A group
or blanket disability insurance policy issued by an
22insurer health benefit plan and a self-insured health plan shall provide coverage of
23nervous and mental disorders and alcoholism and other drug abuse problems if
24required by
pars. (c) to (dm) and as provided in pars.
(b) (c) to
(e)
(dm) and sub. (3).
SB308, s. 20
25Section
20. 632.89 (2) (a) 2. of the statutes is repealed.
SB308, s. 21
1Section
21. 632.89 (2) (b) of the statutes is repealed.
SB308, s. 22
2Section
22. 632.89 (2) (c) 1. of the statutes is renumbered 632.89 (2) (c) and
3amended to read:
SB308,7,84
632.89
(2) (c)
Minimum coverage Coverage of inpatient hospital services. If a
5group
or blanket disability insurance policy issued by an insurer health benefit plan
6or a self-insured health plan provides coverage of any inpatient hospital treatment,
7the
policy plan shall provide coverage for inpatient hospital services for the
8treatment of conditions under par. (a)
1. as provided in subd. 2.
SB308, s. 23
9Section
23. 632.89 (2) (c) 2. of the statutes is repealed.
SB308, s. 24
10Section
24. 632.89 (2) (d) 1. of the statutes is renumbered 632.89 (2) (d) and
11amended to read:
SB308,7,1612
632.89
(2) (d)
Minimum coverage Coverage of outpatient services. If a group
or
13blanket disability insurance policy issued by an insurer health benefit plan or a
14self-insured health plan provides coverage of any outpatient treatment, the
policy 15plan shall provide coverage for outpatient services for the treatment of conditions
16under par. (a)
1. as provided in subd. 2.
SB308, s. 25
17Section
25. 632.89 (2) (d) 2. of the statutes is repealed.
SB308, s. 26
18Section
26. 632.89 (2) (dm) 1. of the statutes is renumbered 632.89 (2) (dm)
19and amended to read:
SB308,7,2520
632.89
(2) (dm)
Minimum coverage Coverage of transitional treatment
21arrangements. If a group
or blanket disability insurance policy issued by an insurer 22health benefit plan or a self-insured health plan provides coverage of any inpatient
23hospital treatment or any outpatient treatment, the
policy plan shall provide
24coverage for transitional treatment arrangements for the treatment of conditions
25under par. (a)
1. as provided in subd. 2.
SB308, s. 27
1Section
27. 632.89 (2) (dm) 2. of the statutes is repealed.
SB308, s. 28
2Section
28. 632.89 (2) (e) of the statutes is renumbered 632.89 (5) (b) and
3amended to read:
SB308,8,74
632.89
(5) (b)
Exclusion
Certain health care plans. This
subsection section does
5not apply to a health care plan offered by a limited service health organization, as
6defined in s. 609.01 (3)
, or by a preferred provider plan, as defined in s. 609.01 (4),
7that is not a managed care plan, as defined in s. 609.01 (3c).
SB308, s. 29
8Section
29. 632.89 (2m) of the statutes is renumbered 632.89 (4m).
SB308, s. 30
9Section
30. 632.89 (3) of the statutes is created to read:
SB308,8,1410
632.89
(3) Equal coverage requirement. (a)
Group plans. A group health
11benefit plan or a self-insured health plan that provides coverage for the treatment
12of nervous and mental disorders and alcoholism and other drug abuse problems shall
13provide the same coverage for that treatment that it provides for the treatment of
14physical conditions.
SB308,8,1815
(b)
Individual plans. If an individual health benefit plan provides coverage for
16the treatment of nervous or mental disorders or alcoholism or other drug abuse
17problems, the individual health benefit plan shall provide the same coverage for that
18treatment that it provides for the treatment of physical conditions.
SB308,8,2319
(c)
All coverage components. The requirements under this subsection apply to
20all coverage-related components, including rates; exclusions and limitations;
21deductibles; copayments; coinsurance; annual and lifetime payment limits;
22out-of-pocket limits; out-of-network charges; day, visit or appointment limits;
23duration or frequency of coverage; and medical necessity definitions.
SB308, s. 31
24Section
31. 632.89 (3m) of the statutes is repealed.
SB308, s. 32
25Section
32. 632.89 (5) (title) of the statutes is amended to read:
SB308,9,1
1632.89
(5) (title)
Medicare exclusion Exclusions.
SB308, s. 33
2Section
33. 632.89 (5) of the statutes is renumbered 632.89 (5) (a).
SB308, s. 34
3Section
34. 632.89 (5) (a) (title) of the statutes is created to read:
SB308,9,44
632.89
(5) (a) (title)
Medicare.
SB308,9,66
(1) This act first applies to all of the following:
SB308,9,97
(a) Except as provided in paragraphs (b) and (c
), health benefit plans that are
8issued or renewed, and self-insured health plans that are established, extended,
9modified or renewed, on the effective date of this paragraph.
SB308,9,1210
(b) Health benefit plans covering employes who are affected by a collective
11bargaining agreement containing provisions inconsistent with this act that are
12issued or renewed on the earlier of the following:
SB308,9,13
131. The day on which the collective bargaining agreement expires.
SB308,9,15
142. The day on which the collective bargaining agreement is extended, modified
15or renewed.
SB308,9,1816
(c) Self-insured health plans covering employes who are affected by a collective
17bargaining agreement containing provisions inconsistent with this act that are
18established, extended, modified or renewed on the earlier of the following:
SB308,9,19
191. The day on which the collective bargaining agreement expires.
SB308,9,21
202. The day on which the collective bargaining agreement is extended, modified
21or renewed.
SB308,9,2423
(1)
This act takes effect on the first day of the 6th month beginning after
24publication.