AB840,25,1512 149.165 (1) Except as provided in s. 149.146 (2) (a), the department board shall
13reduce the premiums established under s. 149.11 in conformity with ss. 149.14 (5m),
14149.143, and 149.17 for the eligible persons and in the manner set forth in subs. (2)
15and (3).
AB840, s. 75 16Section 75. 149.165 (2) of the statutes is amended to read:
AB840,25,2117 149.165 (2) (a) Subject to sub. subs. (3m) and (3r), if the household income, as
18defined in s. 71.52 (5) and as determined under sub. (3), of an eligible person with
19coverage under s. 149.14 (2) (a) is equal to or greater than the first amount and less
20than the 2nd amount listed in any of the following, the department board shall
21reduce the premium for the eligible person to the rate shown after the amounts:
AB840,25,2522 1. If equal to or greater than $0 and less than $10,000, to 100% 100 percent of
23the rate that a standard risk would be charged under an individual policy providing
24substantially the same coverage and deductibles cost-sharing provisions as
25provided under s. 149.14 (2) (a) and (5) (a).
AB840,26,4
12. If equal to or greater than $10,000 and less than $14,000, to 106.5% 106.5
2percent
of the rate that a standard risk would be charged under an individual policy
3providing substantially the same coverage and deductibles cost-sharing provisions
4as provided under s. 149.14 (2) (a) and (5) (a).
AB840,26,85 3. If equal to or greater than $14,000 and less than $17,000, to 115.5% 115.5
6percent
of the rate that a standard risk would be charged under an individual policy
7providing substantially the same coverage and deductibles cost-sharing provisions
8as provided under s. 149.14 (2) (a) and (5) (a).
AB840,26,129 4. If equal to or greater than $17,000 and less than $20,000, to 124.5% 124.5
10percent
of the rate that a standard risk would be charged under an individual policy
11providing substantially the same coverage and deductibles cost-sharing provisions
12as provided under s. 149.14 (2) (a) and (5) (a).
AB840,26,1613 5. If equal to or greater than $20,000 and less than $25,000, to 130% 130
14percent
of the rate that a standard risk would be charged under an individual policy
15providing substantially the same coverage and deductibles cost-sharing provisions
16as provided under s. 149.14 (2) (a) and (5) (a).
AB840,26,2517 (bc) Subject to sub. subs. (3m) and (3r), if the household income, as defined in
18s. 71.52 (5) and as determined under sub. (3), of an eligible person with coverage
19under s. 149.14 (2) (b) is equal to or greater than the first amount and less than the
202nd amount listed in par. (a) 1., 2., 3., 4., or 5., the department board shall reduce the
21premium established for the eligible person by the same percentage as the
22department board reduces, under par. (a), the premium established for an eligible
23person with coverage under s. 149.14 (2) (a) who has a household income specified
24in the same subdivision under par. (a) as the household income of the eligible person
25with coverage under s. 149.14 (2) (b).
AB840, s. 76
1Section 76. 149.165 (3) (a) of the statutes is amended to read:
AB840,27,42 149.165 (3) (a) Subject to par. (b), the department board shall establish and
3implement the method for determining the household income of an eligible person
4under sub. (2).
AB840, s. 77 5Section 77. 149.165 (3) (b) (intro.) of the statutes is amended to read:
AB840,27,96 149.165 (3) (b) (intro.) In determining household income under sub. (2), the
7department board shall consider information submitted by an eligible person on a
8completed federal profit or loss from farming form, schedule F, if all of the following
9apply:
AB840, s. 78 10Section 78. 149.165 (3r) of the statutes is created to read:
AB840,27,1311 149.165 (3r) The board shall use any excess premiums collected under a
12schedule established under s. 149.15 (4) (d) to further reduce the premium rates
13under sub. (2) (a) 1. to 5. and (bc).
AB840, s. 79 14Section 79. 149.17 (4) of the statutes is amended to read:
AB840,27,1615 149.17 (4) Cost containment provisions established by the department board
16by rule, including managed care requirements.
AB840, s. 80 17Section 80. 149.175 of the statutes is amended to read:
AB840,27,22 18149.175 Waiver or exemption from provisions prohibited. Except as
19provided in s. 149.13 (1), the department or the board may not waive, or authorize
20the board to waive,
any of the requirements of this chapter or exempt, or authorize
21the board to exempt,
an individual or a class of individuals from any of the
22requirements of this chapter.
AB840, s. 81 23Section 81. 149.20 of the statutes is amended to read:
AB840,28,2 24149.20 Rule-making in consultation with Rules to be approved by
25board.
In promulgating any Any rules proposed by the department under this

1chapter, the department shall consult with may not be promulgated without the
2approval of
the board.
AB840, s. 82 3Section 82. 149.25 (2) (a) of the statutes is amended to read:
AB840,28,74 149.25 (2) (a) The department shall conduct a 3-year pilot program, beginning
5on July 1, 2002, under which eligible persons who qualify under par. (b) are provided
6community-based case management services. The department shall consult with
7the board as necessary in conducting the pilot program.
AB840, s. 83 8Section 83. 149.25 (4) of the statutes is amended to read:
AB840,28,179 149.25 (4) Evaluation study. The department, in consultation with the board,
10shall conduct a study that evaluates the pilot program in terms of health care
11outcomes and cost avoidance. In the study, the department shall measure and
12compare, for pilot program participants and similarly situated eligible persons not
13participating in the pilot program, plan costs and utilization of services, including
14inpatient hospital days, rates of hospital readmission within 30 days for the same
15diagnosis, and prescription drug utilization. The department shall submit a report
16on the results of the study, including the department's conclusions and
17recommendations, to the legislature under s. 13.172 (2) and to the governor.
AB840, s. 84 18Section 84. 450.10 (2m) of the statutes is created to read:
AB840,28,2119 450.10 (2m) If a manufacturer or labeler fails to pay an assessment levied
20under s. 149.132 within the time required for payment, the board may assess a
21forfeiture of not more than $1,000 for each day that the payment is past due.
AB840, s. 85 22Section 85. Nonstatutory provisions.
AB840,29,523 (1) Federal grant funds. Notwithstanding section 149.143 (1) of the statutes,
24as affected by this act, any federal grant moneys received by the state under the
25Trade Adjustment Assistance Reform Act of 2002 and allocated to the Health

1Insurance Risk-Sharing Plan shall be used to pay plan costs before any moneys
2specified under section 149.143 (1) (am) and (bm) of the statutes, as affected by this
3act, are used. After the federal grant money has been used, plan costs shall be paid
4as provided under section 149.143 (1) (am) and (bm) of the statutes, as affected by
5this act.
AB840,29,96 (2) Selection of plan administrator. The board of governors of the Health
7Insurance Risk-Sharing Plan shall, no later than July 1, 2004, issue a
8request-for-proposals under section 149.15 (3) (e) of the statutes, as created by this
9act, for administration of the Health Insurance Risk-Sharing Plan.
AB840,29,1510 (3) Drug manufacturer and labeler assessments. Notwithstanding section
11149.132 of the statutes, as created by this act, the first assessment under section
12149.132 of the statutes, as created by this act, that is payable by prescription drug
13manufacturers and labelers shall be calculated on prescription drug claims paid by
14the Health Insurance Risk-Sharing Plan from July 1, 2004, to December 31, 2004,
15rather than on total prescription drug claims paid in 2004.
AB840, s. 86 16Section 86 . Initial applicability.
AB840,29,2117 (1) Design. With respect to changes in plan design, including covered expenses
18and exclusions, deductibles, copayments, coinsurance, and out-of-pocket limits, the
19treatment of sections 149.11, 149.14 (3) (intro.) and (a) to (r), (4), (5) (d) and (e), and
20(8), 149.146 (1) (b) and (2) (a), (am) 4. and 5., and (b) (intro.) and 1., 149.15 (3) (b), and
21149.17 (4) of the statutes first applies to the plan year beginning on January 1, 2005.
AB840,29,2422 (2) Eligibility. The treatment of section 149.12 (1) (a), (am), (b), and (c) of the
23statutes first applies to applications for coverage under the Health Insurance
24Risk-Sharing Plan that are received on the effective date of this subsection.
AB840,30,5
1(3) Drug manufacturer and labeler assessments. The treatment of sections
225.55 (3), 149.10 (5f) and (5r), 149.132, 149.143 (1) (bm) 1., 1m., 2., and 2m. (intro.),
3(2) (a) 3. and 4., (3) (a) (by Section 49), and (5) (a) (by Section 53), 149.145 (by Section
457), and 450.10 (2m) of the statutes first applies to drug manufacturer and labeler
5assessments that are payable with respect to claims paid on July 1, 2004.
AB840, s. 87 6Section 87. Effective dates. This act takes effect on the day after publication,
7except as follows:
AB840,30,108 (1) Eligibility. The treatment of section 149.12 (1) (a), (am), (b), and (c) of the
9statutes and Section 86 (2) of this act take effect on the first day of the 4th month
10beginning after publication.
AB840,30,1411 (2) Drug manufacturer and labeler assessments. The treatment of sections
1225.55 (3), 149.10 (5f) and (5r), 149.132, 149.143 (1) (bm) 1., 1m., 2., and 2m. (intro.),
13(2) (a) 3. and 4., (3) (a) (by Section 49), and (5) (a) (by Section 53), 149.145 (by Section
1457), and 450.10 (2m) of the statutes takes effect on July 1, 2004.
AB840,30,1515 (End)
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