145.08 (1) (p) For a plumbing supervisor employed by the department in accord with s. 145.02 (3) (a), no cost for the appropriate 2-year 4-year license for which the plumbing supervisor has previously qualified.
145.08 (1) (q) of the statutes is amended to read:
145.08 (1) (q) For a pipelayer's registration, $90 $180 at the time of registration and $90 $180 for each subsequent 2-year 4-year period of registration.
145.08 (2) of the statutes is amended to read:
145.08 (2) No license or registration may be issued for longer than 2 4 years. Any license or registration may be renewed upon application made prior to the date of expiration. The department may renew licenses or registrations upon application made after the date of expiration if it is satisfied that the applicant has good cause for not applying for renewal prior to the date of expiration and upon payment of the renewal and additional fees prescribed.
146.50 (9) of the statutes is amended to read:
146.50 (9) Training. The department may arrange for or approve courses of or instructional programs in or outside this state to meet the education and training requirements of this section, including training required for license or certificate renewal. Courses required for a license or renewal of a license as an emergency medical technician - basic shall be free of charge to an individual who is employed by or affiliated with a public agency, volunteer fire company or nonprofit corporation and is the holder of a license or training permit as an emergency medical technician- basic or eligible to hold such a license or training permit. If the department determines that an area or community need exists, the courses shall be offered at technical colleges in the area or community. Initial priority shall be given to the training of emergency medical technicians – basic serving the rural areas of the state. If an emergency medical technician - basic completes a course approved by the department on treatment of anaphylactic shock, the emergency medical technician – basic acts within the scope of the license if he or she performs injections or other treatment for anaphylactic shock under the direction of a physician.
146.55 (5) of the statutes is renumbered 146.55 (5) (a) and amended to read:
146.55 (5) (a) From the appropriation under s. 20.435 (5) (ch), the department shall annually distribute funds to entities, including technical college districts, whose courses or instructional programs are approved by the department under s. 146.50 (9), to assist the entities in providing ambulance service providers that are public agencies, volunteer fire departments, or nonprofit corporations to purchase the training required for licensure and renewal of licensure as an emergency medical technician - basic under s. 146.50 (6), and to fund each examination administered by the entity pay for administration of the examination required for licensure or renewal of licensure as an emergency medical technician - basic under s. 146.50 (6) (a) 3. and (b) 1.
146.55 (5) (b) of the statutes is created to read:
146.55 (5) (b) The department shall require as a condition of relicensure that an ambulance service provider submit to the department a financial report on the expenditure of funds received under par. (a).
146.58 (7) of the statutes is amended to read:
146.58 (7) Advise, make recommendations to, and consult with the department concerning the funding under s. 146.55 (4) and (5), including recommending a formula for allocating funds among ambulance service providers under s. 146.55 (5).
146.65 (1) (c) of the statutes is created to read:
146.65 (1) (c) In each fiscal year, not more than $400,000, to a rural health clinic in Chippewa Falls to provide dental services to persons who are developmentally disabled or elderly or who have low income, in the area surrounding Chippewa Falls, including the counties of Chippewa, Dunn, Barron, Taylor, Clark, and Eau Claire.
146.70 (3m) (d) 1g. of the statutes is repealed and recreated to read:
146.70 (3m) (d) 1g. If an application under par. (c) includes an estimate of costs identified in par. (c) 1. d. incurred during the reimbursement period or between January 1, 1999, and September 3, 2003, the commission may approve the application only if the commission determines that the local government's collection of land information, as defined in s. 16.967 (1) (b), and development of a land information system, as defined in s. 16.967 (1) (c), that is related to that purpose are consistent with the applicable county land records modernization plans developed under s. 59.72 (3) (b), conform to the standards on which such plans are based, and do not duplicate land information collection and other efforts funded through the land information program under s. 16.967 (7). The commission shall obtain the advice of the department of administration in making determinations under this subdivision.
Chapter 149 (title) of the statutes is amended to read:
Mandatory health insurance
149.10 (2) of the statutes is amended to read:
149.10 (2) "Board" means the board of governors established directors under s. 149.15 149.11 (1).
149.10 (2j) (a) 3. of the statutes is amended to read:
149.10 (2j) (a) 3. Part A or, part B, or part D of title XVIII of the federal Social Security Act.
149.10 (2m) of the statutes is repealed.
149.10 (2t) (c) of the statutes is amended to read:
149.10 (2t) (c) The individual does not have creditable coverage and is not eligible for coverage under a group health plan, part A or, part B, or part D of title XVIII of the federal Social Security Act or a state plan under title XIX of the federal Social Security Act or any successor program.
149.10 (3) of the statutes is amended to read:
149.10 (3) "Eligible person" means a resident
of this state who qualifies under s. 149.12 whether or not the person is legally responsible for the payment of medical expenses incurred on the person's behalf.
149.10 (3e) of the statutes is amended to read:
149.10 (3e) "Fund" means the health insurance risk-sharing plan Health Insurance Risk-Sharing Plan fund under s. 149.11 (2).
149.10 (7) of the statutes is amended to read:
"Medicare" means coverage under both
part A and,
part B, and part D
of Title XVIII of the federal social security act, 42 USC 1395
et seq., as amended.
149.10 (9) of the statutes is amended to read:
149.10 (9) "Resident" means a person who has been legally domiciled in this state for a period of at least 30 days 6 months or, with respect to an eligible individual, an individual who resides in this state. For purposes of this chapter, legal domicile is established by living in this state and obtaining a Wisconsin motor vehicle operator's license, registering to vote in Wisconsin or filing a Wisconsin income tax return. A child is legally domiciled in this state if the child lives in this state and if at least one of the child's parents or the child's guardian is legally domiciled in this state. A person with a developmental disability or another disability which prevents the person from obtaining a Wisconsin motor vehicle operator's license, registering to vote in Wisconsin, or filing a Wisconsin income tax return, is legally domiciled in this state by living in this state.
149.10 (10) of the statutes is repealed.
149.11 of the statutes is repealed and recreated to read:
149.11 Administration of plan. (1) Appointment of board of directors; formation of administering organization. (a) No later than September 1, 2005, the commissioner shall nominate 13 individuals to be appointed with the advice and consent of the senate to serve as the initial directors of the board of the organization to be formed under par. (b). The board shall consist of 4 representatives of participating insurers; 4 representatives of health care providers, including one representative of the Wisconsin Medical Society, one representative of the Wisconsin Hospital Association, Inc., one representative of the Pharmacy Society of Wisconsin, and one representative of health care providers that provide services to persons with coverage under the plan; and 5 other members, at least one of whom represents small businesses that purchase private health insurance and at least one of whom is a person with coverage under the plan. In making the nominations to the board, the commissioner shall first consult with one or more trade or professional associations whose members include participating insurers, one or more trade or professional associations whose members include health care providers that provide services to persons with coverage under the plan, and one or more trade or professional associations whose members include small business owners.
(b) The individuals appointed as initial directors under par. (a) shall form a private, nonprofit organization under ch. 181 and shall take all actions necessary to exempt the organization from federal taxation under section 501
(a) of the Internal Revenue Code. The articles of incorporation shall include all of the following:
1. The names and addresses of the 13 individuals as the initial directors.
2. That the purpose of the organization is to administer the plan.
3. That the directors, including the initial directors, shall serve staggered 3-year terms.
4. That the directors shall satisfy the criteria specified in par. (a) and shall be nominated by the commissioner, after consultation as specified in par. (a), and appointed with the advice and consent of the senate.
(c) As a condition for the release of funds under s. 20.145 (5) (g), the organization, through the board, shall administer the plan in conformity with this chapter and perform any other duties required of the organization or board under this chapter.
(2) Fund. (a) The board shall pay the operating and administrative expenses of the plan from the fund, which shall be outside the state treasury and which shall consist of all of the following:
3. The earnings resulting from investments under par. (b).
4. Any other moneys received by the organization or board from time to time.
(b) The board controls the assets of the fund and shall select regulated financial institutions in this state that receive deposits in which to establish and maintain accounts for assets needed on a current basis. If practicable, the accounts shall earn interest.
(c) Moneys in the fund may be expended only for the purposes specified in par. (a).
(3) Immunity. No cause of action of any nature may arise against and no liability may be imposed upon the organization, plan, or board; or any agent, employee, or director of any of them; or contributor insurers; or the commissioner; or any of the commissioner's agents, employees, or representatives, for any act or omission by any of them in the performance of their powers and duties under this chapter.
149.115 of the statutes is amended to read:
149.115 Rules relating to creditable coverage.
The commissioner, in consultation with the department,
shall promulgate rules that specify how creditable coverage is to be aggregated for purposes of s. 149.10 (2t) (a) and that determine the creditable coverage to which s. 149.10 (2t) (b) and (d) applies. The rules shall comply with section 2701 (c) of P.L. 104-191
149.12 (1) (intro.) of the statutes is amended to read:
(intro.) Except as provided in subs. (1m) and,
(2), and (3)
, the board or plan administrator
shall certify as eligible a person who is covered by medicare Medicare
because he or she is disabled under 42 USC 423
, a person who submits evidence that he or she has tested positive for the presence of HIV, antigen or nonantigenic products of HIV,
or an antibody to HIV, a person who is an eligible individual, and any person who receives and submits any of the following based wholly or partially on medical underwriting considerations within 9 months prior to making application for coverage by the plan:
149.12 (1) (a) of the statutes is amended to read:
149.12 (1) (a) A notice of rejection of coverage from one 2 or more insurers.
149.12 (1m) of the statutes is amended to read:
149.12 (1m) The board or plan administrator may not certify a person as eligible under circumstances requiring notice under sub. (1) (a) to (d) if the required notices were issued by an insurance intermediary who is not acting as an administrator, as defined in s. 633.01.
149.12 (2) (g) of the statutes is created to read:
149.12 (2) (g) A person is not eligible for coverage under the plan if the person is eligible for any of the following:
1. Services under s. 46.27 (11), 46.275, 46.277, or 46.278.
2. Medical assistance provided as part of a family care benefit, as defined in s. 46.2805 (4).
3. Services provided under a waiver requested under 2001 Wisconsin Act 16
, section 9123 (16rs)
, or 2003 Wisconsin Act 33
, section 9124 (8c)
4. Services provided under the program of all-inclusive care for persons aged 55 or older authorized under 42 USC 1396u-4
5. Services provided under the demonstration program under a federal waiver authorized under 42 USC 1315
6. Health care coverage under the Badger Care health care program under s. 49.665.
149.12 (3) (a) of the statutes is amended to read:
149.12 (3) (a) Except as provided in pars. (b) to (c) and (bm), no person is eligible for coverage under the plan for whom a premium, deductible, or coinsurance amount is paid or reimbursed by a federal, state, county, or municipal government or agency as of the first day of any term for which a premium amount is paid or reimbursed and as of the day after the last day of any term during which a deductible or coinsurance amount is paid or reimbursed.
149.12 (3) (c) of the statutes is repealed.
149.12 (4) and (5) of the statutes are created to read:
149.12 (4) Subject to subs. (1m), (2), and (3), the board may establish criteria that would enable additional persons to be eligible for coverage under the plan. The board shall ensure that any expansion of eligibility is consistent with the purpose of the plan to provide health care coverage for those who are unable to obtain health insurance in the private market and does not endanger the solvency of the plan.
(5) The board shall establish policies for determining and verifying the continued eligibility of an eligible person.
149.13 (1) of the statutes is amended to read:
149.13 (1) Every insurer shall participate in the cost of administering the plan, except the commissioner may by rule exempt as a class those insurers whose share as determined under sub. (2) would be so minimal as to not exceed the estimated cost of levying the assessment. The
commissioner shall advise the department board of the insurers participating in the cost of administering the plan.
149.13 (3) (a) of the statutes is amended to read:
149.13 (3) (a) Each insurer's proportion of participation under sub. (2) shall be determined annually by the commissioner based on annual statements and other reports filed by the insurer with the commissioner. The commissioner shall assess an insurer for the insurer's proportion of participation based on the total assessments estimated by the department under s. 149.143 (2) (a) 3. board.
149.13 (3) (b) of the statutes is amended to read:
149.13 (3) (b) If the department
board or the commissioner finds that the commissioner's authority to require insurers to report under chs. 600 to 646 and 655 is not adequate to permit the department, the commissioner or the board to carry out the department's, commissioner's or board's responsibilities under this chapter, the commissioner shall promulgate rules requiring insurers to report the information necessary for the department, commissioner and board to make the determinations required under this chapter.
149.13 (4) of the statutes is amended to read:
149.13 (4) Notwithstanding subs. (1) to (3), the department board, with the agreement of the commissioner, may perform various administrative functions related to the assessment of insurers participating in the cost of administering the plan.
149.14 (1) (a) of the statutes is amended to read:
149.14 (1) (a) The plan shall offer coverage for each eligible person in an annually renewable policy the coverage specified in this section for each eligible person. If an eligible person is also eligible for medicare Medicare coverage, the plan shall not pay or reimburse any person for expenses paid for by medicare Medicare.
149.14 (2) (a) of the statutes is amended to read:
149.14 (2) (a) The plan shall provide every eligible person who is not eligible for medicare Medicare with major medical expense coverage. Major medical expense coverage offered under the plan under this section shall pay an eligible person's covered expenses, subject to sub. (3) and deductible, copayment, and coinsurance payments authorized under sub. (5), up to a lifetime limit of $1,000,000 per covered individual. The maximum limit under this paragraph shall not be altered by the board, and no actuarially equivalent benefit may be substituted by the board.
149.14 (3) (intro.) of the statutes is renumbered 149.14 (3) and amended to read:
149.14 (3) Covered expenses. Except as provided in sub. (4), except as restricted by cost containment provisions under s. 149.17 (4) and except as reduced by the department under ss. 149.143 and 149.144, covered Covered expenses for the coverage under this section the plan shall be the payment rates established by the department under s. 149.142 board for the services provided by persons licensed under ch. 446 and certified under s. 49.45 (2) (a) 11. Except as provided in sub. (4), except as restricted by cost containment provisions under s. 149.17 (4) and except as reduced by the department under ss. 149.143 and 149.144, covered Covered expenses for the coverage under this section the plan shall also be the payment rates established by the department under s. 149.142 board for the following services and articles if the service or article is prescribed by a physician who is licensed under ch. 448 or in another state and who is certified under s. 49.45 (2) (a) 11. and if the service or article is provided by a provider certified under s. 49.45 (2) (a) 11.:
149.14 (3) (a) to (r) of the statutes are repealed.
149.14 (4) of the statutes is repealed and recreated to read:
149.14 (4) Benefit design. Except as provided in subs. (2) (a) and (6), the board shall determine the benefit design of the plan, including the covered expenses, expenses excluded from coverage, deductibles, copayments, coinsurance, out-of-pocket limits, and coverage limitations. The board may establish more than one benefit design under the plan. All benefit designs shall be comparable to typical individual health insurance policies offered in the private sector market in this state.