LRB-3122/1
CMH&MES:wlj:rs
2005 - 2006 LEGISLATURE
June 28, 2005 - Introduced by Representatives McCormick, Krawczyk, Van Roy,
Vrakas, Musser and
Jensen, cosponsored by Senators Darling, Roessler and
Harsdorf. Referred to Joint Committee on Finance.
AB519,1,9
1An Act to renumber and amend 62.61 and 66.0137 (5);
to amend 66.0137 (1)
2and 632.797 (5); and
to create 16.971 (2) (o), 16.971 (2) (p), 62.61 (2), 62.61 (3),
366.0137 (5) (b) and (c), 601.41 (10), 601.41 (11), 610.66 and 632.797 (1) (d) of the
4statutes;
relating to: disclosure of health insurance claims experience of local
5governmental units; bids submitted to local governmental units for health
6insurance; requiring the commissioner of insurance to promulgate rules
7establishing uniform forms for local government health care coverage requests
8for proposals and health care claims experience and summarizing benefits
9provided under health care benefit plans; and granting rule-making authority.
Analysis by the Legislative Reference Bureau
Under current law, an insurer must provide aggregate claims experience
information, upon request, to the policyholder of a group health insurance policy and
to an employer that provides health care coverage to its employees through a
multiple-employer trust. This requirement applies only if the policyholder or
employer provides coverage under the policy for at least 50 individuals, excluding
individuals who are covered as dependents. Information must be provided for the
current policy period and for up to two immediately preceding policy periods if the
insurer provided coverage during those periods, but information is not required to
be provided for any period of time that is before 18 months before the date of the
request. The insurer must provide the information within 30 days after receiving the
request and may not charge for providing the information one time in a 12-month
period but may charge for additional requests during that time period.
This bill does the following:
1. Requires a local governmental unit, which includes a city, village, town,
county, school district, sewerage district, drainage district, and any other political
subdivision of the state, that requests aggregate group health care claims experience
that an insurer is required to provide to notify the Department of Administration
(DOA) when the local governmental unit requests the information.
2. Requires an insurer to provide to DOA the aggregate group health care
claims experience information that it provides to a local governmental unit at the
same time that the insurer provides the information to the local governmental unit.
3. Requires the Office of the Commissioner of Insurance to develop, by rule, a
uniform form for insurers to use when providing aggregate group health care claims
experience information to local governmental units and requires insurers to use the
form when providing the information to local governmental units and to DOA.
4. Requires DOA to make the aggregate group health care claims experience
information that it receives from insurers available to the public.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB519, s. 1
1Section
1. 16.971 (2) (o) of the statutes is created to read:
AB519,2,82
16.971
(2) (o) Make available to the public without charge to local
3governmental units, the information received from local governmental units under
4s. 66.0137 (5) (c) in a manner determined by the department to enable the general
5public to make meaningful comparisons of the bids received. The department shall
6specify the format that local governmental units shall use in submitting the
7information and shall make information about the format readily available to local
8governmental units.
AB519, s. 2
9Section
2. 16.971 (2) (p) of the statutes is created to read:
AB519,3,3
116.971
(2) (p) Make available to the public the aggregate group health care
2claims experience information received from insurers under s. 632.797 (1) (d) in the
3manner determined by the department.
AB519, s. 3
4Section
3. 62.61 of the statutes is renumbered 62.61 (1) and amended to read:
AB519,3,195
62.61
(1) The common council of a 1st class city may, by ordinance or resolution,
6provide for, including the payment of premiums of, general hospital, surgical and
7group insurance for both active and retired city officers and city employees and their
8respective dependents in private companies, or may, by ordinance or resolution, elect
9to offer to all of its employees a health care coverage plan through a program offered
10by the group insurance board under ch. 40. Municipalities which elect to participate
11under s. 40.51 (7) are subject to the applicable sections of ch. 40 instead of this
section 12subsection. Contracts for insurance under this
section subsection may be entered
13into for active officers and employees separately from contracts for retired officers
14and employees. Appropriations may be made for the purpose of financing insurance
15under this
section subsection. Moneys accruing to a fund to finance insurance under
16this
section subsection, by investment or otherwise, may not be diverted for any other
17purpose than those for which the fund was set up or to defray management expenses
18of the fund or to partially pay premiums to reduce costs to the city or to persons
19covered by the insurance, or both.
AB519, s. 4
20Section
4. 62.61 (2) of the statutes is created to read:
AB519,3,2421
62.61
(2) If a 1st class city solicits bids to provide health care coverage under
22sub. (1), the 1st class city shall use the uniform local government health care
23coverage request-for-proposals form developed by the commissioner of insurance
24under s. 601.41 (10) to solicit the bids.
AB519, s. 5
25Section
5. 62.61 (3) of the statutes is created to read:
AB519,4,5
162.61
(3) A 1st class city shall submit information about a bid it receives to the
2department of administration in the format specified under s. 16.971 (2) (o) no later
3than 30 days after the bid is received or, in the case of a sealed bid, no later than 30
4days after the bid is opened. At the time the information is submitted to the
5department of administration, the 1st class city shall do at least one of the following:
AB519,4,66
(a) Post the same information on the city's Internet site, if any.
AB519,4,87
(b) Post notice on the city's Internet site, if any, that the information has been
8submitted to the department of administration.
AB519,4,129
(c) Post or publish as a class 1 notice under ch. 985 a statement that the
10information has been submitted to the department of administration and will be
11available on the state's Internet site, if any, or a statement that the information may
12be viewed at a specified location in the 1st class city, or both.
AB519, s. 6
13Section
6. 66.0137 (1) of the statutes is amended to read:
AB519,4,1714
66.0137
(1) Definition. In this section, "local governmental unit" means a city,
15village, town, county, school district
(as enumerated in s. 67.01 (5)), sewerage
16district, drainage district, and
, without limitation because of enumeration, any other
17political subdivision of the state.
AB519, s. 7
18Section
7. 66.0137 (5) of the statutes is renumbered 66.0137 (5) (a) amended
19to read:
AB519,5,420
66.0137
(5) (a) The state or a local governmental unit may provide for the
21payment of premiums for hospital, surgical and other health and accident insurance
22and life insurance for employees and officers and their spouses and dependent
23children. A local governmental unit may also provide for the payment of premiums
24for hospital and surgical care for its retired employees. In addition, a local
25governmental unit may, by ordinance or resolution, elect to offer to all of its
1employees a health care coverage plan through a program offered by the group
2insurance board under ch. 40. A local governmental unit that elects to participate
3under s. 40.51 (7) is subject to the applicable sections of ch. 40 instead of this
4subsection paragraph.
AB519, s. 8
5Section
8. 66.0137 (5) (b) and (c) of the statutes are created to read:
AB519,5,96
66.0137
(5) (b) If a local governmental unit solicits bids to provide health care
7coverage under par. (a), the local governmental unit shall use the uniform local
8government health care coverage request-for-proposals form developed by the
9commissioner of insurance under s. 601.41 (10) to solicit the bids.
AB519,5,1510
(c) A local governmental unit shall submit information about a bid it receives
11to the department of administration in the format specified under s. 16.971 (2) (o) no
12later than 30 days after the bid is received or, in the case of a sealed bid, no later than
1330 days after the bid is opened. At the time the information is submitted to the
14department of administration, the local governmental unit shall do at least one of the
15following:
AB519,5,1616
1. Post the same information on the local government's Internet site, if any.
AB519,5,1917
2. Post notice on the local government's Internet site, if any, that the
18information has been submitted to the department of administration and will be
19available on the state's Internet site, if any.
AB519,5,2320
3. Post or publish as a class 1 notice under ch. 985 a statement that the
21information has been submitted to the department of administration and will be
22available on the state's Internet site, if any, or a statement that the information may
23be viewed at a specified location in the local governmental unit, or both.
AB519, s. 9
24Section
9. 601.41 (10) of the statutes is created to read:
AB519,6,6
1601.41
(10) Local government health care coverage request-for-proposals
2form. The commissioner shall by rule develop a uniform local government health
3care coverage request-for-proposals form that a local governmental unit must use
4under s. 66.0137 (5) (b) if the local governmental unit solicits bids for health care
5coverage. The commissioner shall publish a notice in the Wisconsin administrative
6register that states the effective date of the rule required under this subsection.
AB519, s. 10
7Section
10. 601.41 (11) of the statutes is created to read:
AB519,6,148
601.41
(11) Local government health care claims experience form. The
9commissioner shall by rule develop a uniform local government health care claims
10experience form that an insurer must use under s. 632.797 (1) (d). The form may not
11require the disclosure of information that identifies an individual or that is
12confidential under s. 51.30, 146.82, or 252.15 or any applicable federal law. The
13commissioner shall publish a notice in the Wisconsin administrative register that
14states the effective date of the rule required under this subsection.
AB519, s. 11
15Section
11. 610.66 of the statutes is created to read:
AB519,6,19
16610.66 Local government health care coverage request-for-proposals
17form. Every insurer shall use the uniform local government health care coverage
18request-for-proposals form developed by the commissioner under s. 601.41 (10)
19when submitting a bid to a local governmental unit under s. 66.0137 (5) (b).
AB519, s. 12
20Section
12. 632.797 (1) (d) of the statutes is created to read:
AB519,6,2221
632.797
(1) (d) 1. "Local governmental unit" has the meaning given in s.
2266.0137 (1).
AB519,7,223
2. A policyholder or employer that is a local governmental unit and that
24requests information under par. (a) that an insurer is required to provide under this
1section shall notify the department of administration when it makes the request for
2the information.
AB519,7,63
3. An insurer that is required to provide the information under par. (a) to a local
4governmental unit shall also provide the information to the department of
5administration at the same time as the insurer provides the information to the local
6governmental unit.
AB519,7,107
4. The insurer shall use the uniform local government health care claims
8experience form developed by the commissioner under s. 601.41 (11) to submit the
9claims experience information to the local governmental unit and to the department
10of administration.
AB519,7,1311
5. If the insurer fails to provide the information to the department of
12administration by the deadline specified in par. (b), the department of
13administration may report the failure to the commissioner.
AB519, s. 13
14Section
13. 632.797 (5) of the statutes is amended to read:
AB519,7,1615
632.797
(5) An insurer is not required under sub. (1) to provide information
16that identifies an individual or that is confidential under s.
51.30, 146.82
, or 252.15.