LRB-4105/1
PJK:jld:nwn
2007 - 2008 LEGISLATURE
February 27, 2008 - Introduced by Senators Darling and Schultz, cosponsored by
Representatives F. Lasee and Nygren. Referred to Committee on Health,
Human Services, Insurance, and Job Creation.
SB541,1,2
1An Act to amend 632.797 (1) (a) of the statutes;
relating to: providing
2descriptions of claims that exceed $10,000.
Analysis by the Legislative Reference Bureau
Under current law, an insurer is required, at the request of a policyholder of a
group health insurance policy or an employer that provides health care coverage to
its employees through a multiple-employer trust, to provide the policyholder or
employer with the policyholder's or employer's aggregate group health claims
experience for the current policy period and for up to two immediately preceding
periods. The information need not be provided unless the policyholder or employer
provides coverage for at least 50 individuals. This bill requires an insurer, when
providing health claims experience information to a policyholder or employer, to
include at the request of the policyholder or employer a separate description of any
large or catastrophic claims exceeding $10,000 that are included in the policyholder's
or employer's aggregate group health claims experience.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB541, s. 1
3Section
1. 632.797 (1) (a) of the statutes is amended to read:
SB541,2,94
632.797
(1) (a) Except as provided in subs. (2) and (3), an insurer shall provide
5the policyholder of a group or blanket disability insurance policy, or an employer that
1provides health care coverage to its employees through a multiple-employer trust,
2with the policyholder's or the employer's aggregate group health claims experience
3for the current policy period, and for up to 2 policy periods immediately preceding the
4current policy period if the insurer provided coverage during those periods, upon
5request from the policyholder or employer.
As part of the information required under
6this paragraph, an insurer shall, if a policyholder or employer so requests, include
7a separate description of any large or catastrophic claims exceeding $10,000, or a
8higher amount at the request of the policyholder or employer, that are included in
9the policyholder's or employer's aggregate group health claims experience.
SB541,2,1211
(1) This act first applies to requests for aggregate group health claims
12experience that are made on the effective date of this subsection.
