2009 - 2010 LEGISLATURE
August 12, 2009 - Introduced by Representatives Nygren, Spanbauer and
Townsend, cosponsored by Senator Darling. Referred to Committee on
1An Act to amend
632.797 (1) (a) and 632.797 (6) of the statutes; relating to:
2providing descriptions 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:
AB368, s. 1
632.797 (1) (a) of the statutes is amended to read:
(a) Except as provided in subs. (2) and (3), an insurer shall provide 5
the policyholder of a group or blanket disability insurance policy, or an employer that
provides health care coverage to its employees through a multiple-employer trust, 2
with the policyholder's or the employer's aggregate group health claims experience 3
for the current policy period, and for up to 2 policy periods immediately preceding the 4
current policy period if the insurer provided coverage during those periods, upon 5
request 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.
AB368, s. 2
632.797 (6) of the statutes is amended to read:
An insurer that provides aggregate health claims experience the 12
information under sub. (1)
in compliance with this section is immune from civil 13
liability for its acts or omissions in providing such information.
(1) This act first applies to requests for aggregate group health claims 16
experience that are made on the effective date of this subsection.