Under current law, every insurer that issues a group or individual health
benefit plan must have an internal grievance procedure and an independent review
procedure for certain adverse decisions after the internal grievance procedure has
been exhausted. Generally, the adverse decision must relate to the insurer's denial,
reduction, or termination of a health care service or payment for a health care service
on the basis that the service was experimental or did not meet the plan's
requirements for medical necessity, appropriateness, health care setting, level of
care, or effectiveness. An independent review may be conducted only by an
independent review organization that has been certified by OCI.
This bill adds the rescission of a policy or certificate and a coverage denial
determination based on a preexisting condition exclusion to the types of adverse
decisions that are eligible for independent review. The bill also eliminates the $25
fee for an independent review. In addition, the bill requires every insurer that issues
individual health benefit plans to report to OCI annually the number of plans issued
by the insurer in the preceding year and the number of plans with respect to which
the insurer initiated or completed a cancellation or rescission in the preceding year.
Preexisting condition exclusions
Under current law, an insurer may impose a preexisting condition exclusion for
up to two years under an individual health insurance policy and there is no limit on
how long before an insured's coverage began a condition may have existed to be
treated as a preexisting condition. Under a group health insurance policy, a
preexisting condition exclusion generally may not exceed one year and the insurer
may impose an exclusion only with respect to conditions for which treatment was
received or recommended within six months before coverage began. This bill
provides that under an individual health insurance policy, an insurer may impose a
preexisting condition exclusion for up to one year for a condition for which treatment
was received or recommended within one year before the insured's coverage began.
Modifications at renewal of individual health insurance
Currently, with some exceptions, an insurer must renew an individual health
insurance policy at the request of the insured. At renewal, the insurer may modify
the policy form uniformly among all individuals with coverage under that policy
form. This bill requires an insurer, at renewal of an individual health insurance
policy and at the request of the insured, to issue comparable coverage that the
insurer currently offers or coverage currently offered by the insurer that has more
limited benefits or a higher deductible or to provide a higher deductible under the
insured's current coverage. An insurer must annually mail to each insured under
an individual policy issued a notice that informs the insured of his or her right to elect
alternative coverage and that describes the alternatives and the procedure for
electing the alternative coverage.
Uniform application for individual health insurance
This bill requires OCI to prescribe uniform questions and the format for
applications that all insurers offering individual health insurance policies must use
on an application for such a policy.
Dependent coverage
Current law contains a number of provisions related to coverage of dependents
under health insurance policies, such as requiring a health insurer that covers a
child of an insured also to cover any child of the insured's child until the insured's
child is 18 years old and prohibiting a health insurer from terminating coverage of
a dependent child who reaches the age at which the insurer no longer covers
dependents if, and while, the child is incapable of self-sustaining employment
because of mental retardation or physical handicap and is dependent on the insured
for support and maintenance. Current law, however, does not require a health
insurer to cover a dependent of an insured up to any particular age or, for example,
because a dependent is a full-time student.
Under this bill, a health insurer that provides coverage for dependents must
cover any child of an insured if the child is unmarried, is under 27 years old, does not
have other health care coverage, and is not employed full time by an employer that
offers health care coverage to its employees. The coverage requirement applies to
both individual and group health insurance policies and plans, including those
offered by the state, and to self-insured health plans of counties, cities, villages,
towns, school districts, and the state.
Requirement for health insurer to cover claims
This bill prohibits a health insurer from refusing to cover claims for health care
services provided to an insured on the basis that there may be coverage for those
services under a liability insurance policy.
Motor Vehicle insurance
Proof of financial responsibility
Current law imposes certain financial responsibility requirements on owners
and operators of motor vehicles involved in accidents. If a motor vehicle accident
results in injury, death, or property damage of $1,000 or more, DOT must notify the
operator and owner of the vehicle that the person must deposit with DOT security
for the accident in an amount that DOT has determined is sufficient to satisfy any
resulting judgment for damages. Unless an exception applies, if a person fails to
timely deposit security after this notice, DOT must suspend the person's operating
privilege if the person was the vehicle operator and suspend all vehicle registrations
of the person if the person was the vehicle owner. One exception applies to a person
who provides proof of financial responsibility. In addition, if DOT receives a certified
copy of a judgment for damages of $500 or more arising out of a motor vehicle
accident, DOT must immediately suspend the operating privilege and all
registrations of the judgment debtor unless he or she can provide proof of financial
responsibility. In both situations, proof of financial responsibility includes coverage
under a motor vehicle liability insurance policy with the following minimum limits
for any single accident: $25,000 for bodily injury to or death of one person, $50,000
for bodily injury to or death of more than one person, and $10,000 for property
damage.
This bill increases the minimum limits required under a policy that is
acceptable proof of financial responsibility to $100,000 for bodily injury to or death
of one person, $300,000 for bodily injury to or death of more than one person, and
$25,000 for property damage.
Uninsured motorist and medical payments coverages
Under current law, all motor vehicle liability insurance policies must include
uninsured motorist coverage of at least $25,000 per person and $50,000 per accident
and medical payments coverage of at least $1,000 per person. Uninsured motorist
coverage provides coverage for persons who are legally entitled to recover damages
for bodily injury from owners or operators of motor vehicles that are not insured.
Medical payments coverage pays for medical or chiropractic services provided to
persons who are injured while using the insured motor vehicle.
This bill increases the required level of uninsured motorist coverage to
$100,000 per person and $300,000 per accident, and increases the level of required
medical payments coverage to $10,000.
Underinsured motorist coverage
Current law, while not requiring that motor vehicle liability policies include
underinsured motorist coverage, requires insurers to provide written notice of the
availability of that coverage to one insured under each policy written after, or in
effect on, October 1, 1995, that does not include the coverage. If an insured accepts
the coverage after receiving notice of its availability, the policy must include the
coverage in limits of at least $50,000 per person and $100,000 per accident.
Underinsured motorist coverage provides coverage for persons who are legally
entitled to damages for bodily injury from owners or operators of underinsured motor
vehicles. "Underinsured motor vehicle" is not defined in the statutes.
This bill requires every motor vehicle liability insurance policy to include
underinsured motorist coverage of at least $100,000 per person and $300,000 per
accident. In addition, the bill defines an underinsured motor vehicle as a motor
vehicle that is involved in an accident with an insured and which, at the time of the
accident, was covered by a motor vehicle liability insurance policy with limits that
are less than the amount needed to fully compensate the insured for his or her
damages.
Umbrella and excess liability insurance policies
Current law exempts umbrella and excess liability insurance policies from the
requirement that a policy covering motor vehicle liability include uninsured motorist
coverage. Nothing in current law, however, exempts an insurer writing umbrella or
excess liability insurance policies from the requirement to provide notice of the
availability of underinsured motorist coverage.
This bill affirmatively requires an insurer that writes umbrella or excess
liability policies that cover motor vehicle liability to make a written offer of both
uninsured motorist coverage and underinsured motorist coverage whenever
application is made for such a policy. The bill provides that, if an insurer fails to
provide a required written offer of uninsured or underinsured motorist coverage and
the umbrella or excess liability policy does not include the coverage, or coverages, for
which an offer was not given, a court must, on the request of the insured, reform the
policy to include the coverage or coverages with the same limits as the liability
coverage limits under the policy.
Miscellaneous motor vehicle liability insurance provisions
Under current law, uninsured motorist coverage does not apply if an accident
occurs without actual contact between two vehicles. This bill provides that actual
contact is not necessary for uninsured motorist coverage to apply.
Current law specifies a number of provisions that are permissible in a motor
vehicle liability insurance policy and a number of provisions that are prohibited in
such a policy. This bill prohibits the following currently permissible provisions
prohibited in a motor vehicle liability insurance policy:
1. Providing that, regardless of the number of policies, persons, or vehicles
involved, the limits for coverage under the policy may not be added to the limits for
similar coverage applying to other motor vehicles to determine an overall limit of
coverage available for a person in any one accident.
2. Providing that the maximum amount of uninsured or underinsured motorist
coverage available for bodily injury or death suffered by a person not using a motor
vehicle in an accident (such as a pedestrian) is any single limit of uninsured or
underinsured motorist coverage for any vehicle with respect to which the person is
insured at the time of the accident.
3. Providing that the maximum amount of medical payments coverage
available for bodily injury or death suffered by a person not using a motor vehicle in
an accident is any single limit of medical payments coverage for any vehicle with
respect to which the person is insured at the time of the accident.
4. Providing that the limits under the policy for uninsured or underinsured
motorist coverage for bodily injury or death resulting from an accident are reduced
by amounts paid or payable by or on behalf of a person or organization that is legally
responsible for the bodily injury or death; amounts paid or payable under any
worker's compensation law; or amounts paid or payable under any disability benefits
laws.
5. Providing that any coverage under the policy does not apply to a loss
resulting from the use of a motor vehicle that is owned by the named insured or a
spouse or relative of the named insured who lives in the named insured's household,
that is not described in the policy, and that is not covered under the terms of the policy
as a newly acquired or replacement motor vehicle.
Other insurance
Under current law, a care management organization is certified by and
contracts with DHS to administer the Family Care Program, which provides
financial assistance for long-term care to eligible individuals.
This bill requires that, in order to provide family care services, a care
management organization that does not also provide primary or acute medical care
must also obtain a permit from OCI. OCI may issue a permit if, after consulting with
DHS, it finds that: 1) the care management organization has met all requirements
of law, 2) the directors, principal officer, or any controlling person are trustworthy
and competent to engage in the proposed services, and 3) the care management
organization's business plan is consistent with the interests of Family Care Program
enrollees and the public. Under certain circumstances, OCI may revoke or suspend
a permit.
Care management organizations that have a permit are subject to
requirements under the bill similar to requirements in current law applicable to
insurance companies, such as complying with OCI's request for reports, submitting
to examinations and audits, paying the costs of examination, complying with OCI
rules, reporting transactions with affiliates of the care management organization,
and reporting changes in ownership or management of the care management
organization to OCI. A care management organization with a permit must also
deposit an amount determined by DHS, to pay for services on behalf of an insolvent
or financially hazardous care management organization.
The bill also requires that Family Care Program enrollees not be held liable for
any obligations of the care management organization.
Under current law, for each notification or renewal of an insurance agent's
appointment, the insurance company must pay to OCI a fee of not more than $8 for
a resident agent and $24 for a nonresident agent. This bill eliminates the maximum
fee and requires that the fee be paid in an amount, at times, and under procedures,
set by OCI.
Under current law, a fraternal benefit society may provide insurance coverage
only to its members and their spouses and dependent children. The bill authorizes
fraternal benefit societies to provide insurance coverage to the domestic partners of
fraternal members.
Justice and law enforcement
This bill requires a law enforcement agency to collect the following information
concerning motor vehicle stops made in any county having a population of 125,000
or more (populous county) on or after January 1, 2011: 1) the name, address, gender,
and race of the vehicle operator; 2) the reason for the stop; 3) the make and year of
the vehicle; 4) the date, time, and location of the stop; 5) whether a law enforcement
officer conducted a search of the vehicle, operator, or any passenger and, if so,
whether the search was with consent or by other means; 6) the name, address,
gender, and race of any person searched; and 7) the name and badge number of the
officer making the stop.
The information that is collected is not subject to inspection or copying as a
public record, but must be submitted to DOJ. DOJ must then compile and analyze
it, along with any other relevant information, to determine, both for each law
enforcement agency and as an aggregated total for all law enforcement agencies in
populous counties, whether the number of stops and searches involving vehicles
operated or occupied by members of a racial minority are disproportionate compared
to the number of stops and searches involving vehicles operated or occupied solely
by persons who are not members of a racial minority. If DOJ finds that the number
of stops and searches involving racial minorities is disproportionate compared to the
number of stops and searches involving nonminorities, DOJ must then determine
whether it is the result of racial profiling, racial stereotyping, or other race-based
discrimination or selective enforcement. DOJ must prepare an annual report that
summarizes the information submitted to it and describes the methods and
conclusions of its analysis of the information.
Under current law, no person may be appointed as a law enforcement officer
unless the person has been certified by the Law Enforcement Standards Board
(LESB) after completing a training program approved by LESB. This bill requires
additional training on cultural diversity, including sensitivity toward racial and
ethnic differences, to prevent racial profiling, racial stereotyping, or other
race-based discrimination.
Current law allows DOJ to grant compensation to the spouse of a person who
is killed or injured while trying to prevent a crime, trying to detain a criminal, or
trying to assist a crime victim or a law enforcement officer. This bill allows a domestic
partner to receive the same compensation that a spouse receives under current law.
Under current law, DOJ charges firearms dealers an $8 fee to conduct a
firearms restrictions record search, which includes a criminal history search and a
search to determine if the prospective buyer is prohibited from purchasing a firearm
by state law. Forty-eight hours after requesting the search, the dealer may complete
the sale, unless DOJ has informed the dealer that the purchase is prohibited.
This bill increases the fee to $30.
This bill increases from $8 to $13 the crime laboratory and drug enforcement
surcharge a court must assess when imposing a penalty or placing a person on
probation for a violation of state law or a local ordinance.
Under current law, DOJ must impose a fee for a criminal history search that
is not related to criminal justice or to a handgun purchase. The current fee is $2 for
a search requested by a nonprofit organization and $5 for a search requested by a
governmental agency. This bill changes both fees to $7.
Under current law, if a person files a civil action, an action in small claims court,
or a wage garnishment action, or if the person is assessed a civil forfeiture, the person
generally pays a $12 justice information surcharge. Of that amount, $6 is credited
to the consolidated court automation program (CCAP), $5 is credited to the
automated justice information system, and $1 remains in the general fund.
This bill increases the justice information surcharge to $18. Under the bill, $6
is credited to CCAP, $7.50 is credited to the automated justice information system,
$1.50 is credited to the Office of Justice Assistance (OJA) for statistical gathering and
analyses, $2 is credited to DOA for assistance to indigent civil litigants, and $1
remains in the general fund.
Current law requires OJA to provide staff support for oversight and
development of a statewide public safety interoperable communication system. This
bill authorizes OJA to charge state public safety agencies a fee for using the system.
This bill eliminates a grant program, administered by OJA, that provides
funding to law enforcement agencies for digital recording equipment for making
audio or audio and visual recordings of custodial interrogations or for training
personnel to use such equipment.
Under current law, OJA awards grants to counties to provide alternatives to
prosecution and incarceration for criminal offenders who abuse alcohol or drugs.
This bill requires OJA to award a grant of $371,200 in 2010 and in 2011 to the county
with the highest crime rate among counties having a population of 500,000 or more,
upon approval of the county's grant application.
The bill also requires OJA to provide $495,000 in 2010 and in 2011 to the county
that has the highest crime rate among counties having a population of 500,000 or
more to perform presentencing assessments on a portion of the people convicted of
a Class F, G, H, or I felony or a misdemeanor, for the purpose of providing courts
information for sentencing decisions.
local government
Under current law, local levy limits apply to the property tax levies that are
imposed in December 2007 and 2008. Current law prohibits any city, village, town,
or county (political subdivision) from increasing its levy by a percentage that exceeds
its valuation factor, which is the greater of either 2 percent or the percentage change
in the political subdivision's equalized value due to new construction, less
improvements removed, except that for 2007 the levy limit is 3.86 percent. In
addition, the calculation of a political subdivision's levy does not include any tax
increment that is generated by a tax incremental district.
This bill extends the levy limits to the property tax levies that are imposed in
December 2009 and 2010, and increases the 2009 and 2010 limit to the greater of
either 3 percent or the percentage change in the political subdivision's equalized
value due to new construction, less improvements removed. Under the bill, the base
amount of a political subdivision's levy, on which the levy limit is imposed, is the
maximum allowable levy for the immediately preceding year.
This bill authorizes a first class city (presently only Milwaukee) to issue
appropriation bonds on a one-time basis, other than refunding bonds, to pay all or
any part of the city's unfunded prior service liability with respect to an employee
retirement system of the city. An appropriation bond is any bond, note, or other
obligation of a city issued as provided in the bill to evidence the city's obligation to
repay borrowed money that is payable from various sources, including moneys
annually appropriated by the city for debt service due with respect to the
appropriation bonds, proceeds of the sale of the appropriation bonds, and investment
earnings on the appropriated moneys and bond sale proceeds.
Before the city may issue appropriation bonds, however, the city must enact an
ordinance to implement a five-year strategic and financial plan related to the
payment of unfunded employee retirement benefits. The financial plan must provide
that future annual pension liabilities are funded on a current basis and must contain
quantifiable benchmarks to measure compliance with the plan. Annually, the
common council must report to the legislature, DOR, DOA, and the governor on a
number of issues related to the appropriation bonds. If the city does not fully fund
the lower of either the required cost contribution for a particular year or the normal
cost for that year, DOR must reduce and withhold from the city's shared revenue
payments the difference between its required cost contribution and the amount the
city actually contributes to the system for that year. DOR must deposit the withheld
amount into the city's employee retirement system.
The bill states that a first class city is not generally liable for appropriation
bonds, and appropriation bonds are not a debt of the city for any purpose whatsoever.
Appropriation bonds, including the principal and interest payments, are payable
only from amounts that the common council may, from year to year, appropriate.
A similar statute currently applies to a county with a population of 500,000 or
more (presently only Milwaukee county).
This bill requires DOR to impose annually an administrative fee of $150 on each
tax incremental district (TID) or environmental remediation TID (ERTID) for which
DOR authorizes the allocation of a tax increment. The fee is imposed on the
municipality that created the TID or on the municipality or county that created the
ERTID.
Generally, under current law, the governing body of a political subdivision may
enact an ordinance or adopt a resolution declaring itself to be a premier resort area
if at least 40 percent of the equalized assessed value of the taxable property within
the political subdivision is used by tourism-related retailers. A premier resort area
may impose a tax at a rate of 0.5 percent of the gross receipts from the sale, lease,
or rental of goods or services that are subject to the general sales and use tax and are
sold by tourism-related retailers. The proceeds of the tax may be used only to pay
for infrastructure expenses within the premier resort area, including the costs of
purchasing, constructing, or improving parking lots; transportation facilities; sewer
and water facilities; recreational facilities; fire fighting equipment; and police
vehicles.
This bill expands the infrastructure expenses for which the tax proceeds may
be used to include exposition center facilities used primarily for certain specified
activities, including conventions, trade shows, musical or dramatic events, and
educational, cultural, recreational, sporting, and commercial activities.
Under current law, a local governmental unit (which includes a city, village,
town, county, school district, sewerage district, and drainage district) may provide
health and life insurance for employees, officers, and their spouses and dependent
children. Under this bill, such coverage may also be provided for an employee's and
officer's domestic partner and dependent children.
natural resources
Fish, game, and wildlife
Under current law, if a court imposes a fine or forfeiture for a violation of certain
laws regulating hunting, fishing, or trapping, or for a violation of other laws
regulating wild animals, the court must also impose a wildlife violator compact
surcharge of $5. This bill increases the surcharge to $20.
Currently, under the wildlife damage claim program, DNR makes payments to
any eligible person for damage to the person's crops, orchard trees, nursery stock,
apiaries, or livestock caused by certain wild animals. This bill raises the minimum
amount for which a claim may be made from $250 to $500. The bill also lowers the
maximum payment from $15,000 to $10,000 for each claim.
Under current law, DNR and the Lac du Flambeau band of the Lake Superior
Chippewa have an agreement under which the band agrees to limit its treaty-based,
off-reservation rights to fish in exchange for the band being able to issue DNR
fishing licenses and stamps as an agent of DNR. The band retains all of the fees that
the band collects for these fishing licenses and stamps.
For licenses and stamps issued by other DNR agents within the boundaries of
the band's reservation, current law authorizes, but does not require, DNR to make
an annual payment to the band that equals what the band would have received had
it issued those licenses and stamps (reimbursement amount). Current law requires
DNR to annually pay to the band $50,000, which must be used for fishery
management on the reservation. This bill eliminates this mandatory payment.
Instead, the bill requires DNR annually to pay the band the reimbursement
amount or the amount appropriated for that payment, whichever is greater.
Navigable waters
Current law requires DNR to conduct a detailed inspection of each large dam
that is maintained or operated in or across navigable waters. Under this bill, DNR
must classify each dam in this state as a high hazard, significant hazard, or low
hazard dam. DNR must inspect high hazard dams and significant hazard dams once
every ten years. The bill also requires each owner of a large dam, regardless of the
dam's classification, to engage a professional engineer to inspect the owner's dam on
a regular basis. The frequency of the required inspection is based upon the dam's
hazard classification. The bill also provides that the inspection requirements
imposed upon DNR and upon dam owners apply to all large dams, not just those
maintained or operated in or across navigable waters.
Under current law, DNR administers a financial assistance program for
projects that increase dam safety, including projects to maintain, repair, or remove
a dam. DNR may contract public debt for the dam safety program. This bill increases
DNR's bonding authority, the debt service on which is paid from the general fund, to
$8,500,000.
The bill also broadens eligibility for financial assistance under the dam safety
program by authorizing DNR to provide financial assistance to private owners for
the removal of any dam, regardless of size.
The bill increases the cap on financial assistance from $200,000 to $400,000 for
each dam safety project. Current law limits financial assistance for dam safety
projects to 50 percent of the cost of the project except for projects to remove
abandoned dams. This bill provides that any project to remove a dam, whether or
not abandoned, is not subject to the limit.
Current law requires DNR to maintain an inventory of all dams that require
a dam safety project. This bill eliminates this requirement.
Under current law, DNR awards grants to public and private entities for up to
50 percent of the costs of projects to control invasive species and awards contracts
for the creation and support of a statewide lake monitoring network. DNR must
promulgate rules specifying the eligible activities and qualifications for
participation in the statewide lake monitoring network. This bill provides that the
eligible activities must include providing technical assistance to entities that apply
for, or have received, an invasive species grant.
Under current law, with certain exceptions no person may operate a boat in the
waters of this state unless the boat is covered by a certificate of number and a
registration. This bill increases the certificate of number issuance and renewal fees
for most boats other than nonmotorized sailboats.
Other natural resources
Under current law, with one exception, DNR must transfer a decedent's interest
in a boat to his or her surviving spouse upon receipt of the title executed by the
surviving spouse and an affidavit by the spouse that includes specified information.
Under this bill, a domestic partner is provided the same boat transfer privileges as
a surviving spouse.
retirement and group insurance
This bill provides that domestic partners must be treated in the same manner
as spouses with respect to all pension benefits provided to public employees who are
covered under the Wisconsin Retirement System (WRS) and all other benefits
provided to state employees. For purposes of these benefits, a domestic partner is
any individual who is in a relationship with any other individual that satisfies all of
the following:
1. Each individual is at least 18 years old and otherwise competent to enter into
a contract.
2. Neither individual is married to, or in a domestic partnership with, another
individual.
3. The two individuals are not related by blood in any way that would prohibit
marriage under current law.
