2011 - 2012 LEGISLATURE
February 23, 2012 - Introduced by Senators Lassa, Holperin, Risser, Carpenter,
Hansen and C. Larson, cosponsored by Representatives Wynn, Spanbauer,
Pasch, Turner and
Pocan. Referred to Committee on Insurance and Housing.
1An Act to create
227.01 (13) (mg) and 632.843 of the statutes; relating to:
2special enrollment periods for Medicare supplement policies.
Analysis by the Legislative Reference Bureau
Generally, Medicare Part A provides coverage for inpatient care and Medicare
Part B provides coverage for outpatient care. Generally, a person is eligible for
Medicare when he or she reaches age 65 or if he or she is under age 65 and disabled.
Medicare supplement policies are private insurance policies that may be purchased
by persons who are enrolled in Medicare and that provide supplemental coverage to
that provided under Medicare, such as coverage for additional services, for the
portion of the cost of services not paid by Medicare, or for deductibles required under
This bill creates two special enrollment periods under Medicare supplement
policies. Under the bill, an insurer offering a Medicare supplement policy may not
deny coverage under the policy on the basis of health status, claims experience,
receipt of health care, medical condition, disability, or age to a person under age 65
who is eligible for Medicare Part B during the six-month period beginning on the
first day of the month in which the person first enrolls in Medicare Part B. The bill
also requires every insurer offering a Medicare supplement policy to provide a
30-day enrollment period during which no person who is covered under another
Medicare supplement policy and no person who is under age 65 and enrolled in
Medicare Part B may be denied coverage under the insurer's Medicare supplement
policy on the basis of a preexisting condition. In addition, the insurer may not impose
on any person who obtains coverage during the 30-day enrollment period any
preexisting condition exclusion. The commissioner of insurance must specify the 30
days for this enrollment period.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB510, s. 1
227.01 (13) (mg) of the statutes is created to read:
(mg) Specifies the annual enrollment period under s. 632.843 (3).
SB510, s. 2
632.843 of the statutes is created to read:
4632.843 Special enrollment periods for Medicare supplement policies. 5(1) Definition.
In this section, "Medicare Part B" means Part B of Medicare under 642 USC 1395j
7(2) Initial 6-month enrollment period.
(a) During the initial enrollment 8
period specified in par. (b), an insurer offering a Medicare supplement policy may not 9
deny coverage under the policy on the basis of any of the following to an individual 10
under the age of 65 who is eligible for Medicare Part B:
1. Health status.
2. Claims experience.
3. Receipt of health care.
4. Medical condition.
(b) The initial enrollment period referred to in par. (a) for an individual 18
described in par. (a) shall begin on the first day of the month in which the individual 19
first enrolls in Medicare Part B and shall last for 6 months.
20(3) Annual 30-day enrollment period.
(a) In this subsection, "preexisting 21
condition" includes a preexisting disability.
(b) Beginning in 2012, every insurer offering a Medicare supplement policy 2
shall provide an annual 30-day enrollment period, specified by the commissioner 3
under par. (c), during which any individual who has coverage under another 4
Medicare supplement policy or who is under age 65 and enrolled in Medicare Part 5
B may obtain coverage under the insurer's Medicare supplement policy without 6
regard to any preexisting condition. Notwithstanding s. 632.76 (2), an insurer may 7
not impose any preexisting condition exclusion on an individual who obtains 8
coverage under the insurer's Medicare supplement policy during the 30-day 9
enrollment period under this subsection. Each insurer offering a Medicare 10
supplement policy shall post on its Web site the beginning and ending dates for the 11
annual 30-day enrollment period under this subsection.
(c) The commissioner shall specify the beginning and ending dates of the 13
30-day enrollment period required under this subsection.
(1) The treatment of section 632.843 (2) of the statutes first applies to 16
individuals who enroll in Medicare Part B on the effective date of this subsection.