149.10 Definitions.
149.105 Immunity.
149.11 Administration of plan.
149.115 Rules relating to creditable coverage.
149.12 Eligibility determination.
149.13 Participation of insurers.
149.14 Coverage.
149.141 Premiums.
149.142 Provider payment rates.
149.143 Payment of plan costs.
149.165 Reductions in premiums for low-income eligible persons.
149.17 Contents of plan.
149.18 Chapters 600 to 645 applicable.
149.41 Creation and organization of authority.
149.43 Duties of authority.
149.45 Powers of authority.
149.47 Contracting for professional services.
149.50 Political activities.
149.53 Liability limited.
subch. I of ch. 149 SUBCHAPTER I
149.10 149.10 Definitions. In this chapter, unless the context requires otherwise:
149.10(1) (1) "Authority" means the Health Insurance Risk-Sharing Plan Authority.
149.10(2) (2) "Board" means the board of directors of the authority.
149.10(2c) (2c) "Church plan" has the meaning given in section 3 (33) of the federal Employee Retirement Income Security Act of 1974.
149.10(2f) (2f) "Commissioner" means the commissioner of insurance.
149.10(2j) (2j)
149.10(2j)(a)(a) Except as provided in par. (b), "creditable coverage" means coverage under any of the following:
149.10(2j)(a)1. 1. A group health plan.
149.10(2j)(a)2. 2. Health insurance.
149.10(2j)(a)3. 3. Part A, part B, or part D of title XVIII of the federal Social Security Act.
149.10(2j)(a)4. 4. Title XIX of the federal Social Security Act, except for coverage consisting solely of benefits under section 1928 of that act.
149.10(2j)(a)5. 5. Chapter 55 of title 10 of the United States Code.
149.10(2j)(a)6. 6. A medical care program of the federal Indian health service or of an American Indian tribal organization.
149.10(2j)(a)7. 7. A state health benefits risk pool.
149.10(2j)(a)8. 8. A health plan offered under chapter 89 of title 5 of the United States Code.
149.10(2j)(a)9. 9. A public health plan.
149.10(2j)(a)10. 10. A health coverage plan under section 5 (e) of the federal Peace Corps Act, 22 USC 2504 (e).
149.10(2j)(b) (b) "Creditable coverage" does not include coverage consisting solely of coverage of excepted benefits, as defined in section 2791 (c) of P.L. 104-191.
149.10(2t) (2t) "Eligible individual" means an individual for whom all of the following apply:
149.10(2t)(a) (a) The aggregate of the individual's periods of creditable coverage is 18 months or more.
149.10(2t)(b) (b) The individual's most recent period of creditable coverage was under a group health plan, governmental plan, federal governmental plan or church plan, or under any health insurance offered in connection with any of those plans.
149.10(2t)(c) (c) The individual does not have creditable coverage and is not eligible for coverage under a group health plan, part A, part B, or part D of title XVIII of the federal Social Security Act or a state plan under title XIX of the federal Social Security Act or any successor program.
149.10(2t)(d) (d) The individual's most recent period of creditable coverage was not terminated for any reason related to fraud or intentional misrepresentation of material fact or a failure to pay premiums.
149.10(2t)(e) (e) If the individual was offered the option of continuation coverage under a federal continuation provision or similar state program, including under 2009 Wisconsin Act 11, section 9126 (2), the individual elected the continuation coverage.
149.10(2t)(f) (f) The individual has exhausted any continuation coverage under par. (e).
149.10(3) (3) "Eligible person" means a resident who qualifies under s. 149.12 whether or not the person is legally responsible for the payment of medical expenses incurred on the person's behalf.
149.10(3c) (3c) "Federal continuation provision" means any of the following:
149.10(3c)(a) (a) Section 4980B of the Internal Revenue Code of 1986, except for section 4980B (f) (1) of that code insofar as it relates to pediatric vaccines.
149.10(3c)(b) (b) Part 6 of subtitle B of title I of the federal Employee Retirement Income Security Act of 1974, except for section 609 of that act.
This is an archival version of the Wis. Stats. database for 2011. See Are the Statutes on this Website Official?