AB64-ASA1-AA8,51,218 16.85 (2) To furnish engineering, architectural, project management, and other
19building construction services whenever requisitions therefor are presented to the
20department by any agency. The department may deposit moneys received from the
21provision of these services in the account under s. 20.505 (1) (kc) or in the general
22fund as general purpose revenue — earned. In this subsection, “agency" means an
23office, department, independent agency, institution of higher education, association,
24society, or other body in state government created or authorized to be created by the
25constitution or any law, which is entitled to expend moneys appropriated by law,

1including the legislature and the courts, but not including an authority created in
2subch. II of ch. 114 or subch. III of ch. 636 or in ch. 231, 233, 234, 237, 238, or 279.
AB64-ASA1-AA8,1bq 3Section 1bq. 16.865 (8) of the statutes is amended to read:
AB64-ASA1-AA8,51,184 16.865 (8) Annually in each fiscal year, allocate as a charge to each agency a
5proportionate share of the estimated costs attributable to programs administered by
6the agency to be paid from the appropriation under s. 20.505 (2) (k). The department
7may charge premiums to agencies to finance costs under this subsection and pay the
8costs from the appropriation on an actual basis. The department shall deposit all
9collections under this subsection in the appropriation account under s. 20.505 (2) (k).
10Costs assessed under this subsection may include judgments, investigative and
11adjustment fees, data processing and staff support costs, program administration
12costs, litigation costs, and the cost of insurance contracts under sub. (5). In this
13subsection, “agency" means an office, department, independent agency, institution
14of higher education, association, society, or other body in state government created
15or authorized to be created by the constitution or any law, that is entitled to expend
16moneys appropriated by law, including the legislature and the courts, but not
17including an authority created in subch. II of ch. 114 or subch. III of ch. 636 or in ch.
18231, 232, 233, 234, 237, 238, or 279.
AB64-ASA1-AA8,1br 19Section 1br. 25.50 (1) (d) of the statutes is amended to read:
AB64-ASA1-AA8,52,420 25.50 (1) (d) “Local government" means any county, town, village, city, power
21district, sewerage district, drainage district, town sanitary district, public inland
22lake protection and rehabilitation district, local professional baseball park district
23created under subch. III of ch. 229, long-term care district under s. 46.2895, local
24professional football stadium district created under subch. IV of ch. 229, local
25cultural arts district created under subch. V of ch. 229, public library system, school

1district or technical college district in this state, any commission, committee, board
2or officer of any governmental subdivision of this state, any court of this state, other
3than the court of appeals or the supreme court, or any authority created under s.
4114.61, 231.02, 233.02, or 234.02, or 636.70.
AB64-ASA1-AA8,1bs 5Section 1bs. 40.02 (54) (n) of the statutes is created to read:
AB64-ASA1-AA8,52,66 40.02 (54) (n) The Badger Health Benefit Authority.
AB64-ASA1-AA8,1bt 7Section 1bt. 49.45 (2) (a) 3. of the statutes is amended to read:
AB64-ASA1-AA8,52,128 49.45 (2) (a) 3. Determine Subject to s. 636.30 (1) (o), determine the eligibility
9of persons for medical assistance, rehabilitative, and social services under ss. 49.46,
1049.468, 49.47, and 49.471 and rules and policies adopted by the department and may,
11under a contract under s. 49.78 (2), delegate all, or any portion, of this function to the
12county department under s. 46.215, 46.22, or 46.23 or a tribal governing body.
AB64-ASA1-AA8,1bu 13Section 1bu. 70.11 (41c) of the statutes is created to read:
AB64-ASA1-AA8,52,1614 70.11 (41c) Badger Health Benefit Authority. All property owned by the
15Badger Health Benefit Authority, provided that the use of the property is primarily
16related to the purposes of the authority.
AB64-ASA1-AA8,1bv 17Section 1bv. 71.26 (1) (be) of the statutes is amended to read:
AB64-ASA1-AA8,52,2118 71.26 (1) (be) Certain authorities. Income of the University of Wisconsin
19Hospitals and Clinics Authority, of the Badger Health Benefit Authority, of the Fox
20River Navigational System Authority, of the Wisconsin Economic Development
21Corporation, and of the Wisconsin Aerospace Authority.
AB64-ASA1-AA8,1bw 22Section 1bw. 77.54 (9a) (a) of the statutes is amended to read:
AB64-ASA1-AA8,53,223 77.54 (9a) (a) This state or any agency thereof, the University of Wisconsin
24Hospitals and Clinics Authority, the Wisconsin Aerospace Authority, the Badger

1Health Benefit Authority,
the Wisconsin Economic Development Corporation, and
2the Fox River Navigational System Authority.
AB64-ASA1-AA8,1bx 3Section 1bx. 101.055 (2) (a) of the statutes is amended to read:
AB64-ASA1-AA8,53,74 101.055 (2) (a) “Agency" means an office, department, independent agency,
5authority, institution, association, society, or other body in state government created
6or authorized to be created by the constitution or any law, and includes the
7legislature and the courts, but excludes the Badger Health Benefit Authority.
AB64-ASA1-AA8,1bxa 8Section 1bxa. 230.03 (3) of the statutes is amended to read:
AB64-ASA1-AA8,53,189 230.03 (3) “Agency" means any board, commission, committee, council, or
10department in state government or a unit thereof created by the constitution or
11statutes if such board, commission, committee, council, department, unit, or the
12head thereof, is authorized to appoint subordinate staff by the constitution or
13statute, except the Board of Regents of the University of Wisconsin System, a
14legislative or judicial board, commission, committee, council, department, or unit
15thereof or an authority created under subch. II of ch. 114 or subch. III of ch. 636 or
16under ch. 231, 232, 233, 234, 237, 238, or 279. “Agency" does not mean any local unit
17of government or body within one or more local units of government that is created
18by law or by action of one or more local units of government.
AB64-ASA1-AA8,1by 19Section 1by. 230.80 (4) of the statutes is amended to read:
AB64-ASA1-AA8,54,220 230.80 (4) “Governmental unit" means any association, authority, board,
21commission, department, independent agency, institution, office, society, or other
22body in state government created or authorized to be created by the constitution or
23any law, including the legislature, the office of the governor, and the courts, but
24excluding the Badger Health Benefit Authority
. “Governmental unit" does not mean

1any political subdivision of the state or body within one or more political subdivisions
2that is created by law or by action of one or more political subdivisions.
AB64-ASA1-AA8,1bz 3Section 1bz. 230.90 (1) (c) of the statutes is amended to read:
AB64-ASA1-AA8,54,114 230.90 (1) (c) “Governmental unit" means any association, authority, board,
5commission, department, independent agency, institution, office, society or other
6body in state government created or authorized to be created by the constitution or
7any law, including the legislature, the office of the governor and the courts.
8“Governmental unit" does not mean the University of Wisconsin Hospitals and
9Clinics Authority, the Badger Health Benefit Authority, or any political subdivision
10of the state or body within one or more political subdivisions which is created by law
11or by action of one or more political subdivisions.
AB64-ASA1-AA8,1ca 12Section 1ca. 635.18 (1) of the statutes is amended to read:
AB64-ASA1-AA8,54,1413 635.18 (1) Every Any small employer insurer shall may actively market health
14benefit plan coverage to small employers in the state.
AB64-ASA1-AA8,1cb 15Section 1cb. Chapter 636 of the statutes is created to read:
AB64-ASA1-AA8,54,1716 chapter 636
17 health benefit plan exchange
AB64-ASA1-AA8,54,1918 subchapter I
19 general provisions
AB64-ASA1-AA8,54,20 20636.01 Definitions. In this chapter:
AB64-ASA1-AA8,54,21 21(1) “Authority" means the Badger Health Benefit Authority.
AB64-ASA1-AA8,54,24 22(2) “Educated health care consumer" means an individual who is
23knowledgeable about the health care system and who has background or experience
24in making informed decisions regarding health, medical, and scientific matters.
AB64-ASA1-AA8,55,4
1(3) “Federal act" means the federal Patient Protection and Affordable Care Act
2(P.L. 111-148), as amended by the federal Health Care and Education Reconciliation
3Act of 2010 (P.L. 111-152), and any amendments to, or regulations or guidance issued
4under, those acts.
AB64-ASA1-AA8,55,7 5(4) (a) Except as provided in pars. (b) to (e), “health benefit plan" means a policy,
6contract, certificate, or agreement offered or issued by a health carrier to provide,
7deliver, arrange for, pay for, or reimburse any of the costs of health care services.
AB64-ASA1-AA8,55,88 (b) “Health benefit plan" does not include any of the following:
AB64-ASA1-AA8,55,109 1. Coverage only for accident, or disability income insurance, or any
10combination of those.
AB64-ASA1-AA8,55,1111 2. Coverage issued as a supplement to liability insurance.
AB64-ASA1-AA8,55,1312 3. Liability insurance, including general liability insurance and automobile
13liability insurance.
AB64-ASA1-AA8,55,1414 4. Worker's compensation or similar insurance.
AB64-ASA1-AA8,55,1515 5. Automobile medical payment insurance.
AB64-ASA1-AA8,55,1616 6. Credit-only insurance.
AB64-ASA1-AA8,55,1717 7. Coverage for on-site medical clinics.
AB64-ASA1-AA8,55,2018 8. Other similar insurance coverage, specified in federal regulations issued
19under P.L. 104-191, under which benefits for health care services are secondary or
20incidental to other insurance benefits.
AB64-ASA1-AA8,55,2321 (c) “Health benefit plan" does not include any of the following benefits if they
22are provided under a separate policy, certificate, or contract of insurance or otherwise
23not an integral part of the plan:
AB64-ASA1-AA8,55,2424 1. Limited scope dental or vision benefits.
AB64-ASA1-AA8,56,2
12. Benefits for long-term care, nursing home care, home health care,
2community-based care, or any combination of those.
AB64-ASA1-AA8,56,43 3. Other similar, limited benefits specified in federal regulations issued under
4P.L. 104-191.
AB64-ASA1-AA8,56,115 (d) “Health benefit plan" does not include any of the following benefits if the
6benefits are provided under a separate policy, certificate, or contract of insurance,
7there is no coordination between the provision of the benefits and any exclusion of
8benefits under any group health plan maintained by the same plan sponsor, and the
9benefits are paid with respect to an event without regard to whether benefits are
10provided with respect to such an event under any group health plan maintained by
11the same plan sponsor:
AB64-ASA1-AA8,56,1212 1. Coverage only for a specified disease or illness.
AB64-ASA1-AA8,56,1313 2. Hospital indemnity or other fixed indemnity insurance.
AB64-ASA1-AA8,56,1514 (e) “Health benefit plan" does not include any of the following if offered as a
15separate policy, certificate, or contract of insurance:
AB64-ASA1-AA8,56,1716 1. Medicare supplemental health insurance as defined under section 1882 (g)
17(1) of the federal Social Security Act.
AB64-ASA1-AA8,56,1918 2. Coverage supplemental to the coverage provided under the Civilian Health
19and Medical Program of the Uniformed Services 10 USC ch. 55.
AB64-ASA1-AA8,56,2120 3. Similar coverage supplemental to coverage provided under a group health
21plan.
AB64-ASA1-AA8,57,3 22(5) “Health carrier" means an entity subject to the insurance laws and rules
23of this state, or subject to the jurisdiction of the commissioner, that contracts or offers
24to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of
25health care services, including a sickness and accident insurance company, a health

1maintenance organization, a nonprofit hospital and health service corporation, or
2any other entity providing a plan of health insurance, health benefits, or health
3services.
AB64-ASA1-AA8,57,5 4(5m) “Minimum essential coverage" has the meaning given in 26 USC 5000A
5(f) (1).
AB64-ASA1-AA8,57,7 6(6) “Qualified dental plan" means a limited scope dental plan that has been
7certified in accordance with s. 636.42 (5).
AB64-ASA1-AA8,57,11 8(7) “Qualified employer" means a small employer that elects to make its
9full-time employees eligible for one or more qualified health plans offered through
10the SHOP Exchange and, at the option of the employer, some or all of its part-time
11employees, provided that the employer satisfies any of the following:
AB64-ASA1-AA8,57,1412 (a) The employer has its principal place of business in this state and elects to
13provide coverage through the SHOP Exchange to all of its eligible employees,
14wherever employed.
AB64-ASA1-AA8,57,1615 (b) The employer elects to provide coverage through the SHOP Exchange to all
16of its eligible employees who are principally employed in this state.
AB64-ASA1-AA8,57,19 17(8) “Qualified health plan" means a health benefit plan that has in effect a
18certification that the plan meets the criteria for certification described in section
191311 (c) of the federal act and s. 636.42.
AB64-ASA1-AA8,57,21 20(9) “Qualified individual" means an individual, including a minor, who satisfies
21all of the following:
AB64-ASA1-AA8,57,2322 (a) The individual is seeking to enroll in a qualified health plan offered to
23individuals through the exchange under subch. II.
AB64-ASA1-AA8,57,2424 (b) The individual resides in this state.
AB64-ASA1-AA8,58,2
1(c) At the time of enrollment, the individual is not incarcerated in a correctional
2facility, other than incarceration pending the disposition of charges.
AB64-ASA1-AA8,58,53 (d) The individual is, and is reasonably expected to be for the entire period for
4which enrollment is sought, a citizen or national of the United States or an alien
5lawfully present in the United States.
AB64-ASA1-AA8,58,7 6(10) “Secretary" means the secretary of the federal department of health and
7human services.
AB64-ASA1-AA8,58,9 8(11) “SHOP Exchange" means a small business health options program
9established under s. 636.30 (1) (q).
AB64-ASA1-AA8,58,11 10(12) (a) “Small employer" means an employer that employed an average of not
11more than 100 employees during the preceding calendar year.
AB64-ASA1-AA8,58,1212 (b) For purposes of this subsection, all of the following apply:
AB64-ASA1-AA8,58,14131. All persons treated as a single employer under section 414 (b), (c), (m), or (o)
14of the Internal Revenue Code shall be treated as a single employer.
AB64-ASA1-AA8,58,1615 2. An employer and any predecessor employer shall be treated as a single
16employer.
AB64-ASA1-AA8,58,1817 3. All employees shall be counted, including part-time employees and
18employees who are not eligible for coverage through the employer.
AB64-ASA1-AA8,58,2219 4. If an employer was not in existence during the entire preceding calendar
20year, the determination of whether that employer is a small employer shall be based
21on the average number of employees that it is reasonably expected that employer will
22employ on business days in the current calendar year.
AB64-ASA1-AA8,59,223 5. An employer that makes enrollment in qualified health plans available to
24its employees through the SHOP Exchange and that would cease to be a small
25employer by reason of an increase in the number of its employees shall continue to

1be treated as a small employer for purposes of this chapter as long as it continuously
2makes enrollment through the SHOP Exchange available to its employees.
AB64-ASA1-AA8,59,43 subchapter II
4 operation of exchange
AB64-ASA1-AA8,59,8 5636.25 General matters. (1) The authority shall establish and operate a
6Wisconsin Health Benefit Exchange and shall make qualified health plans, with
7effective dates on or before January 1, 2018, available to qualified individuals and
8qualified employers.
AB64-ASA1-AA8,59,10 9(2) (a) The authority may not make available any health benefit plan that is
10not a qualified health plan.
AB64-ASA1-AA8,59,1511 (b) The authority shall allow a health carrier to offer a plan that provides
12limited scope dental benefits meeting the requirements of section 9832 (c) (2) (A) of
13the Internal Revenue Code through the exchange, either separately or in conjunction
14with a qualified health plan, if the plan provides pediatric dental benefits meeting
15the requirements of section 1302 (b) (1) (J) of the federal act.
AB64-ASA1-AA8,59,21 16(3) Neither the authority nor a health carrier offering health benefit plans
17through the exchange may charge an individual a fee or penalty for termination of
18coverage if the individual enrolls in another type of minimum essential coverage
19because the individual has become newly eligible for that coverage or because the
20individual's employer-sponsored coverage has become affordable under the
21standards of section 36B (c) (2) (C) of the Internal Revenue Code.
AB64-ASA1-AA8,60,2 22(4) The authority may enter into information-sharing agreements with federal
23and state agencies and entities operating exchanges in other states to carry out its
24responsibilities under this chapter, provided that such agreements include adequate

1protections with respect to the confidentiality of the information to be shared and
2comply with all state and federal laws and rules and regulations.
AB64-ASA1-AA8,60,5 3636.30 Exchange duties and powers. (1) In addition to all other duties
4imposed under this chapter, the authority shall do all of the following relating to the
5exchange:
AB64-ASA1-AA8,60,96 (a) Implement procedures for the certification, recertification, and
7decertification, consistent with guidelines developed by the secretary under section
81311 (c) of the federal act and s. 636.42, of health benefit plans as qualified health
9plans.
AB64-ASA1-AA8,60,1110 (b) Provide for the operation of a toll-free telephone hotline to respond to
11requests for assistance.
AB64-ASA1-AA8,60,1312 (c) Provide for enrollment periods, as provided under section 1311 (c) (6) of the
13federal act.
AB64-ASA1-AA8,60,1614 (d) Maintain an Internet site through which enrollees and prospective
15enrollees of qualified health plans may obtain standardized comparative
16information on such plans.
AB64-ASA1-AA8,60,2117 (e) Assign a rating to each qualified health plan offered through the exchange
18in accordance with the criteria developed by the secretary under section 1311 (c) (3)
19of the federal act, and determine each qualified health plan's level of coverage in
20accordance with regulations issued by the secretary under section 1302 (d) (2) (A) of
21the federal act.
AB64-ASA1-AA8,60,2422 (f) Use a standardized format for presenting health benefit options in the
23exchange, including the use of the uniform outline of coverage established under 42
24USC 300gg-15
.
AB64-ASA1-AA8,61,2
1(g) Establish quality improvement standards for health benefit plans offered
2through the exchange.
AB64-ASA1-AA8,61,43 (h) Establish a system for enrolling eligible groups and individuals, using a
4standard application form developed by the commissioner under s. 636.46 (2).
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