2017 - 2018 LEGISLATURE
February 20, 2018 - Offered by Representative Zimmerman.
AB920-AA5,1,11 At the locations indicated, amend the bill as follows:
AB920-AA5,1,3 21. Page 1, line 2: after “coverage" insert “, providing an exemption from
3emergency rule procedures, and granting rule-making authority".
AB920-AA5,1,4 42. Page 3, line 5: after that line insert:
AB920-AA5,1,6 5“(am) To qualify under par. (b), an employer group shall satisfy all of the
AB920-AA5,1,87 1. The employer group creates and maintains a formal organizational structure
8with a governing body and an indication of formality, such as having by-laws.
AB920-AA5,1,129 2. The employers in the employer group control functions and activities of the
10employer group, including establishment and maintenance of the employee health
11care benefit arrangement, directly or indirectly through nomination and election of
12representatives that control the employer group or association.
13. The chamber of commerce or industry-based association from which the
2employer group is formed is actively in existence for at least 5 years before providing
3evidence to the commissioner under par. (b), has at least 5 members for the 5 years
4before providing evidence to the commissioner under par. (b), and is formed and
5maintained in good faith for purposes other than obtaining or providing health
AB920-AA5,2,7 73. Page 3, line 18: delete lines 18 and 19.
AB920-AA5,2,12 84. Page 3, line 22: after “arrangement." insert “The employer group shall
9ensure that the actuary making recommendations under this subdivision is in good
10standing with the Academy of Actuaries, has the skills and knowledge necessary to
11perform the analyses and make the recommendations, and is performing the
12analyses and certifications based on sound actuarial principles.".
AB920-AA5,2,14 135. Page 4, line 20: after “finances of the employer group" insert “and containing
14any information specified by the commissioner by rule under sub. (5m)".
AB920-AA5,2,15 156. Page 4, line 20: after that line insert:
AB920-AA5,2,19 16“8. Specify in an agreement among the employers in the employer group or in
17the by-laws of the employer group the procedures to be followed by and
18responsibilities of the involved parties in the event of insolvency or pending
19insolvency of the employer group.”.
AB920-AA5,2,20 207. Page 5, line 12: delete lines 12 to 14 and substitute:
AB920-AA5,2,23 21“1. Offer the same health care benefits, or health care benefit arrangements
22with a de minimis difference in actuarial value, to all of the employer's eligible
23employees and all of eligible employee's dependents.”.
18. Page 6, line 10: delete lines 10 to 12 and substitute “a choice of health care
2benefit plans to employers but each employer that participates in the employer group
3shall offer the same health care benefits, or health care arrangement with a de
4minimis difference in actuarial value, to all employees and dependents of the
AB920-AA5,3,6 69. Page 6, line 24: after that line insert:
AB920-AA5,3,14 7(5m) Commissioner oversight. (a) The commissioner of insurance may
8examine the solvency of an employer group qualified under sub. (2) (b), including the
9surplus funds available to the employer group and the levels and cost of reinsurance,
10using statutory accounting principles. The commissioner may promulgate rules
11regarding the solvency of employer groups qualified under sub. (2) (b). The
12commissioner may require an employer group to take corrective action, issue an
13order, or initiate an enforcement proceeding described under s. 601.41 (4) to remedy
14a violation of rules promulgated under this paragraph.
AB920-AA5,3,1815 (b) If, after the effective date of this paragraph .... [LRB inserts date], the
16federal department of labor publishes a final rule allowing states regulatory
17authority over association health plans, the commissioner of insurance may
18promulgate rules to implement the federal law.”.
AB920-AA5,3,19 1910. Page 7, line 2: after “(A)" insert “and except as provided in sub. (5m)".