2017 - 2018 LEGISLATURE
ASSEMBLY AMENDMENT 5,
TO ASSEMBLY BILL 920
February 20, 2018 - Offered by Representative Zimmerman.
21. Page 1, line 2
: after “coverage" insert “, providing an exemption from 3
emergency rule procedures, and granting rule-making authority".
“(am) To qualify under par. (b), an employer group shall satisfy all of the 6
1. The employer group creates and maintains a formal organizational structure 8
with a governing body and an indication of formality, such as having by-laws.
2. The employers in the employer group control functions and activities of the 10
employer group, including establishment and maintenance of the employee health 11
care benefit arrangement, directly or indirectly through nomination and election of 12
representatives that control the employer group or association.
3. The chamber of commerce or industry-based association from which the 2
employer group is formed is actively in existence for at least 5 years before providing 3
evidence to the commissioner under par. (b), has at least 5 members for the 5 years 4
before providing evidence to the commissioner under par. (b), and is formed and 5
maintained in good faith for purposes other than obtaining or providing health 6
84. Page 3, line 22
: after “arrangement." insert “The employer group shall 9
ensure that the actuary making recommendations under this subdivision is in good 10
standing with the Academy of Actuaries, has the skills and knowledge necessary to 11
perform the analyses and make the recommendations, and is performing the 12
analyses and certifications based on sound actuarial principles.".
135. Page 4, line 20
: after “finances of the employer group" insert “and containing 14
any information specified by the commissioner by rule under sub. (5m)".
“8. Specify in an agreement among the employers in the employer group or in 17
the by-laws of the employer group the procedures to be followed by and 18
responsibilities of the involved parties in the event of insolvency or pending 19
insolvency of the employer group.”.
“1. Offer the same health care benefits, or health care benefit arrangements 22
with a de minimis difference in actuarial value, to all of the employer's eligible 23
employees and all of eligible employee's dependents.”.
18. Page 6, line 10
: delete lines 10 to 12 and substitute “a choice of health care 2
benefit plans to employers but each employer that participates in the employer group 3
shall offer the same health care benefits, or health care arrangement with a de 4
minimis difference in actuarial value, to all employees and dependents of the 5
“(5m) Commissioner oversight.
(a) The commissioner of insurance may 8
examine the solvency of an employer group qualified under sub. (2) (b), including the 9
surplus funds available to the employer group and the levels and cost of reinsurance, 10
using statutory accounting principles. The commissioner may promulgate rules 11
regarding the solvency of employer groups qualified under sub. (2) (b). The 12
commissioner may require an employer group to take corrective action, issue an 13
order, or initiate an enforcement proceeding described under s. 601.41 (4) to remedy 14
a violation of rules promulgated under this paragraph.
(b) If, after the effective date of this paragraph .... [LRB inserts date], the 16
federal department of labor publishes a final rule allowing states regulatory 17
authority over association health plans, the commissioner of insurance may 18
promulgate rules to implement the federal law.”.