LRBa2106/1
TJD:emw
2017 - 2018 LEGISLATURE
SENATE AMENDMENT 1,
TO SENATE BILL 770
February 13, 2018 - Offered by Joint Committee on Finance.
SB770-SA1,1,11 At the locations indicated, amend the bill as follows:
SB770-SA1,1,2 21. Page 5, line 6: after that line insert:
SB770-SA1,1,3 3 Section 3c. 49.45 (23) (a) of the statutes is amended to read:
SB770-SA1,1,114 49.45 (23) (a) The department shall request a waiver from the secretary of the
5federal department of health and human services to permit the department to
6conduct a demonstration project to provide health care coverage to adults who are
7under the age of 65, who have family incomes not to exceed 100 133 percent of the
8poverty line before application of the 5 percent income disregard under 42 CFR
9435.603 (d)
, except as provided in s. 49.471 (4g), and who are not otherwise eligible
10for medical assistance under this subchapter, the Badger Care health care program
11under s. 49.665, or Medicare under 42 USC 1395 et seq.
SB770-SA1,3d 12Section 3d. 49.471 (1) (cr) of the statutes is created to read:
SB770-SA1,2,2
149.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
2federal medical assistance percentage described under 42 USC 1396d (y) or (z).
SB770-SA1,3e 3Section 3e. 49.471 (4) (a) 4. b. of the statutes is amended to read:
SB770-SA1,2,64 49.471 (4) (a) 4. b. The Except as provided in sub. (4g), the individual's family
5income does not exceed 100 133 percent of the poverty line before application of the
65 percent income disregard under 42 CFR 435.603 (d)
.
SB770-SA1,3f 7Section 3f. 49.471 (4g) of the statutes is created to read:
SB770-SA1,2,168 49.471 (4g) Medicaid expansion; federal medical assistance percentage. (a)
9For services provided to individuals described under sub. (4) (a) 4. and s. 49.45 (23),
10the department shall comply with all federal requirements to qualify for the highest
11available enhanced federal medical assistance percentage. The department shall
12submit any amendment to the state medical assistance plan, request for a waiver of
13federal Medicaid law, or other approval request required by the federal government
14to provide services to the individuals described under sub. (4) (a) 4. and s. 49.45 (23)
15and qualify for the highest available enhanced federal medical assistance
16percentage.
SB770-SA1,3,317 (b) If the department does not qualify for an enhanced federal medical
18assistance percentage, or if the enhanced federal medical assistance percentage
19obtained by the department is lower than printed in federal law as of July 1, 2013,
20for individuals eligible under sub. (4) (a) 4. or s. 49.45 (23), the department shall
21submit to the joint committee on finance a fiscal analysis comparing the cost to
22maintain coverage for adults who are not pregnant and not elderly with family
23incomes up to 133 percent of the poverty line to the cost of limiting eligibility to those
24adults with family incomes up to 100 percent of the poverty line. The department
25may reduce income eligibility for adults who are not pregnant and not elderly from

1family incomes of up to 133 percent of the poverty line to family incomes of up to 100
2percent of the poverty line only if this reduction in income eligibility levels is
3approved by the joint committee on finance.”.
SB770-SA1,3,4 42. Page 8, line 18: delete lines 18 to 25.
SB770-SA1,3,5 53. Page 12, line 12: after that line insert:
SB770-SA1,3,9 6“(i) To continue receiving reinsurance payments, an eligible health carrier shall
7apply any savings to the carrier resulting from the healthcare stability plan to
8reducing premium rates for individual enrollees purchasing coverage on the
9individual market.”.
SB770-SA1,3,10 104. Page 13, line 1: after “ Reports." insert “(a)".
SB770-SA1,3,11 115. Page 13, line 5: after that line insert:
SB770-SA1,3,14 12“(b) Annually, the commissioner shall submit to the joint committee on finance
13a report of an actuarial study regarding the reinsurance rates under the healthcare
14stability plan under this subchapter.”.
SB770-SA1,3,16 156. Page 13, line 12: delete the material beginning with “, any possible" and
16ending with “state" on line 13.
SB770-SA1,3,17 177. Page 13, line 20: after that line insert:
SB770-SA1,3,18 18 Section 10d. 625.02 (1) of the statutes is renumbered 625.02 (1m).
SB770-SA1,10f 19Section 10f. 625.02 (1j) of the statutes is created to read:
SB770-SA1,3,2020 625.02 (1j) “Health insurance" has the meaning given in s. 632.745 (12).
SB770-SA1,10h 21Section 10h. 625.03 (1m) (intro.) of the statutes is amended to read:
SB770-SA1,4,222 625.03 (1m) (intro.) This Except as specifically provided otherwise in this
23chapter, this
chapter applies to all kinds and lines of direct insurance written on risks

1or operations in this state by any insurer authorized to do business in this state,
2except:
SB770-SA1,10j 3Section 10j. 625.13 (1) of the statutes is amended to read:
SB770-SA1,4,94 625.13 (1) Filing procedure. Except as provided in sub. (2) and s. 625.25 (2)
5(a)
, every authorized insurer and every rate service organization licensed under s.
6625.31 which has been designated by any insurer for the filing of rates under s.
7625.15 (2) shall file with the commissioner all rates and supplementary rate
8information and all changes and amendments thereof made by it for use in this state
9within 30 days after they become effective.
SB770-SA1,10m 10Section 10m. 625.15 (2) of the statutes is amended to read:
SB770-SA1,4,1811 625.15 (2) Rate filing. An insurer may discharge its obligation under s. 625.13
12(1) or 625.25 (2) (a) by giving notice to the commissioner that it uses rates and
13supplementary rate information prepared by a designated rate service organization,
14with such information about modifications thereof as is necessary fully to inform the
15commissioner. The insurer's rates or proposed rates and supplementary rate
16information shall be those filed from time to time by the rate service organization,
17including any amendments or proposed amendments thereto as filed, subject,
18however, to the modifications filed by the insurer.
SB770-SA1,10p 19Section 10p. 625.21 (1) of the statutes is amended to read:
SB770-SA1,5,620 625.21 (1) Rule instituting delayed effect. If the commissioner finds that
21competition is not an effective regulator of the rates charged or that a substantial
22number of companies are competing irresponsibly through the rates charged, or that
23there are widespread violations of this chapter, in any kind or line of insurance or
24subdivision thereof or in any rating class or rating territory, he or she may
25promulgate a rule requiring that in the kind or line of insurance or subdivision

1thereof or rating class or rating territory comprehended by the finding any
2subsequent changes in the rates or supplementary rate information be filed with the
3commissioner at least 15 days before they become effective. The commissioner may
4extend the waiting period for not to exceed 15 additional days by written notice to
5the filer before the first 15-day period expires. This subsection does not apply to
6health insurance, which is subject to s. 625.25 (2) (a).
SB770-SA1,10r 7Section 10r. 625.22 (1) of the statutes is amended to read:
SB770-SA1,5,118 625.22 (1) Order in event of violation. If the commissioner finds after a
9hearing that a rate or proposed rate is not in compliance with s. 625.11, the
10commissioner shall order that its use be discontinued, or that it may not be used, for
11any policy issued or renewed after a date specified in the order.
SB770-SA1,10t 12Section 10t. 625.22 (3) of the statutes is amended to read:
SB770-SA1,5,1713 625.22 (3) Approval of substituted rate. Within Except for rates for health
14insurance, which is subject to s. 625.25 (2) (a), within
one year after the effective date
15of an order under sub. (1), no rate promulgated to replace a disapproved one may be
16used until it has been filed with the commissioner and not disapproved within 30
17days thereafter.
SB770-SA1,10w 18Section 10w. 625.23 of the statutes is amended to read:
SB770-SA1,6,5 19625.23 Special restrictions on individual insurers. The commissioner
20may by order require that a particular insurer file any or all of its rates and
21supplementary rate information 15 days prior to their effective date, if and to the
22extent that he or she finds, after a hearing, that the protection of the interests of its
23insureds and the public in this state requires closer supervision of its rates because
24of the insurer's financial condition or rating practices. The commissioner may extend
25the waiting period for any filing for not to exceed 15 additional days by written notice

1to the insurer before the first 15-day period expires. A filing not disapproved before
2the expiration of the waiting period shall be deemed to meet the requirements of this
3chapter, subject to the possibility of subsequent disapproval under s. 625.22. This
4section does not apply to an insurer with respect to rates for health insurance, which
5is subject to s. 625.25 (2) (a).
SB770-SA1,10y 6Section 10y. 625.25 of the statutes is created to read:
SB770-SA1,6,7 7625.25 Rates for health insurance. (1) Definitions. In this section:
SB770-SA1,6,88 (a) “Group health benefit plan" has the meaning given in s. 632.745 (9).
SB770-SA1,6,99 (b) “Health benefit plan" has the meaning given in s. 632.745 (11).
SB770-SA1,6,1010 (c) “Insurer" has the meaning given in s. 632.745 (15).
SB770-SA1,6,1111 (d) “Large group market" has the meaning given in s. 632.745 (17).
SB770-SA1,6,1212 (e) “Small group market" has the meaning given in s. 632.745 (26).
SB770-SA1,7,4 13(2) Filing of rates; hearing. (a) Every insurer, and every rate service
14organization licensed under s. 625.31 that has been designated by any insurer for the
15filing of rates under s. 625.15 (2), shall file with the commissioner all proposed rates
16and supplementary rate information, and all proposed changes and amendments to
17rates and supplementary rate information, for use in this state for any health benefit
18plan offered by the insurer before the proposed rates or changes to rates become
19effective. An insurer may not use a proposed rate or change to a rate until it has been
20filed with and approved by the commissioner. Unless the commissioner holds a
21hearing on the proposed rate or change to a rate, a proposed rate or change to a rate
22is approved if the commissioner does not disapprove the proposed rate or change
23within 30 days after filing, or within a 30-day extension of that period ordered by the
24commissioner prior to the expiration of the first 30 days. The requirement under this
25paragraph applies with respect to rates and changes to rates for all health benefit

1plans, including individual health benefit plans, group health benefit plans offered
2in the small group market, and group health benefit plans offered in the large group
3market, that have not gone into effect by the effective date of this paragraph .... [LRB
4inserts date].
SB770-SA1,7,75 (b) If any proposed change to a rate filed under par. (a) increases the existing
6rate by more than 10 percent of that rate, the commissioner shall hold a public
7hearing before approving or disapproving the proposed change to the rate.
SB770-SA1,7,108 (c) The commissioner may disapprove a proposed rate or change to a rate filed
9under par. (a) that the commissioner determines is not justified based on underlying
10medical costs.
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