628.095(4)(b)
(b) The commissioner may disclose any information received under sub.
(1) or
(3) to the department of revenue for the purpose of requesting certifications under s.
73.0301 and to the department of workforce development for the purpose of requesting certifications under s.
108.227.
628.095(5)
(5) If applicant or intermediary or navigator has no social security number. If an applicant who is a natural person does not have a social security number, the applicant shall provide to the commissioner, along with the application for a license and on a form prescribed by the department of children and families, a statement made or subscribed under oath or affirmation that the applicant does not have a social security number. If an intermediary or navigator who is a natural person does not have a social security number, the intermediary or navigator shall provide to the commissioner, each time that the annual fee is paid under s.
601.31 (1) (m) or
(nm) 2. and on a form prescribed by the department of children and families, a statement made or subscribed under oath or affirmation that the intermediary or navigator does not have a social security number.
628.097
628.097
Refusal to issue license; failure to pay support or to comply with subpoena or warrant; tax or unemployment insurance contribution delinquency. 628.097(1m)(1m)
For failure to pay support or to comply with subpoena or warrant. The commissioner shall refuse to issue to a natural person a license, including a temporary license, under this subchapter or subch.
V if the natural person is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses, or other expenses related to the support of a child or former spouse, or if the natural person fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of children and families or a county child support agency under s.
59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s.
49.857.
628.097(2m)
(2m) For liability for delinquent taxes or unemployment insurance contributions. The commissioner shall refuse to issue a license, including a temporary license, under this subchapter or subch.
V, or to register a navigator entity under subch.
V, if the department of revenue certifies under s.
73.0301 that the applicant for the license or registration is liable for delinquent taxes or if the department of workforce development certifies under s.
108.227 that the applicant for the license or registration is liable for delinquent unemployment insurance contributions.
628.10
628.10
Termination of license. 628.10(1)(1)
General. An intermediary's license issued under s.
628.04, or an individual navigator's license issued under s.
628.92 (1), remains in force until it is revoked or limited under sub.
(2), until it is suspended under sub.
(2) or s.
227.51 (3), until it is surrendered, or until the licensee dies or is in this state adjudicated incompetent.
628.10(2)
(2) Revocation, suspension, and limitation of licenses. 628.10(2)(a)(a) For failure to comply with continuing education or annual training requirements. The license of any intermediary or individual navigator who fails to produce evidence of compliance with continuing education standards set by the commissioner or with annual training requirements is revoked, effective on the date on which the evidence of compliance is due. At least 60 days before that date, the commissioner shall notify the intermediary or navigator of the date by which the evidence of compliance is due and that the intermediary's or navigator's license will be revoked if the evidence is not received by that date. An intermediary or navigator whose license is revoked under this paragraph may have his or her license reinstated, or may be relicensed, as provided in sub.
(5).
628.10(2)(am)
(am)
Nonpayment of fees. The license of an intermediary or individual navigator who fails to pay a fee when due is revoked, effective on the date on which the fee is due. At least 60 days before that date, the commissioner shall notify the intermediary or navigator of the date by which the fee is due and that the intermediary's or navigator's license will be revoked if timely payment is not made. An intermediary who is a natural person, or an individual navigator, whose license is revoked under this paragraph may have his or her license reinstated, or may be relicensed, as provided in sub.
(5).
628.10(2)(b)
(b)
For other reasons. Except as provided in pars.
(c) to
(d), after a hearing, the commissioner may revoke, suspend, or limit in whole or in part the license of any intermediary or individual navigator if the commissioner finds that the licensee is unqualified as an intermediary or navigator, is not of good character, or has repeatedly or knowingly violated an insurance statute or rule or a valid order of the commissioner under s.
601.41 (4), or if the intermediary's or navigator's methods and practices in the conduct of business endanger, or financial resources are inadequate to safeguard, the legitimate interests of customers and the public. Nothing in this paragraph limits the authority of the commissioner to suspend summarily an intermediary's or individual navigator's license under s.
227.51 (3).
628.10(2)(c)
(c)
For failure to pay support or to comply with subpoena or warrant. The commissioner shall suspend or limit the license of an intermediary who is a natural person, the license of an individual navigator, or a temporary license of a natural person under s.
628.09, if the natural person is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses, or other expenses related to the support of a child or former spouse, or if the natural person fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of children and families or a county child support agency under s.
59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under s.
49.857. A natural person whose license or temporary license is suspended under this paragraph who satisfies the requirements under this paragraph for which the license was suspended may have his or her license or temporary license reinstated by satisfactorily completing a reinstatement application and paying the application fee for original licensure as specified by rule.
628.10(2)(cm)
(cm)
For liability for delinquent taxes or unemployment insurance contributions. The commissioner shall revoke the license of an intermediary or individual navigator, including a temporary license under s.
628.09, if the department of revenue certifies under s.
73.0301 that the intermediary or navigator is liable for delinquent taxes or if the department of workforce development certifies under s.
108.227 that the intermediary or navigator is liable for delinquent unemployment insurance contributions. An intermediary who is a natural person, or an individual navigator, whose license is revoked under this paragraph may have his or her license reinstated, or may be relicensed, as provided in sub.
(5).
628.10(2)(cr)
(cr)
For providing false information in statement. The commissioner shall revoke the license of an intermediary or individual navigator, including a temporary license under s.
628.09, if the commissioner determines, after a hearing, that the intermediary or navigator provided false information in a statement provided under s.
628.095 (5) with the intermediary's or navigator's application or at the time that the annual fee was paid under s.
601.31 (1) (m) or
(nm) 2. 628.10(2)(d)
(d)
For failure to provide social security number, federal employer identification number or statement. If an intermediary or individual navigator fails to provide a social security number or federal employer identification number as required under s.
628.095 (3) or a statement as required under s.
628.095 (5), the commissioner shall suspend or limit the license of the intermediary or navigator, effective the day following the last day on which the annual fee under s.
601.31 (1) (m) or
(nm) 2. may be paid, if the commissioner has given the intermediary or navigator reasonable notice of when the fee must be paid to avoid suspension or limitation. If the intermediary or navigator provides the social security number, federal employer identification number, or statement within 60 days from the effective date of the suspension, the commissioner shall reinstate the intermediary's or navigator's license effective as of the date of suspension.
628.10(2)(e)
(e)
For changing state of residence. The license of an intermediary or individual navigator who changes residence from one state to another is revoked 60 days after the change of residence. The intermediary or navigator may be relicensed only after satisfying any requirements under s.
628.04 or
628.92 that are specified by the commissioner by rule.
628.10(3)
(3) Delay for new application. An order revoking an intermediary's or individual navigator's license under sub.
(2) (b) or
(cr) may specify a time not to exceed 5 years within which the former intermediary or navigator may not apply for a new license. If no time is specified, the intermediary or navigator may not apply for 5 years.
628.10(5)
(5) Reinstatement or relicensing after certain revocations. 628.10(5)(a)(a)
Reinstatement within 12 months. An intermediary who is a natural person, or an individual navigator, whose license is revoked under sub.
(2) (a),
(am), or
(cm) may have his or her license reinstated within 12 months after the date on which the license was revoked without having to satisfy any prelicensing education or examination requirements under s.
628.04 or any prelicensing training or examination requirements under s.
628.92 (7). To have his or her license reinstated, the intermediary or navigator must satisfy the requirement under sub.
(2) (a),
(am), or
(cm) for which the license was revoked, satisfactorily complete a reinstatement application, and pay twice the amount of the applicable license renewal fee. The reinstatement is effective on the date on which the commissioner actually reinstates the license. If the intermediary or navigator is also a resident who is required to complete continuing education or annual training, the intermediary or navigator must have satisfied all previous continuing education or annual training requirements to have his or her license reinstated under this paragraph.
628.10(5)(b)
(b)
Relicensing required after 12 months. An intermediary or individual navigator specified in par.
(a) whose license has been revoked for more than 12 months is not eligible to have his or her license reinstated under par.
(a) but may apply for relicensing at any time after 12 months have elapsed from the date of revocation. To be relicensed, the intermediary or navigator must satisfy any requirements under s.
628.04 or
628.92 that are specified by the commissioner by rule.
628.10(5)(c)
(c)
Applicability. This subsection applies to all of the following:
628.10(5)(c)1.
1. Intermediaries whose licenses were revoked under sub.
(2) (a),
(am), or
(cm) before April 9, 2008, regardless of whether an order under sub.
(3) applies to the intermediary.
628.11
628.11
Appointment of agents. An insurer shall report to the commissioner at such intervals as the commissioner establishes by rule all appointments, including renewals of appointments, and all terminations of appointments of insurance agents to do business in this state, and shall pay the fees prescribed under s.
601.31 (1) (n).
628.11 Cross-reference
Cross-reference: See also s.
Ins 6.57, Wis. adm. code.
628.12
628.12
Liability of surplus lines insurer. If a surplus lines insurer has assumed a risk and if the premium therefor has been received by the surplus lines agent or broker who placed the insurance, then as between the insurer and the insured the insurer is deemed to have received the premium due to it for the coverage; and the insurer is liable to the insured for losses covered by the insurance and for unearned premiums upon cancellation of the insurance, whether or not the surplus lines agent or broker is indebted to the insurer. Each surplus lines insurer assuming a surplus lines risk under this section thereby subjects itself to the terms of this section.
628.12 History
History: 1975 c. 371.
MARKETING PRACTICES
628.31
628.31
Sale of insurance through vending machines. No insurance policies may be sold by a vending machine except policies of personal travel accident insurance providing benefits for accidental bodily injury or accidental death.
628.32
628.32
Disclosure required. 628.32(1)(1)
An intermediary may not accept compensation from an insured or from both an insured and another source due to the insured's purchase of insurance or for advice regarding the insured's insurance needs or coverage unless the intermediary, before the insured incurs an obligation to pay compensation, clearly and conspicuously and in writing discloses to the insured all of the following:
628.32(1)(a)
(a) The amount of compensation to be paid by the insured, excluding commissions paid by the insurer to the intermediary.
628.32(1)(b)
(b) If compensation will be paid by another source, the fact that the intermediary will also receive compensation from the other source.
628.32(2)
(2) The commissioner may promulgate rules prescribing the form for disclosure under sub.
(1).
628.34
628.34
Unfair marketing practices. 628.34(1)(a)(a)
Conduct forbidden. No person who is or should be licensed under chs.
600 to
646, no employee or agent of any such person, no person whose primary interest is as a competitor of a person licensed under chs.
600 to
646, and no person on behalf of any of the foregoing persons may make or cause to be made any communication relating to an insurance contract, the insurance business, any insurer, or any intermediary that contains false or misleading information, including information that is misleading because of incompleteness. Filing a report and, with intent to deceive a person examining it, making a false entry in a record or willfully refraining from making a proper entry, are “communications" within the meaning of this paragraph. No intermediary or insurer may use any business name, slogan, emblem, or related device that is misleading or likely to cause the intermediary or insurer to be mistaken for another insurer or intermediary already in business. No intermediary may provide a misleading certificate of insurance.
628.34(1)(b)
(b)
Presumption of insurer's violation. If an insurance agent distributes cards or documents, exhibits a sign or publishes an advertisement which violates par.
(a), having reference to a particular insurer that the agent represents, the agent's violation creates a rebuttable presumption that the violation was also committed by the insurer.
628.34(2)(a)
(a)
General. No insurer, no employee of an insurer, and no insurance intermediary may seek to induce any person to enter into an insurance contract or to terminate an existing insurance contract by offering benefits not specified in the policy, nor may any insurer make any agreement of insurance that is not clearly expressed in the policy to be issued. This subsection does not preclude the reduction of premiums by reason of expense savings, including commission reductions, resulting from any form of mass marketing.
628.34(3)(a)
(a) No insurer may unfairly discriminate among policyholders by charging different premiums or by offering different terms of coverage except on the basis of classifications related to the nature and the degree of the risk covered or the expenses involved, subject to ss.
632.365,
632.746 and
632.748. Rates are not unfairly discriminatory if they are averaged broadly among persons insured under a group, blanket or franchise policy, and terms are not unfairly discriminatory merely because they are more favorable than in a similar individual policy.
628.34(3)(b)
(b) No insurer may refuse to insure or refuse to continue to insure, or limit the amount, extent or kind of coverage available to an individual, or charge an individual a different rate for the same coverage because of a mental or physical disability except when the refusal, limitation or rate differential is based on either sound actuarial principles supported by reliable data or actual or reasonably anticipated experience, subject to ss.
632.746 to
632.7495.
628.34(4)
(4) Restraint of competition. No person who is or should be licensed under chs.
600 to
646, no employee or agent of any such person, no person whose primary interest is as a competitor of a person licensed under chs.
600 to
646, and no one acting on behalf of any of the foregoing persons, may commit or enter into any agreement to participate in any act of boycott, coercion or intimidation tending to unreasonable restraint of the business of insurance or to monopoly in that business.
628.34(5)
(5) Free choice of insurer. No person may restrict in the choice of an insurer or insurance intermediary another person required to pay the cost of insurance coverage whenever the procurement of insurance coverage is required as a condition for the conclusion of a contract or other transaction or for the exercise of any right under a contract. However, the person requiring the coverage may reserve the right to disapprove on reasonable grounds the insurer or the coverage selected. The form of corporate organization of an insurer authorized to do business in this state is not a reasonable ground for disapproval, and the commissioner may by rule specify that additional grounds are not reasonable.
628.34(6)
(6) Extra charges. No person may make any charge other than premiums and premium financing charges for the protection of property or of a security interest in property, as a condition for obtaining, renewing or continuing the financing of a purchase of the property or the lending of money on the security of an interest in the property.
628.34(7)
(7) Influencing employers. No insurer or insurance intermediary or employee or agent of either may, in connection with an insurance transaction, encourage, persuade or attempt to influence any employer to refuse employment to or to discharge any person arbitrarily or unreasonably.
628.34(8)
(8) Use of official position. No person holding an elective, appointive or civil service position in federal, state or local government may use decision-making power or influence in that position to coerce the placement of insurance for any prospective policyholder through any particular intermediary or with any particular insurer.
628.34(9)
(9) Refusal to return indicia of agency. No agent may refuse or fail to return promptly all indicia of agency to the principal on demand.
628.34(10)
(10) Insurance security fund. No insurer or insurance intermediary may make use in any manner of the protection given policyholders by ch.
646 as a reason for buying insurance from the insurer or intermediary.
628.34(11)
(11) Other unfair trade practices. No person may engage in any other unfair method of competition or any other unfair or deceptive act or practice in the business of insurance, as defined under sub.
(12).
628.34(12)
(12) Rules defining unfair trade practices. The commissioner may define specific unfair trade practices by rule, after a finding that they are misleading, deceptive, unfairly discriminatory, provide an unfair inducement, or restrain competition unreasonably.
628.34(13)(a)
(a) In this subsection, “wellness program" means a program that is designed to promote health or prevent disease through a reward to insured individuals and that meets the qualifications of
45 CFR 146.121 (f) (1) or (2).
628.34(13)(b)
(b) Notwithstanding subs.
(2) (a),
(3),
(7), and
(11) and any rules promulgated under sub.
(12), it is not a violation of this section for an insurer to advertise, market, offer, or operate a wellness program.
628.34(14)(a)
(a) No person may prepare, issue, request, or require a certificate of insurance or other document used for evidence of insurance to do any of the following:
628.34(14)(a)1.
1. Contain information concerning the policy referenced by the certificate of insurance or other document that is false, misleading, deceptive, unfairly discriminatory, or that otherwise violates public policy or law, as determined by the commissioner.
628.34(14)(a)2.
2. Purport to alter, amend, or extend coverage provided by the policy referenced by the certificate of insurance or other document.
628.34(14)(a)3.
3. Alter the terms and conditions of any notice requirement in the policy. A person is entitled to notice of cancellation, nonrenewal, or any material change to the policy, or to any similar notice concerning the policy only as provided in the policy or an endorsement.
628.34(14)(b)
(b) No person may alter a certificate of insurance or other document used for evidence of insurance after it is issued.
628.34(14)(c)
(c) No certificate of insurance or other document used for evidence of insurance may warrant that the policy referenced by the certificate of insurance or other document fulfills the insurance or indemnification requirements of a specific contract.
628.34(14)(d)1.1. Except as provided in subd.
2., this subsection applies to any certificate of insurance or other document used for evidence of insurance that is issued by an insurer as evidence of property or casualty insurance.
628.34 Annotation
Any administrative rule requiring dissemination of cost disclosure information that is misleading due to incompleteness is beyond the scope of the insurance commissioner's authority in that it violates sub. (1) (a). Aetna Life Insurance Co. v. Mitchell,
101 Wis. 2d 90,
303 N.W.2d 639 (1981).
628.34 Annotation
There is no private right of action to enforce sub. (3). NAACP v. American Family Mutual Insurance Co.
978 F.2d 287 (1992).
628.345
628.345
Prohibited practices during license revocation or surrender. 628.345(1)(a)
(a) “Disciplinary period" means the period of time beginning on the effective date of the termination of the license of an intermediary under par.
(b) 1. and ending on the date on which a new license is issued to the intermediary. The “disciplinary period" of a person under par.
(b) 2.,
3. or
4. is the disciplinary period of the intermediary under par.
(b) 1. through which the person attains the status of “disciplined person".
628.345(1)(b)
(b) “Disciplined person" means any of the following:
628.345(1)(b)3.
3. A person in which an intermediary under subd.
1. has, directly or indirectly, more than a 10 percent ownership interest.
