Register March 2017 No. 735
Chapter Ins 8
EMPLOYEE WELFARE FUNDS; EMPLOYEE BENEFIT PLAN ADMINISTRATORS;
SMALL EMPLOYER HEALTH INSURANCE
Subchapter I — Employee Welfare Funds
Receipt of payments from funds by parties-in-interest.
“Trust fund or other fund", definition.
“Employee benefits", definition.
Annual statement and notice of number of fund participants in Wisconsin, when required.
“Persons employed in this state".
Availability of information to fund participants.
Preservation of records.
County and school district self-insured employee health care benefits: excess or stop-loss insurance requirements.
Subchapter II — Employee Benefit Plan Administrators
Performance bond requirements.
Notification to office.
Subchapter III — Small Employer Health Insurance
Required policy provisions.
Solicitation; disclosure requirements.
Uniform employee application form.
Regulation of rates and rate changes.
Guaranteed renewability; cancellation and renewal restrictions.
Certification of compliance; additional information required.
Small employer insurers shall offer an initial enrollment period to all members of small employer groups; riders and discriminatory coverage are prohibited.
A small employer insurer may accept an employee's or dependent's waiver of coverage during an initial enrollment period only under limited conditions.
Small employer insurers shall offer coverage to new entrants.
Small employer insurers shall offer an open enrollment for individuals excluded prior to enactment or application of the small employer health insurance law.
Small employer insurers shall offer coverage to late enrollees.
Small employer insurers may not participate with a small employer to coerce, or discriminate among, eligible employees or dependents.
A small employer insurer shall require small employers to provide documentation to establish that waivers of coverage are voluntary and permitted.
Qualifying coverage for portability and late enrollees; transition.
Restrictive riders prohibited.
Fair marketing standards.
Minimum standards for market share of basic health benefit plans in force; exemption from guarantee issuance of the basic health benefit plan.
Subchapter IV — Basic Health Benefit Plan For Small Employers
Health insurance mandates.
Policy title; term.
Limitations and restrictions.
Policy terms; exclusions; limitations.
Managed care options.
Form approval and marketing.
Ch. Ins 8 Note
Sections Ins 8.20
were created as emergency rules effective October, 1, 1991. Sections Ins 8.40
were created as emergency rules effective February 12, 1992.