Fiscal Estimate
There will be no state or local government fiscal effect. The full text of the proposed changes, a summary of the changes and the fiscal estimate are attached to this Notice of Hearing.
Initial Regulatory Flexibility Analysis
This rule does not impose any additional requirements on small businesses.
The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266- 7843 or at email address:
Eileen.Mallow@oci.state.wi.us
Contact Person
A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the OCI internet WEB site at
http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, Services Section, OCI, at:
Inger.Williams@OCI.State.WI.US, (608) 264-8110, 125 South Webster Street – 2
nd Floor, Madison WI or PO Box 7873, Madison WI 53707-7873.
Notice of Hearing
Insurance
Notice is hereby given that pursuant to the authority granted under s.
601.41 (3), Stats., and the procedures set forth in under s.
227.18, Stats., OCI will hold a public hearing to consider the adoption of the attached proposed rulemaking order affecting Section
Ins 9.25 (8), Wis. Adm. Code, relating to preferred provider plan limited exemption. This hearing will also be held in compliance with s.
227.24 (4) as this proposed rule was issued as an emergency rule.
Hearing Information
Date: December 12, 2006
Time: 10:00 a.m., or as soon thereafter as the matter may be reached
Place: OCI, Room 227, 125 South Webster St 2nd Floor, Madison, WI
Written comments can be mailed to:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 9258
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Written comments can be hand delivered to:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 9258
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53702
Comments can be emailed to:
Comments submitted through the Wisconsin Administrative Rule website at:
http://adminrules.wisconsin. gov on the proposed rule will be considered.
The deadline for submitting comments is 4:00 p.m. on the 8th day after the date for the hearing stated in this Notice of Hearing.
Fiscal Estimate
There will be no state or local government fiscal effect.
Initial Regulatory Flexibility Analysis
This rule does not impose any additional requirements on small businesses.
The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266- 7843 or at email address
Eileen.Mallow@oci.state.wi.us
Contact Person
A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the OCI internet WEB site at
http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, Services Section, OCI, at:
Inger.Williams@OCI.State.WI.US, (608) 264-8110, 125 South Webster Street – 2
nd Floor, Madison WI or PO Box 7873, Madison WI 53707-7873.
Analysis Prepared by the Office of the Commissioner of Insurance (OCI)
1. Statutes interpreted:
2. Statutory authority:
3. Explanation of the OCI's authority to promulgate the proposed rule under these statutes:
The Commissioner of Insurance is authorized to promulgate rules under ss.
628.34 (12),
601.41 and
609.20, Stats. Section
609.20, Stats., permits the Commissioner to promulgate rules relating to preferred provider plans and defined network plans in order to ensure enrollee access to health care services and ensure continuity of health care while recognizing the differences between preferred provider plans and defined network plans.
4. Related Statutes or rules:
There are no related statutes or rules.
5. The plain language analysis and summary of the proposed rule:
The proposed rule clarifies the applicability dates for ss.
Ins 9.25 and
9.27, Wis. Adm. Code, and specifies that insurers offering preferred provider plans that are issued prior to January 1, 2007 and periodically renewed after December 31, 2006 and that would otherwise be affected by ss.
Ins 9.25 and
9.27, Wis. Adm. Code, will be grandfathered from compliance with those new requirements. The requirements of ss.
Ins 9.25 and
9.27, Wis. Adm. Code, will be applicable to an insurer offering a preferred provider plan on or after January 1, 2007.
6. Summary of and preliminary comparison with any existing or proposed federal regulation that is intended to address the activities to be regulated by the proposed rule:
There is no federal regulation that addresses the activities regulated by the proposed rule.
7. Comparison of similar rules in adjacent states as found by OCI:
Illinois: None
Iowa: None
Michigan: None
Minnesota: None
8. A summary of the factual data and analytical methodologies that OCI used in support of the proposed rule and how any related findings support the regulatory approach chosen for the proposed rule:
The information OCI used in support of this proposed rule includes the information described in the analysis of
Clearinghouse Rule 05-059. However more specifically it includes the information provided by representatives of the insurance industry and preferred provider organizations to JCRAR and OCI concerning the topic addressed by the proposed rule.
9. Any analysis and supporting documentation that OCI used in support of OCI's determination of the rule's effect on small businesses under s.
227.114:
This rule does not impose any additional requirements on small businesses. Its effect will be to limit requirements otherwise applied by rules currently in effect, including
Clearinghouse rule 05-059. This is apparent from the proposed rule itself and the summary.
10. If these changes may have a significant fiscal effect on the private sector, the anticipated costs that will be incurred by private sector in complying with the rule:
This rule will not have a significant fiscal effect on the private sector. Its effect will be to limit requirements otherwise applied by rules currently in effect, including
Clearinghouse rule 05-059.
11. A description of the Effect on Small Business: This rule will have an effect on small businesses only by limiting requirements otherwise applied by rules currently in effect, including
Clearinghouse rule 05-059.
12. Agency contact person:A copy of the full text of the proposed rule changes, analysis and fiscal estimate may be obtained from the WEB sites at:
http://oci.wi.gov/ocirules.htm or by contacting Inger Williams, OCI Services Section, at:
Phone: (608) 264-8110
Address: 125 South Webster St – 2nd Floor Madison WI 53702
Mail: PO Box 7873, Madison WI 53707-7873
13. Place where comments are to be submitted and deadline for submission:
The deadline for submitting comments is 4:00 p.m. on the 8th day after the date for the hearing stated in the Notice of Hearing.
Mailing address:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 9258
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Street address:
Julie E. Walsh
Legal Unit - OCI Rule Comment for Rule Ins 9258
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53702
The proposed rule changes are:
Ins 9.25 (8) This section first applies to an insurer offering a preferred provider plan beginning on January 1, 2007 This section does not apply to an insurer with respect to a preferred provider plan issued prior to January 1, 2007 and periodically renewed after December 31, 2006.
