125 South Webster St – 2nd Floor
Madison WI 53703-3474
Email address:
Julie E. Walsh
The rule changes are:
Section 1. Ins 17.50 (2) (am) is created to read:
Ins 17.50 (2) (am) “Affiliated health care providers” means two or more health care providers delivering services as described in s. 655.002 (1), Stats., and who satisfy all of the following: 1. The health care providers are either legal entities or are employed by one or more separate legal entities over which operating control is exercised by a common controlling legal entity. The controlling legal entity need not be a health care provider.
2. The incomes of the health care providers are consolidated with the controlling legal entity in audited financial statements prepared under generally accepted accounting principles.
Section 2. Ins 17.50 (2) (e) is amended to read:
Ins 17.50 (2) (e) “Provider,” when used without modification, means a health care provider as defined in s. 655.001 (8), Stats., or affiliated health care providers as defined in par. (am), that is responsible for the establishment and operation of a self-insured plan. Section 3. Ins 17.50 (4) (L) and (m) are amended to read:
Ins 17.50 (4) (L) The provider’s most recent audited annual financial statement prepared under generally accepted accounting principles that includes, if applicable, all affiliated health care providers covered under the self-insured plan on a consolidated basis.
(m) A proposed draft of a letter of credit, if the provider intends to use one as part of the initial funding, except for affiliated health care providers who are prohibited from using a letter of credit for initial funding.
Section 4. Ins 17.50 (6) (title) is amended to read:
17.50 (6) Funding requirements for providers: prohibitions.
Section 5. Ins 17.50 (6) (c) (intro.) is created to read:
17.50 (6) (c) For self-insured plans except a self-insured plan for affiliated health care providers, the provider shall provide all of the following:
Section 6. Ins 17.50 (6) (c) 1., is amended to read:
1. If the actuarial estimate under sub. (4) (d) is less than $2,000,000, the provider shall, before the self-insured plan begins operation, deposit in the trust cash equal to the first year's estimated liabilities plus a letter of credit equal to the difference between the cash funding and $2,000,000 except as provided under sub. (4) (m). Section 7. Ins 17.50 (6m) is created to read:
17.50 (6m) Funding requirements for affiliated health care providers. The minimum initial funding required for a self-insured plan is the greater of $2,000,000 or the actuarial estimate under sub. (4) (d).
Section 8. These changes will take effect on the first day of the month after publication in the Wisconsin Administrative Register, as provided in s. 227.22 (2) (intro.), Stats.
