CR 22-070 Rule Text

Minnesota: Minn. Stat. ch. 62D (governing HMOs)

  9.   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:

OCI considered the balance between effective regulation and the increased costs those regulations impose. OCI determined that outside opinions on expenses were not necessary for Medicare and Medicaid only HMOs given the more limited risk these entities bear.

  10.   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 will have little or no effect on small businesses. Insurers affected by the proposed rule changes may experience a slight decrease in administrative costs as the proposals provide reporting and filing relief and clarifications and updates that do not add financial burden to insurers, consumers or licensees.

  11.   A description of the Effect on Small Business:

This rule will have little or no effect on small businesses.

  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 site at: https://oci.wi.gov/Pages/Regulation/RulesCurrentlyPending.aspx or by contacting Karyn Culver at:

Phone:   [phone]

Email:   [e-mail]

Address:   125 South Webster St – 2nd Floor, Madison WI 53703-3474

Mail:   PO Box 7873, Madison, WI 53707-7873

  13.   Place where comments are to be submitted and deadline for submission:

Persons wishing to testify or provide oral or written comments regarding the proposed administrative rule may appear during the hearing. Additionally, the rule may be reviewed and comments made at https://docs.legis.wisconsin.gov/code or sent to the following:

The deadline for submitting comments is 4:00 p.m. on November 14, 2022.

Written comments can be mailed or hand-delivered to:

Legal Unit - OCI Rule Comment for Rule Ins 9

Office of the Commissioner of Insurance

125 South Webster St – 2nd Floor

Madison WI 53703-3474

Email address: [e-mail]

For additional information please contact: [e-mail]  

Text of Rule:

SECTION 1. Ins 9.08 (1) (intro.) is amended to read:

(1) Annual Statement. All insurers authorized to write health maintenance organization business and insurers licensed to write only limited service health organization business shall file with the commissioner by March 1 of each year an annual statement for the preceding year. A health maintenance organization insurer and limited service health organization insurer shall use the current health maintenance organization annual statement blank prepared by the national association of insurance commissioners.

SECTION 2. Ins 9.08 (1m) is created to read:

Ins 9.08 (1m) Medicare and Medicaid Health Maintenance Organizations. A health maintenance organization insurer that writes 100% of its business to Medicare or Medicaid recipients, or a combination of the two, is not required to include a special procedures opinion from a certified public accountant as required by sub. (1) (a) or an audit opinion concerning the statement of covered expenses as required by sub. (1) (c).

SECTION 3. Ins 9.08 (4) is repealed.

SECTION 4. Ins 9.08 (4) (note) is amended to read:

Note: The list of the forms form described in subs. sub. (1) and (4)may be obtained from the Office of the Commissioner of Insurance, P. O. Box 7873, Madison, WI 53707-7873.

SECTION 5. EFFECTIVE DATE. The rule takes effect on the first day of the month following publication in the Wisconsin Administrative Register as provided in s. 227.22 (2) (intro.), Stats.

Section 1.

Section 2.

   

    Nathan Houdek

    Commissioner of Insurance