Amendment SSA1-AB416

AB416-SSA1,3,13 (g) Section 632.896.

AB416-SSA1, s. 6 Section 6. 60.23 (25) (a) of the statutes is created to read:

AB416-SSA1,3,15 60.23 (25) (a) Before July 1, 2000, s. 619.13 (1) (am), (3) and (4).

AB416-SSA1, s. 7 Section 7. 60.23 (25) (a) of the statutes, as created by 1995 Wisconsin Act .... (this act), is repealed.

AB416-SSA1, s. 8 Section 8. 60.23 (25) (h) of the statutes is created to read:

AB416-SSA1,3,19 60.23 (25) (h) Section 635.03 (2), (3) and (5) (a) 2. and (b) 2.

AB416-SSA1, s. 9 Section 9. 60.23 (25) (i) of the statutes is created to read:

AB416-SSA1,3,21 60.23 (25) (i) Section 635.04 (3).

AB416-SSA1, s. 10 Section 10. 66.184 of the statutes is renumbered 66.184 (1).

AB416-SSA1, s. 11 Section 11. 66.184 (1) of the statutes, as affected by 1995 Wisconsin Act .... (this act), is amended to read:

AB416-SSA1,4,6 66.184 (1) If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employes on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10), 632.896, 635.03 (2), (3) and (5) (a) 2. and (b) 2., 635.04 (3), 767.25 (4m) (d) and 767.51 (3m) (d).

AB416-SSA1, s. 12 Section 12. 66.184 (2) of the statutes is created to read:

AB416-SSA1,4,9 66.184 (2) A self-insured plan under sub. (1) shall comply with s. 619.13 (1) (am), (3) and (4). This subsection does not apply after June 30, 2000.

AB416-SSA1, s. 13 Section 13. 66.184 (2) of the statutes, as created by 1995 Wisconsin Act .... (this act), is repealed.

AB416-SSA1, s. 14 Section 14 . 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act 27, is amended to read:

AB416-SSA1,5,11 111.70 (1) (a) "Collective bargaining" means the performance of the mutual obligation of a municipal employer, through its officers and agents, and the representative of its municipal employes in a collective bargaining unit, to meet and confer at reasonable times, in good faith, with the intention of reaching an agreement, or to resolve questions arising under such an agreement, with respect to wages, hours and conditions of employment, and with respect to a requirement of the municipal employer for a municipal employe to perform law enforcement and fire fighting services under s. 61.66, except as provided in sub. (4) (m) and (n) and s. 40.81 (3) and except that a municipal employer shall not meet and confer with respect to any proposal to diminish or abridge the rights guaranteed to municipal employes under ch. 164. The duty to bargain, however, does not compel either party to agree to a proposal or require the making of a concession. Collective bargaining includes the reduction of any agreement reached to a written and signed document. The municipal employer shall not be required to bargain on subjects reserved to management and direction of the governmental unit except insofar as the manner of exercise of such functions affects the wages, hours and conditions of employment of the municipal employes in a collective bargaining unit. In creating this subchapter the legislature recognizes that the municipal employer must exercise its powers and responsibilities to act for the government and good order of the jurisdiction which it serves, its commercial benefit and the health, safety and welfare of the public to assure orderly operations and functions within its jurisdiction, subject to those rights secured to municipal employes by the constitutions of this state and of the United States and by this subchapter.

AB416-SSA1, s. 15 Section 15 . 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act .... (this act), section 14, is repealed and recreated to read:

AB416-SSA1,6,11 111.70 (1) (a) "Collective bargaining" means the performance of the mutual obligation of a municipal employer, through its officers and agents, and the representative of its municipal employes in a collective bargaining unit, to meet and confer at reasonable times, in good faith, with the intention of reaching an agreement, or to resolve questions arising under such an agreement, with respect to wages, hours and conditions of employment, and with respect to a requirement of the municipal employer for a municipal employe to perform law enforcement and fire fighting services under s. 61.66, except as provided in sub. (4) (m), (n) and (o) and s. 40.81 (3) and except that a municipal employer shall not meet and confer with respect to any proposal to diminish or abridge the rights guaranteed to municipal employes under ch. 164. The duty to bargain, however, does not compel either party to agree to a proposal or require the making of a concession. Collective bargaining includes the reduction of any agreement reached to a written and signed document. The municipal employer shall not be required to bargain on subjects reserved to management and direction of the governmental unit except insofar as the manner of exercise of such functions affects the wages, hours and conditions of employment of the municipal employes in a collective bargaining unit. In creating this subchapter the legislature recognizes that the municipal employer must exercise its powers and responsibilities to act for the government and good order of the jurisdiction which it serves, its commercial benefit and the health, safety and welfare of the public to assure orderly operations and functions within its jurisdiction, subject to those rights secured to municipal employes by the constitutions of this state and of the United States and by this subchapter.

AB416-SSA1, s. 16 Section 16 . 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act .... (this act), sections 14 and 15, is repealed and recreated to read:

AB416-SSA1,7,11 111.70 (1) (a) "Collective bargaining" means the performance of the mutual obligation of a municipal employer, through its officers and agents, and the representative of its municipal employes in a collective bargaining unit, to meet and confer at reasonable times, in good faith, with the intention of reaching an agreement, or to resolve questions arising under such an agreement, with respect to wages, hours and conditions of employment, and with respect to a requirement of the municipal employer for a municipal employe to perform law enforcement and fire fighting services under s. 61.66, except as provided in sub. (4) (m) and (o) and s. 40.81 (3) and except that a municipal employer shall not meet and confer with respect to any proposal to diminish or abridge the rights guaranteed to municipal employes under ch. 164. The duty to bargain, however, does not compel either party to agree to a proposal or require the making of a concession. Collective bargaining includes the reduction of any agreement reached to a written and signed document. The municipal employer shall not be required to bargain on subjects reserved to management and direction of the governmental unit except insofar as the manner of exercise of such functions affects the wages, hours and conditions of employment of the municipal employes in a collective bargaining unit. In creating this subchapter the legislature recognizes that the municipal employer must exercise its powers and responsibilities to act for the government and good order of the jurisdiction which it serves, its commercial benefit and the health, safety and welfare of the public to assure orderly operations and functions within its jurisdiction, subject to those rights secured to municipal employes by the constitutions of this state and of the United States and by this subchapter.

AB416-SSA1, s. 17 Section 17. 111.70 (4) (n) of the statutes is created to read:

AB416-SSA1,7,17 111.70 (4) (n) Health insurance risk-sharing plan surcharge. The municipal employer is prohibited from bargaining collectively with respect to compliance with the requirements under s. 619.13 (1) (am), (3) and (4) related to payment of the surcharge for the health insurance risk-sharing plan. This paragraph does not apply after June 30, 2000.

AB416-SSA1, s. 18 Section 18. 111.70 (4) (n) of the statutes, as created by 1995 Wisconsin Act .... (this act), is repealed.

AB416-SSA1, s. 19 Section 19. 111.70 (4) (o) of the statutes is created to read:

AB416-SSA1,7,23 111.70 (4) (o) Health benefit plan requirements. 1. Except as provided in subd. 2., the municipal employer is prohibited from bargaining collectively with respect to compliance with the health benefit plan requirements under subch. I of ch. 635.

AB416-SSA1,8,3 2. If a municipal employer offers its employes a health care coverage plan through a program offered by the group insurance board under s. 40.51 (7), the municipal employer is prohibited from bargaining collectively with respect to compliance with the health benefit plan requirements under ss. 635.03 (1) to (3) and (5) and 635.04 with respect to the health care coverage plan.

AB416-SSA1, s. 20 Section 20. 111.91 (2) (k) of the statutes is created to read:

AB416-SSA1,8,6 111.91 (2) (k) Compliance with the requirements under s. 619.13 (1) (am), (3) and (4). This paragraph does not apply after June 30, 2000.

AB416-SSA1, s. 21 Section 21. 111.91 (2) (k) of the statutes, as created by 1995 Wisconsin Act .... (this act), is repealed.

AB416-SSA1, s. 22 Section 22. 111.91 (2) (L) of the statutes is created to read:

AB416-SSA1,8,11 111.91 (2) (L) Compliance with the health benefit plan requirements under ss. 635.03 (1) to (3) and (5) and 635.04.

AB416-SSA1, s. 23 Section 23. 120.13 (2) (g) of the statutes is amended to read:

AB416-SSA1,8,16 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10), 632.896, 635.03 (2), (3) and (5) (a) 2. and (b) 2., 635.04 (3), 767.25 (4m) (d) and 767.51 (3m) (d).

AB416-SSA1, s. 24 Section 24. 120.13 (2) (gm) of the statutes is created to read:

AB416-SSA1,8,19 120.13 (2) (gm) Every self-insured plan under par. (b) shall comply with s. 619.13 (1) (am), (3) and (4). This paragraph does not apply after June 30, 2000.

AB416-SSA1, s. 25 Section 25. 120.13 (2) (gm) of the statutes, as created by 1995 Wisconsin Act .... (this act), is repealed.

AB416-SSA1, s. 26 Section 26. 185.983 (1g) of the statutes is amended to read:

AB416-SSA1,9,2 185.983 (1g) A cooperative association that is a small employer insurer, as defined in s. 635.02 (8) 635.20 (13), is subject to the health insurance mandates, as defined in s. 601.423 (1), to the same extent as any other small employer insurer, as defined in s. 635.02 (8) 635.20 (13).

AB416-SSA1, s. 27 Section 27 . 619.10 (3m) of the statutes is repealed and recreated to read:

AB416-SSA1,9,6 619.10 (3m) "Health care provider" means a person that may be a provider of a covered service or article under s. 619.14 (3), as specified by the board by rule under s. 619.15 (3) (bc). This subsection does not apply after June 30, 2000.

AB416-SSA1, s. 28 Section 28 . 619.10 (3m) of the statutes, as affected by 1995 Wisconsin Act .... (this act), is repealed and recreated to read:

AB416-SSA1,9,9 619.10 (3m) (a) "Health care coverage revenue" means any of the following:

AB416-SSA1,9,10 1. Premiums received for health care coverage.

AB416-SSA1,9,11 2. Subscriber contract charges received for health care coverage.

AB416-SSA1,9,13 3. Health maintenance organization, limited service health organization or preferred provider plan charges received for health care coverage.

AB416-SSA1,9,15 4. The sum of benefits paid and administrative costs incurred for health care coverage under a medical reimbursement plan.

AB416-SSA1,9,17 (b) This subsection does not apply after 2 years after the effective date of this paragraph .... [revisor inserts date].

AB416-SSA1, s. 29 Section 29 . 619.13 of the statutes is repealed and recreated to read:

AB416-SSA1,9,23 619.13 Health care surcharges. (1) (a) Except as provided in sub. (2), to cover claims paid under the plan and the operating and administrative expenses of the plan, every health care provider shall impose and collect on every charge billed by the health care provider a surcharge in an amount set by the board under s. 619.15 (3) (bm) or (4) (c).

AB416-SSA1,9,25 (am) Each individual or insurer or other 3rd-party payer subject to the surcharge under par. (a) shall pay the surcharge to the health care provider.

AB416-SSA1,10,11 (b) A health care provider may retain up to 15% of the surcharge amounts under par. (a) that are collected before July 1, 1997, for its own administrative expenses. The board shall establish by rule the amount that a health care provider may retain of surcharges collected on and after July 1, 1997, for its administrative expenses at a level sufficient to cover the health care provider's administrative expenses. The health care provider shall remit the remainder of the surcharge amounts collected, after deducting its administrative expenses, to the board on a quarterly basis, on or before the last day of the next month following the end of each calendar quarter, along with a report that identifies any insurer or other 3rd-party payer that has failed to pay a significant surcharge amount billed during that calendar quarter.

AB416-SSA1,10,12 (2) Subsection (1) does not apply to any of the following:

AB416-SSA1,10,13 (a) Charges billed for services or articles provided to any of the following:

AB416-SSA1,10,14 1. Medical assistance recipients.

AB416-SSA1,10,16 2. Persons receiving relief under s. 49.025, 49.027 or 49.029 or under a county-funded relief program under s. 59.07 (154).

AB416-SSA1,10,18 3. Persons with coverage under the plan, including an alternative plan under s. 619.145.

AB416-SSA1,10,20 4. Persons with coverage under part A or part B of Title XVIII of the federal social security act, 42 USC 1395 to 1395zz.

AB416-SSA1,10,22 5. Persons for whom health care benefits are provided under any other federal assistance program.

AB416-SSA1,10,23 (b) Charges payable by worker's compensation insurance.

AB416-SSA1,11,2 (3) An insurer or other 3rd-party payer that pays a charge for a service or article on behalf of the person receiving the service or article shall include a line item identifying payment of the surcharge on any documentation of payment provided to the health care provider providing the service or article.

AB416-SSA1,11,7 (4) The surcharge under this section shall be imposed and paid in addition to the charge for a service or article, including fees and payments for fees specified in existing contracts unless such a contract specifically provides that the fees or payments for fees specified in the contract include any surcharge that may be imposed in addition to the amount charged for a service or article.

AB416-SSA1,11,14 (4m) If the person receiving the service or article, rather than an insurer or other 3rd-party payer, is paying for the service or article directly and full payment is not made in one payment, any instalment payments received by the health care provider shall be credited against the balance due on the charge for the service or article first and credited against the balance due on the surcharge only after the charge for the service or article is paid in full. This subsection does not apply if the payer specifies that a payment is intended to cover the surcharge.

AB416-SSA1,11,18 (5) A health care provider is not liable for the payment of any surcharge amount imposed but not collected by the health care provider. A health care provider is immune from civil liability for imposing, collecting or attempting to collect a surcharge under this section.

AB416-SSA1,11,21 (6) (a) If the surcharge under this section or its application is held by a court to be invalid with respect to any person or group of persons, then the surcharge or its application shall be invalid with respect to all persons.

AB416-SSA1,12,2 (b) If the commissioner, after consulting with the attorney general, determines that the surcharge or its application is invalid under par. (a) with respect to all persons, the commissioner shall certify such determination to the revisor of statutes. Upon the certification, the revisor of statutes shall publish notice in the Wisconsin administrative register of the determination, the date of the certification and that on the date of the certification:

AB416-SSA1,12,3 1. All of the following are effective:

AB416-SSA1,12,4 a. Section 619.10 (3m), 1993 stats., for 2 years.

AB416-SSA1,12,5 b. Section 619.13, 1993 stats., for 2 years.

AB416-SSA1,12,6 c. Section 619.135 (2) and (3), 1993 stats., for 2 years.

AB416-SSA1,12,7 d. Section 619.145 (3) (e) and (4), 1993 stats., for 2 years.

AB416-SSA1,12,8 e. Section 619.15 (3) (c) and (4) (c) and (e), 1993 stats., for 2 years.

AB416-SSA1,12,9 f. Section 619.175, 1993 stats., for 2 years.

AB416-SSA1,12,10 2. All of the following are not effective:

AB416-SSA1,12,11 a. Section 619.10 (3m), 1995 stats.

AB416-SSA1,12,12 b. Section 619.13, 1995 stats.

AB416-SSA1,12,13 c. Section 619.135 (2) and (3), 1995 stats.

AB416-SSA1,12,14 d. Section 619.15 (3) (bc), (bm) and (c) and (4) (c), 1995 stats.

AB416-SSA1,12,15 e. Section 619.175, 1995 stats.

AB416-SSA1,12,16 (7) This section does not apply after June 30, 2000.

AB416-SSA1, s. 30 Section 30 . 619.13 of the statutes, as affected by 1995 Wisconsin Act .... (this act), is repealed and recreated to read:

AB416-SSA1,12,22 619.13 Participation of insurers. (1) (a) Every insurer shall participate in the cost of administering the plan, except the commissioner may by rule exempt as a class those insurers whose share as determined under par. (b) would be so minimal as to not exceed the estimated cost of levying the assessment.

AB416-SSA1,13,3 (b) Except as provided by a rule promulgated under s. 619.145 (4), every participating insurer shall share in the operating, administrative and subsidy expenses of the plan in proportion to the ratio of the insurer's total health care coverage revenue for residents of this state during the preceding calendar year to the aggregate health care coverage revenue of all participating insurers for residents of this state during the preceding calendar year, as determined by the commissioner.

AB416-SSA1,13,9 (c) If assessments and other receipts by the commissioner, board or administering carrier exceed payments made to alternative plans in accordance with contracts entered into under s. 619.145 (3) and the actual losses and administrative expenses of the plan, the excess shall be held at interest and used by the board to offset future losses or to reduce plan premiums. In this paragraph, "future losses" includes reserves for incurred but not reported claims.

AB416-SSA1,13,12 (d) 1. Each insurer's proportion of participation under par. (b) shall be determined annually by the commissioner based on annual statements and other reports filed by the insurer with the commissioner.

AB416-SSA1,13,18 2. If the commissioner finds that the commissioner's authority to require insurers to report under chs. 600 to 646 and 655 is not adequate to permit the commissioner or the board to carry out the commissioner's or the board's responsibilities under this subchapter, the commissioner may promulgate rules requiring insurers to report the information necessary for the commissioner and the board to make the determinations required under this subchapter.

AB416-SSA1,13,22 (2) Any deficit incurred under the plan shall be recouped by assessments apportioned under sub. (1) by the board among participating insurers, who may recover these amounts in the normal course of their respective businesses without time limitation.

AB416-SSA1,13,24 (3) This section does not apply after 2 years after the effective date of this subsection .... [revisor inserts date].

AB416-SSA1, s. 31 Section 31 . 619.135 (2) of the statutes is amended to read:

AB416-SSA1,14,9 619.135 (2) If the moneys under s. 20.145 (7) (a) and (g) are insufficient to reimburse the plan for premium reductions under s. 619.165 and deductible reductions under s. 619.14 (5) (a), or the commissioner determines that the moneys under s. 20.145 (7) (a) and (g) will be insufficient to reimburse the plan for premium reductions under s. 619.165 and deductible reductions under s. 619.14 (5) (a), the commissioner shall, by rule, increase the amount of the assessment under sub. (1) (a) or levy an assessment against every insurer, or a combination of both, sufficient to reimburse the plan for premium reductions under s. 619.165 and deductible reductions under s. 619.14 (5) (a).