LRBs0449/1
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1995 - 1996 LEGISLATURE
SENATE SUBSTITUTE AMENDMENT 1,
To 1995 ASSEMBLY BILL 416
January 30, 1996 - Offered by Committee on Insurance.
AB416-SSA1,2,10 1An Act to repeal 40.51 (8c), 60.23 (25) (a), 66.184 (2), 111.70 (4) (n), 111.91 (2)
2(k), 120.13 (2) (gm), 619.145 (3) (e), 619.145 (4), 619.15 (3) (bc), 619.15 (3) (bm),
3619.15 (4) (e), 635.01, 635.05 and 635.26; to renumber 66.184; to renumber
4and amend
60.23 (25) and 635.18 (1); to amend 40.51 (8), 66.184 (1), 111.70
5(1) (a), 120.13 (2) (g), 185.983 (1g), 619.135 (2), 619.135 (3), 619.14 (5) (a), 619.14
6(5) (d), 619.145 (1), 619.15 (1), 619.15 (3) (c), 619.165 (1) (a), 619.165 (1) (d),
7619.165 (2), 619.17 (1), 619.175, 625.12 (2), 628.34 (3) (a), 628.34 (3) (b), 632.76
8(2) (a), 632.896 (4), chapter 635 (title), 635.11 (intro.), 635.11 (1), 635.11 (4),
9635.13, 635.15, 635.18 (title), 635.18 (2), 635.18 (3), 635.18 (4), 635.18 (5),
10635.18 (6), 635.18 (7), 635.18 (8), 635.20 (1c), 635.20 (2), 635.23 (1) (a), (d), (dp),
11(dr) and (e) (intro.), 1., 2. and 3., 635.23 (4) and (5), 635.25 (title), 635.25 (1) (a)
12(intro.), 635.25 (1) (b), 635.25 (1m), 635.25 (2), 635.254, 635.272 (1) and 635.28;
13to repeal and recreate 111.70 (1) (a), 111.70 (1) (a), 619.10 (3m), 619.10 (3m),
14619.13, 619.13, 619.135 (2), 619.135 (2), 619.135 (3), 619.135 (3), 619.15 (3) (c),
15619.15 (4) (c), 619.15 (4) (c), 619.175, 619.175, 635.02, 635.07, 635.09, 635.17,
16635.20 (1m), 635.20 (13) and 635.29 (title); and to create 40.51 (8c), 40.51 (8m),

160.23 (25) (a), 60.23 (25) (h), 60.23 (25) (i), 66.184 (2), 111.70 (4) (n), 111.70 (4)
2(o), 111.91 (2) (k), 111.91 (2) (L), 120.13 (2) (gm), 619.145 (1m), 619.145 (3) (e),
3619.145 (4), 619.15 (3) (bc), 619.15 (3) (bm), 619.15 (3) (f) and (g), 619.15 (4) (e),
4632.727, 635.03, 635.04, 635.16 and 635.18 (1) (a) and (b) of the statutes;
5relating to: health insurance market reform, including preexisting condition
6exclusions and limitations, guaranteed issue, guaranteed acceptance,
7portability, rating restrictions, contract termination and renewability and fair
8marketing standards; funding the health insurance risk-sharing plan;
9collective bargaining of certain health care coverage requirements; granting
10rule-making authority; and making an appropriation.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB416-SSA1, s. 1 11Section 1. 40.51 (8) of the statutes is amended to read:
AB416-SSA1,2,1412 40.51 (8) Every health care coverage plan offered by the state under sub. (6)
13shall comply with ss. 631.89, 631.90, 631.93 (2), 632.72 (2), 632.87 (3) to (5), 632.895
14(5m) and (8) to (10) and, 632.896, 635.03 (1) to (3) and (5) and 635.04 (3).
AB416-SSA1, s. 2 15Section 2. 40.51 (8c) of the statutes is created to read:
AB416-SSA1,2,1916 40.51 (8c) Every health care coverage plan offered by the state under sub. (6)
17and every health care coverage plan offered by the group insurance board under sub.
18(7) shall comply with s. 619.13 (1) (am), (3) and (4). This subsection does not apply
19after June 30, 2000.
AB416-SSA1, s. 3 20Section 3. 40.51 (8c) of the statutes, as created by 1995 Wisconsin Act .... (this
21act), is repealed.
AB416-SSA1, s. 4 22Section 4. 40.51 (8m) of the statutes is created to read:
AB416-SSA1,3,2
140.51 (8m) Every health care coverage plan offered by the group insurance
2board under sub. (7) shall comply with ss. 635.03 (1) to (3) and (5) and 635.04.
AB416-SSA1, s. 5 3Section 5. 60.23 (25) of the statutes is renumbered 60.23 (25) (intro.) and
4amended to read:
AB416-SSA1,3,75 60.23 (25) Self-insured health plans. (intro.) Provide health care benefits to
6its officers and employes on a self-insured basis if the self-insured plan complies
7with ss. all of the following:
AB416-SSA1,3,8 8(b) Section 631.89,.
AB416-SSA1,3,9 9(c) Section 631.90,.
AB416-SSA1,3,10 10(d) Section 631.93 (2),.
AB416-SSA1,3,11 11(e) Section 632.87 (4) and (5),.
AB416-SSA1,3,12 12(f) Section 632.895 (9) and.
AB416-SSA1,3,13 13(g) Section 632.896.
AB416-SSA1, s. 6 14Section 6. 60.23 (25) (a) of the statutes is created to read:
AB416-SSA1,3,1515 60.23 (25) (a) Before July 1, 2000, s. 619.13 (1) (am), (3) and (4).
AB416-SSA1, s. 7 16Section 7. 60.23 (25) (a) of the statutes, as created by 1995 Wisconsin Act ....
17(this act), is repealed.
AB416-SSA1, s. 8 18Section 8. 60.23 (25) (h) of the statutes is created to read:
AB416-SSA1,3,1919 60.23 (25) (h) Section 635.03 (2), (3) and (5) (a) 2. and (b) 2.
AB416-SSA1, s. 9 20Section 9. 60.23 (25) (i) of the statutes is created to read:
AB416-SSA1,3,2121 60.23 (25) (i) Section 635.04 (3).
AB416-SSA1, s. 10 22Section 10. 66.184 of the statutes is renumbered 66.184 (1).
AB416-SSA1, s. 11 23Section 11. 66.184 (1) of the statutes, as affected by 1995 Wisconsin Act ....
24(this act), is amended to read:
AB416-SSA1,4,6
166.184 (1) If a city, including a 1st class city, or a village provides health care
2benefits under its home rule power, or if a town provides health care benefits, to its
3officers and employes on a self-insured basis, the self-insured plan shall comply
4with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and
5(10), 632.896, 635.03 (2), (3) and (5) (a) 2. and (b) 2., 635.04 (3), 767.25 (4m) (d) and
6767.51 (3m) (d).
AB416-SSA1, s. 12 7Section 12. 66.184 (2) of the statutes is created to read:
AB416-SSA1,4,98 66.184 (2) A self-insured plan under sub. (1) shall comply with s. 619.13 (1)
9(am), (3) and (4). This subsection does not apply after June 30, 2000.
AB416-SSA1, s. 13 10Section 13. 66.184 (2) of the statutes, as created by 1995 Wisconsin Act .... (this
11act), is repealed.
AB416-SSA1, s. 14 12Section 14 . 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act 27,
13is amended to read:
AB416-SSA1,5,1114 111.70 (1) (a) "Collective bargaining" means the performance of the mutual
15obligation of a municipal employer, through its officers and agents, and the
16representative of its municipal employes in a collective bargaining unit, to meet and
17confer at reasonable times, in good faith, with the intention of reaching an
18agreement, or to resolve questions arising under such an agreement, with respect to
19wages, hours and conditions of employment, and with respect to a requirement of the
20municipal employer for a municipal employe to perform law enforcement and fire
21fighting services under s. 61.66, except as provided in sub. (4) (m) and (n) and s. 40.81
22(3) and except that a municipal employer shall not meet and confer with respect to
23any proposal to diminish or abridge the rights guaranteed to municipal employes
24under ch. 164. The duty to bargain, however, does not compel either party to agree
25to a proposal or require the making of a concession. Collective bargaining includes

1the reduction of any agreement reached to a written and signed document. The
2municipal employer shall not be required to bargain on subjects reserved to
3management and direction of the governmental unit except insofar as the manner
4of exercise of such functions affects the wages, hours and conditions of employment
5of the municipal employes in a collective bargaining unit. In creating this subchapter
6the legislature recognizes that the municipal employer must exercise its powers and
7responsibilities to act for the government and good order of the jurisdiction which it
8serves, its commercial benefit and the health, safety and welfare of the public to
9assure orderly operations and functions within its jurisdiction, subject to those
10rights secured to municipal employes by the constitutions of this state and of the
11United States and by this subchapter.
AB416-SSA1, s. 15 12Section 15 . 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act ....
13(this act), section 14, is repealed and recreated to read:
AB416-SSA1,6,1114 111.70 (1) (a) "Collective bargaining" means the performance of the mutual
15obligation of a municipal employer, through its officers and agents, and the
16representative of its municipal employes in a collective bargaining unit, to meet and
17confer at reasonable times, in good faith, with the intention of reaching an
18agreement, or to resolve questions arising under such an agreement, with respect to
19wages, hours and conditions of employment, and with respect to a requirement of the
20municipal employer for a municipal employe to perform law enforcement and fire
21fighting services under s. 61.66, except as provided in sub. (4) (m), (n) and (o) and s.
2240.81 (3) and except that a municipal employer shall not meet and confer with respect
23to any proposal to diminish or abridge the rights guaranteed to municipal employes
24under ch. 164. The duty to bargain, however, does not compel either party to agree
25to a proposal or require the making of a concession. Collective bargaining includes

1the reduction of any agreement reached to a written and signed document. The
2municipal employer shall not be required to bargain on subjects reserved to
3management and direction of the governmental unit except insofar as the manner
4of exercise of such functions affects the wages, hours and conditions of employment
5of the municipal employes in a collective bargaining unit. In creating this subchapter
6the legislature recognizes that the municipal employer must exercise its powers and
7responsibilities to act for the government and good order of the jurisdiction which it
8serves, its commercial benefit and the health, safety and welfare of the public to
9assure orderly operations and functions within its jurisdiction, subject to those
10rights secured to municipal employes by the constitutions of this state and of the
11United States and by this subchapter.
AB416-SSA1, s. 16 12Section 16 . 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act ....
13(this act), sections 14 and 15, is repealed and recreated to read:
AB416-SSA1,7,1114 111.70 (1) (a) "Collective bargaining" means the performance of the mutual
15obligation of a municipal employer, through its officers and agents, and the
16representative of its municipal employes in a collective bargaining unit, to meet and
17confer at reasonable times, in good faith, with the intention of reaching an
18agreement, or to resolve questions arising under such an agreement, with respect to
19wages, hours and conditions of employment, and with respect to a requirement of the
20municipal employer for a municipal employe to perform law enforcement and fire
21fighting services under s. 61.66, except as provided in sub. (4) (m) and (o) and s. 40.81
22(3) and except that a municipal employer shall not meet and confer with respect to
23any proposal to diminish or abridge the rights guaranteed to municipal employes
24under ch. 164. The duty to bargain, however, does not compel either party to agree
25to a proposal or require the making of a concession. Collective bargaining includes

1the reduction of any agreement reached to a written and signed document. The
2municipal employer shall not be required to bargain on subjects reserved to
3management and direction of the governmental unit except insofar as the manner
4of exercise of such functions affects the wages, hours and conditions of employment
5of the municipal employes in a collective bargaining unit. In creating this subchapter
6the legislature recognizes that the municipal employer must exercise its powers and
7responsibilities to act for the government and good order of the jurisdiction which it
8serves, its commercial benefit and the health, safety and welfare of the public to
9assure orderly operations and functions within its jurisdiction, subject to those
10rights secured to municipal employes by the constitutions of this state and of the
11United States and by this subchapter.
AB416-SSA1, s. 17 12Section 17. 111.70 (4) (n) of the statutes is created to read:
AB416-SSA1,7,1713 111.70 (4) (n) Health insurance risk-sharing plan surcharge. The municipal
14employer is prohibited from bargaining collectively with respect to compliance with
15the requirements under s. 619.13 (1) (am), (3) and (4) related to payment of the
16surcharge for the health insurance risk-sharing plan. This paragraph does not
17apply after June 30, 2000.
AB416-SSA1, s. 18 18Section 18. 111.70 (4) (n) of the statutes, as created by 1995 Wisconsin Act ....
19(this act), is repealed.
AB416-SSA1, s. 19 20Section 19. 111.70 (4) (o) of the statutes is created to read:
AB416-SSA1,7,2321 111.70 (4) (o) Health benefit plan requirements. 1. Except as provided in subd.
222., the municipal employer is prohibited from bargaining collectively with respect to
23compliance with the health benefit plan requirements under subch. I of ch. 635.
AB416-SSA1,8,324 2. If a municipal employer offers its employes a health care coverage plan
25through a program offered by the group insurance board under s. 40.51 (7), the

1municipal employer is prohibited from bargaining collectively with respect to
2compliance with the health benefit plan requirements under ss. 635.03 (1) to (3) and
3(5) and 635.04 with respect to the health care coverage plan.
AB416-SSA1, s. 20 4Section 20. 111.91 (2) (k) of the statutes is created to read:
AB416-SSA1,8,65 111.91 (2) (k) Compliance with the requirements under s. 619.13 (1) (am), (3)
6and (4). This paragraph does not apply after June 30, 2000.
AB416-SSA1, s. 21 7Section 21. 111.91 (2) (k) of the statutes, as created by 1995 Wisconsin Act ....
8(this act), is repealed.
AB416-SSA1, s. 22 9Section 22. 111.91 (2) (L) of the statutes is created to read:
AB416-SSA1,8,1110 111.91 (2) (L) Compliance with the health benefit plan requirements under ss.
11635.03 (1) to (3) and (5) and 635.04.
AB416-SSA1, s. 23 12Section 23. 120.13 (2) (g) of the statutes is amended to read:
AB416-SSA1,8,1613 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
1449.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10),
15632.896, 635.03 (2), (3) and (5) (a) 2. and (b) 2., 635.04 (3), 767.25 (4m) (d) and 767.51
16(3m) (d).
AB416-SSA1, s. 24 17Section 24. 120.13 (2) (gm) of the statutes is created to read:
AB416-SSA1,8,1918 120.13 (2) (gm) Every self-insured plan under par. (b) shall comply with s.
19619.13 (1) (am), (3) and (4). This paragraph does not apply after June 30, 2000.
AB416-SSA1, s. 25 20Section 25. 120.13 (2) (gm) of the statutes, as created by 1995 Wisconsin Act
21.... (this act), is repealed.
AB416-SSA1, s. 26 22Section 26. 185.983 (1g) of the statutes is amended to read:
AB416-SSA1,9,223 185.983 (1g) A cooperative association that is a small employer insurer, as
24defined in s. 635.02 (8) 635.20 (13), is subject to the health insurance mandates, as

1defined in s. 601.423 (1), to the same extent as any other small employer insurer, as
2defined in s. 635.02 (8) 635.20 (13).
AB416-SSA1, s. 27 3Section 27 . 619.10 (3m) of the statutes is repealed and recreated to read:
AB416-SSA1,9,64 619.10 (3m) "Health care provider" means a person that may be a provider of
5a covered service or article under s. 619.14 (3), as specified by the board by rule under
6s. 619.15 (3) (bc). This subsection does not apply after June 30, 2000.
AB416-SSA1, s. 28 7Section 28 . 619.10 (3m) of the statutes, as affected by 1995 Wisconsin Act ....
8(this act), is repealed and recreated to read:
AB416-SSA1,9,99 619.10 (3m) (a) "Health care coverage revenue" means any of the following:
AB416-SSA1,9,1010 1. Premiums received for health care coverage.
AB416-SSA1,9,1111 2. Subscriber contract charges received for health care coverage.
AB416-SSA1,9,1312 3. Health maintenance organization, limited service health organization or
13preferred provider plan charges received for health care coverage.
AB416-SSA1,9,1514 4. The sum of benefits paid and administrative costs incurred for health care
15coverage under a medical reimbursement plan.
AB416-SSA1,9,1716 (b) This subsection does not apply after 2 years after the effective date of this
17paragraph .... [revisor inserts date].
AB416-SSA1, s. 29 18Section 29 . 619.13 of the statutes is repealed and recreated to read:
AB416-SSA1,9,23 19619.13 Health care surcharges. (1) (a) Except as provided in sub. (2), to
20cover claims paid under the plan and the operating and administrative expenses of
21the plan, every health care provider shall impose and collect on every charge billed
22by the health care provider a surcharge in an amount set by the board under s. 619.15
23(3) (bm) or (4) (c).
AB416-SSA1,9,2524 (am) Each individual or insurer or other 3rd-party payer subject to the
25surcharge under par. (a) shall pay the surcharge to the health care provider.
AB416-SSA1,10,11
1(b) A health care provider may retain up to 15% of the surcharge amounts
2under par. (a) that are collected before July 1, 1997, for its own administrative
3expenses. The board shall establish by rule the amount that a health care provider
4may retain of surcharges collected on and after July 1, 1997, for its administrative
5expenses at a level sufficient to cover the health care provider's administrative
6expenses. The health care provider shall remit the remainder of the surcharge
7amounts collected, after deducting its administrative expenses, to the board on a
8quarterly basis, on or before the last day of the next month following the end of each
9calendar quarter, along with a report that identifies any insurer or other 3rd-party
10payer that has failed to pay a significant surcharge amount billed during that
11calendar quarter.
AB416-SSA1,10,12 12(2) Subsection (1) does not apply to any of the following:
AB416-SSA1,10,1313 (a) Charges billed for services or articles provided to any of the following:
AB416-SSA1,10,1414 1. Medical assistance recipients.
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