AB591-ASA3,143,16 12106.21 (1) (g) "Public assistance" means relief provided by counties under s.
1359.07 (154), Wisconsin works under ss. 49.141 to 49.161, aid to families with
14dependent children under s. 49.19, medical assistance under subch. IV of ch. 49,
15low-income energy assistance under s. 16.385, weatherization assistance under s.
1616.39 and the food stamp program under 7 USC 2011 to 2029.
AB591-ASA3, s. 225 17Section 225. 106.215 (1) (fm) of the statutes, as affected by 1995 Wisconsin Act
1827
, is amended to read:
AB591-ASA3,143,2319 106.215 (1) (fm) "Public assistance" means relief provided by counties under
20s. 59.07 (154), Wisconsin works under ss. 49.141 to 49.161, aid to families with
21dependent children under s. 49.19, medical assistance under subch. IV of ch. 49,
22low-income energy assistance under s. 16.385, weatherization assistance under s.
2316.39 and the food stamp program under 7 USC 2011 to 2029.
AB591-ASA3, s. 225b 24Section 225b. 108.16 (2) (b) of the statutes is amended to read:
AB591-ASA3,144,6
1108.16 (2) (b) Each Except as provided in sub. (6) and s. 108.19, each employer's
2account shall be credited with all its contributions paid into the fund and any
3amounts transferred by the department to the fund in lieu of such contributions
4under sub. (11)
, and shall be charged with all benefits duly paid from the fund to its
5employes based on their past employment by it, except as otherwise specified in this
6chapter.
AB591-ASA3, s. 225d 7Section 225d. 108.16 (6) (L) of the statutes is created to read:
AB591-ASA3,144,98 108.16 (6) (L) Any moneys payable from the appropriation under s. 20.445 (1)
9(gg) in lieu of contributions under sub. (11).
AB591-ASA3, s. 225f 10Section 225f. 108.16 (11) of the statutes is created to read:
AB591-ASA3,144,2411 108.16 (11) If an employer that is subject to a contribution requirement is
12permitted under s. 71.07 (9e) (em) to pay, and elects to pay, an estimated earned
13income tax credit to its employes, the employer may, after first applying the
14employer's payments to the total amounts owed by that employer under subch. X of
15ch. 71 for any quarter, reduce its contributions otherwise payable to the department
16under ss. 108.17 to 108.19 by the remaining total amount of credits paid by the
17employer to its employes for the same quarter, to the extent of the employer's
18contribution liability for that quarter. The department shall promptly transfer an
19amount equal to any reduction lawfully claimed by an employer under this
20subsection from the appropriation under s. 20.445 (1) (gg) to the unemployment trust
21fund of the United States under sub. (5) (a), except that if the reduced contributions
22would otherwise be credited to the balancing account or administrative account, the
23department shall promptly transfer an amount equal to such reduced contributions
24from the appropriation under s. 20.445 (1) (gg) to the appropriate account.
AB591-ASA3, s. 225h 25Section 225h. 108.18 (1) (a) of the statutes is amended to read:
AB591-ASA3,145,3
1108.18 (1) (a) Each Except as authorized in s. 108.16 (11), each employer shall
2pay contributions to the fund for each calendar year at whatever rate on the
3employer's payroll for that year duly applies to the employer pursuant to this section.
AB591-ASA3, s. 225j 4Section 225j. 108.19 (1) and (1m) of the statutes are amended to read:
AB591-ASA3,145,125 108.19 (1) Each Except as authorized in s. 108.16 (11), each employer subject
6to this chapter shall regularly contribute to the administrative account at the rate
7of two-tenths of one per cent per year on its payroll, except that the department may
8prescribe at the close of any fiscal year such lower rates of contribution under this
9section, to apply to classes of employers throughout the ensuing fiscal year, as will
10in the department's judgment adequately finance the administration of this chapter,
11and as will in the department's judgment fairly represent the relative cost of the
12services rendered by the department to each such class.
AB591-ASA3,146,3 13(1m) Each Except as authorized in s. 108.16 (11), each employer subject to this
14chapter as of the date a rate is established under this subsection shall pay an
15assessment to the administrative account at a rate established by the department
16sufficient to pay interest due on advances from the federal unemployment account
17under title XII of the social security act (42 USC 1321 to 1324). The rate established
18by the department for employers who finance benefits under s. 108.15 (2) or 108.151
19(2) shall be 75% of the rate established for other employers. The amount of any
20employer's assessment shall be the product of the rate established for that employer
21multiplied by the employer's payroll of the previous calendar year as taken from
22quarterly contribution reports filed by the employer or, in the absence of the filing
23of such reports, estimates made by the department. Each assessment made under
24this subsection is due on the 30th day commencing after the date on which notice of
25the assessment is mailed by the department. If the amounts collected under this

1subsection are in excess of the amounts needed to pay interest due, the amounts shall
2be retained in the administrative account and utilized for the purposes specified in
3s. 108.20 (2m).
AB591-ASA3, s. 225L 4Section 225L. 108.20 (2m) of the statutes is amended to read:
AB591-ASA3,146,205 108.20 (2m) From the moneys not appropriated under s. 20.445 (1) (ge) and (gf)
6which are received by the administrative account as interest and penalties under
7this chapter, the department shall pay the benefits chargeable to the administrative
8account under s. 108.07 (5) and, the interest payable to employers under s. 108.17
9(3m) and the cost of administration of s. 108.16 (11) and may pay interest due on
10advances to the unemployment reserve fund from the federal unemployment account
11under title XII of the social security act, 42 USC 1321 to 1324, may make payments
12to satisfy a federal audit exception concerning a payment from the fund or any
13federal aid disallowance involving the unemployment compensation program, or
14may make payments to the fund if such action is necessary to obtain a lower interest
15rate or deferral of interest payments on advances from the federal unemployment
16account under title XII of the social security act, except that any interest earned
17pending disbursement of federal employment security grants under s. 20.445 (1) (n)
18shall be credited to the general fund. Any moneys reverting to the administrative
19account from the appropriations under s. 20.445 (1) (ge) and (gf) shall be utilized as
20provided in this subsection.
AB591-ASA3, s. 225n 21Section 225n. 108.22 (1) (g) of the statutes is created to read:
AB591-ASA3,146,2522 108.22 (1) (g) If an employer lawfully reduces its contributions otherwise
23payable to the department under s. 108.16 (11), the amount of any reduction is
24considered to be timely paid by that employer if a report claiming that reduction is
25filed by the employer in a timely manner.
AB591-ASA3, s. 226
1Section 226. 111.70 (1) (a) of the statutes, as affected by 1995 Wisconsin Act
227
, is amended to read:
AB591-ASA3,147,253 111.70 (1) (a) "Collective bargaining" means the performance of the mutual
4obligation of a municipal employer, through its officers and agents, and the
5representative of its municipal employes in a collective bargaining unit, to meet and
6confer at reasonable times, in good faith, with the intention of reaching an
7agreement, or to resolve questions arising under such an agreement, with respect to
8wages, hours and conditions of employment, and with respect to a requirement of the
9municipal employer for a municipal employe to perform law enforcement and fire
10fighting services under s. 61.66, except as provided in sub. (4) (m) and (n) and s. 40.81
11(3) and except that a municipal employer shall not meet and confer with respect to
12any proposal to diminish or abridge the rights guaranteed to municipal employes
13under ch. 164. The duty to bargain, however, does not compel either party to agree
14to a proposal or require the making of a concession. Collective bargaining includes
15the reduction of any agreement reached to a written and signed document. The
16municipal employer shall not be required to bargain on subjects reserved to
17management and direction of the governmental unit except insofar as the manner
18of exercise of such functions affects the wages, hours and conditions of employment
19of the municipal employes in a collective bargaining unit. In creating this subchapter
20the legislature recognizes that the municipal employer must exercise its powers and
21responsibilities to act for the government and good order of the jurisdiction which it
22serves, its commercial benefit and the health, safety and welfare of the public to
23assure orderly operations and functions within its jurisdiction, subject to those
24rights secured to municipal employes by the constitutions of this state and of the
25United States and by this subchapter.
AB591-ASA3, s. 227
1Section 227. 111.70 (4) (n) of the statutes is created to read:
AB591-ASA3,148,52 111.70 (4) (n) Health benefit plan requirements. 1. Except as provided in subd.
32., the municipal employer is prohibited from bargaining collectively with respect to
4compliance with the health benefit plan requirements under ss. 632.745, 632.747
5and 632.749.
AB591-ASA3,148,106 2. If a municipal employer offers its employes a health care coverage plan
7through a program offered by the group insurance board under s. 40.51 (7), the
8municipal employer is prohibited from bargaining collectively with respect to
9compliance with the health benefit plan requirements under ss. 632.745 (1) to (3) and
10(5) and 632.747 with respect to the health care coverage plan.
AB591-ASA3, s. 228 11Section 228. 111.91 (2) (k) of the statutes is created to read:
AB591-ASA3,148,1312 111.91 (2) (k) Compliance with the health benefit plan requirements under ss.
13632.745 (1) to (3) and (5) and 632.747.
AB591-ASA3, s. 229 14Section 229. 115.347 of the statutes, as affected by 1995 Wisconsin Act 27, is
15amended to read:
AB591-ASA3,149,216 115.347 (2) Whenever a school district that is located in whole or in part in a
17county that has converted to the client assistance for reemployment and economic
18support data system submits a report under sub. (1) in the prescribed format, the
19department of industry, labor and human relations shall determine which children
20enrolled in the school district are members of Wisconsin works groups participating
21under s. 49.147 (3) to (5) or
of families receiving aid to families with dependent
22children or food stamps, or both, and shall provide the information to the school board
23as soon thereafter as possible. The school board shall use the information to directly
24certify children as eligible for free or reduced-price meals served by the school

1district under federal school nutrition programs, pursuant to 42 USC 1758 (b) (2) (C)
2(ii) and (iii).
AB591-ASA3, s. 230 3Section 230. 115.40 (4) (b) of the statutes, as affected by 1995 Wisconsin Act
427
, is amended to read:
AB591-ASA3,149,135 115.40 (4) (b) The secretary and the secretary of health and social services shall
6review the applications and jointly determine the grant recipients and the amount
7of each grant. A grant may not be awarded to a school board, agency or organization
8unless the percentage of the participating school district's membership in the
9previous school year for whom aid to families with dependent children was being
10received under s. 49.19, or who were members of a Wisconsin works group, as defined
11in s. 49.141 (1) (s), with a member who participated under s. 49.147 (3) to (5),
was
12greater than 5%. In this paragraph, "membership" has the meaning given in s.
13121.004 (5).
AB591-ASA3, s. 231 14Section 231. 115.40 (4) (c) 1. of the statutes is amended to read:
AB591-ASA3,149,2115 115.40 (4) (c) 1. Programs that involve a school district that, in the previous
16school year, had a high proportion of pupils for whom aid to families with dependent
17children was being received under s. 49.19, a high proportion of pupils who were
18members of a Wisconsin works group, as defined in s. 49.141 (1) (s), with a member
19who participated under s. 49.147 (3) to (5),
a high proportion of pupils who were
20children at risk, as defined under s. 118.153 (1) (a), or a high proportion of dropouts,
21as defined under s. 118.153 (1) (b).
AB591-ASA3, s. 232 22Section 232. 115.45 (3m) (a) 2. of the statutes is amended to read:
AB591-ASA3,150,223 115.45 (3m) (a) 2. "Low-income pupil" means a pupil for whom aid to families
24with dependent children is being received under s. 49.19 or a pupil who is a member

1of a Wisconsin works group, as defined in s. 49.141 (1) (s), with a member who is
2participating in Wisconsin works under s. 49.147 (3) to (5)
.
AB591-ASA3, s. 233 3Section 233. 119.82 (1) (a) 2. of the statutes is amended to read:
AB591-ASA3,150,64 119.82 (1) (a) 2. Is receiving aid to families with dependent children under s.
549.19 or is a member of a Wisconsin works group, as defined in s. 49.141 (1) (s), with
6a member who is participating in Wisconsin works under s. 49.147 (3) to (5)
.
AB591-ASA3, s. 234 7Section 234. 120.13 (2) (g) of the statutes is amended to read:
AB591-ASA3,150,118 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
949.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2.,
10632.747 (3),
632.87 (4) and (5), 632.895 (9) and (10), 632.896, 767.25 (4m) (d) and
11767.51 (3m) (d).
AB591-ASA3, s. 234m 12Section 234m. 120.13 (14) of the statutes, as affected by 1995 Wisconsin Act
1327
, is amended to read:
AB591-ASA3,151,214 120.13 (14) Day care programs. Establish and provide or contract for the
15provision of day care programs for children. The school board may receive federal
16or state funds for this purpose. The school board may charge a fee for all or part of
17the cost of the service for participation in a day care program established under this
18subsection. Costs associated with a day care program under this subsection may not
19be included in shared costs under s. 121.07 (6). Day care programs established under
20this subsection shall meet the standards for licensed day care centers established by
21the department of health and family services. If a school board proposes to contract
22for or renew a contract for the provision of a day care program under this subsection
23or if on the effective date of this subsection .... [revisor inserts date], a school board
24is a party to a contract for the provision of a day care program under this subsection,
25the school board shall refer the contractor or proposed contractor to the department

1of health and family services for the background investigations required under s.
248.65 (1m).
AB591-ASA3, s. 235 3Section 235. 120.13 (27m) of the statutes is amended to read:
AB591-ASA3,151,164 120.13 (27m) Transportation of indigent pupils. Provide transportation to
5and from school for indigent pupils who reside in the school district and who are not
6required to be transported under s. 121.54. In this subsection, "indigent pupils"
7means pupils eligible for free lunches or reduced-price lunches under 42 USC 1758
8or aid to 18-year-old students under s. 49.20 or for whom aid to families with
9dependent children is being received under s. 49.19 or who are members of a
10Wisconsin works group, as defined in s. 49.141 (1) (s), with a member who is
11participating in Wisconsin works under s. 49.147 (3) to (5)
or any combination
12thereof, as determined by the school board. If a school board determines to provide
13transportation under this subsection, there shall be reasonable uniformity in the
14transportation furnished such pupils whether they attend public or private schools.
15The cost of transporting pupils under this subsection may not be included in the
16school district's shared cost under s. 121.07 (6) (a).
AB591-ASA3, s. 236 17Section 236. 185.981 (4t) of the statutes is amended to read:
AB591-ASA3,151,2018 185.981 (4t) A sickness care plan operated by a cooperative association is
19subject to ss. 252.14, 631.89, 632.72 (2), 632.745, 632.747, 632.749, 632.87 (2m), (3),
20(4) and (5), 632.895 (10) and 632.897 (10) and ch. 155.
AB591-ASA3, s. 237 21Section 237. 185.983 (1) (intro.) of the statutes is amended to read:
AB591-ASA3,152,222 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be
23exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
24601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72
25(2), 632.745, 632.747, 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5),

1632.895 (5), (9) and (10), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609,
2630, 635, 645 and 646, but the sponsoring association shall:
AB591-ASA3, s. 239 3Section 239. 227.01 (13) (zs) of the statutes is created to read:
AB591-ASA3,152,54 227.01 (13) (zs) Establishes geographical areas under s. 49.143 for the
5administration of Wisconsin works under ss. 49.141 to 49.161.
AB591-ASA3, s. 241 6Section 241. 230.04 (13) (a) and (e) 1. and 2. of the statutes are amended to
7read:
AB591-ASA3,152,118 230.04 (13) (a) Establish standards for plans to increase state employment of
9recipients of aid under s. 49.19 or benefits under s. 49.147 (3) to (5) prepared by
10agencies under s. 230.147 (1). The standards shall state the time periods within
11which these plans shall be prepared.
AB591-ASA3,152,1412 (e) 1. A description of each agency's effort during that fiscal year to employ
13under s. 230.147 persons who received aid under s. 49.19 or benefits under s. 49.147
14(3) to (5)
.
AB591-ASA3,152,1715 2. The number of persons receiving aid under s. 49.19 or benefits under s.
1649.147 (3) to (5)
who were employed by each agency under s. 230.147 during that
17fiscal year and the job title or classification of each position filled under s. 230.147.
AB591-ASA3, s. 242 18Section 242. 230.147 (1) of the statutes, as affected by 1995 Wisconsin Act 27,
19is amended to read:
AB591-ASA3,153,420 230.147 (1) Each appointing authority of an agency with more than 100
21authorized permanent full-time equivalent positions shall prepare and implement
22a plan of action to employ persons who, at the time determined under sub. (4), receive
23aid under s. 49.19, or benefits under s. 49.147 (3) to (5), with the goal of making the
24ratio of those persons occupying permanent positions in the agency to the total
25number of persons occupying permanent positions in the agency equal to the ratio

1of the average case load receiving aid under s. 49.19, or benefits under s. 49.147 (3)
2to (5),
in this state in the previous fiscal year to the average number of persons in the
3state civilian labor force in the preceding fiscal year, as determined by the
4department of industry, labor and human relations.
AB591-ASA3, s. 243 5Section 243. 230.147 (2) of the statutes, as affected by 1995 Wisconsin Act 27,
6is amended to read:
AB591-ASA3,153,167 230.147 (2) Each appointing authority of an agency with 100 or fewer
8authorized permanent full-time equivalent positions is encouraged to employ
9persons who, at the time determined under sub. (4), receive aid under s. 49.19, or
10benefits under s. 49.147 (3) to (5),
to attempt to make the ratio of those persons
11occupying permanent positions in the agency to the total number of persons
12occupying permanent positions in the agency equal to the ratio of the average case
13load receiving aid under s. 49.19, or benefits under s. 49.147 (3) to (5) in this state
14in the previous fiscal year to the average number of persons in the state civilian labor
15force in the preceding fiscal year, as determined by the department of industry, labor
16and human relations.
AB591-ASA3, s. 244 17Section 244. 230.147 (3) of the statutes is amended to read:
AB591-ASA3,153,2318 230.147 (3) Notwithstanding subs. (1) and (2), the state fair park board shall
19make every reasonable effort to employ in permanent full-time equivalent positions
20persons who, at the time determined under sub. (4), receive aid under s. 49.19 or
21benefits under s. 49.147 (3) to (5)
. The state fair park board shall consult with the
22department of employment relations to assure that its efforts under this subsection
23comply with ch. 230.
AB591-ASA3, s. 245 24Section 245. 560.14 (1) (a) (intro.) and 1. of the statutes are consolidated,
25renumbered 560.14 (1) (a) and amended to read:
AB591-ASA3,154,4
1560.14 (1) (a) "Applicable median household income" means the greater of the
2following: 1. The
median family income for the county where the household is
3located, as determined annually by the U.S. department of housing and urban
4development.
AB591-ASA3, s. 246 5Section 246. 560.14 (1) (a) 2. of the statutes is repealed.
AB591-ASA3, s. 247 6Section 247. 600.01 (2) (b) of the statutes is amended to read:
AB591-ASA3,154,87 600.01 (2) (b) Group or blanket insurance described in sub. (1) (b) 3. and 4. is
8not exempt from s. 632.745, 632.747 or 632.749 or ch. 633 or 635.
AB591-ASA3, s. 248 9Section 248. 628.34 (3) (a) of the statutes is amended to read:
AB591-ASA3,154,1610 628.34 (3) (a) No insurer may unfairly discriminate among policyholders by
11charging different premiums or by offering different terms of coverage except on the
12basis of classifications related to the nature and the degree of the risk covered or the
13expenses involved, subject to s. ss. 632.365 and 632.745. Rates are not unfairly
14discriminatory if they are averaged broadly among persons insured under a group,
15blanket or franchise policy, and terms are not unfairly discriminatory merely
16because they are more favorable than in a similar individual policy.
AB591-ASA3, s. 249 17Section 249. 628.34 (3) (b) of the statutes is amended to read:
AB591-ASA3,154,2318 628.34 (3) (b) No insurer may refuse to insure or refuse to continue to insure,
19or limit the amount, extent or kind of coverage available to an individual, or charge
20an individual a different rate for the same coverage because of a mental or physical
21disability except when the refusal, limitation or rate differential is based on either
22sound actuarial principles supported by reliable data or actual or reasonably
23anticipated experience, subject to ss. 632.745, 632.747, 632.749, 635.09 and 635.26.
AB591-ASA3, s. 250 24Section 250. 632.745 of the statutes is created to read:
AB591-ASA3,155,3
1632.745 Coverage requirements for group health benefit plans. (1)
2Group health insurance market reform; definitions. In this section and ss. 632.747
3and 632.749:
AB591-ASA3,155,104 (a) 1. Except as provided in subd. 2., "eligible employe" means an employe who
5works on a permanent basis and has a normal work week of 30 or more hours. The
6term includes a sole proprietor, a business owner, including the owner of a farm
7business, a partner of a partnership and a member of a limited liability company if
8the sole proprietor, business owner, partner or member is included as an employe
9under a health benefit plan of an employer, but the term does not include an employe
10who works on a temporary or substitute basis.
AB591-ASA3,155,1311 2. For purposes of a group health benefit plan, or a self-insured health plan,
12that is offered by the state under s. 40.51 (6) or by the group insurance board under
13s. 40.51 (7), "eligible employe" has the meaning given in s. 40.02 (25).
AB591-ASA3,155,1414 (b) "Employer" means any of the following:
AB591-ASA3,155,1715 1. An individual, firm, corporation, partnership, limited liability company or
16association that is actively engaged in a business enterprise in this state, including
17a farm business.
AB591-ASA3,155,1818 2. A municipality, as defined in s. 16.70 (8).
AB591-ASA3,155,1919 3. The state.
AB591-ASA3,155,2320 (c) "Group health benefit plan" means a health benefit plan that is issued by
21an insurer to an employer on behalf of a group consisting of eligible employes of the
22employer. The term includes individual health benefit plans covering eligible
23employes when 3 or more are sold to an employer.
AB591-ASA3,156,724 (d) "Health benefit plan" means any hospital or medical policy or certificate.
25"Health benefit plan" does not include accident-only, credit accident or health,

1dental, vision, medicare supplement, medicare replacement, long-term care,
2disability income or short-term insurance, coverage issued as a supplement to
3liability insurance, worker's compensation or similar insurance, automobile medical
4payment insurance, individual conversion policies, specified disease policies,
5hospital indemnity policies, as defined in s. 632.895 (1) (c), policies or certificates
6issued under the health insurance risk-sharing plan or an alternative plan under
7subch. II of ch. 619 or other insurance exempted by rule of the commissioner.
AB591-ASA3,156,148 (e) "Insurer" means an insurer that is authorized to do business in this state,
9in one or more lines of insurance that includes health insurance, and that offers
10group health benefit plans covering eligible employes of one or more employers in
11this state. The term includes a health maintenance organization, as defined in s.
12609.01 (2), a preferred provider plan, as defined in s. 609.01 (4), an insurer operating
13as a cooperative association organized under ss. 185.981 to 185.985 and a limited
14service health organization, as defined in s. 609.01 (3).
AB591-ASA3,156,1615 (f) 1. "Qualifying coverage" means benefits or coverage provided under any of
16the following:
AB591-ASA3,156,1717 a. Medicare, medicaid or the Wisconsin works healthplan.
AB591-ASA3,156,2018 b. A group health benefit plan or an employer-based health benefit
19arrangement that provides benefits similar to or exceeding benefits provided under
20a basic health benefit plan under subch. II of ch. 635.
AB591-ASA3,156,2321 c. An individual health benefit plan that provides benefits similar to or
22exceeding benefits provided under a basic health benefit plan under subch. II of ch.
23635, if the individual health benefit plan has been in effect for at least one year.
AB591-ASA3,157,524 2. Notwithstanding subd. 1. b. and c., "qualifying coverage" does not include a
25high cost-share health benefit plan that is linked to a tax-preferred savings plan for

1payment of medical expenses if the employer that provides the individual's new
2coverage offers its eligible employes a choice of health benefit plan options that
3includes a high cost-share health benefit plan that may be linked to a tax-preferred
4savings plan for payment of medical expenses and the individual's new coverage is
5not such a high cost-share health benefit plan.
AB591-ASA3,157,76 (g) "Self-insured health plan" means a self-insured health plan of the state or
7a county, city, village, town or school district.
AB591-ASA3,157,11 8(2) Preexisting conditions. (a) A group health benefit plan, or a self-insured
9health plan, may not deny, exclude or limit benefits for a covered individual for losses
10incurred more than 12 months after the effective date of the individual's coverage
11due to a preexisting condition.
AB591-ASA3,157,1412 (b) Except as provided in par. (c), a group health benefit plan, or a self-insured
13health plan, may not define a preexisting condition more restrictively than any of the
14following:
AB591-ASA3,157,1815 1. A condition that would have caused an ordinarily prudent person to seek
16medical advice, diagnosis, care or treatment during the 6 months immediately
17preceding the effective date of coverage and for which the individual did not seek
18medical advice, diagnosis, care or treatment.
AB591-ASA3,157,2119 2. A condition for which medical advice, diagnosis, care or treatment was
20recommended or received during the 6 months immediately preceding the effective
21date of coverage.
AB591-ASA3,157,2522 (c) Notwithstanding par. (b) 1. and 2., a group health benefit plan, or a
23self-insured health plan, shall exclude pregnancy from the definition of a preexisting
24condition for the purpose of coverage of expenses related to prenatal and postnatal
25care, delivery and any complications of pregnancy.
AB591-ASA3,158,7
1(3) Portability. (a) A group health benefit plan, or a self-insured health plan,
2shall waive any period applicable to a preexisting condition exclusion or limitation
3period with respect to particular services for the period that an individual was
4previously covered by qualifying coverage that was not sponsored by the employer
5sponsoring the group health benefit plan or the self-insured health plan and that
6provided benefits with respect to such services, if the qualifying coverage terminated
7not more than 60 days before the effective date of the new coverage.
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