AB100-ASA1, s. 3392 23Section 3392. 601.64 (3) (a) of the statutes is amended to read:
AB100-ASA1,1801,224 601.64 (3) (a) Restitutionary forfeiture. Whoever violates an effective order
25issued under s. 601.41 (4) or, any insurance statute or rule or s. 149.13 or 149.144

1shall forfeit to the state twice the amount of any profit gained from the violation, in
2addition to any other forfeiture or penalty imposed.
AB100-ASA1, s. 3393 3Section 3393. 601.64 (3) (c) of the statutes is amended to read:
AB100-ASA1,1801,104 601.64 (3) (c) Forfeiture for violation of statute or rule. Whoever violates an
5insurance statute or rule or s. 149.13 or 149.144, intentionally aids a person in
6violating an insurance statute or rule or s. 149.13 or 149.144 or knowingly permits
7a person over whom he or she has authority to violate an insurance statute or rule
8or s. 149.13 or 149.144 shall forfeit to the state not more than $1,000 for each
9violation. If the statute or rule imposes a duty to make a report to the commissioner,
10each week of delay in complying with the duty is a new violation.
AB100-ASA1, s. 3394 11Section 3394. 601.64 (4) of the statutes is amended to read:
AB100-ASA1,1801,1812 601.64 (4) Criminal penalty. Whoever intentionally violates or intentionally
13permits any person over whom he or she has authority to violate or intentionally aids
14any person in violating any insurance statute or rule of this state , s. 149.13 or
15149.144
or any effective order issued under s. 601.41 (4) may, unless a specific penalty
16is provided elsewhere in the statutes, be fined not more than $10,000 if a corporation
17or if a natural person be fined not more than $5,000 or imprisoned for not to exceed
183 years or both. Intent has the meaning expressed under s. 939.23.
AB100-ASA1, s. 4804c 19Section 4804c. 609.78 of the statutes is created to read:
AB100-ASA1,1801,23 20609.78 Coverage of procedures involving a bone, joint, muscle or tissue
21and intraoral splint therapy devices.
Health maintenance organizations,
22limited service health organizations and preferred provider plans are subject to s.
23632.895 (11).
AB100-ASA1, s. 4804e 24Section 4804e. 609.79 of the statutes is created to read:
AB100-ASA1,1802,3
1609.79 Coverage of hospital services and anesthetics for dental care.
2Health maintenance organizations, limited service health organizations and
3preferred provider plans are subject to s. 632.895 (12).
AB100-ASA1, s. 3395 4Section 3395. 613.03 (3) of the statutes is amended to read:
AB100-ASA1,1802,95 613.03 (3) Applicability of insurance laws. Except as otherwise specifically
6provided, service insurance corporations organized or operating under this chapter
7are subject to subch. II of ch. 619 and ss. 610.01, 610.11, 610.21, 610.23 and 610.24
8and chs. 600, 601, 609, 617, 620, 623, 625, 627, 628, 631, 632, 635 and 645 and to no
9other insurance laws.
AB100-ASA1, s. 3396 10Section 3396. 613.03 (4) of the statutes is created to read:
AB100-ASA1,1802,1211 613.03 (4) Mandatory health insurance risk-sharing plan. Service insurance
12corporations organized or operating under this chapter are subject to ch. 149.
AB100-ASA1, s. 3397 13Section 3397. 614.05 (1) of the statutes is amended to read:
AB100-ASA1,1802,1514 614.05 (1) Chapters 611 and 619. No section of ch. 611 or subch. I of ch. 619
15applies to fraternals unless it is specifically made applicable by this chapter.
AB100-ASA1, s. 3398 16Section 3398. Subchapter I of chapter 619 [precedes 619.001] of the statutes
17is renumbered chapter 619 [precedes 619.001].
AB100-ASA1, s. 3399 18Section 3399. Subchapter I (title) of chapter 619 [precedes 619.01] of the
19statutes is repealed.
AB100-ASA1, s. 3400 20Section 3400. Subchapter II (title) of chapter 619 [precedes 619.10] of the
21statutes is repealed.
AB100-ASA1, s. 3401 22Section 3401. 619.10 (intro.) of the statutes is renumbered 149.10 (intro.) and
23amended to read:
AB100-ASA1,1802,24 24149.10 Definitions. (intro.) In this subchapter chapter:
AB100-ASA1, s. 3402 25Section 3402. 619.10 (1) of the statutes is repealed.
AB100-ASA1, s. 3403
1Section 3403. 619.10 (1m) of the statutes is repealed.
AB100-ASA1, s. 3404 2Section 3404. 619.10 (2) of the statutes is renumbered 149.10 (2) and amended
3to read:
AB100-ASA1,1803,54 149.10 (2) "Board" means the board of governors established under s. 619.15
5149.15.
AB100-ASA1, s. 4817b 6Section 4817b. 619.10 (2c) of the statutes is created to read:
AB100-ASA1,1803,87 619.10 (2c) "Church plan" has the meaning given in section 3 (33) of the federal
8Employee Retirement Income Security Act of 1974.
AB100-ASA1, s. 4817bm 9Section 4817bm. 619.10 (2c) of the statutes, as created by 1997 Wisconsin Act
10.... (this act), is renumbered 149.10 (2c).
AB100-ASA1, s. 4817c 11Section 4817c. 619.10 (2j) of the statutes is created to read:
AB100-ASA1,1803,1312 619.10 (2j) (a) Except as provided in par. (b), "creditable coverage" means
13coverage under any of the following:
AB100-ASA1,1803,1414 1. A group health plan.
AB100-ASA1,1803,1515 2. Health insurance.
AB100-ASA1,1803,1616 3. Part A or part B of title XVIII of the federal Social Security Act.
AB100-ASA1,1803,1817 4. Title XIX of the federal Social Security Act, except for coverage consisting
18solely of benefits under section 1928 of that act.
AB100-ASA1,1803,1919 5. Chapter 55 of title 10 of the United States Code.
AB100-ASA1,1803,2120 6. A medical care program of the federal Indian health service or of an
21American Indian tribal organization.
AB100-ASA1,1803,2222 7. A state health benefits risk pool.
AB100-ASA1,1803,2323 8. A health plan offered under chapter 89 of title 5 of the United States Code.
AB100-ASA1,1803,2424 9. A public health plan.
AB100-ASA1,1804,2
110. A health coverage plan under section 5 (e) of the federal Peace Corps Act,
222 USC 2504 (e).
AB100-ASA1,1804,43 (b) "Creditable coverage" does not include coverage consisting solely of
4coverage of excepted benefits, as defined in section 2791 (c) of P.L. 104-191.
AB100-ASA1, s. 4817cm 5Section 4817cm. 619.10 (2j) of the statutes, as created by 1997 Wisconsin Act
6.... (this act), is renumbered 149.10 (2j).
AB100-ASA1, s. 4817m 7Section 4817m. 619.10 (2t) of the statutes is created to read:
AB100-ASA1,1804,98 619.10 (2t) "Eligible individual" means an individual for whom all of the
9following apply:
AB100-ASA1,1804,1110 (a) The aggregate of the individual's periods of creditable coverage is 18 months
11or more.
AB100-ASA1,1804,1412 (b) The individual's most recent period of creditable coverage was under a
13group health plan, governmental plan, federal governmental plan or church plan, or
14under any health insurance offered in connection with any of those plans.
AB100-ASA1,1804,1815 (c) The individual does not have creditable coverage and is not eligible for
16coverage under a group health plan, part A or part B of title XVIII of the federal Social
17Security Act or a state plan under title XIX of the federal Social Security Act or any
18successor program.
AB100-ASA1,1804,2119 (d) The individual's most recent period of creditable coverage was not
20terminated for any reason related to fraud or intentional misrepresentation of
21material fact or a failure to pay premiums.
AB100-ASA1,1804,2422 (e) If the individual was offered the option of continuation coverage under a
23federal continuation provision or similar state program, the individual elected the
24continuation coverage.
AB100-ASA1,1804,2525 (f) The individual has exhausted any continuation coverage under par. (e).
AB100-ASA1, s. 4817mm
1Section 4817mm. 619.10 (2t) of the statutes, as created by 1997 Wisconsin Act
2.... (this act), is renumbered 149.10 (2t).
AB100-ASA1, s. 3405 3Section 3405. 619.10 (3) of the statutes is renumbered 149.10 (3) and amended
4to read:
AB100-ASA1,1805,75 149.10 (3) "Eligible person" means a resident of this state who qualifies under
6s. 619.12 149.12 whether or not the person is legally responsible for the payment of
7medical expenses incurred on the person's behalf.
AB100-ASA1, s. 4818c 8Section 4818c. 619.10 (3c) of the statutes is created to read:
AB100-ASA1,1805,99 619.10 (3c) "Federal continuation provision" means any of the following:
AB100-ASA1,1805,1110(a) Section 4980B of the Internal Revenue Code of 1986, except for section
114980B (f) (1) of that code insofar as it relates to pediatric vaccines.
AB100-ASA1,1805,1312 (b) Part 6 of subtitle B of title I of the federal Employee Retirement Income
13Security Act of 1974, except for section 609 of that act.
AB100-ASA1,1805,1414(c) Title XXII of P.L. 104-191.
AB100-ASA1, s. 4818cm 15Section 4818cm. 619.10 (3c) of the statutes, as created by 1997 Wisconsin Act
16.... (this act), is renumbered 149.10 (3c).
AB100-ASA1, s. 4818d 17Section 4818d. 619.10 (3d) of the statutes is created to read:
AB100-ASA1,1805,2018 619.10 (3d) "Federal governmental plan" means a benefit program established
19or maintained for its employes by the government of the United States or by any
20agency or instrumentality of the government of the United States.
AB100-ASA1, s. 4818dm 21Section 4818dm. 619.10 (3d) of the statutes, as created by 1997 Wisconsin Act
22.... (this act), is renumbered 149.10 (3d).
AB100-ASA1, s. 4818g 23Section 4818g. 619.10 (3g) of the statutes is created to read:
AB100-ASA1,1805,2524 619.10 (3g) "Governmental plan" has the meaning given under section 3 (32)
25of the federal Employee Retirement Income Security Act of 1974.
AB100-ASA1, s. 4818gm
1Section 4818gm. 619.10 (3g) of the statutes, as created by 1997 Wisconsin Act
2.... (this act), is renumbered 149.10 (3g).
AB100-ASA1, s. 4818j 3Section 4818j. 619.10 (3j) of the statutes is created to read:
AB100-ASA1,1806,44 619.10 (3j) "Group health plan" means any of the following:
AB100-ASA1,1806,95 (a) An employe welfare plan, as defined in section 3 (1) of the federal Employee
6Retirement Security Act of 1974, to the extent that the employe welfare plan provides
7medical care, including items and services paid for as medical care, to employes or
8to their dependents, as defined under the terms of the employe welfare plan, directly
9or through insurance, reimbursement or otherwise.
AB100-ASA1,1806,1510 (b) Any program that would not otherwise be an employe welfare benefit plan
11and that is established or maintained by a partnership, to the extent that the
12program provides medical care, including items and services paid for as medical care,
13to present or former partners of the partnership or to their dependents, as defined
14under the terms of the program, directly or through insurance, reimbursement or
15otherwise.
AB100-ASA1, s. 4818jm 16Section 4818jm. 619.10 (3j) of the statutes, as created by 1997 Wisconsin Act
17.... (this act), is renumbered 149.10 (3j).
AB100-ASA1, s. 3406 18Section 3406. 619.10 (3m) and (4) of the statutes are renumbered 149.10 (3m)
19and (4).
AB100-ASA1, s. 3407 20Section 3407. 619.10 (4m) of the statutes is renumbered 149.10 (4m).
AB100-ASA1, s. 3408 21Section 3408. 619.10 (5) of the statutes is renumbered 149.10 (5) and amended
22to read:
AB100-ASA1,1807,923 149.10 (5) "Insurer" means any person or association of persons, including a
24health maintenance organization, limited service health organization or preferred
25provider plan offering or insuring health services on a prepaid basis, including, but

1not limited to, policies of health insurance issued by a currently licensed insurer, as
2defined in s. 600.03 (27),
nonprofit hospital or medical service plans under ch. 613,
3cooperative medical service plans under s. 185.981, or other entity whose primary
4function is to provide diagnostic, therapeutic or preventive services to a defined
5population in return for a premium paid on a periodic basis. "Insurer" includes any
6person providing health services coverage for individuals on a self-insurance basis
7without the intervention of other entities, as well as any person providing health
8insurance coverage under a medical reimbursement plan to persons. "Insurer" does
9not include a plan under ch. 613 which offers only dental care.
AB100-ASA1, s. 3409 10Section 3409. 619.10 (6) and (7) of the statutes are renumbered 149.10 (6) and
11(7).
AB100-ASA1, s. 3410 12Section 3410. 619.10 (8) of the statutes is renumbered 149.10 (8) and amended
13to read:
AB100-ASA1,1807,1514 149.10 (8) "Plan" means the health care insurance plan established and
15administered
under this subchapter chapter.
AB100-ASA1, s. 3411 16Section 3411. 619.10 (9) of the statutes is renumbered 149.10 (9) and amended
17to read:
AB100-ASA1,1808,318 149.10 (9) "Resident" means a person who has been legally domiciled in this
19state for a period of at least 30 days or, with respect to an eligible individual, an
20individual who resides in this state
. For purposes of this subchapter chapter, legal
21domicile is established by living in this state and obtaining a Wisconsin motor vehicle
22operator's license, registering to vote in Wisconsin or filing a Wisconsin income tax
23return. A child is legally domiciled in this state if the child lives in this state and if
24at least one of the child's parents or the child's guardian is legally domiciled in this
25state. A person with a developmental disability or another disability which prevents

1the person from obtaining a Wisconsin motor vehicle operator's license, registering
2to vote in Wisconsin, or filing a Wisconsin income tax return, is legally domiciled in
3this state by living in this state for 30 days.
AB100-ASA1, s. 3412 4Section 3412. 619.11 of the statutes is renumbered 149.11 and amended to
5read:
AB100-ASA1,1808,9 6149.11 (title) Establishment Operation of plan. The commissioner
7department shall promulgate rules establishing for the operation of a plan of health
8insurance coverage for an eligible person which satisfies the requirements of this
9chapter.
AB100-ASA1, s. 4825c 10Section 4825c. 619.115 of the statutes is created to read:
AB100-ASA1,1808,15 11619.115 Rules relating to creditable coverage. The commissioner shall
12promulgate rules that specify how creditable coverage is to be aggregated for
13purposes of s. 619.10 (2t) (a) and that determine the creditable coverage to which s.
14619.10 (2t) (b) and (d) applies. The rules shall comply with section 2701 (c) of P.L.
15104-191.
AB100-ASA1, s. 4825f 16Section 4825f. 619.115 of the statutes, as created by 1997 Wisconsin Act ....
17(this act), is renumbered 149.115 and amended to read:
AB100-ASA1,1808,22 18149.115 Rules relating to creditable coverage. The commissioner, in
19consultation with the department,
shall promulgate rules that specify how
20creditable coverage is to be aggregated for purposes of s. 619.10 149.10 (2t) (a) and
21that determine the creditable coverage to which s. 619.10 149.10 (2t) (b) and (d)
22applies. The rules shall comply with section 2701 (c) of P.L. 104-191.
AB100-ASA1, s. 3413 23Section 3413. 619.12 (title) of the statutes is renumbered 149.12 (title).
AB100-ASA1, s. 3414 24Section 3414. 619.12 (1) of the statutes is renumbered 149.12 (1), and 149.12
25(1) (intro.), as renumbered, is amended to read:
AB100-ASA1,1809,8
1149.12 (1) (intro.) Except as provided in subs. (1m) and (2), the board or
2administering carrier plan administrator shall certify as eligible a person who is
3covered by medicare because he or she is disabled under 42 USC 423, a person who
4submits evidence that he or she has tested positive for the presence of HIV, antigen
5or nonantigenic products of HIV or an antibody to HIV, a person who is an eligible
6individual,
and any person who receives and submits any of the following based
7wholly or partially on medical underwriting considerations within 9 months prior to
8making application for coverage by the plan:
AB100-ASA1, s. 3415 9Section 3415. 619.12 (1m) (intro) and (a) of the statutes are consolidated,
10renumbered 149.12 (1m) and amended to read:
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