Amendment ASA1-AB456

AB456-ASA1,6,5 1. Refuse to name as a beneficiary under such a policy or certificate a person who is, or who the insurer has reason to believe is, a perpetrator of abuse or domestic abuse against the insured under the policy.

AB456-ASA1,6,8 2. Refuse to issue such a policy or certificate to a person who is, or who the insurer has reason to believe is, a perpetrator of abuse or domestic abuse against the person who is to be the insured under the policy.

AB456-ASA1,6,10 3. Refuse to issue such a policy or certificate to a person who lacks an insurable interest in the person who is to be the insured under the policy.

AB456-ASA1,6,17 4. For purposes of underwriting, establishing premiums for or administering a claim under such a policy or certificate, inquire about or use information related to a person's existing medical condition, regardless of whether that condition is or may have been caused by abuse or domestic abuse. Any adverse underwriting decision based on a person's medical condition must be made in conformance with sound actuarial principles or otherwise supported by actual or reasonably anticipated experience.

AB456-ASA1,6,21 (2r) Immunity for life insurers. A life insurer is immune from any civil or criminal liability for any action taken under sub. (2m) (b) or for the death of, or injury to, an insured that results from abuse or domestic abuse not committed by the insurer.

AB456-ASA1,6,24 (3) Reason for denial in writing. An insurer that denies coverage under an individual or group insurance policy or a certificate of group insurance shall advise the applicant or proposed insured in writing of the reasons for the denial.

AB456-ASA1,7,3 (4) Use and disclosure of abuse information. (a) Except as provided in par. (c) and sub. (2m), no person employed by or contracting with an insurer may use, disclose or transfer information related to any of the following:

AB456-ASA1,7,9 1. Whether an insured or applicant for insurance or a member of the insured's or applicant's family, or whether an employe or other group member of an insured or applicant for insurance or a member of the employe's or other group member's family, has been a victim of abuse or domestic abuse or is believed, with reason, by the person employed by or contracting with the insurer to be a victim of abuse or domestic abuse.

AB456-ASA1,7,14 2. Any medical condition of an insured or applicant for insurance or a member of the insured's or applicant's family, or of an employe or other group member of an insured or applicant for insurance or a member of the employe's or other group member's family, that is, or that the person employed by or contracting with the insurer has reason to believe is, the result of abuse or domestic abuse.

AB456-ASA1,7,19 3. Whether an insured or applicant for insurance, or whether an employe or other group member of an insured or applicant for insurance, is a family member or associate of, or a person in a relationship with, a person who has been, or who the person employed by or contracting with the insurer has reason to believe is, a victim of abuse or domestic abuse.

AB456-ASA1,7,22 4. Whether an insured or an applicant for insurance is an employer of a person who has been, or who the person employed by or contracting with the insurer has reason to believe is, a victim of abuse or domestic abuse.

AB456-ASA1,8,2 (b) Except as provided in par. (c), a person employed by or contracting with an insurer may not disclose or transfer information related to the telephone number or address or other location of any of the following individuals, if the person knows that the individual has been, or has reason to believe that the individual is, a victim of abuse or domestic abuse:

AB456-ASA1,8,3 1. An insured.

AB456-ASA1,8,4 2. An applicant for insurance.

AB456-ASA1,8,5 3. An employe of an insured or of an applicant for insurance.

AB456-ASA1,8,6 4. A group member of an insured or of an applicant for insurance.

AB456-ASA1,8,7 5. A member of the family of any of the individuals listed in subds. 1. to 4.

AB456-ASA1,8,10 (c) Paragraphs (a) and (b) do not apply if the use, disclosure or transfer of the information is made with the consent of the individual to whom the information relates or if the use, disclosure or transfer satisfies any of the following:

AB456-ASA1,8,11 1. Is for a purpose related to the direct provision of health care services.

AB456-ASA1,8,13 2. Is necessary for a valid business purpose, including the disclosure or transfer of the information to any of the following:

AB456-ASA1,8,14 a. A reinsurer.

AB456-ASA1,8,16 b. A party to a proposed or consummated sale, transfer, merger or consolidation of all or part of the business of the insurer.

AB456-ASA1,8,18 c. Medical, underwriting or claims personnel under contract or affiliated with the insurer.

AB456-ASA1,8,19 d. An attorney representing the interests of the insurer.

AB456-ASA1,8,20 3. Is in response to legal process.

AB456-ASA1,8,22 4. Is required by a court order or an order of an entity with authority to regulate insurance, or is otherwise required by law.

AB456-ASA1,8,23 5. Is required or authorized by the commissioner by rule.

AB456-ASA1,9,2 (d) Nothing in this subsection shall be construed as limiting or precluding an insured or an applicant for insurance, or an employe or other group member of an insured or applicant for insurance, from obtaining his or her own insurance records from an insurer.

AB456-ASA1, s. 6 Section 6. Initial applicability.

AB456-ASA1,9,5 (1) This act first applies to policies or certificates issued, renewed or applied for on the effective date of this subsection.

AB456-ASA1,9,6 (End)