Amendment SA2-AB768

LRBb3265/1

RAC&PJK:kmg&ksh:km

1997 - 1998 LEGISLATURE

SENATE AMENDMENT 2, TO 1997 ASSEMBLY BILL 768

May 7, 1998 - Offered by Senators Moen, Decker, Jauch, Shibilski, Wirch, Grobschmidt, Clausing, C. Potter, Moore, Risser, Plache, Chvala and Burke.

AB768-SA2,1,2 At the locations indicated, amend the bill, as shown by assembly substitute amendment 1, as follows:

AB768-SA2,1,5 1. Page 15, line 17: after "exclusion;" insert "requiring the department of employe trust funds to establish a health care coverage plan for employers in the private sector; creating a private employer health care coverage board;".

AB768-SA2,1,6 2. Page 21, line 8: after that line insert:

AB768-SA2,1,7 " Section 4ic. 13.94 (1) (p) of the statutes is created to read:

AB768-SA2,1,11 13.94 (1) (p) No later than January 1, 2004, prepare a program evaluation audit of the private employer health care coverage plan established under subch. X of ch. 40. The legislative audit bureau shall file a copy of the audit report under this paragraph with the distributees specified in par. (b).

AB768-SA2, s. 4id Section 4id. 13.94 (1) (p) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.".

AB768-SA2,2,1 3. Page 23, line 9: after that line insert:

AB768-SA2,2,2 " Section 4qc. 15.07 (1) (b) 22. of the statutes is created to read:

AB768-SA2,2,3 15.07 (1) (b) 22. Private employer health care coverage board.

AB768-SA2, s. 4qd Section 4qd. 15.07 (1) (b) 22. of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.".

AB768-SA2,2,6 4. Page 23, line 17: after that line insert:

AB768-SA2,2,7 " Section 4rc. 15.165 (5) of the statutes is created to read:

AB768-SA2,2,12 15.165 (5) Private employer health care coverage board. (a) There is created in the department of employe trust funds a private employer health care coverage board consisting of the secretary of employe trust funds or his or her designee, the secretary of health and family services or his or her designee and the following members appointed for 3-year terms:

AB768-SA2,2,13 1. One member who represents health maintenance organizations.

AB768-SA2,2,14 2. One member who represents hospitals.

AB768-SA2,2,15 3. One member who represents insurance agents, as defined in s. 628.02 (4).

AB768-SA2,2,17 4. Two members who are employes eligible to receive health care coverage under subch. X of ch. 40 and whose employer employs not more than 50 employes.

AB768-SA2,2,18 5. One member who represents insurers.

AB768-SA2,2,21 6. Two members who are, or who represent, employers that employ not more than 50 employes and who are eligible to offer health care coverage under subch. X of ch. 40.

AB768-SA2,2,22 7. One member who is a physician, as defined in s. 448.01 (5).

AB768-SA2,2,23 8. Two members who represent the public interest.

AB768-SA2,3,2 (b) The secretary of employe trust funds or his or her designee and the secretary of health and family services or his or her designee shall be nonvoting members.

AB768-SA2, s. 4rd Section 4rd. 15.165 (5) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.".

AB768-SA2,3,5 5. Page 28, line 17: after that line insert: - See PDF for table

AB768-SA2,3,6 6. Page 45, line 8: after that line insert:

AB768-SA2,3,7 " Section 48p. 20.515 (2) (title) of the statutes is created to read:

AB768-SA2,3,8 20.515 (2) (title) Private employer health care coverage plan.

AB768-SA2, s. 48pc Section 48pc. 20.515 (2) (title) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

AB768-SA2, s. 48pd Section 48pd. 20.515 (2) (a) of the statutes is created to read:

AB768-SA2,3,15 20.515 (2) (a) Private employer health care coverage plan; start-up costs. The amounts in the schedule for the start-up costs for designing, establishing and administering the private employer health care coverage plan under subch. X of ch. 40.

AB768-SA2, s. 48pe Section 48pe. 20.515 (2) (a) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.

AB768-SA2, s. 48pf Section 48pf. 20.515 (2) (g) of the statutes is created to read:

AB768-SA2,4,2 20.515 (2) (g) Private employer health care coverage plan. All moneys received under subch. X of ch. 40 from employers who elect to participate in the private employer health care coverage plan under subch. X of ch. 40, for the costs of designing, establishing and administering the plan.

AB768-SA2, s. 48pg Section 48pg. 20.515 (2) (g) of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed.".

AB768-SA2,4,5 7. Page 84, line 10: after that line insert:

AB768-SA2,4,6 " Section 83xc. 40.02 (26) (intro.) of the statutes is amended to read:

AB768-SA2,4,14 40.02 (26) (intro.) "Employe" means any person who receives earnings as payment for personal services rendered for the benefit of any employer including officers of the employer, except as provided in subch. X. An employe is deemed to have separated from the service of an employer at the end of the day on which the employe last performed services for the employer, or, if later, the day on which the employe-employer relationship is terminated because of the expiration or termination of leave without pay, sick leave, vacation or other leave of absence. A person shall not be considered an employe if a person:

AB768-SA2, s. 83xcm Section 83xcm. 40.02 (26) (intro.) of the statutes, as affected by 1997 Wisconsin Act .... (this act), is amended to read:

AB768-SA2,4,24 40.02 (26) (intro.) "Employe" means any person who receives earnings as payment for personal services rendered for the benefit of any employer including officers of the employer, except as provided in subch. X. An employe is deemed to have separated from the service of an employer at the end of the day on which the employe last performed services for the employer, or, if later, the day on which the employe-employer relationship is terminated because of the expiration or termination of leave without pay, sick leave, vacation or other leave of absence. A person shall not be considered an employe if a person:

AB768-SA2, s. 83xd Section 83xd. 40.02 (28) of the statutes is amended to read:

AB768-SA2,5,10 40.02 (28) "Employer" means the state, including each state agency, any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government now existing or hereafter created within the state and, any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more and a local exposition district created under subch. II of ch. 229, except as provided under ss. 40.51 (7) and 40.61 (3), or a local exposition district created under subch. II of ch. 229 and subch. X. Each employer shall be a separate legal jurisdiction for OASDHI purposes.

AB768-SA2,5,12 " Section 83xdm. 40.02 (28) of the statutes, as affected by 1997 Wisconsin Act .... (this act), is amended to read:

AB768-SA2,5,20 40.02 (28) "Employer" means the state, including each state agency, any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government now existing or hereafter created within the state, any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more and a local exposition district created under subch. II of ch. 229, except as provided under ss. 40.51 (7) and 40.61 (3) and subch. X. Each employer shall be a separate legal jurisdiction for OASDHI purposes.".

AB768-SA2,5,21 8. Page 84, line 11: delete "82zx" and substitute "83xem".

AB768-SA2,5,22 9. Page 88, line 13: after that line insert:

AB768-SA2,5,24 " Section 90bv. Subchapter X of chapter 40 [precedes 40.98] of the statutes is created to read:

AB768-SA2,6,1 Chapter 40

AB768-SA2,6,4 Subchapter X Private employer health Care coverage

AB768-SA2,6,5 40.98 Health care coverage. (1) In this subchapter:

AB768-SA2,6,6 (a) "Board" means the private employer health care coverage board.

AB768-SA2,6,10 (b) "Dependent" means a spouse, an unmarried child under the age of 19 years, an unmarried child who is a full-time student under the age of 21 years and who is financially dependent upon the parent, or an unmarried child of any age who is medically certified as disabled and who is dependent upon the parent.

AB768-SA2,6,18 (c) "Employe" means any person who receives earnings as payment for personal services rendered for the benefit of any employer including officers of the employer. An employe is considered to have separated from the service of an employer at the end of the day on which the employe last performed services for the employer, or, if later, the day on which the employe-employer relationship is terminated because of the expiration or termination of leave without pay, sick leave, vacation or other leave of absence. A person shall not be considered an employe if any of the following applies:

AB768-SA2,6,20 1. The person is employed under a contract involving the furnishing of more than personal services.

AB768-SA2,6,24 2. The person is customarily engaged in an independently established trade, business or profession providing the same type of services to more than one employer and the person's services to an employer are not compensated for on a payroll of that employer.

AB768-SA2,7,2 3. The person is a patient or inmate of a hospital, home or institution and performs services in the hospital, home or institution.

AB768-SA2,7,5 (d) "Employer" means any person who is doing business or operating an organization in this state and who employs at least 2 employes, but who is not an employer, as defined in s. 40.02 (28).

AB768-SA2,7,7 (e) "Health care coverage plan" means the health care coverage plan established under sub. (2) (a).

AB768-SA2,7,8 (f) "Insurer" has the meaning given in s. 600.03 (27).

AB768-SA2,7,20 (2) (a) The department shall design, establish and administer an actuarially sound health care coverage plan for employers that provides coverage beginning not later than January 1, 2000. In designing the health care coverage plan, the department shall consult with the departments of commerce and health and family services and the office of the commissioner of insurance. In establishing the health care coverage plan, the department shall solicit and accept bids and enter into contracts with insurers who are to provide health care coverage under the health care coverage plan. The health care coverage plan is subject to the provisions of chs. 600 to 646 that apply to group health benefit plans, as defined in s. 632.745 (9), to the same extent as any other group health benefit plan, as defined in s. 632.745 (9). Before the health care coverage plan may be implemented, the board must approve the plan.

AB768-SA2,7,22 (am) The health care coverage plan established under par. (a) may not be combined with any health care coverage plan under subch. IV.

AB768-SA2,8,2 (b) The health care coverage plan shall require that all insurance rates under the plan be published annually in a single publication that is made available to employers and employes. The rates shall be listed by county and by any other factor that the department considers appropriate.

AB768-SA2,8,4 (c) The health care coverage plan shall have an enrollment period that is established by the board.

AB768-SA2,8,8 (d) The department shall charge employers who participate in the health care coverage plan a fee to cover the department's cost in designing, establishing and administering the health care coverage plan. All moneys received under this paragraph shall be credited to the appropriation account under s. 20.515 (2) (g).

AB768-SA2,8,11 (e) The department may not sell any health care coverage plan to an employer or enroll any employe in the health care coverage plan, but the department may publicize the availability of the health care coverage plan for employers.

AB768-SA2,8,13 (f) The department may enter into a contract with any person to provide services relating to the administration of the health care coverage plan.

AB768-SA2,8,15 (3) Any employer who participates in the health care coverage plan shall do all of the following:

AB768-SA2,8,18 (a) Offer health care coverage under the plan to all of its permanent employes who have a normal work week of 30 or more hours and may offer health care coverage under the plan to any of its other employes.

AB768-SA2,8,22 (b) Provide health care coverage under the plan to at least 50% of its permanent employes who have a normal work week of 30 or more hours and who do not otherwise receive health care coverage as a dependent under any other plan that is not offered by the employer.

AB768-SA2,8,25 (c) Pay for each employe at least 50% but not more than 100% of the lowest premium rate that would be available to the employer for that employe's coverage under the health care coverage plan.

AB768-SA2,9,2 (d) Make premium payments for the health care coverage of its employes in the manner specified by the board.

AB768-SA2,9,5 (4) Any employer that provides health care coverage for its employes under the plan and that voluntarily terminates coverage under the plan is not eligible to participate in the plan for at least 3 years from the date that coverage is terminated.

AB768-SA2,9,10 (5) Any insurer that offers the health care coverage plan shall provide coverage under the plan to any employer that applies for coverage, and to all of the employer's employes who elect coverage under the health care coverage plan, without regard to the health condition or claims experience of any individual who would be covered under the health care coverage plan if all of the following apply: