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-SA2,1,21
At the locations indicated, amend the
bill, as shown by assembly substitute
2amendment 1, as follows:
AB768-SA2,1,5
31. Page 15, line 17: after "exclusion;" insert "requiring the department of
4employe trust funds to establish a health care coverage plan for employers in the
5private sector; creating a private employer health care coverage board;".
AB768-SA2,1,7
7"
Section 4ic. 13.94 (1) (p) of the statutes is created to read:
AB768-SA2,1,118
13.94
(1) (p) No later than January 1, 2004, prepare a program evaluation audit
9of the private employer health care coverage plan established under subch. X of ch.
1040. The legislative audit bureau shall file a copy of the audit report under this
11paragraph with the distributees specified in par. (b).
AB768-SA2, s. 4id
12Section 4id. 13.94 (1) (p) of the statutes, as created by 1997 Wisconsin Act ....
13(this act), is repealed.".
AB768-SA2,2,2
2"
Section 4qc. 15.07 (1) (b) 22. of the statutes is created to read:
AB768-SA2,2,33
15.07
(1) (b) 22. Private employer health care coverage board.
AB768-SA2, s. 4qd
4Section 4qd. 15.07 (1) (b) 22. of the statutes, as created by 1997 Wisconsin Act
5.... (this act), is repealed.".
AB768-SA2,2,7
7"
Section 4rc. 15.165 (5) of the statutes is created to read:
AB768-SA2,2,128
15.165
(5) Private employer health care coverage board. (a) There is created
9in the department of employe trust funds a private employer health care coverage
10board consisting of the secretary of employe trust funds or his or her designee, the
11secretary of health and family services or his or her designee and the following
12members appointed for 3-year terms:
AB768-SA2,2,1313
1. One member who represents health maintenance organizations.
AB768-SA2,2,1414
2. One member who represents hospitals.
AB768-SA2,2,1515
3. One member who represents insurance agents, as defined in s. 628.02 (4).
AB768-SA2,2,1716
4. Two members who are employes eligible to receive health care coverage
17under subch. X of ch. 40 and whose employer employs not more than 50 employes.
AB768-SA2,2,1818
5. One member who represents insurers.
AB768-SA2,2,2119
6. Two members who are, or who represent, employers that employ not more
20than 50 employes and who are eligible to offer health care coverage under subch. X
21of ch. 40.
AB768-SA2,2,2222
7. One member who is a physician, as defined in s. 448.01 (5).
AB768-SA2,2,2323
8. Two members who represent the public interest.
AB768-SA2,3,2
1(b) The secretary of employe trust funds or his or her designee and the secretary
2of health and family services or his or her designee shall be nonvoting members.
AB768-SA2, s. 4rd
3Section 4rd. 15.165 (5) of the statutes, as created by 1997 Wisconsin Act ....
4(this act), is repealed.".
AB768-SA2,3,7
7"
Section 48p. 20.515 (2) (title) of the statutes is created to read:
AB768-SA2,3,88
20.515
(2) (title)
Private employer health care coverage plan.
AB768-SA2, s. 48pc
9Section 48pc. 20.515 (2) (title) of the statutes, as created by 1997 Wisconsin
10Act .... (this act), is repealed.
AB768-SA2,3,1512
20.515
(2) (a)
Private employer health care coverage plan; start-up costs. The
13amounts in the schedule for the start-up costs for designing, establishing and
14administering the private employer health care coverage plan under subch. X of ch.
1540.
AB768-SA2, s. 48pe
16Section 48pe. 20.515 (2) (a) of the statutes, as created by 1997 Wisconsin Act
17.... (this act), is repealed.
AB768-SA2,4,219
20.515
(2) (g)
Private employer health care coverage plan. All moneys received
20under subch. X of ch. 40 from employers who elect to participate in the private
1employer health care coverage plan under subch. X of ch. 40, for the costs of
2designing, establishing and administering the plan.
AB768-SA2, s. 48pg
3Section 48pg. 20.515 (2) (g) of the statutes, as created by 1997 Wisconsin Act
4.... (this act), is repealed.".
AB768-SA2,4,6
6"
Section 83xc. 40.02 (26) (intro.) of the statutes is amended to read:
AB768-SA2,4,147
40.02
(26) (intro.) "Employe" means any person who receives earnings as
8payment for personal services rendered for the benefit of any employer including
9officers of the employer
, except as provided in subch. X. An employe is deemed to
10have separated from the service of an employer at the end of the day on which the
11employe last performed services for the employer, or, if later, the day on which the
12employe-employer relationship is terminated because of the expiration or
13termination of leave without pay, sick leave, vacation or other leave of absence. A
14person shall not be considered an employe if a person:
AB768-SA2, s. 83xcm
15Section 83xcm. 40.02 (26) (intro.) of the statutes, as affected by 1997
16Wisconsin Act .... (this act), is amended to read:
AB768-SA2,4,2417
40.02
(26) (intro.) "Employe" means any person who receives earnings as
18payment for personal services rendered for the benefit of any employer including
19officers of the employer
, except as provided in subch. X. An employe is deemed to
20have separated from the service of an employer at the end of the day on which the
21employe last performed services for the employer, or, if later, the day on which the
22employe-employer relationship is terminated because of the expiration or
23termination of leave without pay, sick leave, vacation or other leave of absence. A
24person shall not be considered an employe if a person:
AB768-SA2,5,102
40.02
(28) "Employer" means the state, including each state agency, any
3county, city, village, town, school district, other governmental unit or
4instrumentality of 2 or more units of government now existing or hereafter created
5within the state
and, any federated public library system established under s. 43.19
6whose territory lies within a single county with a population of 500,000 or more
and
7a local exposition district created under subch. II of ch. 229, except as provided under
8ss. 40.51 (7) and 40.61 (3)
, or a local exposition district created under subch. II of ch.
9229 and subch. X. Each employer shall be a separate legal jurisdiction for OASDHI
10purposes.
AB768-SA2,5,12
11"
Section 83xdm. 40.02 (28) of the statutes, as affected by 1997 Wisconsin Act
12.... (this act), is amended to read:
AB768-SA2,5,2013
40.02
(28) "Employer" means the state, including each state agency, any
14county, city, village, town, school district, other governmental unit or
15instrumentality of 2 or more units of government now existing or hereafter created
16within the state, any federated public library system established under s. 43.19
17whose territory lies within a single county with a population of 500,000 or more and
18a local exposition district created under subch. II of ch. 229, except as provided under
19ss. 40.51 (7) and 40.61 (3)
and subch. X. Each employer shall be a separate legal
20jurisdiction for OASDHI purposes.".
AB768-SA2,5,24
23"
Section 90bv. Subchapter X of chapter 40 [precedes 40.98] of the statutes is
24created to read:
AB768-SA2,6,42
Subchapter X
3
Private employer health
4
Care coverage
AB768-SA2,6,5
540.98 Health care coverage. (1) In this subchapter:
AB768-SA2,6,66
(a) "Board" means the private employer health care coverage board.
AB768-SA2,6,107
(b) "Dependent" means a spouse, an unmarried child under the age of 19 years,
8an unmarried child who is a full-time student under the age of 21 years and who is
9financially dependent upon the parent, or an unmarried child of any age who is
10medically certified as disabled and who is dependent upon the parent.
AB768-SA2,6,1811
(c) "Employe" means any person who receives earnings as payment for personal
12services rendered for the benefit of any employer including officers of the employer.
13An employe is considered to have separated from the service of an employer at the
14end of the day on which the employe last performed services for the employer, or, if
15later, the day on which the employe-employer relationship is terminated because of
16the expiration or termination of leave without pay, sick leave, vacation or other leave
17of absence. A person shall not be considered an employe if any of the following
18applies:
AB768-SA2,6,2019
1. The person is employed under a contract involving the furnishing of more
20than personal services.
AB768-SA2,6,2421
2. The person is customarily engaged in an independently established trade,
22business or profession providing the same type of services to more than one employer
23and the person's services to an employer are not compensated for on a payroll of that
24employer.
AB768-SA2,7,2
13. The person is a patient or inmate of a hospital, home or institution and
2performs services in the hospital, home or institution.
AB768-SA2,7,53
(d) "Employer" means any person who is doing business or operating an
4organization in this state and who employs at least 2 employes, but who is not an
5employer, as defined in s. 40.02 (28).
AB768-SA2,7,76
(e) "Health care coverage plan" means the health care coverage plan
7established under sub. (2) (a).
AB768-SA2,7,88
(f) "Insurer" has the meaning given in s. 600.03 (27).
AB768-SA2,7,20
9(2) (a) The department shall design, establish and administer an actuarially
10sound health care coverage plan for employers that provides coverage beginning not
11later than January 1, 2000. In designing the health care coverage plan, the
12department shall consult with the departments of commerce and health and family
13services and the office of the commissioner of insurance. In establishing the health
14care coverage plan, the department shall solicit and accept bids and enter into
15contracts with insurers who are to provide health care coverage under the health
16care coverage plan. The health care coverage plan is subject to the provisions of chs.
17600 to 646 that apply to group health benefit plans, as defined in s. 632.745 (9), to
18the same extent as any other group health benefit plan, as defined in s. 632.745 (9).
19Before the health care coverage plan may be implemented, the board must approve
20the plan.
AB768-SA2,7,2221
(am) The health care coverage plan established under par. (a) may not be
22combined with any health care coverage plan under subch. IV.
AB768-SA2,8,223
(b) The health care coverage plan shall require that all insurance rates under
24the plan be published annually in a single publication that is made available to
1employers and employes. The rates shall be listed by county and by any other factor
2that the department considers appropriate.
AB768-SA2,8,43
(c) The health care coverage plan shall have an enrollment period that is
4established by the board.
AB768-SA2,8,85
(d) The department shall charge employers who participate in the health care
6coverage plan a fee to cover the department's cost in designing, establishing and
7administering the health care coverage plan. All moneys received under this
8paragraph shall be credited to the appropriation account under s. 20.515 (2) (g).
AB768-SA2,8,119
(e) The department may not sell any health care coverage plan to an employer
10or enroll any employe in the health care coverage plan, but the department may
11publicize the availability of the health care coverage plan for employers.
AB768-SA2,8,1312
(f) The department may enter into a contract with any person to provide
13services relating to the administration of the health care coverage plan.
AB768-SA2,8,15
14(3) Any employer who participates in the health care coverage plan shall do all
15of the following:
AB768-SA2,8,1816
(a) Offer health care coverage under the plan to all of its permanent employes
17who have a normal work week of 30 or more hours and may offer health care coverage
18under the plan to any of its other employes.
AB768-SA2,8,2219
(b) Provide health care coverage under the plan to at least 50% of its permanent
20employes who have a normal work week of 30 or more hours and who do not otherwise
21receive health care coverage as a dependent under any other plan that is not offered
22by the employer.
AB768-SA2,8,2523
(c) Pay for each employe at least 50% but not more than 100% of the lowest
24premium rate that would be available to the employer for that employe's coverage
25under the health care coverage plan.
AB768-SA2,9,2
1(d) Make premium payments for the health care coverage of its employes in the
2manner specified by the board.
AB768-SA2,9,5
3(4) Any employer that provides health care coverage for its employes under the
4plan and that voluntarily terminates coverage under the plan is not eligible to
5participate in the plan for at least 3 years from the date that coverage is terminated.
AB768-SA2,9,10
6(5) Any insurer that offers the health care coverage plan shall provide coverage
7under the plan to any employer that applies for coverage, and to all of the employer's
8employes who elect coverage under the health care coverage plan, without regard to
9the health condition or claims experience of any individual who would be covered
10under the health care coverage plan if all of the following apply: