Amendment AA19-ASA1-SB55

SB55-ASA1-AA19, s. 3761c Section 3761c. 632.89 (1) (em) of the statutes is repealed.

SB55-ASA1-AA19, s. 3761d Section 3761d. 632.89 (1) (er) of the statutes is created to read:

SB55-ASA1-AA19,5,16 632.89 (1) (er) "Self-insured health plan" has the meaning given in s. 632.745 (24).

SB55-ASA1-AA19, s. 3761e Section 3761e. 632.89 (2) (title) of the statutes is amended to read:

SB55-ASA1-AA19,5,18 632.89 (2) (title) Required coverage for group plans.

SB55-ASA1-AA19, s. 3761f Section 3761f. 632.89 (2) (a) 1. of the statutes is renumbered 632.89 (2) (a) and amended to read:

SB55-ASA1-AA19,6,2 632.89 (2) (a) Conditions covered. A group or blanket disability insurance policy issued by an insurer health benefit plan and a self-insured health plan shall provide coverage of nervous and mental disorders and alcoholism and other drug abuse problems if required by pars. (c) to (dm) and as provided in pars. (b) (c) to (e) (dm) and sub. (3).

SB55-ASA1-AA19, s. 3761fm Section 3761fm. 632.89 (2) (a) 2. of the statutes is repealed.

SB55-ASA1-AA19, s. 3761g Section 3761g. 632.89 (2) (b) of the statutes is repealed.

SB55-ASA1-AA19, s. 3761gm Section 3761gm. 632.89 (2) (c) 1. of the statutes is renumbered 632.89 (2) (c) and amended to read:

SB55-ASA1-AA19,6,11 632.89 (2) (c) Minimum coverage Coverage of inpatient hospital services. If a group or blanket disability insurance policy issued by an insurer health benefit plan or a self-insured health plan provides coverage of any inpatient hospital treatment, the policy plan shall provide coverage for inpatient hospital services for the treatment of conditions under par. (a) 1. as provided in subd. 2.

SB55-ASA1-AA19, s. 3761h Section 3761h. 632.89 (2) (c) 2. of the statutes is repealed.

SB55-ASA1-AA19, s. 3761hm Section 3761hm. 632.89 (2) (d) 1. of the statutes is renumbered 632.89 (2) (d) and amended to read:

SB55-ASA1-AA19,6,19 632.89 (2) (d) Minimum coverage Coverage of outpatient services. If a group or blanket disability insurance policy issued by an insurer health benefit plan or a self-insured health plan provides coverage of any outpatient treatment, the policy plan shall provide coverage for outpatient services for the treatment of conditions under par. (a) 1. as provided in subd. 2.

SB55-ASA1-AA19, s. 3761i Section 3761i. 632.89 (2) (d) 2. of the statutes is repealed.

SB55-ASA1-AA19, s. 3761im Section 3761im. 632.89 (2) (dm) 1. of the statutes is renumbered 632.89 (2) (dm) and amended to read:

SB55-ASA1-AA19,7,3 632.89 (2) (dm) Minimum coverage Coverage of transitional treatment arrangements. If a group or blanket disability insurance policy issued by an insurer health benefit plan or a self-insured health plan provides coverage of any inpatient hospital treatment or any outpatient treatment, the policy plan shall provide coverage for transitional treatment arrangements for the treatment of conditions under par. (a) 1. as provided in subd. 2.

SB55-ASA1-AA19, s. 3761j Section 3761j. 632.89 (2) (dm) 2. of the statutes is repealed.

SB55-ASA1-AA19, s. 3761jm Section 3761jm. 632.89 (2) (e) of the statutes is renumbered 632.89 (5) (b) and amended to read:

SB55-ASA1-AA19,7,10 632.89 (5) (b) Exclusion Certain health care plans. This subsection section does not apply to a health care plan offered by a limited service health organization, as defined in s. 609.01 (3), or by a preferred provider plan, as defined in s. 609.01 (4), that is not a managed care plan, as defined in s. 609.01 (3c).

SB55-ASA1-AA19, s. 3761k Section 3761k. 632.89 (2m) of the statutes is renumbered 632.89 (4m).

SB55-ASA1-AA19, s. 3761km Section 3761km. 632.89 (3) of the statutes is created to read:

SB55-ASA1-AA19,7,17 632.89 (3) Equal coverage requirement. (a) Group plans. A group health benefit plan or a self-insured health plan that provides coverage for the treatment of nervous and mental disorders and alcoholism and other drug abuse problems shall provide the same coverage for that treatment that it provides for the treatment of physical conditions.

SB55-ASA1-AA19,7,21 (b) Individual plans. If an individual health benefit plan provides coverage for the treatment of nervous or mental disorders or alcoholism or other drug abuse problems, the individual health benefit plan shall provide the same coverage for that treatment that it provides for the treatment of physical conditions.

SB55-ASA1-AA19,8,2 (c) All coverage components. The requirements under this subsection apply to all coverage-related components, including rates; exclusions and limitations; deductibles; copayments; coinsurance; annual and lifetime payment limits; out-of-pocket limits; out-of-network charges; day, visit, or appointment limits; duration or frequency of coverage; and medical necessity definitions.

SB55-ASA1-AA19, s. 3761L Section 3761L. 632.89 (3m) of the statutes is repealed.

SB55-ASA1-AA19, s. 3761Lm Section 3761Lm. 632.89 (5) (title) of the statutes is amended to read:

SB55-ASA1-AA19,8,5 632.89 (5) (title) Medicare exclusion Exclusions.

SB55-ASA1-AA19, s. 3761m Section 3761m. 632.89 (5) of the statutes is renumbered 632.89 (5) (a).

SB55-ASA1-AA19, s. 3761mm Section 3761mm. 632.89 (5) (a) (title) of the statutes is created to read:

SB55-ASA1-AA19,8,8 632.89 (5) (a) (title) Medicare.".

SB55-ASA1-AA19,8,9 11. Page 1399, line 25: after that line insert:

SB55-ASA1-AA19,8,17 "(1mg) Health insurance coverage of mental disorders. The treatment of sections 40.51 (8) and (8m), 46.10 (8) (d) and (14) (a), 66.0137 (4), 111.91 (2) (qm), 120.13 (2) (g), 185.981 (4t), 185.983 (1) (intro.), 301.12 (8) (d) and (14) (a), 609.86, and 632.89 (title), (1) (b), (em), and (er), (2) (title), (a) 1. and 2., (b), (c) 1. and 2., (d) 1. and 2., (dm) 1. and 2., and (e), (2m), (3), and (3m) of the statutes, the renumbering of section 632.89 (5) of the statutes, the amendment of section 632.89 (5) (title) of the statutes, and the creation of section 632.89 (5) (a) (title) of the statutes first apply to all of the following:

SB55-ASA1-AA19,8,20 (a) Except as provided in paragraphs (b) and (c), health benefit plans that are issued or renewed, and self-insured health plans that are established, extended, modified, or renewed, on the effective date of this paragraph.

SB55-ASA1-AA19,8,23 (b) Health benefit plans covering employees who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are issued or renewed on the earlier of the following:

SB55-ASA1-AA19,8,24 1. The day on which the collective bargaining agreement expires.

SB55-ASA1-AA19,9,2 2. The day on which the collective bargaining agreement is extended, modified, or renewed.

SB55-ASA1-AA19,9,5 (c) Self-insured health plans covering employees who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are established, extended, modified, or renewed on the earlier of the following:

SB55-ASA1-AA19,9,6 1. The day on which the collective bargaining agreement expires.

SB55-ASA1-AA19,9,8 2. The day on which the collective bargaining agreement is extended, modified, or renewed.".

SB55-ASA1-AA19,9,9 12. Page 1421, line 4: after that line insert:

SB55-ASA1-AA19,9,18 "(1mg) Health insurance coverage of mental disorders. The treatment of sections 40.51 (8) and (8m), 46.10 (8) (d) and (14) (a), 66.0137 (4), 111.91 (2) (qm), 120.13 (2) (g), 185.981 (4t), 185.983 (1) (intro.), 301.12 (8) (d) and (14) (a), 609.86, and 632.89 (title), (1) (b), (em), and (er), (2) (title), (a) 1. and 2., (b), (c) 1. and 2., (d) 1. and 2., (dm) 1. and 2., and (e), (2m), (3), and (3m) of the statutes, the renumbering of section 632.89 (5) of the statutes, the amendment of section 632.89 (5) (title) of the statutes, the creation of section 632.89 (5) (a) (title) of the statutes, and Section 9327 (1mg) of this act take effect on the first day of the 6th month beginning after the effective date of this subsection.".

SB55-ASA1-AA19,9,19 (End)