SB451-SSA1, s. 150 23Section 150. Subchapter III of chapter 149 [precedes 149.40] of the statutes
24is created to read:
SB451-SSA1,46,2525 CHapter 149
SB451-SSA1,47,3
1Subchapter III
2 Health Insurance Risk-Sharing
3 Plan Authority
SB451-SSA1,47,4 4149.40 Definitions. In this subchapter:
SB451-SSA1,47,5 5(1) "Authority" means the Health Insurance Risk-Sharing Plan Authority.
SB451-SSA1,47,6 6(2) "Board" means the board of directors of the authority.
SB451-SSA1,47,12 7149.41 Creation and organization of authority. (1) There is created a
8public body corporate and politic to be known as the "Health Insurance Risk-Sharing
9Plan Authority." The board of directors of the authority shall consist of the
10commissioner of insurance, or his or her designee, as a nonvoting member, and the
11following members, who shall be nominated by the governor, and with the advice and
12consent of the senate appointed, for 3-year terms:
SB451-SSA1,47,1313 (a) Four members who represent insurers participating in the plan.
SB451-SSA1,47,1814 (b) Four members who represent health care providers, including one
15representative of the Wisconsin Medical Society, one representative of the Wisconsin
16Hospital Association, Inc., one representative of the Pharmacy Society of Wisconsin,
17and one representative of health care providers that provide services to persons with
18coverage under the plan.
SB451-SSA1,47,2119 (c) Five other members, at least one of whom represents small businesses that
20purchase private health insurance and at least 2 of whom are persons with coverage
21under the plan.
SB451-SSA1,47,23 22(2) A vacancy on the board shall be filled in the same manner as the original
23appointment to the board for the remainder of the unexpired term, if any.
SB451-SSA1,48,3
1(3) A member of the board may not be compensated for his or her services but
2shall be reimbursed for actual and necessary expenses, including travel expenses,
3incurred in the performance of his or her duties.
SB451-SSA1,48,10 4(4) Annually, the governor shall appoint one member other than the
5commissioner as chairperson, and the members of the board may elect other officers
6as they consider appropriate. Seven voting members of the board constitute a
7quorum for the purpose of conducting the business and exercising the powers of the
8authority, notwithstanding the existence of any vacancy. The board may take action
9upon a vote of a majority of the members present, unless the bylaws of the authority
10require a larger number.
SB451-SSA1,48,22 11(5) The board may appoint an executive director who shall not be a member of
12the board and who shall serve at the pleasure of the board. The authority may
13delegate by resolution to one or more of its members or its executive director any
14powers and duties that it considers proper. The executive director shall receive such
15compensation as may be determined by the board. The executive director or other
16person designated by resolution of the board shall keep a record of the proceedings
17of the authority and shall be custodian of all books, documents, and papers filed with
18the authority, the minute book or journal of the authority, and its official seal. The
19executive director or other person may cause copies to be made of all minutes and
20other records and documents of the authority and may give certificates under the
21official seal of the authority to the effect that such copies are true copies, and all
22persons dealing with the authority may rely upon such certificates.
SB451-SSA1,48,24 23149.43 Duties of authority. In addition to all other duties imposed under this
24chapter, the authority shall do all of the following:
SB451-SSA1,48,25 25(1) Adopt policies for the administration of this chapter.
SB451-SSA1,49,3
1(2) Contract with the plan administrator under s. 149.16, 2003 stats., in the
2manner required under 2005 Wisconsin Act .... (this act), section 165 (1) (b) until the
3end of the contract term.
SB451-SSA1,49,5 4(3) Establish the authority's annual budget and monitor the fiscal
5management of the authority.
SB451-SSA1,49,7 6(4) Beginning on July 1, 2006, do, or contract with another person to do, all of
7the following:
SB451-SSA1,49,98 (a) Perform all eligibility and administrative claims payment functions
9relating to the plan.
SB451-SSA1,49,1210 (b) Establish a premium billing procedure for collection of premiums from
11insured persons. Billings shall be made on a periodic basis as determined by the
12authority.
SB451-SSA1,49,1413 (c) Perform all necessary functions to assure timely payment of benefits to
14covered persons under the plan, including:
SB451-SSA1,49,1715 1. Making available information relating to the proper manner of submitting
16a claim for benefits under the plan and distributing forms upon which submissions
17shall be made.
SB451-SSA1,49,1818 2. Evaluating the eligibility of each claim for payment under the plan.
SB451-SSA1,49,2019 3. Notifying each claimant within 30 days after receiving a properly completed
20and executed proof of loss whether the claim is accepted, rejected, or compromised.
SB451-SSA1,49,22 21(5) Seek to qualify or maintain the plan as a state pharmacy assistance
22program, as defined in 42 CFR 423.464.
SB451-SSA1,49,24 23(6) Annually submit a report to the legislature under s. 13.172 (2) and to the
24governor on the operation of the plan.
SB451-SSA1,50,4
1149.45 Powers of authority. (1) Except as restricted under sub. (2), the
2authority shall have all the powers necessary or convenient to carry out the purposes
3and provisions of this chapter. In addition to all other powers granted by this chapter,
4the authority may:
SB451-SSA1,50,65 (a) Adopt bylaws and policies and procedures for the regulation of its affairs
6and the conduct of its business.
SB451-SSA1,50,87 (b) Have a seal and alter the seal at pleasure; have perpetual existence; and
8maintain an office.
SB451-SSA1,50,99 (c) Hire employees, define their duties, and fix their rate of compensation.
SB451-SSA1,50,1010 (d) Incur debt, except as restricted under sub. (2).
SB451-SSA1,50,1211 (e) Contract for any professional services required for the authority, subject to
12ss. 149.43 (2) and 149.47.
SB451-SSA1,50,1613 (f) Appoint any technical or professional advisory committee that the authority
14finds necessary to assist the authority in exercising its duties and powers. The
15authority shall define the duties of the committee, and provide reimbursement for
16the expenses of the committee.
SB451-SSA1,50,1717 (g) Execute contracts and other instruments.
SB451-SSA1,50,1918 (h) Accept gifts, grants, loans, or other contributions from private or public
19sources.
SB451-SSA1,50,2020 (i) Procure liability insurance.
SB451-SSA1,50,21 21(2) The authority may not issue bonds.
SB451-SSA1,51,2 22149.47 Contracting for professional services. (1) Whenever contracting
23for professional services, the authority shall solicit competitive sealed bids or
24competitive sealed proposals, whichever is appropriate. Each request for

1competitive sealed proposals shall state the relative importance of price and other
2evaluation factors.
SB451-SSA1,51,10 3(2) (a) When the estimated cost exceeds $25,000, the authority may invite
4competitive sealed bids or proposals by publishing a class 2 notice under ch. 985 or
5by posting notice on the Internet at a site determined or approved by the authority.
6The notice shall describe the contractual services to be purchased, the intent to make
7the procurement by solicitation of bids or proposals, any requirement for surety, and
8the date the bids or proposals will be opened, which shall be at least 7 days after the
9date of the last insertion of the notice or at least 7 days after the date of posting on
10the Internet.
SB451-SSA1,51,1311 (b) When the estimated cost is $25,000 or less, the authority may award the
12contract in accordance with simplified procedures established by the authority for
13such transactions.
SB451-SSA1,51,1714 (c) For purposes of clarification, the authority may discuss the requirements
15of the proposed contract with any person who submits a bid or proposal and shall
16permit any offerer to revise his or her bid or proposal to ensure its responsiveness to
17those requirements.
SB451-SSA1,51,25 18(3) (a) The authority shall determine which bids or proposals are reasonably
19likely to be awarded the contract and shall provide each offerer of such a bid or
20proposal a fair and equal opportunity to discuss the bid or proposal. The authority
21may negotiate with each offerer in order to obtain terms that are advantageous to
22the authority. Prior to the award of the contract, any offerer may revise his or her
23bid or proposal. The authority shall keep a written record of all meetings,
24conferences, oral presentations, discussions, negotiations, and evaluations of bids or
25proposals under this section.
SB451-SSA1,52,3
1(b) In opening, discussing, and negotiating bids or proposals, the authority may
2not disclose any information that would reveal the terms of a competing bid or
3proposal.
SB451-SSA1,52,9 4(4) (a) After receiving each offerer's best and final offer, the authority shall
5determine which proposal is most advantageous and shall award the contract to the
6person who offered it. The authority's determination shall be based only on price and
7the other evaluation factors specified in the request for bids or proposals. The
8authority shall state in writing the reason for the award and shall place the
9statement in the contract file.
SB451-SSA1,52,1110 (b) Following the award of the contract, the authority shall prepare a register
11of all bids or proposals.
SB451-SSA1,52,21 12149.50 Political activities. (1) No employee of the authority may directly
13or indirectly solicit or receive subscriptions or contributions for any partisan political
14party or any political purpose while engaged in his or her official duties as an
15employee. No employee of the authority may engage in any form of political activity
16calculated to favor or improve the chances of any political party or any person seeking
17or attempting to hold partisan political office while engaged in his or her official
18duties as an employee or engage in any political activity while not engaged in his or
19her official duties as an employee to such an extent that the person's efficiency during
20working hours will be impaired or that he or she will be tardy or absent from work.
21Any violation of this section is adequate grounds for dismissal.
SB451-SSA1,52,25 22(2) If an employee of the authority declares an intention to run for partisan
23political office, the employee shall be placed on a leave of absence for the duration
24of the election campaign and if elected shall no longer be employed by the authority
25on assuming the duties and responsibilities of such office.
SB451-SSA1,53,2
1(3) An employee of the authority may be granted, by the executive director, a
2leave of absence to participate in partisan political campaigning.
SB451-SSA1,53,5 3(4) Persons on leave of absence under sub. (2) or (3) shall not be subject to the
4restrictions of sub. (1), except as they apply to the solicitation of assistance,
5subscription, or support from any other employee in the authority.
SB451-SSA1,53,9 6149.53 Liability limited. (1) Neither the state nor any political subdivision
7of the state nor any officer, employee, or agent of the state or a political subdivision
8who is acting within the scope of employment or agency is liable for any debt,
9obligation, act, or omission of the authority.
SB451-SSA1,53,11 10(2) All of the expenses incurred by the authority in exercising its duties and
11powers under this chapter shall be payable only from funds of the authority.
SB451-SSA1, s. 151 12Section 151. 149.40 of the statutes, as created by 2005 Wisconsin Act .... (this
13act), is repealed.
SB451-SSA1, s. 152 14Section 152. Subchapter IV of chapter 149 [precedes 149.60] of the statutes
15is created to read:
SB451-SSA1,53,1616 Chapter 149
SB451-SSA1,53,1817 Subchapter IV
18 Health Care Tax Credit Program
SB451-SSA1,53,20 19149.60 Definition. In this subchapter, "eligible individual" has the meaning
20given in 26 USC 35 (c).
SB451-SSA1,54,2 21149.65 Program requirements. (1) Subject to sub. (2), the authority shall
22design and administer a program of health care coverage, called the Health Care Tax
23Credit Program, under which a covered eligible individual may receive an income tax
24credit under 26 USC 35 for a portion of premiums paid for the coverage. The Health

1Care Tax Credit Program shall be designed to satisfy the requirements of qualified
2health insurance under 26 USC 35 (e) (1) (E), (2), and (3).
SB451-SSA1,54,5 3(2) Subsection (1) applies only as long as federal law provides for income tax
4credits for premiums paid for coverage that satisfies the requirements specified in
5sub. (1).
SB451-SSA1,54,7 6149.70 Eligibility. An individual shall be eligible for coverage under the
7Health Care Tax Credit Program if the individual is any of the following:
SB451-SSA1,54,8 8(1) An eligible individual for whom all of the following apply:
SB451-SSA1,54,109 (a) The aggregate of the individual's periods of creditable coverage, determined
10in the manner provided by rule under s. 149.115, is 3 months or more.
SB451-SSA1,54,1111 (b) The individual does not have other health care coverage.
SB451-SSA1,54,1212 (c) The individual is not confined in a prison, jail, or house of correction.
SB451-SSA1,54,15 13(2) An individual who is a qualifying family member, as defined in 26 USC 35
14(d), of an eligible individual described in sub. (1) and who does not have other health
15care coverage.
SB451-SSA1, s. 153 16Section 153. 230.03 (3) of the statutes is amended to read:
SB451-SSA1,54,2517 230.03 (3) "Agency" means any board, commission, committee, council, or
18department in state government or a unit thereof created by the constitution or
19statutes if such board, commission, committee, council, department, unit, or the
20head thereof, is authorized to appoint subordinate staff by the constitution or
21statute, except a legislative or judicial board, commission, committee, council,
22department, or unit thereof or an authority created under chs. subch. III of ch. 149
23or under ch.
231, 232, 233, 234, 235, or 237. "Agency" does not mean any local unit
24of government or body within one or more local units of government that is created
25by law or by action of one or more local units of government.
SB451-SSA1, s. 154
1Section 154. 230.80 (4) of the statutes is amended to read:
SB451-SSA1,55,92 230.80 (4) "Governmental unit" means any association, authority, board,
3commission, department, independent agency, institution, office, society , or other
4body in state government created or authorized to be created by the constitution or
5any law, including the legislature, the office of the governor, and the courts, but
6excluding the Health Insurance Risk-Sharing Plan Authority
. "Governmental unit"
7does not mean any political subdivision of the state or body within one or more
8political subdivisions which that is created by law or by action of one or more political
9subdivisions.
SB451-SSA1, s. 155 10Section 155. 601.41 (1) of the statutes is amended to read:
SB451-SSA1,55,1411 601.41 (1) Duties. The commissioner shall administer and enforce chs. 600 to
12655 and ss. 59.52 (11) (c), 66.0137 (4) and (4m), 100.203, 120.13 (2) (b) to (g), and
13149.13, and 149.144 and shall act as promptly as possible under the circumstances
14on all matters placed before the commissioner.
SB451-SSA1, s. 156 15Section 156. 601.415 (12) of the statutes is amended to read:
SB451-SSA1,55,1916 601.415 (12) Health insurance risk-sharing plan Insurance Risk-Sharing
17Plan
. The commissioner shall perform the duties specified to be performed by the
18commissioner in ss. s. 149.13 and 149.144. The commissioner, or his or her designee,
19shall serve as a member of the board under s. 149.15
.
SB451-SSA1, s. 157 20Section 157. 601.64 (1) of the statutes is amended to read:
SB451-SSA1,56,221 601.64 (1) Injunctions and restraining orders. The commissioner may
22commence an action in circuit court in the name of the state to restrain by temporary
23or permanent injunction or by temporary restraining order any violation of chs. 600
24to 655, or s. 149.13 or 149.144, any rule promulgated under chs. 600 to 655, or any

1order issued under s. 601.41 (4). The commissioner need not show irreparable harm
2or lack of an adequate remedy at law in an action commenced under this subsection.
SB451-SSA1, s. 158 3Section 158. 601.64 (3) (a) of the statutes is amended to read:
SB451-SSA1,56,74 601.64 (3) (a) Restitutionary forfeiture. Whoever violates an effective order
5issued under s. 601.41 (4), any insurance statute or rule, or s. 149.13 or 149.144 shall
6forfeit to the state twice the amount of any profit gained from the violation, in
7addition to any other forfeiture or penalty imposed.
SB451-SSA1, s. 159 8Section 159. 601.64 (3) (c) of the statutes is amended to read:
SB451-SSA1,56,159 601.64 (3) (c) Forfeiture for violation of statute or rule. Whoever violates an
10insurance statute or rule or s. 149.13 or 149.144, intentionally aids a person in
11violating an insurance statute or rule or s. 149.13 or 149.144, or knowingly permits
12a person over whom he or she has authority to violate an insurance statute or rule
13or s. 149.13 or 149.144 shall forfeit to the state not more than $1,000 for each
14violation. If the statute or rule imposes a duty to make a report to the commissioner,
15each week of delay in complying with the duty is a new violation.
SB451-SSA1, s. 160 16Section 160. 601.64 (4) of the statutes is amended to read:
SB451-SSA1,56,2217 601.64 (4) Criminal penalty. Whoever intentionally violates or intentionally
18permits any person over whom he or she has authority to violate or intentionally aids
19any person in violating any insurance statute or rule of this state, s. 149.13 or
20149.144
, or any effective order issued under s. 601.41 (4) is guilty of a Class I felony,
21unless a specific penalty is provided elsewhere in the statutes. Intent has the
22meaning expressed under s. 939.23.
SB451-SSA1, s. 161 23Section 161. 613.03 (4) of the statutes is amended to read:
SB451-SSA1,57,224 613.03 (4) Mandatory health insurance risk-sharing plan Health Insurance
25Risk-Sharing Plan
. Service insurance corporations organized or operating under

1this chapter are subject to the requirements that apply to insurers and insurance
2under
ch. 149.
SB451-SSA1, s. 162 3Section 162. 631.20 (2) (f) of the statutes is created to read:
SB451-SSA1,57,54 631.20 (2) (f) In the case of a policy form under ch. 149, that any of the following
5applies:
SB451-SSA1,57,76 1. The benefit design is not comparable to a typical comprehensive individual
7health insurance policy offered in the private sector market in this state.
SB451-SSA1,57,108 2. The benefit levels are not generally reflective of and commensurate with
9comprehensive health insurance coverage offered in the private individual market
10in the state.
SB451-SSA1,57,1211 3. The copayments, deductibles, and coinsurance are not actuarially equivalent
12to comprehensive individual plans and would create undue financial hardship.
SB451-SSA1,57,1413 4. It is inconsistent with the purpose of providing health care coverage to those
14unable to obtain coverage in the private market.
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