SB451-SSA2, s. 57 20Section 57. 77.54 (9a) (a) of the statutes is amended to read:
SB451-SSA2,27,2321 77.54 (9a) (a) This state or any agency thereof, the University of Wisconsin
22Hospitals and Clinics Authority, the Health Insurance Risk-Sharing Plan Authority,
23and the Fox River Navigational System Authority.
SB451-SSA2, s. 58 24Section 58. 77.92 (4) of the statutes is amended to read:
SB451-SSA2,28,15
177.92 (4) "Net business income," with respect to a partnership, means taxable
2income as calculated under section 703 of the Internal Revenue Code; plus the items
3of income and gain under section 702 of the Internal Revenue Code, including taxable
4state and municipal bond interest and excluding nontaxable interest income or
5dividend income from federal government obligations; minus the items of loss and
6deduction under section 702 of the Internal Revenue Code, except items that are not
7deductible under s. 71.21; plus guaranteed payments to partners under section 707
8(c) of the Internal Revenue Code; plus the credits claimed under s. 71.07 (2dd), (2de),
9(2di), (2dj), (2dL), (2dm), (2dr), (2ds), (2dx), (3g), (3s), (3n), (3t), and (5b), and (5g); and
10plus or minus, as appropriate, transitional adjustments, depreciation differences,
11and basis differences under s. 71.05 (13), (15), (16), (17), and (19); but excluding
12income, gain, loss, and deductions from farming. "Net business income," with respect
13to a natural person, estate, or trust, means profit from a trade or business for federal
14income tax purposes and includes net income derived as an employee as defined in
15section 3121 (d) (3) of the Internal Revenue Code.
SB451-SSA2, s. 59 16Section 59. 101.055 (2) (a) of the statutes is amended to read:
SB451-SSA2,28,2117 101.055 (2) (a) "Agency" means an office, department, independent agency,
18authority, institution, association, society, or other body in state government created
19or authorized to be created by the constitution or any law, and includes the
20legislature and the courts, but excludes the Health Insurance Risk-Sharing Plan
21Authority
.
SB451-SSA2, s. 60 22Section 60. 101.177 (1) (d) of the statutes is amended to read:
SB451-SSA2,29,623 101.177 (1) (d) "State agency" means any office, department, agency,
24institution of higher education, association, society, or other body in state
25government created or authorized to be created by the constitution or any law which

1, that is entitled to expend moneys appropriated by law, including the legislature and
2the courts, the Wisconsin Housing and Economic Development Authority, the
3Bradley Center Sports and Entertainment Corporation, the University of Wisconsin
4Hospitals and Clinics Authority, and the Wisconsin Health and Educational
5Facilities Authority, but excluding the Health Insurance Risk-Sharing Plan
6Authority
.
SB451-SSA2, s. 61 7Section 61. Chapter 149 (title) of the statutes is amended to read:
SB451-SSA2,29,108 CHAPTER 149
9Mandatory health insurance
10 risk-sharing plan Plans
SB451-SSA2, s. 62 11Section 62. Subchapter I (title) of chapter 149 [precedes 149.10] of the statutes
12is created to read:
SB451-SSA2,29,1313 CHAPTER 149
SB451-SSA2,29,1514 subchapter I
15 General provisions
SB451-SSA2, s. 63 16Section 63. 149.10 (intro.) of the statutes is amended to read:
SB451-SSA2,29,18 17149.10 Definitions. (intro.) In this chapter, unless the context requires
18otherwise
:
SB451-SSA2, s. 64 19Section 64. 149.10 (1) of the statutes is created to read:
SB451-SSA2,29,2120 149.10 (1) "Authority" means the Health Insurance Risk-Sharing Plan
21Authority.
SB451-SSA2, s. 65 22Section 65. 149.10 (2) of the statutes is amended to read:
SB451-SSA2,29,2423 149.10 (2) "Board" means the board of governors established under s. 149.15
24directors of the authority.
SB451-SSA2, s. 66 25Section 66. 149.10 (2j) (a) 3. of the statutes is amended to read:
SB451-SSA2,30,2
1149.10 (2j) (a) 3. Part A or, part B, or part D of title XVIII of the federal Social
2Security Act.
SB451-SSA2, s. 67 3Section 67. 149.10 (2m) of the statutes is repealed.
SB451-SSA2, s. 68 4Section 68. 149.10 (2t) (c) of the statutes is amended to read:
SB451-SSA2,30,85 149.10 (2t) (c) The individual does not have creditable coverage and is not
6eligible for coverage under a group health plan, part A or , part B, or part D of title
7XVIII of the federal Social Security Act or a state plan under title XIX of the federal
8Social Security Act or any successor program.
SB451-SSA2, s. 69 9Section 69. 149.10 (3) of the statutes is amended to read:
SB451-SSA2,30,1210 149.10 (3) "Eligible person" means a resident of this state who qualifies under
11s. 149.12 whether or not the person is legally responsible for the payment of medical
12expenses incurred on the person's behalf.
SB451-SSA2, s. 70 13Section 70. 149.10 (3e) of the statutes is amended to read:
SB451-SSA2,30,1514 149.10 (3e) "Fund" means the health insurance risk-sharing plan Health
15Insurance Risk-Sharing Plan
fund under s. 149.11 (2).
SB451-SSA2, s. 71 16Section 71. 149.10 (7) of the statutes is amended to read:
SB451-SSA2,30,1817 149.10 (7) "Medicare" means coverage under both part A and, part B, and part
18D
of Title XVIII of the federal social security act, 42 USC 1395 et seq., as amended.
SB451-SSA2, s. 72 19Section 72. 149.10 (8) of the statutes is amended to read:
SB451-SSA2,30,2120 149.10 (8) "Plan" means the health care insurance plan established and
21administered under subchapter II of this chapter.
SB451-SSA2, s. 73 22Section 73. 149.10 (9) of the statutes is amended to read:
SB451-SSA2,31,823 149.10 (9) "Resident" means a person who has been legally domiciled in this
24state for a period of at least 30 days 3 months or, with respect to an eligible individual,
25an individual who resides in this state. For purposes of this chapter, legal domicile

1is established by living in this state and obtaining a Wisconsin motor vehicle
2operator's license, registering to vote in Wisconsin, or filing a Wisconsin income tax
3return. A child is legally domiciled in this state if the child lives in this state and if
4at least one of the child's parents or the child's guardian is legally domiciled in this
5state. A person with a developmental disability or another disability which that
6prevents the person from obtaining a Wisconsin motor vehicle operator's license,
7registering to vote in Wisconsin, or filing a Wisconsin income tax return, is legally
8domiciled in this state by living in this state.
SB451-SSA2, s. 74 9Section 74. 149.10 (10) of the statutes is repealed.
SB451-SSA2, s. 75 10Section 75. 149.105 of the statutes is created to read:
SB451-SSA2,31,17 11149.105 Immunity. No cause of action of any nature may arise against, and
12no liability may be imposed upon, the authority, plan, or board; or any agent,
13employee, or director of any of them; or participating insurers; or the commissioner;
14or any of the commissioner's agents, employees, or representatives, for any act or
15omission by any of them in the performance of their powers and duties under this
16chapter, unless the person asserting liability proves that the act or omission
17constitutes willful misconduct.
SB451-SSA2, s. 76 18Section 76. Subchapter II (title) of chapter 149 [precedes 149.11] of the
19statutes is created to read:
SB451-SSA2,31,2020 CHAPTER 149
SB451-SSA2,31,2321 subchapter II
22 Health insurance risk-sharing
23 plan provisions
SB451-SSA2, s. 77 24Section 77. 149.11 of the statutes is repealed and recreated to read:
SB451-SSA2,32,3
1149.11 Administration of plan. (1) Authority. The authority shall be
2responsible for the operation of the plan and, subject to ss. 149.43 (2) and 149.47, may
3enter into contracts for the plan's administration.
SB451-SSA2,32,6 4(2) Fund. (a) The authority shall pay the operating and administrative
5expenses of the plan from the fund, which shall be outside the state treasury and
6which shall consist of all of the following:
SB451-SSA2,32,77 3. Federal moneys paid to the authority under s. 20.145 (5) (m).
SB451-SSA2,32,98 4. The moneys transferred under 2005 Wisconsin Act .... (this act), section 166
9(1).
SB451-SSA2,32,1010 5. The earnings resulting from investments under par. (b).
SB451-SSA2,32,1111 6. Any other moneys received by the authority from time to time.
SB451-SSA2,32,1512 (b) The authority controls the assets of the fund and shall select regulated
13financial institutions in this state that receive deposits in which to establish and
14maintain accounts for assets needed on a current basis. If practicable, the accounts
15shall earn interest.
SB451-SSA2,32,1716 (c) Moneys in the fund may be expended only for the purposes specified in par.
17(a).
SB451-SSA2, s. 78 18Section 78. 149.115 of the statutes is amended to read:
SB451-SSA2,32,23 19149.115 Rules relating to creditable coverage. The commissioner, in
20consultation with the department,
shall promulgate rules that specify how
21creditable coverage is to be aggregated for purposes of s. 149.10 (2t) (a) and that
22determine the creditable coverage to which s. 149.10 (2t) (b) and (d) applies. The
23rules shall comply with section 2701 (c) of P.L. 104-191.
SB451-SSA2, s. 79 24Section 79. 149.12 (1) (intro.) of the statutes is amended to read:
SB451-SSA2,33,8
1149.12 (1) (intro.) Except as provided in subs. (1m) and, (2), and (3), the board
2or plan administrator authority shall certify as eligible a person who is covered by
3medicare Medicare because he or she is disabled under 42 USC 423, a person who
4submits evidence that he or she has tested positive for the presence of HIV, antigen
5or nonantigenic products of HIV, or an antibody to HIV, a person who is an eligible
6individual, and any person who receives and submits any of the following based
7wholly or partially on medical underwriting considerations within 9 months prior to
8making application for coverage by the plan:
SB451-SSA2, s. 80 9Section 80. 149.12 (1) (a) of the statutes is amended to read:
SB451-SSA2,33,1010 149.12 (1) (a) A notice of rejection of coverage from one 2 or more insurers.
SB451-SSA2, s. 81 11Section 81. 149.12 (1m) of the statutes is amended to read:
SB451-SSA2,33,1512 149.12 (1m) The board or plan administrator authority may not certify a
13person as eligible under circumstances requiring notice under sub. (1) (a) to (d) if the
14required notices were issued by an insurance intermediary who is not acting as an
15administrator, as defined in s. 633.01.
SB451-SSA2, s. 82 16Section 82. 149.12 (2) (f) of the statutes is renumbered 149.12 (2) (f) 1. and
17amended to read:
SB451-SSA2,33,1918 149.12 (2) (f) 1. No Except as provided in subd. 2., no person who is eligible for
19medical assistance is eligible for coverage under the plan.
SB451-SSA2, s. 83 20Section 83. 149.12 (2) (f) 2. of the statutes is created to read:
SB451-SSA2,33,2321 149.12 (2) (f) 2. Subdivision 1. does not apply to a person who is otherwise
22eligible for coverage under the plan and who is eligible for only any of the following
23types of medical assistance:
SB451-SSA2,33,2424 a. Family planning services under s. 49.45 (24r).
SB451-SSA2,34,2
1b. Care and services for the treatment of an emergency medical condition under
242 USC 1396b (v), as provided in s. 49.45 (27).
SB451-SSA2,34,33 c. Medical assistance under s. 49.46 (1) (a) 15.
SB451-SSA2,34,44 d. Ambulatory prenatal care under s. 49.465.
SB451-SSA2,34,65 e. Medicare premium, coinsurance, and deductible payments under s. 49.46 (2)
6(c) 2. or 3., 49.468 (1) (b) or (c), or 49.47 (6) (a) 6. b. or c.
SB451-SSA2,34,87 f. Medicare premium payments under s. 49.46 (2) (cm), 49.468 (1m) or (2), or
849.47 (6) (a) 6m.
SB451-SSA2, s. 84 9Section 84. 149.12 (2) (g) of the statutes is created to read:
SB451-SSA2,34,1110 149.12 (2) (g) A person is not eligible for coverage under the plan if the person
11is eligible for any of the following:
SB451-SSA2,34,1212 1. Services under s. 46.27 (11), 46.275, 46.277, or 46.278.
SB451-SSA2,34,1413 2. Medical assistance provided as part of a family care benefit, as defined in s.
1446.2805 (4).
SB451-SSA2,34,16153. Services provided under a waiver requested under 2001 Wisconsin Act 16,
16section 9123 (16rs), or 2003 Wisconsin Act 33, section 9124 (8c).
SB451-SSA2,34,1817 4. Services provided under the program of all-inclusive care for persons aged
1855 or older authorized under 42 USC 1396u-4.
SB451-SSA2,34,2019 5. Services provided under the demonstration program under a federal waiver
20authorized under 42 USC 1315.
SB451-SSA2,34,2221 6. Health care coverage under the Badger Care health care program under s.
2249.665.
SB451-SSA2, s. 85 23Section 85. 149.12 (3) (a) of the statutes is amended to read:
SB451-SSA2,35,424 149.12 (3) (a) Except as provided in pars. (b) to (c) and (bm), no person is eligible
25for coverage under the plan for whom a premium, deductible, or coinsurance amount

1is paid or reimbursed by a federal, state, county, or municipal government or agency
2as of the first day of any term for which a premium amount is paid or reimbursed and
3as of the day after the last day of any term during which a deductible or coinsurance
4amount is paid or reimbursed.
SB451-SSA2, s. 86 5Section 86. 149.12 (3) (c) of the statutes is repealed.
SB451-SSA2, s. 87 6Section 87. 149.12 (4) and (5) of the statutes are created to read:
SB451-SSA2,35,127 149.12 (4) Subject to subs. (1m), (2), and (3), the authority may establish
8criteria that would enable additional persons to be eligible for coverage under the
9plan. The authority shall ensure that any expansion of eligibility is consistent with
10the purpose of the plan to provide health care coverage for those who are unable to
11obtain health insurance in the private market and does not endanger the solvency
12of the plan.
SB451-SSA2,35,14 13(5) The authority shall establish policies for determining and verifying the
14continued eligibility of an eligible person.
SB451-SSA2, s. 88 15Section 88. 149.13 (1) of the statutes is amended to read:
SB451-SSA2,35,2016 149.13 (1) Every insurer shall participate in the cost of administering the plan,
17except the commissioner may by rule exempt as a class those insurers whose share
18as determined under sub. (2) would be so minimal as to not exceed the estimated cost
19of levying the assessment. The commissioner shall advise the department authority
20of the insurers participating in the cost of administering the plan.
SB451-SSA2, s. 89 21Section 89. 149.13 (3) (a) of the statutes is amended to read:
SB451-SSA2,36,222 149.13 (3) (a) Each insurer's proportion of participation under sub. (2) shall be
23determined annually by the commissioner based on annual statements and other
24reports filed by the insurer with the commissioner. The commissioner shall assess

1an insurer for the insurer's proportion of participation based on the total
2assessments estimated by the department under s. 149.143 (2) (a) 3. authority.
SB451-SSA2, s. 90 3Section 90. 149.13 (3) (b) of the statutes is amended to read:
SB451-SSA2,36,104 149.13 (3) (b) If the department authority or the commissioner finds that the
5commissioner's authority to require insurers to report under chs. 600 to 646 and 655
6is not adequate to permit the department, the commissioner or the board authority
7to carry out the department's, commissioner's or board's authority's responsibilities
8under this chapter subchapter, the commissioner shall promulgate rules requiring
9insurers to report the information necessary for the department, commissioner and
10board authority to make the determinations required under this chapter subchapter.
SB451-SSA2, s. 91 11Section 91 . 149.13 (4) of the statutes is amended to read:
SB451-SSA2,36,1712 149.13 (4) Notwithstanding subs. (1) to (3), the department, with the
13agreement of the commissioner, may perform various administrative functions
14related to the assessment of insurers participating in the cost of administering the
15plan. Neither the commissioner nor the department may assess any type of
16insurance that was not being assessed as of December 1, 2005, or any type of insurer
17that was not being assessed as December 1, 2005.
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