AB1-ASA1,2,63 20.145 (5) (k) Operational expenses. All moneys transferred from the
4appropriation account under par. (g) for operational expenses related to winding up
5the affairs of the Health Insurance Risk-Sharing Plan, including hiring consultants,
6limited-term employees, and experts.
AB1-ASA1,2 7Section 2 . 49.45 (23) (a) of the statutes, as affected by 2013 Wisconsin Act 20,
8section 1046, is repealed and recreated to read:
AB1-ASA1,2,179 49.45 (23) (a) The department shall request a waiver from the secretary of the
10federal department of health and human services to permit the department to
11conduct a demonstration project to provide health care coverage to adults who are
12under the age of 65, who have family incomes not to exceed 133 percent of the poverty
13line, except as provided in s. 49.471 (4g), and who are not otherwise eligible for
14medical assistance under this subchapter, the Badger Care health care program
15under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department creates
16a policy under sub. (2m) (c) 10., this paragraph does not apply to the extent that it
17conflicts with the policy.
AB1-ASA1,3 18Section 3 . 49.45 (23) (a) of the statutes, as affected by 2013 Wisconsin Act 20,
19section 1047, and 2013 Wisconsin Act .... (this act), is repealed and recreated to read:
AB1-ASA1,3,320 49.45 (23) (a) The department shall request a waiver from the secretary of the
21federal department of health and human services to permit the department to
22conduct a demonstration project to provide health care coverage to adults who are
23under the age of 65, who have family incomes not to exceed 133 percent of the poverty

1line, except as provided in s. 49.471 (4g), and who are not otherwise eligible for
2medical assistance under this subchapter, the Badger Care health care program
3under s. 49.665, or Medicare under 42 USC 1395 et seq.
AB1-ASA1,3p 4Section 3p. 49.471 (1) (cr) of the statutes is created to read:
AB1-ASA1,3,65 49.471 (1) (cr) "Enhanced federal medical assistance percentage" means a
6federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB1-ASA1,4 7Section 4. 49.471 (4) (a) 4. b. of the statutes, as affected by 2013 Wisconsin Act
820
, is repealed and recreated to read:
AB1-ASA1,3,109 49.471 (4) (a) 4. b. Except as provided in sub. (4g), the individual's family
10income does not exceed 133 percent of the poverty line.
AB1-ASA1,4d 11Section 4d. 49.471 (4g) of the statutes is created to read:
AB1-ASA1,3,2012 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
13services provided to individuals described under sub. (4) (a) 4. and s. 49.45 (23), the
14department shall comply with all federal requirements to qualify for the highest
15available enhanced federal medical assistance percentage. The department shall
16submit any amendment to the state medical assistance plan, any request for a waiver
17of the federal Medicaid law, or any other approval required by the federal
18government to provide services to the individuals described under sub. (4) (a) 4. and
19s. 49.45 (23) and to qualify for the highest available enhanced federal medical
20assistance percentage.
AB1-ASA1,5 21Section 5. 49.471 (4m) of the statutes, as created by 2013 Wisconsin Act 20,
22is repealed.
AB1-ASA1,6 23Section 6. 49.67 (9m) of the statutes is repealed.
AB1-ASA1,7 24Section 7. 71.07 (5g) (b) of the statutes, as affected by 2013 Wisconsin Act 20,
25is amended to read:
AB1-ASA1,4,6
171.07 (5g) (b) Filing claims. Subject to the limitations provided under this
2subsection, for taxable years beginning after December 31, 2005, and before January
31, 2014 2015, a claimant may claim as a credit against the taxes imposed under s.
471.02 an amount that is equal to the amount of the assessment under s. 149.13, 2011
5stats., that the claimant paid in the claimant's taxable year, multiplied by the
6percentage determined under par. (c) 1.
AB1-ASA1,8 7Section 8. 71.07 (5g) (c) 1. of the statutes, as affected by 2013 Wisconsin Act
820
, is amended to read:
AB1-ASA1,4,219 71.07 (5g) (c) 1. The department of revenue, in consultation with the office of
10the commissioner of insurance, shall determine the percentage under par. (b) for
11each claimant for each taxable year. The percentage shall be equal to $5,000,000
12divided by the aggregate assessment under s. 149.13, 2011 stats., except that for
13taxable years beginning after December 31, 2013, and before January 1, 2015, the
14percentage shall be equal to $1,250,000 divided by the aggregate assessment under
15s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
16commissioner of insurance shall provide to each claimant that participates in the
17cost of administering the plan the aggregate assessment at the time that it notifies
18the claimant of the claimant's assessment. The aggregate amount of the credit under
19this subsection and ss. 71.28 (5g), 71.47 (5g), and 76.655 for all claimants
20participating in the cost of administering the plan under ch. 149, 2011 stats., shall
21not exceed $5,000,000 in each fiscal year.
AB1-ASA1,9 22Section 9. 71.07 (5g) (d) 2. of the statutes, as created by 2013 Wisconsin Act
2320
, is amended to read:
AB1-ASA1,5,224 71.07 (5g) (d) 2. No credit may be claimed under this subsection for taxable
25years beginning after December 31, 2013 2014. Credits under this subsection for

1taxable years that begin before January 1, 2014 2015, may be carried forward to
2taxable years that begin after December 31, 2013 2014.
AB1-ASA1,10 3Section 10. 71.28 (5g) (b) of the statutes, as affected by 2013 Wisconsin Act 20,
4is amended to read:
AB1-ASA1,5,105 71.28 (5g) (b) Filing claims. Subject to the limitations provided under this
6subsection, for taxable years beginning after December 31, 2005, and before January
71, 2014 2015, a claimant may claim as a credit against the taxes imposed under s.
871.23 an amount that is equal to the amount of assessment under s. 149.13, 2011
9stats., that the claimant paid in the claimant's taxable year, multiplied by the
10percentage determined under par. (c) 1.
AB1-ASA1,11 11Section 11. 71.28 (5g) (c) 1. of the statutes, as affected by 2013 Wisconsin Act
1220
, is amended to read:
AB1-ASA1,5,2513 71.28 (5g) (c) 1. The department of revenue, in consultation with the office of
14the commissioner of insurance, shall determine the percentage under par. (b) for
15each claimant for each taxable year. The percentage shall be equal to $5,000,000
16divided by the aggregate assessment under s. 149.13, 2011 stats., except that for
17taxable years beginning after December 31, 2013, and before January 1, 2015, the
18percentage shall be equal to $1,250,000 divided by the aggregate assessment under
19s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
20commissioner of insurance shall provide to each claimant that participates in the
21cost of administering the plan the aggregate assessment at the time that it notifies
22the claimant of the claimant's assessment. The aggregate amount of the credit under
23this subsection and ss. 71.07 (5g), 71.47 (5g), and 76.655 for all claimants
24participating in the cost of administering the plan under ch. 149, 2011 stats., shall
25not exceed $5,000,000 in each fiscal year.
AB1-ASA1,12
1Section 12. 71.28 (5g) (d) 2. of the statutes, as created by 2013 Wisconsin Act
220
, is amended to read:
AB1-ASA1,6,63 71.28 (5g) (d) 2. No credit may be claimed under this subsection for taxable
4years beginning after December 31, 2013 2014. Credits under this subsection for
5taxable years that begin before January 1, 2014 2015, may be carried forward to
6taxable years that begin after December 31, 2013 2014.
AB1-ASA1,13 7Section 13. 71.47 (5g) (b) of the statutes, as affected by 2013 Wisconsin Act 20,
8is amended to read:
AB1-ASA1,6,149 71.47 (5g) (b) Filing claims. Subject to the limitations provided under this
10subsection, for taxable years beginning after December 31, 2005, and before January
111, 2014 2015, a claimant may claim as a credit against the taxes imposed under s.
1271.43 an amount that is equal to the amount of assessment under s. 149.13, 2011
13stats., that the claimant paid in the claimant's taxable year, multiplied by the
14percentage determined under par. (c) 1.
AB1-ASA1,14 15Section 14. 71.47 (5g) (c) 1. of the statutes, as affected by 2013 Wisconsin Act
1620
, is amended to read:
AB1-ASA1,7,417 71.47 (5g) (c) 1. The department of revenue, in consultation with the office of
18the commissioner of insurance, shall determine the percentage under par. (b) for
19each claimant for each taxable year. The percentage shall be equal to $5,000,000
20divided by the aggregate assessment under s. 149.13, 2011 stats., except that for
21taxable years beginning after December 31, 2013, and before January 1, 2015, the
22percentage shall be equal to $1,250,000 divided by the aggregate assessment under
23s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
24commissioner of insurance shall provide to each claimant that participates in the
25cost of administering the plan the aggregate assessment at the time that it notifies

1the claimant of the claimant's assessment. The aggregate amount of the credit under
2this subsection and ss. 71.07 (5g), 71.28 (5g), and 76.655 for all claimants
3participating in the cost of administering the plan under ch. 149, 2011 stats., shall
4not exceed $5,000,000 in each fiscal year.
AB1-ASA1,15 5Section 15. 71.47 (5g) (d) 2. of the statutes, as created by 2013 Wisconsin Act
620
, is amended to read:
AB1-ASA1,7,107 71.47 (5g) (d) 2. No credit may be claimed under this subsection for taxable
8years beginning after December 31, 2013 2014. Credits under this subsection for
9taxable years that begin before January 1, 2014 2015, may be carried forward to
10taxable years that begin after December 31, 2013 2014.
AB1-ASA1,16 11Section 16. 76.655 (2) of the statutes, as affected by 2013 Wisconsin Act 20,
12is amended to read:
AB1-ASA1,7,1813 76.655 (2) Filing claims. Subject to the limitations provided under this section,
14for taxable years beginning after December 31, 2005, and before January 1, 2014
152015, a claimant may claim as a credit against the fees imposed under ss. 76.60,
1676.63, 76.65, 76.66 or 76.67 an amount that is equal to the amount of assessment
17under s. 149.13, 2011 stats., that the claimant paid in the claimant's taxable year,
18multiplied by the percentage determined under sub. (3).
AB1-ASA1,17 19Section 17. 76.655 (3) (a) of the statutes, as affected by 2013 Wisconsin Act 20,
20is amended to read:
AB1-ASA1,8,821 76.655 (3) (a) The department of revenue, in consultation with the office of the
22commissioner of insurance, shall determine the percentage under sub. (2) for each
23claimant for each taxable year. The percentage shall be equal to $5,000,000 divided
24by the aggregate assessment under s. 149.13, 2011 stats., except that for taxable
25years beginning after December 31, 2013, and before January 1, 2015, the

1percentage shall be equal to $1,250,000 divided by the aggregate assessment under
2s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
3commissioner of insurance shall provide to each claimant that participates in the
4cost of administering the plan the aggregate assessment at the time that it notifies
5the claimant of the claimant's assessment. The aggregate amount of the credit under
6this subsection and ss. 71.07 (5g), 71.28 (5g), and 71.47 (5g) for all claimants
7participating in the cost of administering the plan under ch. 149, 2011 stats., shall
8not exceed $5,000,000 in each fiscal year.
AB1-ASA1,18 9Section 18. 76.655 (5) of the statutes, as created by 2013 Wisconsin Act 20, is
10amended to read:
AB1-ASA1,8,1411 76.655 (5) Sunset. No credit may be claimed under this section for taxable
12years beginning after December 31, 2013 2014. Credits under this section for taxable
13years that begin before January 1, 2014 2015, may be carried forward to taxable
14years that begin after December 31, 2013 2014.
AB1-ASA1,19 15Section 19. 177.075 (3) of the statutes, as created by 2013 Wisconsin Act 20,
16is amended to read:
AB1-ASA1,8,2117 177.075 (3) Any intangible property distributable in the course of the
18dissolution of the Health Insurance Risk-Sharing Plan under 2013 Wisconsin Act
1920
, section 9122 (1L), and 2013 Wisconsin Act .... (this act), section 32 (1) (b ), is
20presumed abandoned as otherwise provided under this chapter if sub. (1) (a), (b), or
21(c) does not apply with respect to the distribution.
AB1-ASA1,20 22Section 20. 895.514 (2) of the statutes, as created by 2013 Wisconsin Act 20,
23is amended to read:
AB1-ASA1,9,624 895.514 (2) No cause of action of any nature may arise against, and no liability
25may be imposed upon, the authority, plan, or board; or any agent, employee, or

1director of any of them; or insurers participating in the plan; or the commissioner;
2or any agent, employee, or representative of the commissioner, for any act or
3omission by any of them in the performance of their powers and duties under ch. 149,
42011 stats., or under 2013 Wisconsin Act 20, section 9122 (1L), or under 2013
5Wisconsin Act .... (this act), section 32 (1) (b ),
unless the person asserting liability
6proves that the act or omission constitutes willful misconduct.
AB1-ASA1,21 7Section 21. 895.514 (3) (a) of the statutes, as created by 2013 Wisconsin Act
820
, is amended to read:
AB1-ASA1,9,139 895.514 (3) (a) Except as provided in 2013 Wisconsin Act 20, section 9122 (1L),
10and 2013 Wisconsin Act .... (this act), section 32 (1 ) (b), neither the state nor any
11political subdivision of the state nor any officer, employee, or agent of the state or a
12political subdivision acting within the scope of employment or agency is liable for any
13debt, obligation, act, or omission of the authority.
AB1-ASA1,22 14Section 22. 895.514 (3) (b) of the statutes, as created by 2013 Wisconsin Act
1520
, is amended to read:
AB1-ASA1,9,2116 895.514 (3) (b) All of the expenses incurred by the authority, or the
17commissioner, or any agent, employee, or representative of the commissioner, in
18exercising its duties and powers under ch. 149, 2011 stats., or under 2013 Wisconsin
19Act 20
, section 9122 (1L), or under 2013 Wisconsin Act .... (this act), section 32 (1) (b ),
20shall be payable only from funds of the authority or from the appropriation under s.
2120.145 (5) (g) or (k), or from any combination of those payment sources.
AB1-ASA1,23 22Section 23. 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. b. is repealed and
23recreated to read:
AB1-ASA1,9,2524[2013 Wisconsin Act 20] Section 9122 (1L) (b) 1. b. Coverage under the policies
25issued under the plan, including to persons whose coverage under the plan is funded

1under a contract with the federal department of health and human services,
2terminates at 11:59 p.m. on December 31, 2013. At least 60 days before coverage
3terminates, the authority shall provide notice of the date on which coverage
4terminates to all covered persons, all insurers and providers that are affected by the
5termination of the coverage, the office, the legislative audit bureau, and the insurers
6described in subsection (1m) (b) 1.
AB1-ASA1,24 7Section 24. 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. c. is repealed.
AB1-ASA1,25 8Section 25. 2013 Wisconsin Act 20, section 9122 (1L) (b) 2. and 3. a. and c. are
9repealed and recreated to read:
AB1-ASA1,10,1810[2013 Wisconsin Act 20] Section 9122 (1L) (b) 2. `Provider claims.' Providers
11of medical services and devices and prescription drugs to covered persons must file
12claims for payment no later than June 1, 2014. Any claim filed after that date is not
13payable and may not be charged to the covered person who received the service,
14device, or drug. Except for copayments, coinsurance, or deductibles required under
15the plan, consistent with sections 149.14 (3) and 149.142 (2m) of the statutes, a
16provider may not bill a covered person who receives a covered service or article and
17shall accept as payment in full the payment rate determined under section 149.142
18(1) of the statutes.
AB1-ASA1,10,2119 3. a. Except for a grievance related to a prior authorization, any grievance by
20a covered person must be in writing and received no later than July 1, 2014, or be
21barred.
AB1-ASA1,10,2522 c. A covered person who submits a grievance after March 31, 2014, must
23request an independent review, if any, with respect to the grievance no later than
24August 1, 2014, or be barred from requesting an independent review with respect to
25the grievance.
AB1-ASA1,26
1Section 26. 2013 Wisconsin Act 20, section 9122 (1L) (b) 4. is amended to read:
AB1-ASA1,11,82[2013 Wisconsin Act 20] Section 9122 (1L) (b) 4. `Payment of plan costs.' The
3To the extent possible, the authority shall pay plan costs incurred in 2013 and all
4other costs associated with dissolving the plan that are incurred before
5administrative responsibility for the dissolution of the plan is transferred to the
6office under subdivision 8. The authority and the office shall make every effort to pay
7plan costs in accordance with, or as closely as possible to, the manner provided in
8section 149.143 of the statutes.
AB1-ASA1,27 9Section 27. 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. (intro.) is repealed
10and recreated to read:
AB1-ASA1,11,1211[2013 Wisconsin Act 20] Section 9122 (1L) (b) 8. `Transfer to the office.' (intro.)
12On February 28, 2014, all of the following shall occur:
AB1-ASA1,28 13Section 28. 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. a., 9. a., 10. a. and
14b. and 11. b. are amended to read:
AB1-ASA1,11,2315[2013 Wisconsin Act 20] Section 9122 (1L) (b) 8. a. Administrative
16responsibility for the operations and dissolution of the plan is transferred to the
17office. The commissioner shall take any action necessary or advisable to manage and
18wind up the affairs of the plan and shall notify the legislative audit bureau when the
19windup is completed and provide to the legislative audit bureau the final financial
20statements of the plan. For purposes of chapter 177 of the statutes, as affected by
21this act, the dissolution, and winding up of the affairs, of the plan shall be considered
22a dissolution of an insurer in accordance with section 645.44 of the statutes, except
23that a court order of dissolution is not required to effect the dissolution of the plan.
AB1-ASA1,12,324 9. a. There is created, 60 days after the date coverage under the plan terminates
25under subdivision 1. b.
on March 1, 2014, a Health Insurance Risk-Sharing Plan

1advisory committee consisting of the commissioner, or his or her designee, and the
2other 13 members of the board holding office on the date the advisory committee is
3created.
AB1-ASA1,12,144 10. a. On behalf of the commissioner, the authority shall provide notice of the
5plan's dissolution to all persons known, or reasonably expected from the plan's
6records, to have claims against the plan, including all covered persons. The notice
7shall be sent by first class mail to the last-known addresses at least 60 days before
8the date on which coverage terminates under subdivision 1. b. Notice to potential
9claimants of the plan shall require the claimants to file their claims, together with
10proofs of claims, within 90 days after the date on which coverage terminates under
11subdivision 1. b.
by June 1, 2014. The notice shall be consistent with any relevant
12terms of the policies under the plan and contracts and with section 645.47 (1) (a) of
13the statutes. The notice shall serve as final notice consistent with section 645.47 (3)
14of the statutes.
AB1-ASA1,13,215 b. Proofs of all claims must be filed with the office in the form provided by the
16office consistent with the proof of claim, as applicable, under section 645.62 of the
17statutes, on or before the last day for filing specified in the notice. For good cause
18shown, the office shall permit a claimant to make a late filing if the existence of the
19claim was not known to the claimant and the claimant files the claim within 30 days
20after learning of the claim, but not more than 210 days after the date on which
21coverage terminates under subdivision 1. b.
later than September 1, 2014. Any such
22late claim that would have been payable under the policy under the plan if it had been
23filed timely and that was not covered by a succeeding insurer shall be permitted
24unless the claimant had actual notice of the termination of the plan or the notice was

1mailed to the claimant by first class mail at least 10 days before the insured event
2occurred.
AB1-ASA1,13,53 11. b. Complete a final audit of the plan, after the termination of the plan in
42014, within 90 days after the office provides the final financial statements of the
5plan under subdivision 8. a.
by June 30, 2015.
AB1-ASA1,32 6Section 32 . Nonstatutory provisions.
AB1-ASA1,13,87 (1) Coverage extension of the Health Insurance Risk-Sharing Plan;
8issuance of Medicare supplement and replacement policies.
AB1-ASA1,13,99 (a) Definitions. In this subsection:
AB1-ASA1,13,11 101. "Authority" means the Health Insurance Risk-Sharing Plan Authority
11under subchapter III of chapter 149 of the statutes.
AB1-ASA1,13,12 122. "Commissioner" means the commissioner of insurance.
AB1-ASA1,13,13 133. "Covered person" means a person who has coverage under the plan.
AB1-ASA1,13,14 144. "Medicare" has the meaning given in section 149.10 (7) of the statutes.
AB1-ASA1,13,16 155. "Medicare Advantage" has the meaning given in section INS 3.39 (3) (r),
16Wisconsin Administrative Code.
AB1-ASA1,13,18 176. "Medicare replacement policy" has the meaning given in section 600.03 (28p)
18of the statutes.
AB1-ASA1,13,20 197. "Medicare supplement policy" has the meaning given in section 600.03 (28r)
20of the statutes.
AB1-ASA1,13,21 218. "Office" means the office of the commissioner of insurance.
AB1-ASA1,13,23 229. "Plan" means the Health Insurance Risk-Sharing Plan under subchapter II
23of chapter 149 of the statutes.
AB1-ASA1,14,224 (b) Extension of the plan and authority. Notwithstanding any statute,
25administrative rule, or provision of a policy or contract or of the plan to the contrary,

1the dissolution of the plan and the authority as provided in 2013 Wisconsin Act 20,
2section 9122 (1L), is modified as follows:
AB1-ASA1,14,4 31. `Coverage provisions.' Notwithstanding 2013 Wisconsin Act 20, section 9122
4(1L) (b)
1. b., all of the following apply:
AB1-ASA1,14,17 5a. A covered person whose coverage under the plan was in effect on December
61, 2013, who paid his or her December premium, and who, if eligible for Medicare,
7had not enrolled in Medicare Advantage during the federal open enrollment period
8in 2013 may elect to obtain a policy under the plan by making a timely payment of
9the January 2014 premium. The covered person must maintain the same policy
10benefits, including the same deductible amount, that were in effect on December 1,
112013. A new deductible period will commence on January 1, 2014. The premium for
12January 2014 must be paid no later than February 1, 2014. Thereafter, the covered
13person must pay premiums in accordance with the terms of the contract for coverage,
14which may not extend beyond 11:59 p.m. on March 31, 2014. Any medical claims that
15the covered person incurs after December 31, 2013, and before the plan receives the
16premium payment for January 2014 shall be held in abeyance and the plan shall not
17be responsible for payment until the premium payment is received.
AB1-ASA1,14,25 18b. If a covered person's coverage under the plan is funded under a contract with
19the federal department of health and human services, the covered person's coverage
20will end as provided in 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. b., unless the
21federal department of health and human services issues a contract amendment that
22extends the contract and coverage to a date later than December 31, 2013, and the
23terms of the contract amendment are such that the federal government will be
24financially liable for all costs related to the operation of the contract that exceed
25member premium collections.
AB1-ASA1,15,15
1c. If the requirements under subdivision 1 . b. are satisfied, a covered person
2whose coverage is funded under a contract with the federal department of health and
3human services, whose coverage under the plan was in effect on December 1, 2013,
4who paid his or her December premium, and who had not enrolled in Medicare
5Advantage during the federal open enrollment period in 2013 may elect to obtain a
6policy under the plan by making a timely payment of the January 2014 premium.
7The covered person must maintain the same policy benefits, including the same
8deductible amount, that were in effect on December 1, 2013. A new deductible period
9will commence on January 1, 2014. The premium for January 2014 must be paid no
10later than February 1, 2014. Thereafter, the covered person must pay premiums in
11accordance with the terms of the contract for coverage, which may not extend beyond
1211:59 p.m. on March 31, 2014. Any medical claims that the covered person incurs
13after December 31, 2013, and before the plan receives the premium payment for
14January 2014 shall be held in abeyance and the plan shall not be responsible for
15payment until the premium payment is received.
AB1-ASA1,15,19 16d. No later than February 1, 2014, the authority shall provide notice that
17coverage shall terminate on March 31, 2014, to all covered persons, all insurers and
18providers that are affected by the termination of the coverage, the office, the
19legislative audit bureau, and the insurers described in paragraph (c) 1 .
AB1-ASA1,16,3 202. `Provider claims.' Providers of medical services and devices and prescription
21drugs to covered persons whose coverage is extended as provided in this paragraph
22must file claims for payment no later than June 1, 2014. Any claim filed after that
23date is not payable and may not be charged to the covered person who received the
24service, device, or drug. Except for copayments, coinsurance, or deductibles required
25under the plan, consistent with sections 149.14 (3) and 149.142 (2m) of the statutes,

1a provider may not bill a covered person who receives a covered service or article and
2shall accept as payment in full the payment rate determined under section 149.142
3(1) of the statutes.
AB1-ASA1,16,4 43. `Grievances and review.'
AB1-ASA1,16,7 5a. Any grievance by a covered person whose coverage is extended as provided
6in this paragraph must be in writing and received no later than July 1, 2014, or be
7barred.
AB1-ASA1,16,11 8b. A covered person whose coverage is extended as provided in this paragraph
9who submits a grievance after March 31, 2014, must request an independent review,
10if any, with respect to the grievance no later than August 1, 2014, or be barred from
11requesting an independent review with respect to the grievance.
AB1-ASA1,16,12 124. `Payment of plan costs.'
AB1-ASA1,16,16 13a. To the extent possible, the authority shall pay plan costs incurred in 2013
14and 2014 and all other costs associated with operating and dissolving the plan that
15are incurred before administrative responsibility for the dissolution of the plan is
16transferred to the office on February 28, 2014.
AB1-ASA1,16,17 17b. All provider claims shall be adjudicated by September 30, 2014.
AB1-ASA1,16,22 18c. The authority, before March 1, 2014, and the office, on and after March 1,
192014, but no later than July 1, 2014, shall determine whether an assessment of
20insurers under section 149.13 of the statutes is necessary to cover in full the plan's
21expenses related to operations, winding up operations, and dissolution of the plan.
22Any such assessment shall be based on the 2013 filed plan assessment form.
AB1-ASA1,17,2 23d. No later than 30 days before distribution of any surplus remaining after the
24dissolution of the plan, or within 30 days after completion of the dissolution of the
25plan if there is no surplus to distribute, the office shall submit a final report to the

1joint committee on finance on the operation and dissolution of the plan, including the
2proposed distribution of any remaining surplus.
Loading...
Loading...