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.
AB1-ASA1,17,3 35. `Dissolution notice, claims, and updates.'
AB1-ASA1,17,13 4a. On behalf of the commissioner, the authority shall provide notice of the plan's
5dissolution to all persons known, or reasonably expected from the plan's records, to
6have claims against the plan, including all covered persons. Notwithstanding 2013
7Wisconsin Act 20
, section 9122 (1L) (b) 10. a., the notice shall be sent by 1st class mail
8to the last-known addresses no later than February 1, 2014. Notice to potential
9claimants of the plan shall require the claimants to file their claims, together with
10proofs of claims, by June 1, 2014. The notice shall be consistent with any relevant
11terms of the policies under the plan and contracts and with section 645.47 (1) (a) of
12the statutes. The notice shall serve as final notice consistent with section 645.47 (3)
13of the statutes.
AB1-ASA1,17,23 14b. Proofs of all claims must be filed with the office in the form provided by the
15office consistent with the proof of claim, as applicable, under section 645.62 of the
16statutes, on or before the last day for filing specified in the notice. For good cause
17shown, the office shall permit a claimant to make a late filing if the existence of the
18claim was not known to the claimant and the claimant files the claim within 30 days
19after learning of the claim, but not later than September 1, 2014. Any such late claim
20that would have been payable under the policy under the plan if it had been filed
21timely and that was not covered by a succeeding insurer shall be permitted unless
22the claimant had actual notice of the termination of the plan or the notice was mailed
23to the claimant by 1st class mail at least 10 days before the insured event occurred.
AB1-ASA1,17,2424 (c) Medicare supplement and replacement policy issuance.
AB1-ASA1,18,4
11. In addition to the requirement under 2013 Wisconsin Act 20, section 9122
2(1m)
, an insurer offering a Medicare supplement policy or a Medicare replacement
3policy in this state shall provide coverage under the policy to any individual who
4satisfies all of the following:
AB1-ASA1,18,5 5a. The individual is eligible for Medicare.
AB1-ASA1,18,6 6b. The individual had coverage under the plan.
AB1-ASA1,18,7 7c. The individual's coverage under the plan terminated on March 31, 2014.
AB1-ASA1,18,9 8d. The individual applies for coverage under the policy before 63 days after the
9date specified in subdivision 1 . c.
AB1-ASA1,18,10 10e. The individual pays the premium for the coverage under the policy.
AB1-ASA1,18,13 112. An insurer under subdivision 1. may not deny coverage to any individual who
12satisfies the criteria under subdivision 1 . a. to e . on the basis of health status, receipt
13of health care, claims experience, or medical condition including disability.
AB1-ASA1,18,16 143. In addition to any other notice requirements to insurers, no later than
15February 1, 2014, the authority shall provide notice to the insurers described in
16subdivision 1. of the requirements under this paragraph.
AB1-ASA1,18,19 17(2m) Medical Assistance eligibility; temporary extension. Beginning on
18January 1, 2014, the department of health services shall do all of the following until
19April 1, 2014:
AB1-ASA1,18,2420 (a) Allow individuals whose family income does not exceed 200 percent of the
21federal poverty line, who were receiving benefits under section 49.471 (4) (a) 4. or (b)
224. of the statutes on December 31, 2013, and who would otherwise be eligible for
23benefits under section 49.471 (4) (a) 4. of the statutes except for the income limit to
24be eligible to receive benefits under section 49.471 (4) (a) 4. of the statutes.
AB1-ASA1,19,5
1(b) Allow individuals whose family income does not exceed 200 percent of the
2federal poverty line, who were receiving benefits under section 49.45 (23) of the
3statutes as of December 31, 2013, and who would otherwise be eligible for benefits
4under section 49.45 (23) of the statutes except for the income limit to be eligible to
5continue receiving benefits under section 49.45 (23) of the statutes.
AB1-ASA1,33 6Section 33. Effective dates. This act takes effect on the day after publication,
7except as follows:
AB1-ASA1,19,98 (1) Health Insurance Risk-Sharing Plan. The treatment of section 895.514
9(2) and (3) (a) and (b) of the statutes takes effect on January 1, 2015.
AB1-ASA1,19,1210 (2) Medical Assistance eligibility. The treatment of sections 49.45 (23) (a) (by
11Section 2) and 49.471 (1) (cr), (4) (a) 4. b., and (4g) of the statutes takes effect on
12January 1, 2014.
AB1-ASA1,19,1413 (3) Reconciliation with 2011 Wisconsin Act 32. The treatment of section 49.45
14(23) (a) (by Section 3 ) of the statutes takes effect on January 1, 2015.
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