AB394, s. 36 3Section 36. 635.20 (intro.) of the statutes is amended to read:
AB394,31,4 4635.20 Definitions. (intro.) In this subchapter chapter:
AB394, s. 37 5Section 37. Subchapter II (title) of chapter 635 [precedes 635.20] of the
6statutes is repealed.
AB394, s. 38 7Section 38. 635.20 (1c) of the statutes is repealed and recreated to read:
AB394,31,118 635.20 (1c) "Dependent" means a spouse, an unmarried child under the age of
919 years, an unmarried child who is a full-time student under the age of 21 years and
10who is financially dependent upon the parent, or an unmarried child of any age who
11is medically certified as disabled and who is dependent upon the parent.
AB394, s. 39 12Section 39. 635.20 (1m) of the statutes is repealed and recreated to read:
AB394,31,2013 635.20 (1m) "Eligible employe" means an employe who works on a full-time
14basis and has a normal work week of 30 or more hours. "Eligible employe" includes
15a sole proprietor, a business owner, including the owner of a farm business, a partner
16of a partnership, a member of a limited liability company and an independent
17contractor if the sole proprietor, business owner, partner, member or independent
18contractor is included as an employe under a health benefit plan of a small employer,
19but "eligible employe" does not include an employe who works on a part-time,
20temporary or substitute basis.
AB394, s. 40 21Section 40. 635.20 (10) of the statutes is amended to read:
AB394,31,2422 635.20 (10) "Plan" means the health insurance plan for individuals employed
23by small employers that is created under s. 635.21 and that consists of a policy under
24this subchapter chapter containing the basic benefits.
AB394, s. 41 25Section 41. 635.20 (13) of the statutes is repealed and recreated to read:
AB394,32,9
1635.20 (13) "Small employer insurer" means an insurer that is authorized to do
2business in this state, in one or more lines of insurance that includes health
3insurance, and that offers group health benefit plans covering eligible employes of
4one or more small employers in this state, or that sells 3 or more individual health
5benefit plans to a small employer, covering eligible employes of the small employer.
6"Small employer insurer" includes a health maintenance organization, as defined in
7s. 609.01 (2), a preferred provider plan, as defined in s. 609.01 (4), and an insurer
8operating as a cooperative association organized under ss. 185.981 to 185.985, but
9does not include a limited service health organization, as defined in s. 609.01 (3).
AB394, s. 42 10Section 42. 635.25 (1) (a) (intro.) of the statutes is amended to read:
AB394,32,1211 635.25 (1) (a) (intro.) To be eligible to participate in the plan by purchasing a
12policy under this subchapter chapter containing the basic benefits, an employer:
AB394, s. 43 13Section 43. 635.25 (1) (b) of the statutes is amended to read:
AB394,32,1714 635.25 (1) (b) Except as provided in ss. 645.43 and 646.35, an employer that
15purchases a policy under this subchapter chapter containing the basic benefits and
16that ceases to be eligible to participate in the plan during a policy period shall retain
17coverage under the plan to the end of the policy period.
AB394, s. 44 18Section 44. 635.25 (1m) of the statutes is amended to read:
AB394,32,2119 635.25 (1m) Notwithstanding sub. (1), an employer is not eligible to participate
20in the plan if all of the individuals to be covered under the plan may be covered by
21a single one policy providing individual single or family coverage.
AB394, s. 45 22Section 45. 635.254 (1) of the statutes is amended to read:
AB394,33,223 635.254 (1) An employer that participates in the plan shall pay a premium
24contribution of not less than 50% of the premium rate on behalf of an eligible employe

1with individual single coverage and not less than 40% of the premium rate on behalf
2of an eligible employe with family coverage.
AB394, s. 46 3Section 46. 635.254 (3) of the statutes is amended to read:
AB394,33,84 635.254 (3) For an eligible employe who obtains coverage under the health
5insurance risk-sharing plan under s. 619.12 (2) (e) 2., an employer under sub. (1)
6shall pay a premium contribution to the health insurance risk-sharing plan that is
7equal to the amount that the employer would pay on behalf of the employe for
8coverage under the plan under this subchapter chapter.
AB394, s. 47 9Section 47. 635.26 (1s) of the statutes is repealed.
AB394, s. 48 10Section 48. 635.28 of the statutes is amended to read:
AB394,33,14 11635.28 Liability of state and plan board. Neither the state nor the plan
12board is liable for any obligation arising under the plan. Plan board members are
13immune from civil liability for acts or omissions while performing their duties under
14this subchapter chapter.
AB394, s. 49 15Section 49. 635.29 of the statutes is amended to read:
AB394,33,18 16635.29 (title) Applicability of health insurance mandates. The health
17insurance mandates apply to the plan under this subchapter chapter only to the
18extent determined by the plan board under s. 635.23 (1) (b).
AB394, s. 50 19Section 50. 635.31 of the statutes is amended to read:
AB394,33,22 20635.31 Chapters 600 to 655 applicable. Except as otherwise provided in this
21subchapter chapter, the plan shall comply with and be administered in compliance
22with chs. 600 to 655.
AB394, s. 51 23Section 51. 646.35 (5) of the statutes is amended to read:
AB394,34,724 646.35 (5) Rate increases. The board may increase any rates or premiums on
25policies during continuation of coverage under sub. (2) (b) or (3) (b) to the extent the

1policies permit the insurer to increase the rates or premiums and subject to s.
2632.746 and any rules promulgated under s. 632.7465
. If the board determines that
3the rates or premiums on policies which do not permit an increase or the rates or
4premiums as increased to the extent permitted by the policies are inadequate under
5s. 625.11 (3), the board may offer the policyholders the option of terminating the
6coverage or continuing the coverage at adequate rates or premiums as determined
7by the board.
AB394, s. 52 8Section 52 . Nonstatutory provisions.
AB394,34,12 9(1)   Rules on risk adjustment mechanism. The commissioner of insurance
10shall submit proposed rules required under section 632.747 (4) (a) of the statutes, as
11created by this act, to the legislative council staff for review under section 227.15 (1)
12of the statutes no later than April 1, 1996.
AB394, s. 53 13Section 53. Initial applicability.
AB394,34,21 14(1)  The treatment of sections 15.735 (1), 185.981 (4t), 185.983 (1) (intro.) and
15(1g), 600.01 (2) (b), 601.424, 625.03 (6), 625.12 (2), 625.15 (1), 625.22 (1) and (4),
16628.34 (3) (c), 628.36 (2) (b) 1., 3. and 5., 631.01 (4), 632.70, 632.745, 632.746,
17632.7465, 632.747, 632.748, 632.749, 632.76 (2) (a), 632.896 (4), 632.897 (2) (d) and
18(9) (c), 635.20 (intro.), (1c), (1m), (10) and (13), 635.25 (1) (a) (intro.) and (b), 635.26
19(1s), 635.28, 635.29, 635.31 and 646.35 (5), chapter 635 (title) and subchapter I and
20subchapter II (title) of chapter 635 of the statutes first applies to health benefit plans
21issued or renewed on October 1, 1996.
AB394, s. 54 22Section 54. Effective date. This act takes effect on October 1, 1996, except
23as follows:
AB394,35,3
1(1) The treatment of sections 619.12 (1) (intro.), 632.727, 632.747 (4) and (5)
2and 632.83 of the statutes and Section 52 (1) of this act take effect on the day after
3publication.
AB394,35,44 (End)
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