AB416,12,1514 (a) The eligible employe was covered as a dependent under qualifying coverage
15when he or she waived coverage under the self-insured health plan.
AB416,12,1916 (b) The eligible employe's coverage under the qualifying coverage has
17terminated or will terminate due to a divorce from the insured under the qualifying
18coverage, the death of the insured under the qualifying coverage or loss of coverage
19under the qualifying coverage by the insured under the qualifying coverage.
AB416,12,2220 (c) The eligible employe applies for coverage under the self-insured health plan
21not more than 30 days after termination of his or her coverage under the qualifying
22coverage.
AB416, s. 16 23Section 16. 632.749 of the statutes is created to read:
AB416,13,4 24632.749 Contract termination and renewability. (1) Midterm
25cancellation.
Notwithstanding s. 631.36 (2) to (4m), a group health benefit plan

1may not be canceled by an insurer before the expiration of the agreed term, and shall
2be renewable to the policyholder and all insureds and dependents eligible under the
3terms of the group health benefit plan at the expiration of the agreed term at the
4option of the policyholder, except for any of the following reasons:
AB416,13,55 (a) Failure to pay a premium when due.
AB416,13,76 (b) Fraud or misrepresentation by the policyholder, or, with respect to coverage
7for an insured individual, fraud or misrepresentation by that insured individual.
AB416,13,88 (c) Substantial breaches of contractual duties, conditions or warranties.
AB416,13,109 (d) The number of individuals covered under the group health benefit plan is
10less than the number required by the group health benefit plan.
AB416,13,1211 (e) The employer to which the group health benefit plan is issued is no longer
12actively engaged in a business enterprise.
AB416,13,14 13(2) Nonrenewal. Notwithstanding sub. (1), an insurer may elect not to renew
14a group health benefit plan if the insurer complies with all of the following:
AB416,13,1615 (a) The insurer ceases to renew all other group health benefit plans issued by
16the insurer.
AB416,13,1917 (b) The insurer provides notice to all affected policyholders and to the
18commissioner in each state in which an affected insured individual resides at least
19one year before termination of coverage.
AB416,13,2120 (c) The insurer does not issue a group health benefit plan before 5 years after
21the nonrenewal of the group health benefit plans.
AB416,13,2522 (d) The insurer does not transfer or otherwise provide coverage to a
23policyholder from the nonrenewed business unless the insurer offers to transfer or
24provide coverage to all affected policyholders from the nonrenewed business without
25regard to claims experience, health condition or duration of coverage.
AB416,14,2
1(3) Insurer in liquidation. This section does not apply to a group health benefit
2plan if the insurer that issued the group health benefit plan is in liquidation.
AB416, s. 17 3Section 17. 632.76 (2) (a) of the statutes is amended to read:
AB416,14,94 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years
5from the date of issue of the policy may be reduced or denied on the ground that a
6disease or physical condition existed prior to the effective date of coverage, unless the
7condition was excluded from coverage by name or specific description by a provision
8effective on the date of loss. This paragraph does not apply to a group health benefit
9plan, as defined in s. 632.745 (1) (c), which is subject to s. 632.745 (2).
AB416, s. 18 10Section 18. 632.896 (4) of the statutes is amended to read:
AB416,14,1611 632.896 (4) Preexisting conditions. Notwithstanding s. ss. 632.745 (2) and
12632.76 (2) (a), a disability insurance policy that is subject to sub. (2) and that is in
13effect when a court makes a final order granting adoption or when the child is placed
14for adoption may not exclude or limit coverage of a disease or physical condition of
15the child on the ground that the disease or physical condition existed before coverage
16is required to begin under sub. (3).
AB416, s. 19 17Section 19. 635.02 (5m) of the statutes is repealed.
AB416, s. 20 18Section 20. 635.07 of the statutes is repealed.
AB416, s. 21 19Section 21. 635.17 of the statutes is repealed.
AB416, s. 22 20Section 22. 635.26 (1) (a) of the statutes is renumbered 635.26 (1).
AB416, s. 23 21Section 23. 635.26 (1) (b) of the statutes is repealed.
AB416, s. 24 22Section 24. Initial applicability.
AB416,15,2 23(1)  This act first applies to group health benefit plans that are issued or
24renewed, and to self-insured health plans that are extended, modified or renewed

1under collective bargaining agreements, on the first day of the 12th month beginning
2after publication.
AB416, s. 25 3Section 25. Effective date.
AB416,15,5 4(1) This act takes effect on the first day of the 12th month beginning after
5publication.
AB416,15,66 (End)
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