AB122: Bill Text

AB122,5,6 1. Is employed under a contract involving the furnishing of more than personal services.

AB122,5,9 2. Is customarily engaged in an independently established trade, business or profession providing the same type of services to more than one employer and whose services to an employer are not compensated for on a payroll of that employer.

AB122,5,11 3. Is a patient or inmate of a hospital, home or institution and performs services in the hospital, home or institution.

AB122,5,15 (b) "Employer" means any person doing business or operating an organization in this state other than the state, including each state agency, and any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government.

AB122,5,18 (c) "Federal metropolitan statistical area" means an area defined by the federal office of management and budget under 44 USC 3504 (d) (3) as a metropolitan statistical area or a primary metropolitan statistical area.

AB122,5,25 (2) (a) Subject to pars. (b) and (c), any employer may offer to all of its employes a health care coverage plan through a program offered by the group insurance board. The department may, by rule, establish eligibility standards or contribution requirements for such employes and employers and may, by rule, limit the category of employers allowed to be included in any program available under this subchapter. The department may not require an employer to contribute more than 50% of the cost of an employe's health care coverage offered under this subchapter.

AB122,6,4 (b) An employer who participates in a program offered by the group insurance board under par. (a) shall offer health care coverage under that program to all of its employes who have a normal work week of 30 or more hours, but may offer that coverage to its employes who have a normal work week of fewer than 30 hours.

AB122,6,7 (c) An employer who participates in a program offered by the group insurance board under par. (a) shall make any premium payments for the health care coverage of the employer's employes directly to the insurer providing the coverage.

AB122,6,11 (3) The department shall make available to employers who participate in a health care coverage plan under sub. (2) information that describes any grievance procedure that may be available to any employe who receives health care coverage under sub. (2).

AB122,6,15 (4) The private employer health care coverage board shall advise the group insurance board on health care issues affecting private employers and shall recommend to the group insurance board the design for a uniform benefit structure for the health care coverage plans under sub. (2).

AB122,6,19 (5m) The department shall, by rule, define "community" for purposes of the definition of "community rate" under sub. (1) (a). The department may not define "community" as a geographical area that includes less than an entire federal metropolitan statistical area or an entire county, whichever is larger.

AB122,6,22 (5r) (a) Except as provided in par. (b), an insurer who participates in a program under this subchapter shall charge a community rate for coverage under a health care coverage plan under this subchapter.

AB122,6,24 (b) The department may, by rule, modify the community rate under par. (a) by taking into account any of the following factors:

AB122,6,25 1. The insured's age.

AB122,7,1 2. Whether the insured's coverage is single or a type of family coverage.

AB122,7,2 3. The insured's gender.

AB122,7,6 (c) If an insurer raises a community rate for a health care coverage plan, the insurer shall raise all community rates for that health care coverage plan and for all other health care coverage plans offered by the insurer under this subchapter by the same percentage.

AB122,7,10 (6m) (a) The group insurance board shall solicit widely throughout the state bids from insurers, who provide health maintenance organization health care plans, preferred provider plans and standard plans, as defined in s. 609.01 (7), to offer the health care coverage plans under this subchapter.

AB122,7,14 (b) Subject to par. (c), the group insurance board shall require that in every area of the state each health care coverage plan offered under this subchapter include at least 2 health maintenance organization health care plans, 2 preferred provider plans and a standard plan, as defined in s. 609.01 (7).

AB122,7,19 (c) The department may, by rule, establish standards that permit the group insurance board to waive the requirements under par. (b) if the group insurance board determines that at least 2 health maintenance organization health care plans, 2 preferred provider plans or a standard plan, as defined in s. 609.01 (7), are not available in every area of the state.

AB122,7,22 (6r) No rule may be promulgated under this subchapter unless the private employer health care coverage board, with at least 4 members voting in the majority, approves the rule.

AB122, s. 9 Section 9. 628.36 (4) (b) 1. of the statutes is amended to read:

AB122,7,25 628.36 (4) (b) 1. Assisting the department of employe trust funds in the development of health care plans under s. 40.51 (7) and subch. XI of ch. 40.

AB122, s. 10 Section 10. 628.36 (4) (b) 2. of the statutes is amended to read:

AB122,8,4 628.36 (4) (b) 2. Providing employers and their employes with information regarding the availability and nature of health care coverage that may be obtained under s. 40.51 (7) and subch. XI of ch. 40.

AB122, s. 11 Section 11. 628.36 (4) (b) 3. of the statutes is amended to read:

AB122,8,8 628.36 (4) (b) 3. Providing information to employers regarding how to proceed under s. 40.51 (7) and subch. XI of ch. 40 to obtain health care coverage for their employes.

AB122, s. 12 Section 12. Nonstatutory provisions.

AB122,8,14 (1) Private employer health care coverage board; initial membership. Notwithstanding the length of terms or qualifications specified for the members of the private employer health care coverage board under section 15.165 (5) of the statutes, as created by this act, the initial members shall be appointed for the following terms:

AB122,8,16 (a) Two persons who are eligible to be employes specified under section 15.165 (5) (a) 1. of the statutes, as created by this act, for terms expiring on July 1, 1999.

AB122,8,18 (b) Two persons who are eligible to be employers specified under section 15.165 (5) (a) 2. of the statutes, as created by this act, for terms expiring on July 1, 2000.

AB122,8,23 (c) One person who is an actuary specified under section 15.165 (5) (a) 3. of the statutes, as created by this act, one person who is eligible to be an employer specified under section 15.165 (5) (a) 2. of the statutes, as created by this act, and one person who is eligible to be an employe specified under section 15.165 (5) (a) 1. of the statutes, as created by this act, for a term expiring on July 1, 2002.

AB122,8,24 (End)