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185.983
(1) (intro.) Every such voluntary nonprofit sickness care plan shall be
21exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
22601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72
23(2), 632.745, 632.747, 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5),
24632.895 (5)
, (9) and (10) and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619
25and chs. 609, 630, 635, 645 and 646, but the sponsoring association shall:
AB76, s. 9
1Section
9. 609.86 of the statutes is created to read:
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2609.86 Coverage of preventive pediatric health care services. Health
3maintenance organizations and preferred provider plans are subject to s. 632.895
4(11).
AB76, s. 10
5Section
10. 632.895 (11) of the statutes is created to read:
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632.895
(11) Preventive pediatric health care services. (a) In this
7subsection:
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1. "Appropriate and necessary immunizations" means the administration of
9vaccine that meets the standards approved by the U.S. public health service for such
10biological products against at least all of the following:
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a. Diphtheria.
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b. Pertussis.
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h. Haemophilus influenza B.
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i. Hepatitis B.
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j. Any other disease for which immunization is recommended by the American
21Academy of Pediatrics.
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2. "Dependent" has the meaning given in s. 635.02 (3c).
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3. "Preventive pediatric health care services" includes appropriate and
24necessary immunizations and such other services that are in accord with the
25prevailing medical standards of the American Academy of Pediatrics as physical
1examinations, developmental assessments, sensory screening, anticipatory
2guidance, initial dental referral and appropriate laboratory tests.
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(b) Except as provided in par. (d), every disability insurance policy, and every
4self-insured health plan of the state or a county, city, town, village or school district,
5that provides coverage for a dependent of the insured shall provide coverage of
6preventive pediatric health care services, from birth to the age of 19 years, for a
7dependent who is a child of the insured.
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(c) The coverage required under par. (b) may not be subject to any deductibles,
9copayments or coinsurance.
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(d) This subsection does not apply to any of the following:
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1. A disability insurance policy that covers only certain specified diseases.
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2. A health care plan offered by a limited service health organization, as defined
13in s. 609.01 (3).
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3. A long-term care insurance policy, as defined in s. 600.03 (28g).
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4. A medicare replacement policy, as defined in s. 600.03 (28p).
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5. A medicare supplement policy, as defined in s. 600.03 (28r).
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(1) This act first applies to all of the following:
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(a) Except as provided in paragraphs (b) and (c
), disability insurance policies
20that are issued or renewed, and self-insured health plans that are established,
21extended, modified or renewed, on the effective date of this paragraph.
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(b) Disability insurance policies covering employes who are affected by a
23collective bargaining agreement containing provisions inconsistent with this act
24that are issued or renewed on the earlier of the following:
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251. The day on which the collective bargaining agreement expires.
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12. The day on which the collective bargaining agreement is extended, modified
2or renewed.
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(c) Self-insured health plans covering employes who are affected by a collective
4bargaining agreement containing provisions inconsistent with this act that are
5established, extended, modified or renewed on the earlier of the following:
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61. The day on which the collective bargaining agreement expires.
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72. The day on which the collective bargaining agreement is extended, modified
8or renewed.
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(1)
This act takes effect on the first day of the 5th month beginning after
11publication.
