1997 - 1998 LEGISLATURE
February 24, 1998 - Introduced by Representatives Ainsworth, Bock, Hahn,
Hasenohrl, Musser, Owens, Robson, Skindrud, Springer
and Travis,
cosponsored by Senators Darling and Drzewiecki. Referred to Committee on
Insurance, Securities and Corporate Policy.
AB816,1,4 1An Act to amend 40.51 (1); and to create 20.515 (1) (g) and 40.515 of the
2statutes; relating to: the purchase of health care coverage by certain
3individuals through the group insurance board, granting rule-making
4authority and making an appropriation.
Analysis by the Legislative Reference Bureau
Under current law, the group insurance board, attached to the department of
employe trust funds (DETF), is required to contract on behalf of the state for the
purpose of providing health care coverage to state employes. Many other public
sector employers may also participate in programs offered by the group insurance
board to provide health care coverage for their employes.
This bill provides that, beginning on January 1, 1999, any individual in this
state who is not otherwise eligible for health care coverage under any group
insurance board plan may elect to receive coverage under any health care coverage
plan offered to state employes by paying to DETF the full cost of the required
premiums. The bill also specifies several conditions that must be met by any
individual seeking health care coverage under the state plan and authorizes DETF
to establish preexisting condition exclusions for individuals who elect to receive
coverage under the state plan.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB816, s. 1 5Section 1. 20.515 (1) (g) of the statutes is created to read:
AB816,2,4
120.515 (1) (g) Benefit and coverage payments; private sector health care
2coverage.
All moneys received from individuals under s. 40.515 who elect to be
3included in a health care coverage plan under s. 40.51 (6), for the payment of benefits
4and the cost of administering benefits for the individuals.
AB816, s. 2 5Section 2. 40.51 (1) of the statutes is amended to read:
AB816,2,96 40.51 (1) The procedures and provisions pertaining to enrollment, premium
7transmitted and coverage of eligible employes and individuals eligible for health care
8coverage under s. 40.515
for health care benefits shall be established by contract or
9rule except as otherwise specifically provided by this chapter.
AB816, s. 3 10Section 3. 40.515 of the statutes is created to read:
AB816,2,12 1140.515 Health care coverage for individuals who are not eligible
12employes. (1)
In this section:
AB816,2,1413 (a) "Employer" means any person doing business or operating an organization
14in this state, but who is not an employer, as defined in s. 40.02 (28).
AB816,2,1815 (b) "Preexisting condition" means a condition, whether physical or mental,
16regardless of the cause of the condition, for which medical advice, diagnosis, care or
17treatment was recommended or received within the 6-month period immediately
18preceding the individual's election under sub. (2).
AB816,2,22 19(2) Beginning on January 1, 1999, any individual in this state, who is not
20otherwise eligible for health care coverage under this subchapter, may elect coverage
21under any health care coverage plan offered under s. 40.51 (6) subject to all of the
22following conditions:
AB816,2,2323 (a) The individual is a resident of this state.
AB816,2,2524 (b) The individual pays to the department the full cost of the required
25premiums.
AB816,3,2
1(c) The individual is not eligible for health care coverage for which his or her
2employer is paying or would pay at least 80% of the cost of the coverage.
AB816,3,53 (d) If the individual has terminated health care coverage under this section, the
4individual may not again receive any health care coverage under this section for a
5period of 12 months from the date of termination.
AB816,3,9 6(3) The department shall establish preexisting condition exclusions for
7individuals who elect to receive health care coverage under sub. (2), but any such
8preexisting condition exclusion may not exceed the maximum period permitted
9under s. 632.746.
AB816,3,1010 (End)
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