May 13, 1997 - Introduced by Senators Plache, Moen, Clausing, Wineke, Rude,
Breske and Rosenzweig, cosponsored by Representatives Huebsch,
Handrick, Kelso, Hanson, Musser, R. Young, Seratti, Cullen, Turner,
Black, Baumgart, Bock, La Fave, Gronemus, Morris-Tatum, Staskunas,
Notestein, Wasserman, Coggs, Murat, J. Lehman, Plouff, Hasenohrl and
Baldwin. Referred to Committee on Health, Human Services, Aging,
Corrections, Veterans and Military Affairs.
SB206,1,4
1An Act to amend 40.51 (8), 40.51 (8m), 60.23 (25), 66.184, 120.13 (2) (g), 185.981
2(4t) and 185.983 (1) (intro.); and
to create 111.91 (2) (n) and 632.895 (11) of the
3statutes;
relating to: requiring insurance coverage of certain immunizations
4for children.
Analysis by the Legislative Reference Bureau
This bill requires every health insurance policy (called "disability insurance
policy" in the statutes), including health care plans offered by health maintenance
organizations, preferred provider plans and the state, and every self-insured health
plan of the state or a county, city, town, village or school district, to provide coverage
of appropriate and necessary immunizations, specified in the bill, from birth to age
2, for a dependent child of the insured if the policy or plan covers a dependent of the
insured. (Under current law, health insurance policies are required to cover a newly
born child of the insured, even if the policy did not provide coverage for dependents
at the time of the birth.) Coverage of the specified immunizations may not be subject
to any deductibles, coinsurance or copayments under the policy or plan. Specifically
excluded from this coverage requirement are health insurance policies that cover
only certain specified diseases, health care plans offered by limited service health
organizations, medicare replacement or supplement policies and long-term care
insurance policies.
For further information see the state and local 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:
SB206,2,53
40.51
(8) Every health care coverage plan offered by the state under sub. (6)
4shall comply with ss. 631.89, 631.90, 631.93 (2), 632.72 (2), 632.745 (1) to (3) and (5),
5632.747, 632.87 (3) to (5), 632.895 (5m) and (8) to
(10) (11) and 632.896.
SB206,2,108
40.51
(8m) Every health care coverage plan offered by the group insurance
9board under sub. (7) shall comply with ss. 632.745 (1) to (3) and (5)
and, 632.747
and
10632.895 (11).
SB206,2,1613
60.23
(25) Self-insured health plans. Provide health care benefits to its
14officers and employes on a self-insured basis if the self-insured plan complies with
15ss. 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3),
16632.87 (4) and (5), 632.895 (9)
and (11) and 632.896.
SB206,3,3
1966.184 Self-insured health plans. If a city, including a 1st class city, or a
20village provides health care benefits under its home rule power, or if a town provides
21health care benefits, to its officers and employes on a self-insured basis, the
1self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
2632.745 (2), (3) and (5) (a) 2. and (b) 2., 632.747 (3), 632.87 (4) and (5), 632.895 (9)
and
3(10) to (11), 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).
SB206, s. 5
4Section
5. 111.91 (2) (n) of the statutes is created to read:
SB206,3,65
111.91
(2) (n) The provision to employes of the health insurance coverage
6required under s. 632.895 (11).
SB206,3,129
120.13
(2) (g) Every self-insured plan under par. (b) shall comply with ss.
1049.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.745 (2), (3) and (5) (a) 2. and (b) 2.,
11632.747 (3), 632.87 (4) and (5), 632.895 (9)
and (10)
to (11), 632.896, 767.25 (4m) (d)
12and 767.51 (3m) (d).
SB206,3,1715
185.981
(4t) A sickness care plan operated by a cooperative association is
16subject to ss. 252.14, 631.89, 632.72 (2), 632.745, 632.747, 632.749, 632.87 (2m), (3),
17(4) and (5), 632.895 (10)
and (11) and 632.897 (10) and ch. 155.
SB206,3,2520
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:
SB206, s. 9
1Section
9. 632.895 (11) of the statutes is created to read:
SB206,4,22
632.895
(11) Coverage of immunizations. (a) In this subsection:
SB206,4,53
1. "Appropriate and necessary immunizations" means the administration of
4vaccine that meets the standards approved by the U.S. public health service for such
5biological products against at least all of the following:
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a. Diphtheria.
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h. Any other disease for which immunization is recommended by the state
14health officer appointed under s. 250.02 (1).
SB206,4,1515
2. "Dependent" has the meaning given in s. 635.02 (3c).
SB206,4,2016
(b) Except as provided in par. (d), every disability insurance policy, and every
17self-insured health plan of the state or a county, city, town, village or school district,
18that provides coverage for a dependent of the insured shall provide coverage of
19appropriate and necessary immunizations, from birth to the age of 2 years, for a
20dependent who is a child of the insured.
SB206,4,2221
(c) The coverage required under par. (b) may not be subject to any deductibles,
22copayments or coinsurance under the policy or plan.
SB206,4,2323
(d) This subsection does not apply to any of the following:
SB206,4,2424
1. A disability insurance policy that covers only certain specified diseases.
SB206,5,2
12. A health care plan offered by a limited service health organization, as defined
2in s. 609.01 (3).
SB206,5,33
3. A long-term care insurance policy, as defined in s. 600.03 (28g).
SB206,5,44
4. A medicare replacement policy, as defined in s. 600.03 (28p).
SB206,5,55
5. A medicare supplement policy, as defined in s. 600.03 (28r).
SB206,5,97
(1) The treatment of sections 40.51 (8) and (8m), 60.23 (25), 66.184, 111.91 (2)
8(n), 120.13 (2) (g), 185.981 (4t), 185.983 (1) (intro.) and 632.895 (11) of the statutes
9first applies to all of the following:
SB206,5,1210
(a) Except as provided in paragraphs (b) and (c), disability insurance policies
11that are issued or renewed, and self-insured health plans that are established,
12extended, modified or renewed, on the effective date of this paragraph.
SB206,5,1513
(b) Disability insurance policies covering employes who are affected by a
14collective bargaining agreement containing provisions inconsistent with this act
15that are issued or renewed on the earlier of the following:
SB206,5,16
161. The day on which the collective bargaining agreement expires.
SB206,5,18
172. The day on which the collective bargaining agreement is extended, modified
18or renewed.
SB206,5,2119
(c) Self-insured health plans covering employes who are affected by a
20collective bargaining agreement containing provisions inconsistent with this act
21that are established, extended, modified or renewed on the earlier of the following:
SB206,5,22
221. The day on which the collective bargaining agreement expires.
SB206,5,24
232. The day on which the collective bargaining agreement is extended, modified
24or renewed.
SB206,6,2
1(1) This act takes effect on the first day of the 5th month beginning after
2publication.
