SB77: Bill Text

SB77,1801,15 601.41 (1) Duties. The commissioner shall administer and enforce chs. 153 and 600 to 655 and ss. 59.52 (11) (c), 66.184 and 120.13 (2) (b) to (g) and shall act as promptly as possible under the circumstances on all matters placed before the commissioner.

SB77, s. 4796 Section 4796 . 601.41 (1) of the statutes, as affected by 1997 Wisconsin Act .... (this act), is amended to read:

SB77,1801,21 601.41 (1) Duties. The commissioner shall administer and enforce chs. 600 to 655 and ss. 59.52 (11) (c), 66.184 and, 120.13 (2) (b) to (g), 149.13 and 149.135 and shall act as promptly as possible under the circumstances on all matters placed before the commissioner.

SB77, s. 4797 Section 4797. 601.415 (12) of the statutes is created to read:

SB77,1802,2 601.415 (12) Health insurance risk-sharing plan. The commissioner shall perform the duties specified to be performed by the commissioner in ss. 149.13 and 149.135. The commissioner, or his or her designee, shall serve as a member of the board under s. 149.15.

SB77, s. 4798 Section 4798. 601.429 of the statutes is repealed.

SB77, s. 4799 Section 4799. 601.465 (intro.) of the statutes is amended to read:

SB77,1802,7 601.465 Nondisclosure of information. (intro.) The Except for information requested under s. 49.22 (2m), the office may refuse to disclose and may prevent any other person from disclosing any of the following:

SB77, s. 4800 Section 4800. 601.59 (6) (e) of the statutes is amended to read:

SB77,1802,24 601.59 (6) (e) The commission's rules shall establish conditions and procedures under which the commission shall make its information and official records available to the public for inspection or copying. The commission may exempt from disclosure any information or official records to the extent disclosure would adversely affect personal privacy rights or proprietary interests. In promulgating such rules, the commission may consider any special circumstances pertaining to insurer insolvencies, but shall be guided by the principles embodied in state and federal freedom of information laws. The commission may promulgate additional rules under which it may make available to law enforcement agencies, and to the department of industry, labor and job development and county child support agencies under s. 59.53 (5) in the administration of ss. 49.145, 49.19, 49.22, 49.46 and 49.47 and programs carrying out the purposes of 7 USC 2011 to 2029, records and information otherwise exempt from disclosure, and may enter into agreements with law enforcement agencies, the department of industry, labor and job development and county child support agencies under s. 59.53 (5) to receive or exchange information or records subject to nondisclosure and confidentiality provisions.

SB77, s. 4801 Section 4801. 601.64 (1) of the statutes is amended to read:

SB77,1803,7 601.64 (1) Injunctions and restraining orders. The commissioner may commence an action in circuit court in the name of the state to restrain by temporary or permanent injunction or by temporary restraining order any violation of chs. 600 to 655, s. 149.13 or 149.135, any rule promulgated under chs. 600 to 655 or any order issued under s. 601.41 (4). Except as provided in s. 641.20, the commissioner need not show irreparable harm or lack of an adequate remedy at law in an action commenced under this subsection.

SB77, s. 4802 Section 4802. 601.64 (3) (a) of the statutes is amended to read:

SB77,1803,12 601.64 (3) (a) Restitutionary forfeiture. Whoever violates an effective order issued under s. 601.41 (4) or, any insurance statute or rule or s. 149.13 or 149.135 shall forfeit to the state twice the amount of any profit gained from the violation, in addition to any other forfeiture or penalty imposed.

SB77, s. 4803 Section 4803. 601.64 (3) (c) of the statutes is amended to read:

SB77,1803,20 601.64 (3) (c) Forfeiture for violation of statute or rule. Whoever violates an insurance statute or rule or s. 149.13 or 149.135, intentionally aids a person in violating an insurance statute or rule or s. 149.13 or 149.135 or knowingly permits a person over whom he or she has authority to violate an insurance statute or rule or s. 149.13 or 149.135 shall forfeit to the state not more than $1,000 for each violation. If the statute or rule imposes a duty to make a report to the commissioner, each week of delay in complying with the duty is a new violation.

SB77, s. 4804 Section 4804. 601.64 (4) of the statutes is amended to read:

SB77,1804,3 601.64 (4) Criminal penalty. Whoever intentionally violates or intentionally permits any person over whom he or she has authority to violate or intentionally aids any person in violating any insurance statute or rule of this state , s. 149.13 or 149.135 or any effective order issued under s. 601.41 (4) may, unless a specific penalty is provided elsewhere in the statutes, be fined not more than $10,000 if a corporation or if a natural person be fined not more than $5,000 or imprisoned for not to exceed 3 years or both. Intent has the meaning expressed under s. 939.23.

SB77, s. 4805 Section 4805. 611.11 (4) (title) of the statutes is amended to read:

SB77,1804,5 611.11 (4) (title) Municipalities Local governmental units.

SB77, s. 4806 Section 4806. 611.11 (4) (a) of the statutes is amended to read:

SB77,1804,8 611.11 (4) (a) In this subsection, "municipality" "local governmental unit" has the meaning given in s. 345.05 (1) (c) (bg).

SB77, s. 4807 Section 4807. 611.11 (4) (b) (intro.) of the statutes is amended to read:

SB77,1804,13 611.11 (4) (b) (intro.) Any number of municipalities local governmental units or associations of municipalities local governmental units or both may organize a municipal insurance mutual under s. 611.13, subject to s. 611.23, to provide any of the following for its members:

SB77, s. 4808 Section 4808. 613.03 (3) of the statutes is amended to read:

SB77,1804,19 613.03 (3) Applicability of insurance laws. Except as otherwise specifically provided, service insurance corporations organized or operating under this chapter are subject to subch. II of ch. 619 and ss. 610.01, 610.11, 610.21, 610.23 and 610.24 and chs. 600, 601, 609, 617, 620, 623, 625, 627, 628, 631, 632, 635 and 645 and to no other insurance laws.

SB77, s. 4809 Section 4809. 613.03 (4) of the statutes is created to read:

SB77,1804,22 613.03 (4) Mandatory health insurance risk-sharing plan. Service insurance corporations organized or operating under this chapter are subject to ch. 149.

SB77, s. 4810 Section 4810. 614.05 (1) of the statutes is amended to read:

SB77,1804,25 614.05 (1) Chapters 611 and 619. No section of ch. 611 or subch. I of ch. 619 applies to fraternals unless it is specifically made applicable by this chapter.

SB77, s. 4811 Section 4811. Subchapter I of chapter 619 [precedes 619.001] of the statutes is renumbered chapter 619 [precedes 619.001].

SB77, s. 4812 Section 4812. Subchapter I (title) of chapter 619 [precedes 619.01] of the statutes is repealed.

SB77, s. 4813 Section 4813. Subchapter II (title) of chapter 619 [precedes 619.10] of the statutes is repealed.

SB77, s. 4814 Section 4814. 619.10 (intro.) of the statutes is renumbered 149.10 (intro.) and amended to read:

SB77,1805,9 149.10 Definitions. (intro.) In this subchapter chapter:

SB77, s. 4815 Section 4815. 619.10 (1) of the statutes is repealed.

SB77, s. 4816 Section 4816. 619.10 (1m) of the statutes is repealed.

SB77, s. 4817 Section 4817. 619.10 (2) of the statutes is renumbered 149.10 (2) and amended to read:

SB77,1805,15 149.10 (2) "Board" means the board of governors established under s. 619.15 149.15.

SB77, s. 4818 Section 4818. 619.10 (3) of the statutes is renumbered 149.10 (3) and amended to read:

SB77,1805,20 149.10 (3) "Eligible person" means a resident of this state who qualifies under s. 619.12 149.12 whether or not the person is legally responsible for the payment of medical expenses incurred on the person's behalf.

SB77, s. 4819 Section 4819. 619.10 (3m) and (4) of the statutes are renumbered 149.10 (3m) and (4).

SB77, s. 4820 Section 4820. 619.10 (4m) of the statutes is renumbered 149.10 (4m).

SB77, s. 4821 Section 4821. 619.10 (5) of the statutes is renumbered 149.10 (5) and amended to read:

SB77,1806,12 149.10 (5) "Insurer" means any person or association of persons, including a health maintenance organization, limited service health organization or preferred provider plan offering or insuring health services on a prepaid basis, including, but not limited to, policies of health insurance issued by a currently licensed insurer, as defined in s. 600.03 (27), nonprofit hospital or medical service plans under ch. 613, cooperative medical service plans under s. 185.981, or other entity whose primary function is to provide diagnostic, therapeutic or preventive services to a defined population in return for a premium paid on a periodic basis. "Insurer" includes any person providing health services coverage for individuals on a self-insurance basis without the intervention of other entities, as well as any person providing health insurance coverage under a medical reimbursement plan to persons. "Insurer" does not include a plan under ch. 613 which offers only dental care.

SB77, s. 4822 Section 4822. 619.10 (6) and (7) of the statutes are renumbered 149.10 (6) and (7).

SB77, s. 4823 Section 4823. 619.10 (8) of the statutes is renumbered 149.10 (8) and amended to read:

SB77,1806,18 149.10 (8) "Plan" means the health care insurance plan established and administered under this subchapter chapter.

SB77, s. 4824 Section 4824. 619.10 (9) of the statutes is renumbered 149.10 (9) and amended to read:

SB77,1807,5 149.10 (9) "Resident" means a person who has been is legally domiciled in this state for a period of at least 30 days. For purposes of this subchapter chapter, legal domicile is established by living in this state and obtaining a Wisconsin motor vehicle operator's license, registering to vote in Wisconsin or filing a Wisconsin income tax return. A child is legally domiciled in this state if the child lives in this state and if at least one of the child's parents or the child's guardian is legally domiciled in this state. A person with a developmental disability or another disability which prevents the person from obtaining a Wisconsin motor vehicle operator's license, registering to vote in Wisconsin, or filing a Wisconsin income tax return, is legally domiciled in this state by living in this state for 30 days.

SB77, s. 4825 Section 4825. 619.11 of the statutes is renumbered 149.11 and amended to read:

SB77,1807,11 149.11 (title) Establishment Operation of plan. The commissioner department shall promulgate rules establishing for the operation of a plan of health insurance coverage for an eligible person which satisfies the requirements of this chapter.

SB77, s. 4826 Section 4826. 619.12 (title) of the statutes is renumbered 149.12 (title).

SB77, s. 4827 Section 4827. 619.12 (1) of the statutes is renumbered 149.12 (1), and 149.12 (1) (intro.), as renumbered, is amended to read:

SB77,1807,21 149.12 (1) (intro.) Except as provided in subs. (1m) and (2), the board or administering carrier plan administrator shall certify as eligible a person who is covered by medicare because he or she is disabled under 42 USC 423, a person who submits evidence that he or she has tested positive for the presence of HIV, antigen or nonantigenic products of HIV or an antibody to HIV, and any person who receives and submits any of the following based wholly or partially on medical underwriting considerations within 9 months prior to making application for coverage by the plan:

SB77, s. 4828 Section 4828. 619.12 (1m) (intro) and (a) of the statutes are consolidated, renumbered 149.12 (1m) and amended to read:

SB77,1808,2 149.12 (1m) The board or administering carrier plan administrator may not certify a person as eligible under circumstances requiring notice under sub. (1) (a) to (d) if the required notices were issued by one of the following: (a) An an insurance intermediary who is not acting as an administrator, as defined in s. 633.01.

SB77, s. 4829 Section 4829. 619.12 (1m) (b) of the statutes is repealed.

SB77, s. 4830 Section 4830. 619.12 (2) of the statutes is renumbered 149.12 (2), and 149.12 (2) (b) 1. and (e) 2. c., as renumbered, are amended to read:

SB77,1808,9 149.12 (2) (b) 1. Except as provided in subd. 2., no person who is covered under the plan and who voluntarily terminates the coverage under the plan, is again eligible for coverage unless 12 months have elapsed since the person's latest voluntary termination of coverage under the plan.

SB77,1808,14 (e) 2. c. The board finds that the person is eligible for coverage under the plan after a review process, determined by the commissioner department by rule under s. 619.123 149.123, that evaluates and approves the certification by the physician that the person has a severe and chronic or long-lasting physical or mental illness or disability.

SB77, s. 4831 Section 4831. 619.12 (3) of the statutes is renumbered 149.12 (3), and 149.12 (3) (c), as renumbered, is amended to read:

SB77,1808,20 149.12 (3) (c) The commissioner, in consultation with the board, department may promulgate rules specifying other deductible or coinsurance amounts that, if paid or reimbursed for persons, will not make the persons ineligible for coverage under the plan.

SB77, s. 4832 Section 4832. 619.123 of the statutes is renumbered 149.123 and amended to read:

SB77,1809,2 149.123 Rules for review of physician certification. The commissioner department shall promulgate rules that establish the procedure to be used by the board under s. 619.12 149.12 (2) (e) 2. c. The rules shall provide for an insurer that would be affected by the decision of the board to participate in the review process to contest or support the physician's certification.

SB77, s. 4833 Section 4833. 619.125 of the statutes is renumbered 149.125 and amended to read:

SB77,1809,7 149.125 Health insurance risk-sharing plan fund. There is created a health insurance risk-sharing plan fund, under the management of the board department, to fund administrative expenses.

SB77, s. 4834 Section 4834. 619.13 (title) of the statutes is renumbered 149.13 (title).

SB77, s. 4835 Section 4835. 619.13 (1) (a) of the statutes is renumbered 149.13 (1) (a) and amended to read:

SB77,1809,15 149.13 (1) (a) Every insurer shall participate in the cost of administering the plan, except the commissioner may by rule exempt as a class those insurers whose share as determined under par. (b) would be so minimal as to not exceed the estimated cost of levying the assessment. The commissioner shall advise the department of the insurers participating in the cost of administering the plan.

SB77, s. 4836 Section 4836. 619.13 (1) (b) of the statutes is renumbered 149.13 (1) (b) and amended to read:

SB77,1809,24 149.13 (1) (b) Except as provided by a rule promulgated under s. 619.145 (4), every Every participating insurer shall share in the operating, administrative and subsidy expenses of the plan in proportion to the ratio of the insurer's total health care coverage revenue for residents of this state during the preceding calendar year to the aggregate health care coverage revenue of all participating insurers for residents of this state during the preceding calendar year, as determined by the commissioner.

SB77, s. 4837 Section 4837. 619.13 (1) (c) of the statutes is repealed.

SB77, s. 4838 Section 4838. 619.13 (1) (d) of the statutes is renumbered 149.13 (1) (d), and 149.13 (1) (d) 2., as renumbered, is amended to read:

SB77,1810,9 149.13 (1) (d) 2. If the department or the commissioner finds that the commissioner's authority to require insurers to report under chs. 600 to 646 and 655 is not adequate to permit the department, the commissioner or the board to carry out the department's, commissioner's or the board's responsibilities under this subchapter chapter, the commissioner may shall promulgate rules requiring insurers to report the information necessary for the department, commissioner and the board to make the determinations required under this subchapter chapter.

SB77, s. 4839 Section 4839. 619.13 (2) of the statutes is renumbered 149.13 (2).

SB77, s. 4840 Section 4840. 619.135 (title) of the statutes is renumbered 149.135 (title).

SB77, s. 4841 Section 4841. 619.135 (1) (a) of the statutes is renumbered 149.135 (1) (a) and amended to read:

SB77,1810,21 149.135 (1) (a) Whenever a person becomes eligible for and obtains coverage under the plan as a result of receiving a notice under s. 619.12 149.12 (1) (am), (b) or (c), the commissioner shall levy an assessment of $1,750 against the insurer that issued the notice, except that the commissioner may not levy an assessment if the notice of cancellation under s. 619.12 149.12 (1) (am) was issued on one of the permissible grounds under s. 631.36 (2) (a). The commissioner shall notify the department if an assessment is not levied under this paragraph because a notice of cancellation was issued on permissible grounds.

SB77, s. 4842 Section 4842. 619.135 (1) (b) of the statutes is renumbered 149.135 (1) (b).

SB77, s. 4843 Section 4843. 619.135 (1) (c) of the statutes is renumbered 149.135 (1) (c) and amended to read:

SB77,1811,4 149.135 (1) (c) If an assessment levied under par. (a) is not paid within the time prescribed, the commissioner shall impose a penalty against the insurer in an amount established by the commissioner by rule, in consultation with the department.

SB77, s. 4844 Section 4844. 619.135 (1) (d) of the statutes is renumbered 149.135 (1) (d) and amended to read:

SB77,1811,8 149.135 (1) (d) All assessments and penalties collected under this subsection shall be credited to the appropriation under s. 20.145 (7) (g) 20.435 (5) (hp).

SB77, s. 4845 Section 4845. 619.135 (2) of the statutes is renumbered 149.135 (2) and amended to read:

SB77,1811,21 149.135 (2) If the moneys under s. 20.145 (7) (a) and (g) 20.435 (5) (ah), (g) and (hp) are insufficient to reimburse the plan for premium reductions under s. 619.165 149.165 and deductible reductions under s. 619.14 149.14 (5) (a), or the commissioner department determines that the moneys under s. 20.145 (7) (a) and (g) 20.435 (5) (ah), (g) and (hp) will be insufficient to reimburse the plan for premium reductions under s. 619.165 149.165 and deductible reductions under s. 619.14 149.14 (5) (a), the department shall notify the commissioner. In consultation with the department, the commissioner shall, by rule, increase the amount of the assessment under sub. (1) (a) or levy an assessment against every insurer, or a combination of both, sufficient to reimburse the plan for premium reductions under s. 619.165 149.165 and deductible reductions under s. 619.14 149.14 (5) (a).

SB77, s. 4846 Section 4846. 619.135 (3) of the statutes is renumbered 149.135 (3) and amended to read:

SB77,1812,5 149.135 (3) In addition to the assessments under subs. (1) (a) and (2), in consultation with the department the commissioner may, by rule, establish an assessment to be levied against each insurer that issues a notice of rejection under s. 619.12 149.12 (1) (a) to a person who becomes eligible for and obtains coverage under the plan as a result of receiving the notice. Any assessments levied and collected under this subsection shall be credited to the appropriation under s. 20.145 (7) (g) 20.435 (5) (hp).

SB77, s. 4847 Section 4847. 619.14 (title) of the statutes is renumbered 149.14 (title).