AB392,1,4 1An Act to amend 40.51 (8), 40.51 (8m), 185.981 (4t) and 185.983 (1) (intro.); and
2to create 111.91 (2) (kc), 609.90 and 631.95 of the statutes; relating to:
3prohibiting certain insurance practices on the basis of domestic abuse and
4prohibiting collective bargaining by the state with respect to the prohibitions.
Analysis by the Legislative Reference Bureau
This bill prohibits an insurer from refusing to provide or renew coverage to a
person or a group, or from canceling a person's or group's coverage, under any type
of insurance policy on the basis that the person or a group member has been, or that
the insurer has reason to believe that the person or a group member is, a victim of
child or domestic abuse or that a member of the person's or a group member's family
has been, or that the insurer has reason to believe that a member of the person's or
a group member's family is, a victim of child or domestic abuse. (Under the statutes,
domestic abuse refers to abuse of an adult family or household member.) The bill
provides, however, that for life, disability income or long-term care insurance an
insurer may refuse to issue a policy that would name as beneficiary a person who is,
or who the insurer has reason to believe is, a perpetrator of child or domestic abuse
against the person who would be the insured under the policy. An insurer also may
refuse to issue a life, disability income or long-term care insurance policy to a person
who lacks an insurable interest in the person who would be the insured under the
policy.
Under the bill, an insurer is prohibited from using as a factor in determining
rates, or any other aspect of insurance coverage, the knowledge or suspicion that a

person or group member has been or is a victim of child or domestic abuse or that a
member of the person's or a group member's family has been or is a victim of child
or domestic abuse. The bill provides, however, that in establishing premiums for an
individual health insurance policy (called disability insurance policy in the statutes)
an insurer may inquire about and use information related to a person's existing
medical condition, regardless of whether the condition was caused by child or
domestic abuse.
The bill prohibits a health insurer from excluding or limiting coverage to a
person or a group under a health insurance policy, or from denying a claim, for
services or items related to the treatment of injury or disease resulting from child or
domestic abuse on the basis that the person or a group member has been, or that the
insurer has reason to believe that the person or a group member is, a victim of child
or domestic abuse or that a member of the person's or a group member's family has
been, or that the insurer has reason to believe that a member of the person's or a
group member's family is, a victim of child or domestic abuse.
A life insurer is prohibited from denying or limiting benefits to a beneficiary in
the event that the death of the person whose life is insured results from child or
domestic abuse on the basis that the person whose life is insured has been, or that
the insurer has reason to believe that the person whose life is insured is, a victim of
child or domestic abuse or that a member of the family of the person whose life is
insured has been, or that the insurer has reason to believe that a member of the
family of the person whose life is insured is, a victim of child or domestic abuse. A
life insurer may, however, deny or limit benefits to a beneficiary who perpetrates
child or domestic abuse that results in the death of the person whose life is insured.
An insurer under a property and casualty insurance policy is prohibited from
denying a claim of an insured on the basis that the damage to which the claim relates
was caused by an intentional act, including child or domestic abuse. If the purpose
of the claim is to obtain insurance proceeds, however, the prohibition applies only if
the insured making the claim was unaware that the person intended to commit the
intentional act.
With certain exceptions, the bill prohibits a person employed by an insurer or
contracting with an insurer from using, disclosing or transferring certain personal
information related to child or domestic abuse, such as information about whether
a person or group member, or a member of the person's or group member's family, has
been or is believed to be a victim of child or domestic abuse and information about
any medical condition of a person or group member, or member of the person's or
group member's family, that is or that is believed to be the result of child or domestic
abuse. With certain exceptions, the bill also prohibits a person employed by an
insurer or contracting with an insurer from disclosing or transferring information
related to the telephone number or address of a person or group member who is an
insured or applicant for insurance, or a member of the family of a person or group
member who is an insured or applicant for insurance.
The bill requires an insurer that denies coverage to a person or group under any
type of insurance policy to advise the applicant in writing of the reasons for the
denial. Insurers are already required under current law to specify in a cancellation

or nonrenewal notice the basis for the cancellation or nonrenewal of an insurance
policy.
Finally, the bill gives life insurers immunity from any civil or criminal liability
for: 1) denying benefits to a beneficiary who is the perpetrator of child or domestic
abuse that results in the death of the insured; 2) refusing to issue a life insurance
policy that names as a beneficiary a person who is, or who the insurer has reason to
believe is, a perpetrator of child or domestic abuse against the person who would be
the insured under the policy; and 3) the death of, or injury to, an insured resulting
from child or domestic abuse.
Current law contains two provisions that are somewhat similar to provisions
in the bill. An insurer may not condition the provision of insurance coverage on, or
consider in the determination of rates or any other aspect of insurance coverage,
whether a person has obtained, or the results of, a test for the presence of human
immunodeficiency virus (HIV), antigen or nonantigenic products of HIV or an
antibody to HIV, or whether a person or a member of the person's family has obtained,
or the results of, a genetic test.
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:
AB392, s. 1 1Section 1. 40.51 (8) of the statutes, as affected by 1997 Wisconsin Act 27,
2section 1324m, is amended to read:
AB392,3,53 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), 631.95, 632.72 (2), 632.746 (1) to (8)
5and (10), 632.747, 632.748, 632.87 (3) to (5), 632.895 (5m) and (8) to (13) and 632.896.
AB392, s. 2 6Section 2. 40.51 (8m) of the statutes, as affected by 1997 Wisconsin Act 27,
7section 1325m, is amended to read:
AB392,3,108 40.51 (8m) Every health care coverage plan offered by the group insurance
9board under sub. (7) shall comply with ss. 631.95, 632.746 (1) to (8) and (10), 632.747
10and, 632.748 and 632.895 (11) to (13).
AB392, s. 3 11Section 3. 111.91 (2) (kc) of the statutes is created to read:
AB392,3,1212 111.91 (2) (kc) Compliance with the insurance requirements under s. 631.95.
AB392, s. 4
1Section 4. 185.981 (4t) of the statutes, as affected by 1997 Wisconsin Act 27,
2section 3133m, is amended to read:
AB392,4,53 185.981 (4t) A sickness care plan operated by a cooperative association is
4subject to ss. 252.14, 631.89, 631.95, 632.72 (2), 632.745 to 632.749, 632.87 (2m), (3),
5(4) and (5), 632.895 (10) to (13) and 632.897 (10) and chs. 149 and 155.
AB392, s. 5 6Section 5. 185.983 (1) (intro.) of the statutes, as affected by 1997 Wisconsin
7Act 27
, section 3134m, is amended to read:
AB392,4,138 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be
9exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
10601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 631.95,
11632.72 (2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5),
12632.895 (5) and (9) to (13), 632.896 and 632.897 (10) and chs. 609, 630, 635, 645 and
13646, but the sponsoring association shall:
AB392, s. 6 14Section 6. 609.90 of the statutes is created to read:
AB392,4,17 15609.90 Restrictions related to domestic abuse. Limited service health
16organizations, preferred provider plans and managed care plans are subject to s.
17631.95.
AB392, s. 7 18Section 7. 631.95 of the statutes is created to read:
AB392,4,20 19631.95 Restrictions on insurance practices; domestic abuse. (1)
20Definitions. In this section:
AB392,4,2121 (a) "Abuse" has the meaning given in s. 813.122 (1) (a).
AB392,4,2222 (b) "Disability insurance policy" has the meaning given in s. 632.895 (1) (a).
AB392,4,2323 (c) "Domestic abuse" has the meaning given in s. 968.075 (1) (a).
AB392,4,25 24(2) General prohibitions. Except as provided in sub. (3), an insurer may not
25do any of the following:
AB392,5,6
1(a) Refuse to provide or renew coverage to a person, or cancel a person's
2coverage, under an individual or group insurance policy or a certificate of group
3insurance on the basis that the person has been, or the insurer has reason to believe
4that the person is, a victim of abuse or domestic abuse or that a member of the
5person's family has been, or the insurer has reason to believe that a member of the
6person's family is, a victim of abuse or domestic abuse.
AB392,5,137 (b) Refuse to provide or renew coverage to an employer or other group, or cancel
8an employer's or other group's coverage, under a group insurance policy on the basis
9that an employe or other group member has been, or the insurer has reason to believe
10that an employe or other group member is, a victim of abuse or domestic abuse or that
11a member of an employe's or other group member's family has been, or the insurer
12has reason to believe that a member of an employe's or other group member's family
13is, a victim of abuse or domestic abuse.
AB392,5,1914 (c) Use as a factor in the determination of rates or any other aspect of insurance
15coverage under an individual or group insurance policy or a certificate of group
16insurance the knowledge or suspicion that a person or an employe or other group
17member has been or is a victim of abuse or domestic abuse or that a member of the
18person's or an employe's or other group member's family has been or is a victim of
19abuse or domestic abuse.
AB392,6,320 (d) Under an individual or group disability insurance policy or a certificate of
21group disability insurance, exclude or limit coverage of, or deny a claim for, health
22care services or items related to the treatment of injury or disease resulting from
23abuse or domestic abuse on the basis that a person or an employe or other group
24member has been, or the insurer has reason to believe that a person or an employe
25or other group member is, a victim of abuse or domestic abuse or that a member of

1the person's or an employe's or other group member's family has been, or the insurer
2has reason to believe that a member of the person's or an employe's or other group
3member's family is, a victim of abuse or domestic abuse.
AB392,6,114 (e) Under an individual or group life insurance policy or a certificate of group
5life insurance, deny or limit benefits in the event that the death of the person whose
6life is insured results from abuse or domestic abuse on the basis that the person
7whose life is insured has been, or the insurer has reason to believe that the person
8whose life is insured is, a victim of abuse or domestic abuse or that a member of the
9family of the person whose life is insured has been, or the insurer has reason to
10believe that a member of the family of the person whose life is insured is, a victim
11of abuse or domestic abuse.
AB392,6,1812 (f) Under a property and casualty insurance policy, deny a claim of an insured
13on the basis that the damages to which the claim relates were caused by an
14intentional act, including abuse or domestic abuse, committed by another person,
15regardless of whether that other person is also an insured. If the intentional act was
16committed for the purpose of obtaining insurance proceeds, this paragraph applies
17only if the insured making the claim had no knowledge that the other person
18intended to commit the intentional act.
AB392,6,24 19(3) Exceptions and qualifications related to prohibitions. (a) Individual
20disability insurance.
In establishing premiums for an individual disability
21insurance policy, an insurer may inquire about a person's existing medical condition
22and, based on the opinion of a qualified actuary, as defined in s. 623.06 (1c), use
23information related to a person's existing medical condition, regardless of whether
24that condition is or may have been caused by abuse or domestic abuse.
AB392,7,3
1(b) Life insurance. With respect to an individual or group life insurance policy
2or a certificate of group life insurance, an insurer may, on the basis of information
3in medical, law enforcement or court records, do any of the following:
AB392,7,54 1. Deny or limit benefits under such a policy or certificate to a beneficiary who
5is the perpetrator of abuse or domestic abuse that results in the death of the insured.
AB392,7,86 2. Refuse to issue such a policy or certificate that names as a beneficiary a
7person who is, or who the insurer has reason to believe is, a perpetrator of abuse or
8domestic abuse against the person who is to be the insured under the policy.
AB392,7,119 3. Refuse to name as a beneficiary under such a policy or certificate a person
10who is, or who the insurer has reason to believe is, a perpetrator of abuse or domestic
11abuse against the insured under the policy.
AB392,7,1412 4. Refuse to issue such a policy or certificate to a person who is, or who the
13insurer has reason to believe is, a perpetrator of abuse or domestic abuse against the
14person who is to be the insured under the policy.
AB392,7,1615 5. Refuse to issue such a policy or certificate to a person who lacks an insurable
16interest in the person who is to be the insured under the policy.
AB392,7,2217 6. For purposes of underwriting or administering a claim under such a policy
18or certificate, inquire about and use information related to a person's existing
19medical condition, regardless of whether that condition is or may have been caused
20by abuse or domestic abuse. Any adverse underwriting decision based on a person's
21medical condition must be made in conformance with sound actuarial principles or
22otherwise supported by actual or reasonably anticipated experience.
AB392,8,223 (c) Disability income or long-term care insurance. With respect to an individual
24or group disability income or long-term care insurance policy or a certificate of group

1disability income or long-term care insurance, an insurer may, on the basis of
2information in medical, law enforcement or court records, do any of the following:
AB392,8,53 1. Refuse to name as a beneficiary under such a policy or certificate a person
4who is, or who the insurer has reason to believe is, a perpetrator of abuse or domestic
5abuse against the insured under the policy.
AB392,8,86 2. Refuse to issue such a policy or certificate to a person who is, or who the
7insurer has reason to believe is, a perpetrator of abuse or domestic abuse against the
8person who is to be the insured under the policy.
AB392,8,109 3. Refuse to issue such a policy or certificate to a person who lacks an insurable
10interest in the person who is to be the insured under the policy.
AB392,8,1711 4. For purposes of underwriting, establishing premiums for or administering
12a claim under such a policy or certificate, inquire about and use information related
13to a person's existing medical condition, regardless of whether that condition is or
14may have been caused by abuse or domestic abuse. Any adverse underwriting
15decision based on a person's medical condition must be made in conformance with
16sound actuarial principles or otherwise supported by actual or reasonably
17anticipated experience.
AB392,8,21 18(4) Immunity for life insurers. A life insurer is immune from any civil or
19criminal liability for any action taken under sub. (3) (b) or for the death of, or injury
20to, an insured that results from abuse or domestic abuse not committed by the
21insurer.
AB392,8,24 22(5) Reason for denial in writing. An insurer that denies coverage under an
23individual or group insurance policy or a certificate of group insurance shall advise
24the applicant or proposed insured in writing of the reasons for the denial.
AB392,9,3
1(6) Use and disclosure of abuse information. (a) Except as provided in pars.
2(c) and (d) and sub. (3), no person employed by or contracting with an insurer may
3use, disclose or transfer information related to any of the following:
AB392,9,94 1. Whether an insured or applicant for insurance or a member of the insured's
5or applicant's family, or whether an employe or other group member of an insured
6or applicant for insurance or a member of the employe's or other group member's
7family, has been a victim of abuse or domestic abuse or is believed, with reason, by
8the person employed by or contracting with the insurer to be a victim of abuse or
9domestic abuse.
AB392,9,1410 2. Any medical condition of an insured or applicant for insurance or a member
11of the insured's or applicant's family, or of an employe or other group member of an
12insured or applicant for insurance or a member of the employe's or other group
13member's family, that is, or that the person employed by or contracting with the
14insurer has reason to believe is, the result of abuse or domestic abuse.
AB392,9,1915 3. Whether an insured or applicant for insurance, or whether an employe or
16other group member of an insured or applicant for insurance, is a family member or
17associate of, or a person in a relationship with, a person who has been, or who the
18person employed by or contracting with the insurer has reason to believe is, a victim
19of abuse or domestic abuse.
AB392,9,2220 4. Whether an insured or an applicant for insurance is an employer of a person
21who has been, or who the person employed by or contracting with the insurer has
22reason to believe is, a victim of abuse or domestic abuse.
AB392,9,2523 (b) Except as provided in pars. (c) and (d), a person employed by or contracting
24with an insurer may not disclose or transfer information related to the telephone
25number or address or other location of any of the following individuals, if the person

1knows that the individual has been, or has reason to believe that the individual is,
2a victim of abuse or domestic abuse:
AB392,10,33 1. An insured.
AB392,10,44 2. An applicant for insurance.
AB392,10,55 3. An employe of an insured or of an applicant for insurance.
AB392,10,66 4. A group member of an insured or of an applicant for insurance.
AB392,10,77 5. A member of the family of any of the individuals listed in subds. 1. to 4.
AB392,10,108 (c) Paragraphs (a) and (b) do not apply if the use, disclosure or transfer of the
9information is made with the consent of the individual to whom the information
10relates or if the use, disclosure or transfer satisfies any of the following:
AB392,10,1111 1. Is for a purpose related to the direct provision of health care services.
AB392,10,1312 2. Is necessary for a valid business purpose, including the disclosure or transfer
13of the information to any of the following:
AB392,10,1414 a. A reinsurer.
AB392,10,1615 b. A party to a proposed or consummated sale, transfer, merger or consolidation
16of all or part of the business of the insurer.
AB392,10,1817 c. Medical, underwriting or claims personnel under contract or affiliated with
18the insurer.
AB392,10,1919 d. An attorney representing the interests of the insurer.
AB392,10,2020 3. Is in response to legal process.
AB392,10,2221 4. Is required by a court order or an order of an entity with authority to regulate
22insurance, or is otherwise required by law.
AB392,10,2323 5. Is required or authorized by the commissioner by rule.
AB392,11,3
1(d) Nothing in this subsection limits or precludes an insured or an applicant
2for insurance, or an employe or other group member of an insured or applicant for
3insurance, from obtaining his or her own insurance records from an insurer.
AB392, s. 8 4Section 8. Initial applicability.
AB392,11,55 (1) This act first applies to all of the following:
AB392,11,86 (a) Except as provided in paragraph (b), policies or certificates that are issued,
7renewed or applied for, whichever is appropriate, on the effective date of this
8paragraph.
AB392,11,129 (b) Policies or certificates covering employes who are affected by a collective
10bargaining agreement containing provisions inconsistent with this act that are
11issued, renewed or applied for, whichever is appropriate, on the earlier of the
12following:
AB392,11,13 131. The day on which the collective bargaining agreement expires.
AB392,11,15 142. The day on which the collective bargaining agreement is extended, modified
15or renewed.
AB392, s. 9 16Section 9. Effective date.
AB392,11,1817 (1) This act takes effect on the first day of the 6th month beginning after
18publication.
AB392,11,1919 (End)
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