AB793, s. 18
20Section
18. 632.89 (2) (title) of the statutes is amended to read:
AB793,6,2121
632.89
(2) (title)
Required coverage
for group plans.
AB793, s. 19
22Section
19. 632.89 (2) (a) 1. of the statutes is renumbered 632.89 (2) (a) and
23amended to read:
AB793,7,224
632.89
(2) (a) A group
or blanket disability insurance policy issued by an
25insurer health benefit plan and a self-insured health plan shall provide coverage of
1nervous and mental disorders and alcoholism and other drug abuse problems if
2required by
pars. (c) to (dm) and as provided in pars.
(b) (c) to
(e)
(dm) and sub. (3).
AB793, s. 22
7Section
22. 632.89 (2) (c) 1. of the statutes is renumbered 632.89 (2) (c) and
8amended to read:
AB793,7,139
632.89
(2) (c)
Minimum coverage Coverage of inpatient hospital services. If a
10group
or blanket disability insurance policy issued by an insurer health benefit plan
11or a self-insured health plan provides coverage of any inpatient hospital treatment,
12the
policy plan shall provide coverage for inpatient hospital services for the
13treatment of conditions under par. (a)
1. as provided in subd. 2.
AB793, s. 24
16Section
24. 632.89 (2) (d) 1. of the statutes is renumbered 632.89 (2) (d) and
17amended to read:
AB793,7,2218
632.89
(2) (d)
Minimum coverage Coverage of outpatient services. If a group
or
19blanket disability insurance policy issued by an insurer health benefit plan or a
20self-insured health plan provides coverage of any outpatient treatment, the
policy 21plan shall provide coverage for outpatient services for the treatment of conditions
22under par. (a)
1. as provided in subd. 2.
AB793, s. 26
1Section
26. 632.89 (2) (dm) 1. of the statutes is renumbered 632.89 (2) (dm)
2and amended to read:
AB793,8,83
632.89
(2) (dm)
Minimum coverage Coverage of transitional treatment
4arrangements. If a group
or blanket disability insurance policy issued by an insurer 5health benefit plan or a self-insured health plan provides coverage of any inpatient
6hospital treatment or any outpatient treatment, the
policy plan shall provide
7coverage for transitional treatment arrangements for the treatment of conditions
8under par. (a)
1. as provided in subd. 2.
AB793, s. 28
11Section
28. 632.89 (2) (e) of the statutes is renumbered 632.89 (5) (b) and
12amended to read:
AB793,8,1613
632.89
(5) (b)
Exclusion
Certain health care plans. This
subsection section does
14not apply to a health care plan offered by a limited service health organization, as
15defined in s. 609.01 (3)
, or by a preferred provider plan, as defined in s. 609.01 (4),
16that is not a managed care plan, as defined in s. 609.01 (3c).
AB793, s. 29
17Section
29. 632.89 (2m) of the statutes is renumbered 632.89 (4m).
AB793, s. 30
18Section
30. 632.89 (3) of the statutes is created to read:
AB793,8,2319
632.89
(3) Equal coverage requirement. (a)
Group plans. A group health
20benefit plan or a self-insured health plan that provides coverage for the treatment
21of nervous and mental disorders and alcoholism and other drug abuse problems shall
22provide the same coverage for that treatment that it provides for the treatment of
23physical conditions.
AB793,9,224
(b)
Individual plans. If an individual health benefit plan provides coverage for
25the treatment of nervous or mental disorders or alcoholism or other drug abuse
1problems, the individual health benefit plan shall provide the same coverage for that
2treatment that it provides for the treatment of physical conditions.
AB793,9,73
(c)
All coverage components. The requirements under this subsection apply to
4all coverage-related components, including rates; exclusions and limitations;
5deductibles; copayments; coinsurance; annual and lifetime payment limits;
6out-of-pocket limits; out-of-network charges; day, visit or appointment limits;
7duration or frequency of coverage; and medical necessity definitions.
AB793, s. 31
8Section
31. 632.89 (3m) of the statutes is repealed.
AB793, s. 32
9Section
32. 632.89 (5) (title) of the statutes is amended to read:
AB793,9,1010
632.89
(5) (title)
Medicare exclusion Exclusions.
AB793, s. 33
11Section
33. 632.89 (5) of the statutes is renumbered 632.89 (5) (a).
AB793, s. 34
12Section
34. 632.89 (5) (a) (title) of the statutes is created to read:
AB793,9,1313
632.89
(5) (a) (title)
Medicare.
AB793,9,1515
(1) This act first applies to all of the following:
AB793,9,1816
(a) Except as provided in paragraphs (b) and (c
), health benefit plans that are
17issued or renewed, and self-insured health plans that are established, extended,
18modified or renewed, on the effective date of this paragraph.
AB793,9,2119
(b) Health benefit plans covering employes who are affected by a collective
20bargaining agreement containing provisions inconsistent with this act that are
21issued or renewed on the earlier of the following:
AB793,9,22
221. The day on which the collective bargaining agreement expires.
AB793,9,24
232. The day on which the collective bargaining agreement is extended, modified
24or renewed.
AB793,10,3
1(c) Self-insured health plans covering employes who are affected by a collective
2bargaining agreement containing provisions inconsistent with this act that are
3established, extended, modified or renewed on the earlier of the following:
AB793,10,4
41. The day on which the collective bargaining agreement expires.
AB793,10,6
52. The day on which the collective bargaining agreement is extended, modified
6or renewed.
AB793,10,98
(1)
This act takes effect on the first day of the 6th month beginning after
9publication.