SB466,27,4
15. If equal to or greater than $20,000 and less than $25,000, to 130% 130
2percent
of the rate that a standard risk would be charged under an individual policy
3providing substantially the same coverage and deductibles cost-sharing provisions
4as provided under s. 149.14 (2) (a) and (5) (a).
SB466,27,135 (bc) Subject to sub. subs. (3m) and (3r), if the household income, as defined in
6s. 71.52 (5) and as determined under sub. (3), of an eligible person with coverage
7under s. 149.14 (2) (b) is equal to or greater than the first amount and less than the
82nd amount listed in par. (a) 1., 2., 3., 4., or 5., the department board shall reduce the
9premium established for the eligible person by the same percentage as the
10department board reduces, under par. (a), the premium established for an eligible
11person with coverage under s. 149.14 (2) (a) who has a household income specified
12in the same subdivision under par. (a) as the household income of the eligible person
13with coverage under s. 149.14 (2) (b).
SB466, s. 76 14Section 76. 149.165 (3) (a) of the statutes is amended to read:
SB466,27,1715 149.165 (3) (a) Subject to par. (b), the department board shall establish and
16implement the method for determining the household income of an eligible person
17under sub. (2).
SB466, s. 77 18Section 77. 149.165 (3) (b) (intro.) of the statutes is amended to read:
SB466,27,2219 149.165 (3) (b) (intro.) In determining household income under sub. (2), the
20department board shall consider information submitted by an eligible person on a
21completed federal profit or loss from farming form, schedule F, if all of the following
22apply:
SB466, s. 78 23Section 78. 149.165 (3r) of the statutes is created to read:
SB466,28,3
1149.165 (3r) The board shall use any excess premiums collected under a
2schedule established under s. 149.15 (4) (d) to further reduce the premium rates
3under sub. (2) (a) 1. to 5. and (bc).
SB466, s. 79 4Section 79. 149.17 (4) of the statutes is amended to read:
SB466,28,65 149.17 (4) Cost containment provisions established by the department board
6by rule, including managed care requirements.
SB466, s. 80 7Section 80. 149.175 of the statutes is amended to read:
SB466,28,12 8149.175 Waiver or exemption from provisions prohibited. Except as
9provided in s. ss. 149.13 (1) and 149.132 (1) (b), the department or the board may not
10waive, or authorize the board to waive, any of the requirements of this chapter or
11exempt, or authorize the board to exempt, an individual or a class of individuals from
12any of the requirements of this chapter.
SB466, s. 81 13Section 81. 149.20 of the statutes is amended to read:
SB466,28,17 14149.20 Rule-making in consultation with Rules to be approved by
15board.
In promulgating any Any rules proposed by the department under this
16chapter, the department shall consult with may not be promulgated without the
17approval of
the board.
SB466, s. 82 18Section 82. 149.25 (2) (a) of the statutes is amended to read:
SB466,28,2219 149.25 (2) (a) The department shall conduct a 3-year pilot program, beginning
20on July 1, 2002, under which eligible persons who qualify under par. (b) are provided
21community-based case management services. The department shall consult with
22the board as necessary in conducting the pilot program.
SB466, s. 83 23Section 83. 149.25 (4) of the statutes is amended to read:
SB466,29,724 149.25 (4) Evaluation study. The department, in consultation with the board,
25shall conduct a study that evaluates the pilot program in terms of health care

1outcomes and cost avoidance. In the study, the department shall measure and
2compare, for pilot program participants and similarly situated eligible persons not
3participating in the pilot program, plan costs and utilization of services, including
4inpatient hospital days, rates of hospital readmission within 30 days for the same
5diagnosis, and prescription drug utilization. The department shall submit a report
6on the results of the study, including the department's conclusions and
7recommendations, to the legislature under s. 13.172 (2) and to the governor.
SB466, s. 84 8Section 84. 450.10 (2m) of the statutes is created to read:
SB466,29,119 450.10 (2m) If a manufacturer or labeler fails to pay an assessment levied
10under s. 149.132 within the time required for payment, the board may assess a
11forfeiture of not more than $1,000 for each day that the payment is past due.
SB466, s. 85 12Section 85. Nonstatutory provisions.
SB466,29,2013 (1) Federal grant funds. Notwithstanding section 149.143 (1) of the statutes,
14as affected by this act, any federal grant moneys received by the state under the
15Trade Adjustment Assistance Reform Act of 2002 and allocated to the Health
16Insurance Risk-Sharing Plan shall be used to pay plan costs before any moneys
17specified under section 149.143 (1) (am) and (bm) of the statutes, as affected by this
18act, are used. After the federal grant money has been used, plan costs shall be paid
19as provided under section 149.143 (1) (am) and (bm) of the statutes, as affected by
20this act.
SB466,29,2421 (2) Selection of plan administrator. The board of governors of the Health
22Insurance Risk-Sharing Plan shall, no later than July 1, 2004, issue a
23request-for-proposals under section 149.15 (3) (e) of the statutes, as created by this
24act, for administration of the Health Insurance Risk-Sharing Plan.
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1(3) Drug manufacturer and labeler assessments. Notwithstanding section
2149.132 of the statutes, as created by this act, the first assessment under section
3149.132 of the statutes, as created by this act, that is payable by prescription drug
4manufacturers and labelers shall be calculated on prescription drug claims paid by
5the Health Insurance Risk-Sharing Plan from July 1, 2004, to December 31, 2004,
6rather than on total prescription drug claims paid in 2004.
SB466, s. 86 7Section 86 . Initial applicability.
SB466,30,128 (1) Design. With respect to changes in plan design, including covered expenses
9and exclusions, deductibles, copayments, coinsurance, and out-of-pocket limits, the
10treatment of sections 149.11, 149.14 (3) (intro.) and (a) to (r), (4), (5) (d) and (e), and
11(8), 149.146 (1) (b) and (2) (a), (am) 4. and 5., and (b) (intro.) and 1., 149.15 (3) (b), and
12149.17 (4) of the statutes first applies to the plan year beginning on January 1, 2005.
SB466,30,1513 (2) Eligibility. The treatment of section 149.12 (1) (a), (am), (b), and (c) of the
14statutes first applies to applications for coverage under the Health Insurance
15Risk-Sharing Plan that are received on the effective date of this subsection.
SB466,30,2016 (3) Drug manufacturer and labeler assessments. The treatment of sections
1725.55 (3), 149.10 (5f) and (5r), 149.132, 149.143 (1) (bm) 1., 1m., 2., and 2m. (intro.),
18(2) (a) 3. and 4., (3) (a) (by Section 49), and (5) (a) (by Section 53), 149.145 (by Section
1957), and 450.10 (2m) of the statutes first applies to drug manufacturer and labeler
20assessments that are payable with respect to claims paid on July 1, 2004.
SB466, s. 87 21Section 87. Effective dates. This act takes effect on the day after publication,
22except as follows:
SB466,30,2523 (1) Eligibility. The treatment of section 149.12 (1) (a), (am), (b), and (c) of the
24statutes and Section 86 (2) of this act take effect on the first day of the 4th month
25beginning after publication.
SB466,31,4
1(2) Drug manufacturer and labeler assessments. The treatment of sections
225.55 (3), 149.10 (5f) and (5r), 149.132, 149.143 (1) (bm) 1., 1m., 2., and 2m. (intro.),
3(2) (a) 3. and 4., (3) (a) (by Section 49), and (5) (a) (by Section 53), 149.145 (by Section
457), and 450.10 (2m) of the statutes takes effect on July 1, 2004.
SB466,31,55 (End)
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