AB1218: Bill Text

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:

AB1218, s. 1 Section 1. 40.51 (8) of the statutes is amended to read:

AB1218,2,5 40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.746 (1) to (8) and (10), 632.747, 632.748, 632.83, 632.835, 632.85, 632.853, 632.855, 632.87 (3) to (5), 632.895 (5m) and (8) to (14) (15), and 632.896.

AB1218, s. 2 Section 2. 40.51 (8m) of the statutes is amended to read:

AB1218,2,9 40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.83, 632.835, 632.85, 632.853, 632.855, and 632.895 (11) to (14) (15).

AB1218, s. 3 Section 3. 66.0137 (4) of the statutes is amended to read:

AB1218,2,16 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.85, 632.853, 632.855, 632.87 (4) and (5), 632.895 (9) to (14) (15), 632.896 , and 767.25 (4m) (d).

AB1218, s. 4 Section 4. 111.91 (2) (n) of the statutes is amended to read:

AB1218,2,19 111.91 (2) (n) The provision to employees of the health insurance coverage required under s. 632.895 (11) to (14) (15).

AB1218, s. 5 Section 5. 120.13 (2) (g) of the statutes is amended to read:

AB1218,3,5 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.85, 632.853, 632.855, 632.87 (4) and (5), 632.895 (9) to (14) (15), 632.896, and 767.25 (4m) (d).

AB1218, s. 6 Section 6. 185.981 (4t) of the statutes is amended to read:

AB1218,3,10 185.981 (4t) A sickness care plan operated by a cooperative association is subject to ss. 252.14, 631.17, 631.89, 631.95, 632.72 (2), 632.745 to 632.749, 632.85, 632.853, 632.855, 632.87 (2m), (3), (4), and (5), 632.895 (10) to (14) (15), and 632.897 (10) and chs. 149 and 155.

AB1218, s. 7 Section 7. 185.983 (1) (intro.) of the statutes is amended to read:

AB1218,3,18 185.983 (1) (intro.) Every such voluntary nonprofit sickness care plan shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.17, 631.89, 631.93, 631.95, 632.72 (2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.85, 632.853, 632.855, 632.87 (2m), (3), (4), and (5), 632.895 (5) and (9) to (14) (15), 632.896 , and 632.897 (10) and chs. 609, 630, 635, 645, and 646, but the sponsoring association shall:

AB1218, s. 8 Section 8. 632.895 (15) of the statutes is created to read:

AB1218,3,21 632.895 (15) Drugs for the treatment of rare diseases. (a) In this subsection, "rare disease or condition" has the meaning given in 21 USC 360bb (a) (2).

AB1218,4,2 (b) Except as provided in par. (e), every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town, or school district, that provides coverage of prescription medication shall provide coverage for any drug that is prescribed for an individual covered under the policy or plan by a physician for the treatment of a rare disease or condition.

AB1218,4,5 (c) The coverage required under par. (b) may be subject to any limitations, exclusions, or cost-sharing provisions that apply generally to other prescription medication under the disability insurance policy or self-insured health plan.

AB1218,4,7 (d) The commissioner shall by rule specify the prescription drugs to which the requirement under par. (b) applies.

AB1218,4,8 (e) This subsection does not apply to any of the following:

AB1218,4,9 1. A disability insurance policy that covers only certain specified diseases.

AB1218,4,12 2. A health care plan offered by a preferred provider plan, as defined in s. 609.01 (4), that provides only limited-scope dental or vision benefits, or by a limited service health organization, as defined in s. 609.01 (3).

AB1218,4,13 3. A medicare replacement policy or a medicare supplement policy.

AB1218, s. 9 Section 9. Initial applicability.

AB1218,4,15 (1) This act first applies to all of the following:

AB1218,4,18 (a) Except as provided in paragraphs (b) and (c ), disability insurance policies that are issued or renewed, and self-insured health plans that are established, extended, modified, or renewed, on the effective date of this paragraph.

AB1218,4,21 (b) Disability insurance policies covering employees who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are issued or renewed on the earlier of the following:

AB1218,4,22 1. The day on which the collective bargaining agreement expires.

AB1218,4,24 2. The day on which the collective bargaining agreement is extended, modified, or renewed.

AB1218,5,3 (c) Self-insured health plans covering employees who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are established, extended, modified, or renewed on the earlier of the following:

AB1218,5,4 1. The day on which the collective bargaining agreement expires.

AB1218,5,6 2. The day on which the collective bargaining agreement is extended, modified, or renewed.

AB1218, s. 10 Section 10. Effective date.

AB1218,5,9 (1) This act takes effect on the first day of the 13th month beginning after publication.

AB1218,5,10 (End)