LRB-3783/1
PJK:lmk:jf
2005 - 2006 LEGISLATURE
November 3, 2005 - Introduced by Senators Kanavas, Darling, Leibham, Lazich
and Roessler, cosponsored by Representatives Gielow, Hahn, Hines,
Hundertmark, Jensen, Jeskewitz, Krawczyk, F. Lasee, McCormick, Mursau,
Musser, Nischke, Ott, Shilling, Towns, Townsend
and Vos. Referred to
Committee on Health, Children, Families, Aging and Long Term Care.
SB420,1,2 1An Act to amend 632.745 (9), 635.01 and 635.02 (8) of the statutes; relating to:
2the definition of a group health benefit plan.
Analysis by the Legislative Reference Bureau
Current law contains various requirements that apply to group health benefit
plans or the insurers that issue group health benefit plans. For example, consistent
with the federal Health Insurance Portability and Accountability Act, insurers that
sell group health benefit plans to employers must comply with requirements related
to preexisting conditions, enrollment periods, and contract renewals. Insurers that
sell group health benefit plans to small employers (those with between 2 and 50
employees) are subject to certain marketing standards and to certain restrictions on
premium rates that may be charged for those policies.
Current law generally defines a group health benefit plan as a health benefit
plan that is sold to or through an employer on behalf of a group that consists of at
least two employees or individual health benefit plans covering eligible employees
when three or more are sold to or through an employer. This bill changes the
definition of a group health benefit plan by increasing, from three to nine, the
number of individual health benefit plans that constitute a group health benefit plan
when sold to or through an employer covering eligible employees of the employer.
This change applies regardless of the number of employees the employer has.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB420, s. 1
1Section 1. 632.745 (9) of the statutes is amended to read:
SB420,2,62 632.745 (9) "Group health benefit plan" means a health benefit plan that is
3issued by an insurer to or through an employer on behalf of a group consisting of at
4least 2 employees or a group including at least 2 eligible employees. The term
5includes individual health benefit plans covering eligible employees when 3 9 or
6more are sold to or through an employer.
SB420, s. 2 7Section 2. 635.01 of the statutes is amended to read:
SB420,2,14 8635.01 Scope. This chapter applies to all group health insurance plans,
9policies or certificates, written on risks or operations in this state, providing coverage
10for employees of a small employer, or employees of a small employer and the
11employer, and to individual health insurance policies, written on risks or operations
12in this state, providing coverage for employees of a small employer, or employees of
13a small employer and the employer when 3 9 or more are sold to or through a small
14employer.
SB420, s. 3 15Section 3. 635.02 (8) of the statutes is amended to read:
SB420,2,2416 635.02 (8) "Small employer insurer" means an insurer that is authorized to do
17business in this state, in one or more lines of insurance that includes health
18insurance, and that offers group health benefit plans covering eligible employees of
19one or more small employers in this state, or that sells 3 9 or more individual health
20benefit plans to a small employer, covering eligible employees of the small employer.
21The term includes a health maintenance organization, as defined in s. 609.01 (2), a
22preferred provider plan, as defined in s. 609.01 (4), and an insurer operating as a
23cooperative association organized under ss. 185.981 to 185.985, but does not include
24a limited service health organization, as defined in s. 609.01 (3).
SB420,2,2525 (End)
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