SB698,4,32
15.07
(2) (i) The commissioner of insurance shall serve as nonvoting
3chairperson of the Wisconsin health care plan board.
SB698, s. 2
4Section
2. 15.735 of the statutes is created to read:
SB698,4,7
515.735 Same; attached boards. (1) Wisconsin health care plan board. (a)
6There is created a Wisconsin health care plan board, attached to the office of the
7commissioner of insurance under s. 15.03, consisting of the following members:
SB698,4,108
1. Five persons who represent employers, including at least one person who
9represents small employers, and who are nominated by Wisconsin Manufacturers
10and Commerce.
SB698,4,1211
2. Five persons who represent employees and who are nominated by the
12Wisconsin State AFL-CIO.
SB698,4,1313
3. The commissioner of insurance, who shall serve as nonvoting chairperson.
SB698,4,1614
(b) Notwithstanding par. (a), the governor may appoint to the board nonvoting
15members who represent hospitals, physicians, and other state agencies or
16organizations with a connection to health care.
SB698,4,1817
(c) The members of the board under par. (a) 1. and 2. shall be appointed for
183-year terms and may be reappointed.
SB698,4,2019
(d) Notwithstanding s. 15.07 (4), 8 votes are required for approval of any matter
20within the jurisdiction of the board.
SB698, s. 3
1Section
3. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
2the following amounts for the purposes indicated:
-
See PDF for table SB698, s. 4
3Section
4. 20.145 (6) of the statutes is created to read:
SB698,5,64
20.145
(6) Wisconsin Health Care Plan. (a)
Development and administration. 5The amounts in the schedule for the expenses of the Wisconsin health care plan board
6in the development and administration of the Wisconsin Health Care Plan.
SB698,5,107
(d)
Employer assessments received from the state; general purpose revenue. A
8sum sufficient to pay employer assessments for state employees whose salaries are
9paid from general purpose revenue for the operating costs of the Wisconsin Health
10Care Plan.
SB698,5,1311
(g)
Operating costs. All moneys received from employer assessments and from
12premiums paid by individuals covered under the Wisconsin Health Care Plan for the
13operating costs of the Wisconsin Health Care Plan.
SB698,5,1814
(gm)
Employer assessments received from the state; program revenue. From the
15appropriate program revenue and program revenue-service accounts, a sum
16sufficient to pay employer assessments for state employees whose salaries are paid
17from program revenue or program revenue-service accounts for the operating costs
18of the Wisconsin Health Care Plan.
SB698,5,2019
(h)
Gifts and grants. All moneys received from gifts, grants, and bequests to
20carry out the purposes for which made.
SB698,6,3
1(m)
Federal funds; state operations. All moneys received from the federal
2government, as authorized by the governor under s. 16.54, for the purposes for which
3made and received.
SB698,6,74
(s)
Employer assessments received from the state; segregated revenue. From the
5appropriate segregated funds, a sum sufficient to pay employer assessments for state
6employees whose salaries are paid from segregated funds for the operating costs of
7the Wisconsin Health Care Plan.
SB698, s. 5
8Section
5. 40.05 (4) (ag) of the statutes is repealed.
SB698, s. 6
9Section
6. 40.05 (4) (ar) of the statutes is repealed.
SB698, s. 7
10Section
7. 40.51 (2) of the statutes is amended to read:
SB698,7,211
40.51
(2) Except as provided in subs. (10), (10m), (11) and (16), any eligible
12employee may become covered by group health insurance
benefits under this
13subchapter by electing coverage within 30 days of being hired, to be effective as of
14the first day of the month which begins on or after the date the application is received
15by the employer, or by electing coverage prior to becoming eligible for
any employer
16contribution towards the premium cost as provided in s. 40.05 (4) (a) to be effective
17upon becoming eligible for employer contributions.
An eligible employee who is not
18insured, but who is eligible for an employer contribution under s. 40.05 (4) (ag) 1.,
19may elect coverage prior to becoming eligible for an employer contribution under s.
2040.05 (4) (ag) 2., with the coverage to be effective upon becoming eligible for the
21increase in the employer contribution. Any employee who does not so elect at one of
22these times, or who subsequently cancels the insurance, shall not thereafter become
23insured unless the employee furnishes evidence of insurability satisfactory to the
24insurer, at the employee's own expense or obtains coverage subject to contractual
1waiting periods. The method to be used shall be specified in the health insurance
2contract.
SB698, s. 8
3Section
8. 40.51 (6) of the statutes is renumbered 40.51 (6) (a) and amended
4to read:
SB698,7,135
40.51
(6) (a) This state shall offer to all of its
eligible employees
described in
6subs. (10), (10m), and (16) at least 2 insured or uninsured health care coverage plans
7providing substantially equivalent hospital and medical benefits, including a health
8maintenance organization or a preferred provider plan, if those health care plans are
9determined by the group insurance board to be available in the area of the place of
10employment and are approved by the group insurance board. The group insurance
11board shall place each of the plans into one of 3 tiers established in accordance with
12standards adopted by the group insurance board. The tiers shall be separated
13according to
the employee's share of premium costs.
SB698, s. 9
14Section
9. 40.51 (6) (b) of the statutes is created to read:
SB698,7,1715
40.51
(6) (b) The state may offer to its employees coverage for health care
16benefits not provided to the employees under the Wisconsin Health Care Plan under
17ch. 634.
SB698, s. 10
18Section
10. 40.51 (7) of the statutes is amended to read:
SB698,8,219
40.51
(7) Any employer, other than the state, may offer to all of its employees
20a health care coverage plan coverage for health care benefits not provided to the
21employees under the Wisconsin Health Care Plan under ch. 634 through a program
22offered by the group insurance board. Notwithstanding sub. (2) and ss. 40.05 (4) and
2340.52 (1), the department may by rule establish different eligibility standards or
24contribution requirements for such employees and employers and may by rule limit
1the categories of employers, other than the state, which may be included as
2participating employers under this subchapter.
SB698,8,85
40.51
(8) Every health care coverage plan offered by the state under sub. (6)
6(a) shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.746 (1) to
7(8) and (10), 632.747, 632.748, 632.83, 632.835, 632.85, 632.853, 632.855, 632.87 (3)
8to (6), 632.895 (5m) and (8) to (14)
, and 632.896.
SB698, s. 12
9Section
12. 40.51 (8m) of the statutes is amended to read:
SB698,8,1310
40.51
(8m) Every health care coverage plan offered by the group insurance
11board under
sub. subs. (6) (b) and (7) shall comply with ss.
631.89, 631.90, 631.93 (2), 12631.95,
632.72 (2), 632.746 (1) to (8) and (10), 632.747, 632.748, 632.83, 632.835,
13632.85, 632.853, 632.855
, and
632.895 (11) to (14) 632.87 (3) to (6).
SB698, s. 13
14Section
13. 40.52 (1) (intro.) of the statutes is amended to read:
SB698,8,1815
40.52
(1) (intro.) The group insurance board shall establish by contract a
16standard health insurance plan in which all insured employees shall participate
17except as otherwise provided in this chapter.
The
Except as provided in sub. (1m),
18the standard plan shall provide:
SB698, s. 14
19Section
14. 40.52 (1m) of the statutes is created to read:
SB698,8,2220
40.52
(1m) The standard health insurance plan described under sub. (1) shall
21not provide employees any health care coverage that the employees receive under the
22Wisconsin Health Care Plan under ch. 634.
SB698, s. 15
23Section
15. 40.52 (2) of the statutes is amended to read:
SB698,9,1324
40.52
(2) Health insurance benefits under this subchapter shall be integrated,
25with exceptions determined appropriate by the group insurance board, with benefits
1under federal plans for hospital and health care for the aged and disabled
and with
2benefits provided under the Wisconsin Health Care Plan under ch. 634. Exclusions
3and limitations with respect to benefits and different rates may be established for
4persons eligible under federal plans for hospital and health care for the aged and
5disabled in recognition of the utilization by persons within the age limits eligible
6under the federal program
and for employees who receive benefits under the
7Wisconsin Health Care Plan under ch. 634. The plan may include special provisions
8for spouses and other dependents covered under a plan established under this
9subchapter where one spouse is eligible under federal plans for hospital and health
10care for the aged
or under the Wisconsin Health Care Plan under ch. 634 but the
11others are not eligible because of age or other reasons. As part of the integration, the
12department may, out of premiums collected under s. 40.05 (4), pay premiums for the
13federal health insurance.
SB698, s. 16
14Section
16. 49.473 (2) (c) of the statutes is amended to read:
SB698,9,1815
49.473
(2) (c) The woman is not
covered under the Wisconsin Health Care Plan
16under ch. 634 and is not eligible for
any other health care coverage that qualifies as
17creditable coverage in
42 USC 300gg (c), excluding the coverage specified in
42 USC
18300gg (c) (1) (F).
SB698, s. 17
19Section
17. 49.474 of the statutes is created to read:
SB698,9,25
2049.474 Eligibility for Wisconsin Health Care Plan. Notwithstanding ss.
2149.46, 49.465, 49.47, and 49.472, if a waiver under 2005 Wisconsin Act .... (this act),
22section 57 (2) (a
) 2., is granted and in effect, a person who is covered under the
23Wisconsin Health Care Plan under s. 634.10 (2) (a) is eligible for medical assistance
24only with respect to health care benefits not provided under the Wisconsin Health
25Care Plan.
SB698, s. 18
1Section
18. 49.665 (4) (e) of the statutes is created to read:
SB698,10,62
49.665
(4) (e) Notwithstanding pars. (a) to (ap), if a waiver under 2005
3Wisconsin Act .... (this act), section 57 (2) (a
) 2., is granted and in effect, a person who
4is covered under the Wisconsin Health Care Plan under s. 634.10 (2) (a) is eligible
5for health care coverage under this section only with respect to health care benefits
6not provided under the Wisconsin Health Care Plan.
SB698, s. 19
7Section
19. 49.68 (3) (d) 1. of the statutes is amended to read:
SB698,10,228
49.68
(3) (d) 1. No aid may be granted under this subsection
unless if the
9recipient has
no other form of aid available from the federal
medicare Medicare
10program, from private health, accident, sickness, medical,
and or hospital insurance
11coverage,
from the Wisconsin Health Care Plan under ch. 634, or from other health
12care coverage specified by rule under s. 49.687 (1m). If insufficient aid is available
13from other sources and if the recipient has paid an amount equal to the annual
14medicare Medicare deductible amount specified in subd. 2., the state shall pay the
15difference in cost to a qualified recipient. If at any time sufficient federal or private
16insurance aid or other health care coverage becomes available during the treatment
17period, state aid under this subsection shall be terminated or appropriately reduced.
18Any patient who is eligible for the federal
medicare
Medicare program shall register
19and pay the premium for
medicare Medicare medical insurance coverage where
20permitted, and shall pay an amount equal to the annual
medicare Medicare 21deductible amounts required under
42 USC 1395e and
1395L (b), prior to becoming
22eligible for state aid under this subsection.
SB698, s. 20
23Section
20. 49.683 (3) of the statutes is amended to read:
SB698,11,324
49.683
(3) No payment shall be made under this section for any portion of
25medical care costs that are payable under any state, federal, or other health care
1coverage program, including
the Wisconsin Health Care Plan under ch. 634 or a
2health care coverage program specified by rule under s. 49.687 (1m), or under any
3grant, contract, or other contractual arrangement.
SB698, s. 21
4Section
21. 49.685 (6) (b) of the statutes is amended to read:
SB698,11,125
49.685
(6) (b) Reimbursement shall not be made under this section for any
6blood products or supplies that are not purchased from or provided by a
7comprehensive hemophilia treatment center, or a source approved by the treatment
8center. Reimbursement shall not be made under this section for any portion of the
9costs of blood products or supplies that are payable under any other state, federal,
10or other health care coverage program, including
the Wisconsin Health Care Plan
11under ch. 634 or a health care coverage program specified by rule under s. 49.687
12(1m), or under any grant, contract, or other contractual arrangement.
SB698, s. 22
13Section
22. 59.52 (11) (c) of the statutes is amended to read:
SB698,12,214
59.52
(11) (c)
Employee insurance. Provide for individual or group
hospital,
15surgical and life insurance for county officers and employees and for payment of
16premiums for county officers and employees. A county
may elect to provide health
17care benefits not provided under the Wisconsin Health Care Plan under ch. 634 to
18its officers and employees and a county with at least 100 employees may elect to
19provide health care benefits
not provided under the Wisconsin Health Care Plan
20under ch. 634 on a self-insured basis to its officers and employees. A county and one
21or more cities, villages, towns, or other counties that together have at least 100
22employees may jointly provide health care benefits
not provided under the Wisconsin
23Health Care Plan under ch. 634 to their officers and employees on a self-insured
24basis. Counties that elect to provide health care benefits
not provided under the
25Wisconsin Health Care Plan under ch. 634 on a self-insured basis to their officers
1and employees shall be subject to the requirements set forth under s. 120.13 (2) (c)
2to (e) and (g).
SB698, s. 23
3Section
23. 60.23 (25) of the statutes is amended to read:
SB698,12,64
60.23
(25) Self-insured health plans. Provide health care benefits
not
5provided under the Wisconsin Health Care Plan under ch. 634 to its officers and
6employees on a self-insured basis, subject to s. 66.0137 (4).
SB698, s. 24
7Section
24. 62.61 of the statutes is renumbered 62.61 (1) (intro.) and amended
8to read:
SB698,12,109
62.61
(1) (intro.) The common council of a 1st class city may, by ordinance or
10resolution,
provide do any of the following:
SB698,12,14
11(a) Provide for, including the payment of premiums of, general hospital,
12surgical and group insurance for
both active and retired city officers and city
13employees and their respective dependents in private companies
, or may, by
14ordinance or resolution, elect.
SB698,12,18
15(c) Elect to offer to all of its employees a health care coverage plan through a
16program offered by the group insurance board under ch. 40. Municipalities
which 17that elect to participate under s. 40.51 (7) are subject to the applicable sections of ch.
1840 instead of this section.
SB698,13,2
19(2) Contracts for insurance under this section may be entered into for active
20officers and employees separately from contracts for retired officers and employees.
21Appropriations may be made for the purpose of financing insurance under this
22section. Moneys accruing to a fund to finance insurance under this section, by
23investment or otherwise, may not be diverted for any other purpose than those for
24which the fund was set up or to defray management expenses of the fund or to
1partially pay premiums to reduce costs to the city or to persons covered by the
2insurance, or both.
SB698, s. 25
3Section
25. 62.61 (1) (b) of the statutes is created to read:
SB698,13,64
62.61
(1) (b) Subject to s. 634.40, provide for, including the payment of
5premiums of, group health insurance for active city officers and city employees and
6their respective dependents.
SB698,13,169
66.0137
(4) Self-insured health plans. If a city, including a 1st class city, or
10a village provides health care benefits
not provided under the Wisconsin Health Care
11Plan under ch. 634 under its home rule power, or if a town provides health care
12benefits
not provided under the Wisconsin Health Care Plan under ch. 634, to its
13officers and employees on a self-insured basis, the self-insured plan shall comply
14with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747
15(3), 632.85, 632.853, 632.855, 632.87 (4)
, (5), and (6), 632.895 (9) to (14), 632.896
, and
16767.25 (4m) (d).
SB698, s. 27
17Section
27. 66.0137 (4m) (b) of the statutes is amended to read:
SB698,13,2118
66.0137
(4m) (b) A political subdivision and one or more other political
19subdivisions, that together have at least 100 employees, may jointly provide health
20care benefits
not provided under the Wisconsin Health Care Plan under ch. 634 to
21their officers and employees on a
self insured self-insured basis.
SB698, s. 28
22Section
28. 66.0137 (5) of the statutes is amended to read:
SB698,14,723
66.0137
(5) Hospital, accident, and life insurance. The Subject to s. 634.40,
24the state or a local governmental unit may provide for the payment of premiums for
25hospital, surgical and other health and accident insurance and life insurance for
1employees and officers and their spouses and dependent children. A local
2governmental unit may also provide for the payment of premiums for hospital and
3surgical care for its retired employees. In addition, a local governmental unit may,
4by ordinance or resolution, elect to offer to all of its employees a health care coverage
5plan through a program offered by the group insurance board under ch. 40. A local
6governmental unit that elects to participate under s. 40.51 (7) is subject to the
7applicable sections of ch. 40 instead of this subsection.
SB698, s. 29
8Section
29. 109.075 (9) of the statutes is created to read:
SB698,14,119
109.075
(9) This section does not apply to an employer that ceases providing
10health care benefits to its employees because the employees are covered under the
11Wisconsin Health Care Plan under ch. 634.
SB698, s. 30
12Section
30. 111.70 (1) (dm) of the statutes is amended to read:
SB698,15,213
111.70
(1) (dm) "Economic issue" means salaries, overtime pay, sick leave,
14payments in lieu of sick leave usage, vacations, clothing allowances in excess of the
15actual cost of clothing, length-of-service credit, continuing education credit, shift
16premium pay, longevity pay, extra duty pay, performance bonuses, health insurance
17coverage of benefits not provided under the Wisconsin Health Care Plan under ch.
18634, life insurance, dental insurance, disability insurance, vision insurance,
19long-term care insurance, worker's compensation and unemployment insurance,
20social security benefits, vacation pay, holiday pay, lead worker pay, temporary
21assignment pay, retirement contributions, supplemental retirement benefits,
22severance or other separation pay, hazardous duty pay, certification or license
23payment, limitations on layoffs that create a new or increased financial liability on
24the employer and contracting or subcontracting of work that would otherwise be
1performed by municipal employees in the collective bargaining unit with which there
2is a labor dispute.
SB698, s. 31
3Section
31. 111.91 (2) (pm) of the statutes is created to read:
SB698,15,54
111.91
(2) (pm) Health care coverage of employees under the Wisconsin Health
5Care Plan under ch. 634.
SB698, s. 32
6Section
32. 120.12 (24) of the statutes is amended to read:
SB698,15,117
120.12
(24) Health care benefits. Prior to the selection
for school district
8professional employees, as defined in s. 111.70 (1) (ne), of any
provider of group
9health care benefits
provider for school district professional employees, as defined
10in s. 111.70 (1) (ne) not provided under the Wisconsin Health Care Plan under ch. 634,
11solicit sealed bids for the provision of such benefits.
SB698, s. 33
12Section
33. 120.13 (2) (b) of the statutes is amended to read:
SB698,15,1813
120.13
(2) (b) Provide health care benefits
not provided under the Wisconsin
14Health Care Plan under ch. 634 on a self-insured basis to the employees of the school
15district if the school district has at least 100 employees. In addition, any 2 or more
16school districts which together have at least 100 employees may jointly provide
17health care benefits
not provided under the Wisconsin Health Care Plan under ch.
18634 on a self-insured basis to employees of the school districts.
SB698,15,2421
120.13
(2) (g) Every self-insured plan under par. (b) shall comply with ss.
2249.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
23632.85, 632.853, 632.855, 632.87 (4)
, (5), and (6), 632.895 (9) to (14), 632.896
, and
24767.25 (4m) (d).
SB698, s. 35
25Section
35. 149.12 (2) (e) of the statutes is repealed and recreated to read:
SB698,16,3
1149.12
(2) (e) No person who is covered under the Wisconsin Health Care Plan
2under s. 634.10 (2) (a) is eligible for coverage under the plan established under this
3chapter.
SB698, s. 36
4Section
36. 227.01 (13) (nm) of the statutes is created to read:
SB698,16,65
227.01
(13) (nm) Relates to determining coverage under s. 634.10 (4) or setting
6premiums or assessments under s. 634.25.
SB698, s. 37
7Section
37. 254.11 (13) of the statutes is amended to read:
SB698,16,158
254.11
(13) "Third-party payer" means a disability insurance policy that is
9required to provide coverage for a blood lead test under s. 632.895 (10) (a); a health
10maintenance organization or preferred provider plan under ch. 609;
a health care
11coverage plan offered by the state under s. 40.51 (6); a self-insured health plan
12offered by a city or village under s. 66.0137 (4), a political subdivision under s.
1366.0137 (4m), a town under s. 60.23 (25), a county under s. 59.52 (11) (c), or a school
14district under s. 120.13 (2) (b); or a sickness care plan operated by a cooperative
15association under s. 185.981.
SB698, s. 38
16Section
38. 609.10 of the statutes is repealed.
SB698, s. 39
17Section
39. 609.20 (1m) (c) of the statutes is repealed.
SB698, s. 40
18Section
40. 609.20 (1m) (d) of the statutes is repealed.
SB698, s. 41
19Section
41. 628.36 (4) (a) (intro.) of the statutes is amended to read: