SB562,23,135 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.
SB562, s. 43 14Section 43. 40.51 (6) (b) of the statutes is created to read:
SB562,23,1715 40.51 (6) (b) The state may offer to its employees coverage for health care
16benefits not provided to the employees under the Healthy Wisconsin Plan under ch.
17260.
SB562, s. 44 18Section 44. 40.51 (7) of the statutes is amended to read:
SB562,24,219 40.51 (7) Any employer, other than the state, may offer to all of its employees
20 a health care coverage plan coverage for health care benefits not provided to the
21employees under the Healthy Wisconsin Plan under ch. 260
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.
SB562, s. 45 3Section 45. 40.51 (8) of the statutes, as affected by 2007 Wisconsin Act 36, is
4amended to read:
SB562,24,85 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 (5) (6), 632.895 (5m) and (8) to (15), and 632.896.
SB562, s. 46 9Section 46. 40.51 (8m) of the statutes, as affected by 2007 Wisconsin Act 36,
10is amended to read:
SB562,24,1411 40.51 (8m) Every health care coverage plan offered by the group insurance
12board under sub. subs. (6) (b) and (7) shall comply with ss. 631.89, 631.90, 631.93 (2),
13631.95, 632.72 (2), 632.746 (1) to (8) and (10), 632.747, 632.748, 632.83, 632.835,
14632.85, 632.853, 632.855, and 632.895 (11) to (15) 632.87 (3) to (6).
SB562, s. 47 15Section 47. 40.52 (1) (intro.) of the statutes is amended to read:
SB562,24,1916 40.52 (1) (intro.) The group insurance board shall establish by contract a
17standard health insurance plan in which all insured employees shall participate
18except as otherwise provided in this chapter. The Except as provided in sub. (1m),
19the
standard plan shall provide:
SB562, s. 48 20Section 48. 40.52 (1m) of the statutes is created to read:
SB562,24,2321 40.52 (1m) The standard health insurance plan described under sub. (1) shall
22not provide employees any health care coverage that the employees receive under the
23Healthy Wisconsin Plan under ch. 260.
SB562, s. 49 24Section 49. 40.52 (2) of the statutes is amended to read:
SB562,25,15
140.52 (2) Health insurance benefits under this subchapter shall be integrated,
2with exceptions determined appropriate by the group insurance board, with benefits
3under federal plans for hospital and health care for the aged and disabled and with
4benefits provided under the Healthy Wisconsin Plan under ch. 260
. Exclusions and
5limitations with respect to benefits and different rates may be established for
6persons eligible under federal plans for hospital and health care for the aged and
7disabled in recognition of the utilization by persons within the age limits eligible
8under the federal program and for employees who receive benefits under the Healthy
9Wisconsin Plan under ch. 260
. The plan may include special provisions for spouses
10and other dependents covered under a plan established under this subchapter where
11one spouse is eligible under federal plans for hospital and health care for the aged
12or under the Healthy Wisconsin Plan under ch. 260 but the others are not eligible
13because of age or other reasons. As part of the integration, the department may, out
14of premiums collected under s. 40.05 (4), pay premiums for the federal health
15insurance.
SB562, s. 50 16Section 50. 40.98 (2) (a) 1. of the statutes is amended to read:
SB562,26,217 40.98 (2) (a) 1. The department shall design an actuarially sound health care
18coverage program for employers that includes more than one group health care
19coverage plan and that provides coverage beginning not later than January 1, 2001.
20The health care coverage program shall be known as the "Private Employer Health
21Care Purchasing Alliance". In designing the health care coverage program, the
22department shall consult with the office of the commissioner of insurance and may
23consult with the departments of commerce and health and family services. The
24health care coverage program may not be implemented until it is approved by the
25board. The health care coverage program shall not provide employees any health

1care coverage that the employees receive under the Healthy Wisconsin Plan under
2ch. 260.
SB562, s. 51 3Section 51. 49.45 (54) of the statutes is created to read:
SB562,26,64 49.45 (54) Eligibility for Healthy Wisconsin. (a) In this subsection,
5"program" means any Medical Assistance program administered under this
6subchapter.
SB562,26,127 (b) Notwithstanding any other statute to the contrary, if a program, or the
8provision of health care benefits for any eligibility category of persons under a
9program, is not eligible for, or supported by, federal matching funds, persons who are
10eligible for health care benefits under the program, or under the eligibility category
11under the program, are not eligible for those health care benefits but are instead
12eligible for coverage under the Healthy Wisconsin Plan under ch. 260.
SB562, s. 52 13Section 52. 49.473 (2) (c) of the statutes is amended to read:
SB562,26,1714 49.473 (2) (c) The woman is not covered under the Healthy Wisconsin Plan
15under ch. 260 and is not
eligible for any other health care coverage that qualifies as
16creditable coverage in 42 USC 300gg (c), excluding the coverage specified in 42 USC
17300gg
(c) (1) (F).
SB562, s. 53 18Section 53. 49.68 (3) (d) 1. of the statutes is amended to read:
SB562,27,819 49.68 (3) (d) 1. No aid may be granted under this subsection unless if the
20recipient has no other form of aid available from the federal medicare Medicare
21program, from private health, accident, sickness, medical, and or hospital insurance
22coverage, or from other health care coverage specified by rule under s. 49.687 (1m),
23excluding the Healthy Wisconsin Plan under ch. 260
. If insufficient aid is available
24from other sources and if the recipient has paid an amount equal to the annual
25medicare Medicare deductible amount specified in subd. 2., the state shall pay the

1difference in cost to a qualified recipient. If at any time sufficient federal or private
2insurance aid or other health care coverage becomes available during the treatment
3period, state aid under this subsection shall be terminated or appropriately reduced.
4Any patient who is eligible for the federal medicare Medicare program shall register
5and pay the premium for medicare Medicare medical insurance coverage where
6permitted, and shall pay an amount equal to the annual medicare Medicare
7deductible amounts required under 42 USC 1395e and 1395L (b), prior to becoming
8eligible for state aid under this subsection.
SB562, s. 54 9Section 54. 49.683 (3) of the statutes is amended to read:
SB562,27,1410 49.683 (3) No payment shall be made under this section for any portion of
11medical care costs that are payable under any state, federal, or other health care
12coverage program, including a health care coverage program specified by rule under
13s. 49.687 (1m), or under any grant, contract, or other contractual arrangement, but
14excluding the Healthy Wisconsin Plan under ch. 260
.
SB562, s. 55 15Section 55. 49.685 (6) (b) of the statutes is amended to read:
SB562,27,2416 49.685 (6) (b) Reimbursement shall not be made under this section for any
17blood products or supplies that are not purchased from or provided by a
18comprehensive hemophilia treatment center, or a source approved by the treatment
19center. Reimbursement shall not be made under this section for any portion of the
20costs of blood products or supplies that are payable under any other state, federal,
21or other health care coverage program under which the person is covered, including
22a health care coverage program specified by rule under s. 49.687 (1m), or under any
23grant, contract, or other contractual arrangement, but excluding the Healthy
24Wisconsin Plan under ch. 260
.
SB562, s. 56 25Section 56. 49.687 (1m) (d) of the statutes is created to read:
SB562,28,4
149.687 (1m) (d) Notwithstanding the health care programs for which a person
2must apply that are specified by the department by rule under pars. (a) and (b), a
3person is not ineligible to receive benefits under s. 49.68, 49.683, or 49.685 by reason
4of being eligible for or covered under the Healthy Wisconsin Plan under ch. 260.
SB562, s. 57 5Section 57. 59.52 (11) (c) of the statutes is amended to read:
SB562,28,186 59.52 (11) (c) Employee insurance. Provide for individual or group hospital,
7surgical and
life insurance for county officers and employees and for payment of
8premiums for county officers and employees. A county may elect to provide health
9care benefits not provided under the Healthy Wisconsin Plan under ch. 260 to its
10officers and employees and a county
with at least 100 employees may elect to provide
11health care benefits not provided under the Healthy Wisconsin Plan under ch. 260
12on a self-insured basis to its officers and employees. A county and one or more cities,
13villages, towns, or other counties that together have at least 100 employees may
14jointly provide health care benefits not provided under the Healthy Wisconsin Plan
15under ch. 260
to their officers and employees on a self-insured basis. Counties that
16elect to provide health care benefits not provided under the Healthy Wisconsin Plan
17under ch. 260
on a self-insured basis to their officers and employees shall be subject
18to the requirements set forth under s. 120.13 (2) (c) to (e) and (g).
SB562, s. 58 19Section 58. 60.23 (25) of the statutes is amended to read:
SB562,28,2220 60.23 (25) Self-insured health plans. Provide health care benefits not
21provided under the Healthy Wisconsin Plan under ch. 260
to its officers and
22employees on a self-insured basis, subject to s. 66.0137 (4).
SB562, s. 59 23Section 59. 62.61 of the statutes is renumbered 62.61 (1) (intro.) and amended
24to read:
SB562,29,2
162.61 (1) (intro.) The common council of a 1st class city may, by ordinance or
2resolution, provide do any of the following:
SB562,29,6 3(a) Provide for, including the payment of premiums of, general hospital,
4surgical and group insurance for both active and retired city officers and city
5employees and their respective dependents in private companies, or may, by
6ordinance or resolution, elect
.
SB562,29,10 7(c) Elect to offer to all of its employees a health care coverage plan through a
8program offered by the group insurance board under ch. 40. Municipalities which
9that elect to participate under s. 40.51 (7) are subject to the applicable sections of ch.
1040 instead of this section.
SB562,29,18 11(2) Contracts for insurance under this section may be entered into for active
12officers and employees separately from contracts for retired officers and employees.
13Appropriations may be made for the purpose of financing insurance under this
14section. Moneys accruing to a fund to finance insurance under this section, by
15investment or otherwise, may not be diverted for any other purpose than those for
16which the fund was set up or to defray management expenses of the fund or to
17partially pay premiums to reduce costs to the city or to persons covered by the
18insurance, or both.
SB562, s. 60 19Section 60. 62.61 (1) (b) of the statutes is created to read:
SB562,29,2220 62.61 (1) (b) Subject to s. 260.37, provide for, including the payment of
21premiums of, group health insurance for active city officers and city employees and
22their respective dependents.
SB562, s. 61 23Section 61. 66.0137 (4) of the statutes, as affected by 2007 Wisconsin Act 36,
24is amended to read:
SB562,30,8
166.0137 (4) Self-insured health plans. If a city, including a 1st class city, or
2a village provides health care benefits not provided under the Healthy Wisconsin
3Plan under ch. 260
under its home rule power, or if a town provides health care
4benefits not provided under the Healthy Wisconsin Plan under ch. 260, to its officers
5and employees on a self-insured basis, the self-insured plan shall comply with ss.
649.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
7632.85, 632.853, 632.855, 632.87 (4) and (5), 632.895 (9) to (15), 632.896, and 767.25
8(4m) (d)
767.513 (4).
SB562, s. 62 9Section 62. 66.0137 (4m) (b) of the statutes is amended to read:
SB562,30,1310 66.0137 (4m) (b) A political subdivision and one or more other political
11subdivisions, that together have at least 100 employees, may jointly provide health
12care benefits not provided under the Healthy Wisconsin Plan under ch. 260 to their
13officers and employees on a self insured self-insured basis.
SB562, s. 63 14Section 63. 66.0137 (5) of the statutes is amended to read:
SB562,30,2415 66.0137 (5) Hospital, accident, and life insurance. The Subject to s. 260.37,
16the
state or a local governmental unit may provide for the payment of premiums for
17hospital, surgical and other health and accident insurance and life insurance for
18employees and officers and their spouses and dependent children. A local
19governmental unit may also provide for the payment of premiums for hospital and
20surgical care for its retired employees. In addition, a local governmental unit may,
21by ordinance or resolution, elect to offer to all of its employees a health care coverage
22plan through a program offered by the group insurance board under ch. 40. A local
23governmental unit that elects to participate under s. 40.51 (7) is subject to the
24applicable sections of ch. 40 instead of this subsection.
SB562, s. 64 25Section 64. 70.11 (41p) of the statutes is created to read:
SB562,31,3
170.11 (41p) Healthy Wisconsin Authority. All property owned by the Healthy
2Wisconsin Authority, provided that use of the property is primarily related to the
3purposes of the authority.
SB562, s. 65 4Section 65. 71.26 (1) (be) of the statutes is amended to read:
SB562,31,85 71.26 (1) (be) Certain authorities. Income of the University of Wisconsin
6Hospitals and Clinics Authority, of the Health Insurance Risk-Sharing Plan
7Authority, and of the Healthy Wisconsin Authority, of the Fox River Navigational
8System Authority, and of the Wisconsin Aerospace Authority.
SB562, s. 66 9Section 66. 77.54 (9a) (a) of the statutes is amended to read:
SB562,31,1310 77.54 (9a) (a) This state or any agency thereof, the University of Wisconsin
11Hospitals and Clinics Authority, the Wisconsin Aerospace Authority, the Health
12Insurance Risk-Sharing Plan Authority, the Healthy Wisconsin Authority, and the
13Fox River Navigational System Authority.
SB562, s. 67 14Section 67. 100.45 (1) (dm) of the statutes is amended to read:
SB562,31,2315 100.45 (1) (dm) "State agency" means any office, department, agency,
16institution of higher education, association, society or other body in state
17government created or authorized to be created by the constitution or any law which
18is entitled to expend moneys appropriated by law, including the legislature and the
19courts, the Wisconsin Housing and Economic Development Authority, the Bradley
20Center Sports and Entertainment Corporation, the University of Wisconsin
21Hospitals and Clinics Authority, the Wisconsin Health and Educational Facilities
22Authority, the Wisconsin Aerospace Authority, and the Fox River Navigational
23System Authority, and the Healthy Wisconsin Authority.
SB562, s. 68 24Section 68. 109.075 (9) of the statutes is created to read:
SB562,32,3
1109.075 (9) This section does not apply to an employer that ceases providing
2health care benefits to its employees because the employees are covered under the
3Healthy Wisconsin Plan under ch. 260.
SB562, s. 69 4Section 69. 111.70 (1) (dm) of the statutes is amended to read:
SB562,32,185 111.70 (1) (dm) "Economic issue" means salaries, overtime pay, sick leave,
6payments in lieu of sick leave usage, vacations, clothing allowances in excess of the
7actual cost of clothing, length-of-service credit, continuing education credit, shift
8premium pay, longevity pay, extra duty pay, performance bonuses, health insurance
9coverage of benefits not provided under the Healthy Wisconsin Plan under ch. 260,
10life insurance, dental insurance, disability insurance, vision insurance, long-term
11care insurance, worker's compensation and unemployment insurance, social
12security benefits, vacation pay, holiday pay, lead worker pay, temporary assignment
13pay, retirement contributions, supplemental retirement benefits, severance or other
14separation pay, hazardous duty pay, certification or license payment, limitations on
15layoffs that create a new or increased financial liability on the employer and
16contracting or subcontracting of work that would otherwise be performed by
17municipal employees in the collective bargaining unit with which there is a labor
18dispute.
SB562, s. 70 19Section 70. 111.70 (4) (cm) 8s. of the statutes is amended to read:
SB562,34,220 111.70 (4) (cm) 8s. `Forms for determining costs.' The commission shall
21prescribe forms for calculating the total increased cost to the municipal employer of
22compensation and fringe benefits provided to school district professional employees.
23The cost shall be determined based upon the total cost of compensation and fringe
24benefits provided to school district professional employees who are represented by
25a labor organization on the 90th day before expiration of any previous collective

1bargaining agreement between the parties, or who were so represented if the
2effective date is retroactive, or the 90th day prior to commencement of negotiations
3if there is no previous collective bargaining agreement between the parties, without
4regard to any change in the number, rank or qualifications of the school district
5professional employees. For purposes of such determinations, any cost increase that
6is incurred on any day other than the beginning of the 12-month period commencing
7with the effective date of the agreement or any succeeding 12-month period
8commencing on the anniversary of that effective date shall be calculated as if the cost
9increase were incurred as of the beginning of the 12-month period beginning on the
10effective date or anniversary of the effective date in which the cost increase is
11incurred. For the purpose of determining if a municipal employer has maintained
12current fringe benefits under sub. (1) (nc) 1. a., the commission shall consider the
13municipal employer to have maintained its health care coverage benefit if the
14municipal employer provides health care coverage to its school district professional
15employees through the Healthy Wisconsin Plan under ch. 260 and supplements that
16coverage, if necessary, to produce a health care coverage benefit that is actuarially
17equivalent to the health care coverage benefit in place before the school district
18professional employees become covered under the Healthy Wisconsin Plan under ch.
19260. If a dispute arises concerning the municipal employer's determination of
20actuarial equivalence or what supplemental benefits are sufficient to achieve
21actuarial equivalence, the dispute shall be resolved by a neutral person who is
22designated by the commission.
In each collective bargaining unit to which subd. 5s.
23applies, the municipal employer shall transmit to the commission and the labor
24organization a completed form for calculating the total increased cost to the
25municipal employer of compensation and fringe benefits provided to the school

1district professional employees covered by the agreement as soon as possible after
2the effective date of the agreement.
SB562, s. 71 3Section 71. 111.91 (2) (pt) of the statutes is created to read:
SB562,34,54 111.91 (2) (pt) Health care coverage of employees under the Healthy Wisconsin
5Plan under ch. 260.
SB562, s. 72 6Section 72. 120.13 (2) (b) of the statutes is amended to read:
SB562,34,127 120.13 (2) (b) Provide health care benefits not provided under the Healthy
8Wisconsin Plan under ch. 260
on a self-insured basis to the employees of the school
9district if the school district has at least 100 employees. In addition, any 2 or more
10school districts which together have at least 100 employees may jointly provide
11health care benefits not provided under the Healthy Wisconsin Plan under ch. 260
12on a self-insured basis to employees of the school districts.
SB562, s. 73 13Section 73. 120.13 (2) (g) of the statutes, as affected by 2007 Wisconsin Act 36,
14is amended to read:
SB562,34,1815 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
1649.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.746 (10) (a) 2. and (b) 2., 632.747 (3),
17632.85, 632.853, 632.855, 632.87 (4) and (5), 632.895 (9) to (15), 632.896, and 767.25
18(4m) (d)
767.513 (4).
SB562, s. 74 19Section 74. 149.12 (2) (em) of the statutes is created to read:
SB562,34,2220 149.12 (2) (em) No person who is eligible for coverage under the Healthy
21Wisconsin Plan under ch. 260 is eligible for coverage under the plan under this
22chapter.
SB562, s. 75 23Section 75. 230.03 (3) of the statutes, as affected by 2007 Wisconsin Act 20,
24is amended to read:
SB562,35,10
1230.03 (3) "Agency" means any board, commission, committee, council, or
2department in state government or a unit thereof created by the constitution or
3statutes if such board, commission, committee, council, department, unit, or the
4head thereof, is authorized to appoint subordinate staff by the constitution or
5statute, except a legislative or judicial board, commission, committee, council,
6department, or unit thereof or an authority created under subch. II of ch. 114 or
7subch. III of ch. 149 or under ch. 231, 232, 233, 234, 235, 237, 260, or 279. "Agency"
8does not mean any local unit of government or body within one or more local units
9of government that is created by law or by action of one or more local units of
10government.
SB562, s. 76 11Section 76. Chapter 260 of the statutes is created to read:
SB562,35,1212 Chapter 260
SB562,35,13 13Healthy Wisconsin Plan
SB562,35,14 14260.01 Definitions. In this chapter, except as otherwise provided:
SB562,35,15 15(1) "Authority" means the Healthy Wisconsin Authority.
SB562,35,16 16(2) "Board" means the board of trustees of the authority.
SB562,35,21 17(3) "Health care network" means a provider-driven, coordinated group of
18health care providers comprised of primary care physicians, medical specialists,
19physician assistants, nurses, clinics, one or more hospitals, and other health care
20providers and facilities, including providers and facilities that specialize in mental
21health services and alcohol or other drug abuse treatment.
SB562,35,25 22(4) "Medical inflation" means changes in the consumer price index for all
23consumers, U.S. city average, for the medical care group, including medical care
24commodities and medical care services, as determined by the U.S. department of
25labor.
SB562,36,1
1(5) "Plan" means the Healthy Wisconsin Plan.
SB562,36,10 2(6) "Primary care provider" means a health care provider who is identified as
3the key professional responsible for coordinating all medical care for a given
4participant, including referral to a specialist. "Primary care provider" includes
5general practice physicians, family practitioners, internists, pediatricians,
6obstetricians and gynecologists, advanced practice nurses, certified nurse midwives,
7and physician assistants. "Primary care provider" may also include a specialist who
8is treating a person with a chronic medical condition or special health care needs for
9which regular treatment by a specialist is medically necessary or a specialist who is
10treating a disabled person.
SB562,36,20 11260.05 Creation and organization of authority. (1) Creation and
12membership of board.
There is created a public body corporate and politic to be
13known as the "Healthy Wisconsin Authority." The nonvoting members of the board
14shall consist of the secretary of employee trust funds and 4 representatives from the
15advisory committee under s. 260.49 who are health care personnel and
16administrators, selected by the advisory committee. The secretary of employee trust
17funds shall serve as the initial chairperson of the board until such time as the board
18elects a chairperson from its voting membership. The board shall also consist of the
19following voting members, nominated by the governor and with the advice and
20consent of the senate appointed, for staggered 6-year terms:
SB562,36,2221 (a) Four members selected from a list of names submitted by statewide labor
22or union coalitions. One of these members shall be a public employee.
SB562,36,2523 (b) Four members selected from a list of names submitted by statewide
24business and employer organizations. One of these members shall be a public
25employer.
SB562,37,2
1(c) One member selected from a list of names submitted by statewide public
2school teacher labor organizations.
SB562,37,43 (d) One member selected from a list of names submitted by statewide small
4business organizations.
SB562,37,65 (e) Two members who are farmers, selected from a list of names submitted by
6statewide general farm organizations.
SB562,37,77 (f) One member who is a self-employed person.
SB562,37,98 (g) Three members selected from a list of names submitted by statewide health
9care consumer organizations.
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