SB70, s. 6
14Section
6. 185.981 (4t) of the statutes is amended to read:
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185.981
(4t) A sickness care plan operated by a cooperative association is
16subject to ss. 252.14, 631.17, 631.89, 631.95, 632.72 (2), 632.745 to 632.749, 632.85,
17632.853, 632.855, 632.87 (2m), (3), (4),
and (5)
, and (6), 632.885, 632.895 (10) to (15),
18and 632.897 (10) and chs. 149 and 155.
SB70, s. 7
19Section
7. 185.983 (1) (intro.) of the statutes is amended to read:
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185.983
(1) (intro.) Every such voluntary nonprofit sickness care plan shall be
21exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
22601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.17, 631.89, 631.93,
23631.95, 632.72 (2), 632.745 to 632.749, 632.775, 632.79, 632.795, 632.85, 632.853,
24632.855, 632.87 (2m), (3), (4),
and (5)
, and (6), 632.885, 632.895 (5) and (9) to (15),
1632.896, and 632.897 (10) and chs. 609, 630, 635, 645, and 646, but the sponsoring
2association shall:
SB70, s. 8
3Section
8. 609.74 of the statutes is created to read:
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4609.74 Coverage of dependents. Limited service health organizations,
5preferred provider plans, and defined network plans are subject to s. 632.885.
SB70, s. 9
6Section
9. 632.885 of the statutes is created to read:
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7632.885 Coverage of dependents. (1) Definitions. In this section:
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(a) "Disability insurance policy" has the meaning given in s. 632.895 (1) (a).
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(b) "Insured" includes an enrollee.
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(c) "Self-insured health plan" has the meaning given in s. 632.745 (24).
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11(2) Requirement to offer dependent coverage. (a) Subject to ss. 632.88 and
12632.895 (5), every insurer that issues a disability insurance policy, and every
13self-insured health plan, shall offer and, if so requested by an applicant or an
14insured, provide coverage for an adult child of the applicant or insured as a
15dependent of the applicant or insured if the child satisfies all of the following criteria:
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1. The child is over 17 but less than 27 years of age.
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2. The child is not married.
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3. The child is not eligible for coverage under a group health benefit plan, as
19defined in s. 632.745 (9), that is offered by the child's employer and for which the
20amount of the child's premium contribution is no greater than the premium amount
21for his or her coverage as a dependent under this section.
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(b) Notwithstanding par. (a) 1., the coverage requirement under this section
23applies to an adult child who satisfies all of the following criteria:
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1. The child is a full-time student, regardless of age.
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2. The child satisfies the criteria under par. (a) 2. and 3.
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13. The child was called to federal active duty in the national guard or in a
2reserve component of the U.S. armed forces while the child was attending, on a
3full-time basis, an institution of higher education.
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4. The child was under the age of 27 years when called to federal active duty
5under subd. 3.
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6(3) Premium determination. An insurer or self-insured health plan shall
7determine the premium for coverage of a dependent who is over 18 years of age on
8the same basis as the premium is determined for coverage of a dependent who is 18
9years of age or younger.
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10(4) Documentation of criteria satisfaction. An insurer or self-insured health
11plan may require that an applicant or insured seeking coverage of a dependent child
12provide written documentation, initially and annually thereafter, that the
13dependent child satisfies the criteria for coverage under this section.
SB70, s. 10
14Section
10. 632.895 (15) (a) of the statutes is amended to read:
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632.895
(15) (a) Subject to pars. (b) and (c), every disability insurance policy,
16and every self-insured health plan of the state or a county, city, town, village, or
17school district, that provides coverage for a person as a dependent of the insured
18because the person is a full-time student
, including the coverage under s. 632.885
19(2) (b), shall continue to provide dependent coverage for the person if, due to a
20medically necessary leave of absence, he or she ceases to be a full-time student.
SB70, s. 11
21Section
11. 632.895 (15) (c) 5. of the statutes is amended to read:
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632.895
(15) (c) 5.
The Except for a person who has coverage as a dependent
23under s. 632.885 (2) (b), the person reaches the age at which coverage as a dependent
24who is a full-time student would otherwise end under the terms and conditions of
25the policy or plan.
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(1) This act first applies to all of the following:
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(a) Except as provided in paragraphs (b) and (c
), disability insurance policies
4that are issued or renewed, and governmental or school district self-insured health
5plans that are established, extended, modified, or renewed, on the effective date of
6this paragraph.
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(b) Disability insurance policies covering employees who are affected by a
8collective bargaining agreement containing provisions inconsistent with this act
9that are issued or renewed on the earlier of the following:
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101. The day on which the collective bargaining agreement expires.
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112. The day on which the collective bargaining agreement is extended, modified,
12or renewed.
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(c) Governmental or school district self-insured health plans covering
14employees who are affected by a collective bargaining agreement containing
15provisions inconsistent with this act that are established, extended, modified, or
16renewed on the earlier of the following:
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171. The day on which the collective bargaining agreement expires.
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182. The day on which the collective bargaining agreement is extended, modified,
19or renewed.
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(1) This act takes effect on the first day of the 7th month beginning after
22publication.