632.898(2)(d)
(d) An employer that establishes a medical savings account on behalf of an employe is not required to deposit in the account more than $2,000 per year for the employe if the employe's coverage is single, or more than $2,000 per year for the employe, $2,000 per year for the employe's spouse or $1,000 per year for each nonspouse dependent of the employe if the employe's coverage is family. Beginning in 1998, the amounts specified in this paragraph shall be increased each year in the manner provided in
s. 71.05 (6) (b) 22. [24.].
632.898 Note
NOTE: The bracketed language indicates the correct cross-reference. Corrective legislation is pending.
632.898(2)(e)
(e) An employe who chooses a high cost-share health plan and for whom a medical savings account is established is not eligible for coverage under a different health benefit plan offered by the employer before the end of the policy term of the high cost-share health plan.
632.898(3)(a)(a) A self-employed person who purchases a high cost-share health plan may establish a medical savings account in his or her name. Upon establishing a medical savings account, a self-employed person shall notify the department of revenue, in the manner prescribed by the department of revenue, of the establishment of the account, the self-employed person's name and social security number, the name and address of the account administrator and any other information that the department of revenue may require.
632.898(3)(b)
(b) Except as provided in
par. (c), a self-employed person who establishes a medical savings account shall deposit in the account the difference between what the self-employed person pays for the high cost-share health plan, including coverage for his or her dependents, and what the self-employed person would pay for a more expensive health benefit plan, including coverage for his or her dependents. Except as provided in
sub. (4) (b), no other deposits may be made in the account.
632.898(3)(c)
(c) A self-employed person who establishes a medical savings account is not required to deposit in the account more than $2,000 per year for himself or herself if the self-employed person's coverage is single, or more than $2,000 per year for himself or herself, $2,000 per year for his or her spouse or $1,000 per year for each nonspouse dependent if the self-employed person's coverage is family. Beginning in 1998, the amounts specified in this paragraph shall be increased each year in the manner provided in
s. 71.05 (6) (b) 22. [24.].
632.898 Note
NOTE: The bracketed language indicates the correct cross-reference. Corrective legislation is pending.
632.898(4)(a)(a) If an employe with a medical savings account under this section becomes self-employed and purchases a high cost-share health plan, he or she may make deposits in the account as provided in
sub. (3).
632.898(4)(b)
(b) If a self-employed person with a medical savings account under this section becomes employed by an employer described in
sub. (2) (a) and chooses a high cost-share health plan, the employer may make deposits in the account as provided in
sub. (2).
632.898(5)(a)(a) Amounts deposited in an account under this section and any interest, dividends or other gain that accrues on amounts deposited in the account may be used only for any of the following:
632.898(5)(a)2.
2. To pay long-term care expenses of the employe or self-employed person or any of the employe's or self-employed person's dependents.
632.898(5)(a)3.
3. To purchase a long-term care insurance policy for the employe or self-employed person or any of the employe's or self-employed person's dependents.
632.898(5)(b)
(b) An employe or self-employed person with a medical savings account shall provide information about the use of the account funds, in the manner prescribed by the department of revenue, in conjunction with the filing of his or her Wisconsin income tax return.
632.898(5)(c)
(c) Paragraph (a) does not apply after the death of the employe or self-employed person.
632.898(6)(a)(a) A person that provides medical care, long-term care or a long-term care insurance policy, the cost of which is to be paid with funds in a medical savings account, shall bill the employe or self-employed person who is the holder of the account directly, rather than billing the account administrator of the medical savings account.
632.898(6)(b)
(b) The account administrator of a medical savings account shall do all of the following:
632.898(6)(b)1.
1. Permit withdrawals from the account at least once a month.
632.898(6)(b)2.
2. Issue an account statement to the holder of the account at least quarterly.
632.898(7)
(7) If the federal government enacts legislation providing for a federal income tax exemption for amounts deposited in an account established under this section and for any interest, dividends or other gain that accrues in the account if redeposited in the account, the commissioner shall conduct a study, to be completed within 4 years after the enactment of the federal legislation, of individuals and groups that had coverage under a high cost-share health plan and that terminated that coverage in order to enroll in a health benefit plan that was not a high cost-share health plan. If as a result of the study the commissioner determines that
s. 632.745 (1) (f) 2. is not necessary for the purpose for which it was intended, the commissioner shall certify that determination to the revisor of statutes. Upon the certification, the revisor of statutes shall publish notice in the Wisconsin administrative register of the determination, the date of the certification and that after 30 days after the date of the certification
s. 632.745 (1) (f) 2. is not effective.
632.898 History
History: 1995 a. 453.
FRATERNAL INSURANCE
632.91
632.91
Definition. In this subchapter, "insured employe" means an employe of a fraternal or of a subsidiary or other affiliate of a fraternal who is provided insurance benefits by the fraternal under
s. 614.10 (2) (c) but is not a member of the fraternal.
632.91 History
History: 1989 a. 336;
1991 a. 189.
632.93
632.93
The fraternal contract. 632.93(1)
(1)
Issuance of certificate. A fraternal shall issue to each benefit member and insured employe a policy or certificate specifying the benefits provided and containing at least in substance all sections of the laws of the fraternal which might result in the termination of coverage or the reduction of benefits. The policy or certificate, any riders or endorsements attached thereto, the laws of the fraternal, and the application and declarations made in connection therewith and signed by the applicant, constitute the agreement between the fraternal and the member or insured employe, and the policy or certificate shall so state.
632.93(2)
(2) Changes in laws of fraternals. Except as provided in
s. 614.24 (1m), any changes in the laws of a fraternal made subsequent to the issuance of a policy or certificate bind the member, beneficiary and insured employe as if they had been in force at the time of the application, so long as they do not destroy or diminish benefits promised in the policy or certificate.
632.93(3)
(3) Proof of terms. Copies of any documents mentioned in
subs. (1) and
(2), certified by the secretary or corresponding officer of the fraternal, are evidence of the terms and conditions of the contract.
632.93(5)
(5) Grace period. Every fraternal certificate shall contain a provision entitling the member or insured employe to a grace period of not less than one month, or 30 days at the fraternal's option, for the payment of any premium due except the first, during which the death benefit shall continue in force. A fraternal may specify in the grace period provision that the overdue premium will be deducted from the death benefit in the event of death before it is paid.
632.93(6)
(6) Compliance with other provisions. If a fraternal's laws provide for expulsion or suspension of a member for any reason other than nonpayment of premium or under
s. 632.46, the fraternal's insurance certificate shall contain a provision that if a member is expelled or suspended for any reason other than nonpayment of premium or under
s. 632.46, the expelled member has the right to maintain the policy in force by continuing payment of the required premium.
632.93(7)
(7) Scope of application. This section applies to all contracts made by a fraternal beginning 6 months after December 18, 1979. A fraternal may elect to have this section apply at an earlier date, so long as it applies simultaneously to all such contracts and the fraternal gives the commissioner at least 30 days' notice of intention to adopt this section.
632.95
632.95
Fraud in obtaining membership. Subject to
s. 632.46, any certificate of membership secured by misrepresentation in or with reference to any application for membership or documentary or other proof for the purpose of obtaining membership in or noninsurance benefit from the fraternal is void, if the fraternal relied on it and it is either material or fraudulent.
632.95 History
History: 1975 c. 373.
632.95 Annotation
Legislative Council Note, 1975: This section continues the contractual portion of s. 208.38, edited with a change in meaning, to include nonfraudulent but material misrepresentation, and also to subject the provision to the rule of incontestability provided in s. 632.46. [Bill 643-S]
632.96
632.96
Beneficiaries in fraternal contracts. 632.96(1)
(1) Any member or insured employe may designate as beneficiary any person permitted by the laws of the fraternal. Those laws shall authorize the designation of the member's or insured employe's estate as beneficiary.
632.96 History
History: 1975 c. 373,
421;
1989 a. 336.
632.96 Annotation
Legislative Council Note, 1975: Sub. (1) states a rule slightly more restrictive of the range of permitted beneficiaries than for commercial life insurance; this reflects the nature of the fraternal. Sub. (2) applies the general provision for life insurance, subject to sub. (1). [Bill 643-S]
MISCELLANEOUS
632.97
632.97
Application of proceeds of credit insurance policy. Payment to a creditor of any amounts insured under the terms of a credit insurance policy reduces the debt proportionately. This rule does not apply to an insurance policy on which the debtor pays no part of the premium, directly or indirectly.
632.97 History
History: 1975 c. 375.
632.98
632.98
Worker's compensation insurance. Sections 102.31 and
102.62 apply to worker's compensation insurance.
632.98 History
History: 1975 c. 375,
421;
1979 c. 102.
632.99
632.99
Certifications of disability. Every insurer doing a health or disability insurance business in this state shall afford equal weight to a certification of disability signed by a physician with respect to matters within the scope of the physician's professional license and to a certification of disability signed by a chiropractor with respect to matters within the scope of the chiropractor's professional license for the purpose of insurance policies they issue. This section does not require an insurer to treat any certification of disability as conclusive evidence of disability.
632.99 History
History: 1981 c. 55.
