149.16 History
History: 1997 a. 27 ss.
3030,
3031,
4882 to
4884c,
4886;
1999 a. 9.
149.165
149.165
Reductions in premiums for low-income eligible persons. 149.165(2)(a)(a) Subject to
sub. (3m), if the household income, as defined in
s. 71.52 (5) and as determined under
sub. (3), of an eligible person with coverage under
s. 149.14 (2) (a) is equal to or greater than the first amount and less than the 2nd amount listed in any of the following, the department shall reduce the premium for the eligible person to the rate shown after the amounts:
149.165(2)(a)1.
1. If equal to or greater than $0 and less than $10,000, to 100% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as provided under
s. 149.14 (2) (a) and
(5) (a).
149.165(2)(a)2.
2. If equal to or greater than $10,000 and less than $14,000, to 106.5% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as provided under
s. 149.14 (2) (a) and
(5) (a).
149.165(2)(a)3.
3. If equal to or greater than $14,000 and less than $17,000, to 115.5% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as provided under
s. 149.14 (2) (a) and
(5) (a).
149.165(2)(a)4.
4. If equal to or greater than $17,000 and less than $20,000, to 124.5% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as provided under
s. 149.14 (2) (a) and
(5) (a).
149.165(2)(a)5.
5. If equal to or greater than $20,000 and less than $25,000, to 130% of the rate that a standard risk would be charged under an individual policy providing substantially the same coverage and deductibles as provided under
s. 149.14 (2) (a) and
(5) (a).
149.165(2)(bc)
(bc) Subject to
sub. (3m), if the household income, as defined in
s. 71.52 (5) and as determined under
sub. (3), of an eligible person with coverage under
s. 149.14 (2) (b) is equal to or greater than the first amount and less than the 2nd amount listed in
par. (a) 1.,
2.,
3.,
4. or
5., the department shall reduce the premium established for the eligible person by the same percentage as the department reduces, under
par. (a), the premium established for an eligible person with coverage under
s. 149.14 (2) (a) who has a household income specified in the same subdivision under
par. (a) as the household income of the eligible person with coverage under
s. 149.14 (2) (b).
149.165(3)(a)(a) Subject to
par. (b), the department shall establish and implement the method for determining the household income of an eligible person under
sub. (2).
149.165(3)(b)
(b) In determining household income under
sub. (2), the department shall consider information submitted by an eligible person on a completed federal profit or loss from farming form, schedule F, if all of the following apply:
149.165(3m)
(3m) The board may approve adjustment of the household income dollar amounts listed in
sub. (2) (a) 1. to
5., except for the first dollar amount listed in
sub. (2) (a) 1., to reflect changes in the consumer price index for all urban consumers, U.S. city average, as determined by the U.S. department of labor.
149.165(4)
(4) The department shall reimburse the plan for premium reductions under
sub. (2) and deductible reductions under
s. 149.14 (5) (a) with moneys transferred to the fund from the appropriation account under
s. 20.435 (4) (ah).
149.165 History
History: 1985 a. 29;
1987 a. 27;
1987 a. 312 s.
17;
1991 a. 39;
1997 a. 27 ss.
4889 to
4894; Stats. 1997 s. 149.165;
1999 a. 9,
165.
149.17
149.17
Contents of plan. The plan shall include, but is not limited to, the following:
149.17(2)
(2) A schedule of premiums, deductibles, copayments and coinsurance payments that complies with all requirements of this chapter.
149.17(3)
(3) Procedures for applicants and participants to have grievances reviewed by an impartial body.
149.17(4)
(4) Cost containment provisions established by the department by rule, including managed care requirements.
149.175
149.175
Waiver or exemption from provisions prohibited. Except as provided in
s. 149.13 (1), the department may not waive, or authorize the board to waive, any of the requirements of this chapter or exempt, or authorize the board to exempt, an individual or a class of individuals from any of the requirements of this chapter.
149.175 History
History: 1991 a. 39;
1997 a. 27 s.
4901; Stats. 1997 s. 149.175.
149.18
149.18
Chapters 600 to 645 applicable. Except as otherwise provided in this chapter, the plan shall comply and be administered in compliance with
chs. 600 to
645.
149.18 History
History: 1979 c. 313;
1981 c. 314;
1997 a. 27 s.
4902; Stats. 1997 s. 149.18.
149.20
149.20
Rule-making in consultation with board. In promulgating any rules under this chapter, the department shall consult with the board.
149.20 History
History: 1997 a. 27.