633.09(3)
(3) Interest on deposits. Interest earned on moneys deposited in a fiduciary account is the property of the principal unless otherwise provided in the written agreement required under
s. 633.04.
633.09(4)
(4) Withdrawals from fiduciary account. 633.09(4)(a)(a) An administrator may not pay any claim by withdrawal from a fiduciary account.
633.09(4)(b)
(b) An administrator may make the following payments from a fiduciary account:
633.09(4)(b)1.
1. To a principal, the funds belonging to the principal.
633.09(4)(b)2.
2. To a plan policyholder for payment to a principal, the funds belonging to the principal.
633.09(4)(b)4.
4. To another account maintained in the name of a principal, the funds belonging to the principal.
633.09(4)(b)5.
5. To a claims paying account, the funds belonging to a principal for payment of claims owed by the principal.
633.09(4)(b)6.
6. To the administrator, commissions, fees or charges owed the administrator by a principal.
633.09 History
History: 1991 a. 39.
633.10
633.10
Payment of claims. An administrator shall pay claims from funds paid to the claims paying account under
s. 633.09 (4) (b) 5. on drafts or checks authorized in advance by the principal.
633.10 History
History: 1991 a. 39.
633.11
633.11
Claim adjustment compensation. If an administrator adjusts or settles claims under a plan, the commission, fees or charges that the principal pays the administrator may not be based on the plan's loss experience. This section does not prohibit compensation based on the number or amount of premiums or charges collected, or the number or amount of claims paid or processed by the administrator.
633.11 History
History: 1991 a. 39.
633.12
633.12
Notification required. 633.12(1)
(1) An administrator shall prepare sufficient copies of a written notice approved in advance by the principal for distribution to all insureds of the principal and either shall distribute the copies to the insureds or shall provide the copies to the principal for distribution to the insureds. The written notice shall contain all of the following:
633.12(1)(a)
(a) The names and addresses of the administrator and the principal.
633.12(1)(b)
(b) An explanation of the respective rights and responsibilities of the administrator, the principal and the insureds.
633.12(1)(c)
(c) A statement of the extent to which the plan is insured or self-insured, and an explanation of the terms "insured" and "self-insured".
633.12(2)
(2) If an administrator collects premiums or charges from a person on behalf of a principal, at least once in every year, prior to collecting the premiums or charges, the administrator shall provide written notice to the person stating the amount of the premiums or charges.
633.12 History
History: 1991 a. 39.
633.13
633.13
License required. 633.13(1)(1)
General. Except as provided in
sub. (2), a person may not perform, offer to perform or advertise any service as an administrator unless the person has obtained a license under
s. 633.14.
633.13(2)
(2) Exemptions. The commissioner may exempt by rule certain classes of administrators from the requirement of
sub. (1) if the commissioner determines any of the following:
633.13(2)(a)
(a) That the functions that the administrators perform do not require special competence or trustworthiness or otherwise do not require the regulatory surveillance of a licensing requirement.
633.13(2)(b)
(b) That other safeguards make a licensing requirement unnecessary.
633.13(3)
(3) Responsibilities of principal. A principal may not use the services of an administrator unless the administrator furnishes proof of licensure under
s. 633.14 or exemption under
sub. (2).
633.13 History
History: 1991 a. 39.
633.14
633.14
Issuance of license. 633.14(1)(1) The commissioner shall issue a license to act as an administrator to an individual who does all of the following:
633.14(1)(b)
(b) Supplies a bond meeting the specifications established under
sub. (3).
633.14(1)(c)
(c) Shows to the satisfaction of the commissioner all of the following:
633.14(1)(c)1.
1. That the person intends in good faith to act as an administrator in compliance with applicable laws of this state and rules and orders of the commissioner.
633.14(1)(c)4.
4. If a nonresident, that the person has executed in a form acceptable to the commissioner an agreement to be subject to the jurisdiction of the commissioner and the courts of this state and rules and orders of the commissioner, with service of process as provided under
ss. 601.72 and
601.73.
633.14(1)(d)
(d) Provides his or her social security number, unless the individual does not have a social security number.
633.14(1)(e)
(e) If an individual who does not have a social security number, provides on a form prescribed by the department of workforce development a statement made or subscribed under oath or affirmation that he or she does not have a social security number.
633.14(2)
(2) The commissioner shall issue a license to act as an administrator to a corporation, limited liability company or partnership that does all of the following:
633.14(2)(b)
(b) Supplies a bond meeting the specifications established under
sub. (3).
633.14(2)(c)
(c) Shows to the satisfaction of the commissioner all of the following:
633.14(2)(c)1.
1. That the corporation, limited liability company or partnership intends in good faith to act as an administrator through individuals designated under
subd. 3. in compliance with applicable laws of this state and rules and orders of the commissioner.
633.14(2)(c)2.
2. That each officer, director, member, partner or other individual having comparable responsibilities in the corporation, limited liability company or partnership is competent and trustworthy.
633.14(2)(c)3.
3. That for each plan to be administered, the corporation, limited liability company or partnership has designated or will designate an individual in the corporation, limited liability company or partnership to directly administer the plan.
633.14(2)(c)4.
4. If not organized under the laws of this state, that the corporation, limited liability company or partnership has executed in a form acceptable to the commissioner an agreement to be subject to the jurisdiction of the commissioner and the courts of this state and rules and orders of the commissioner, with service of process as provided under
ss. 601.72 and
601.73.
633.14(2)(d)
(d) Provides its federal employer identification number.
633.14(2c)(a)(a) The commissioner shall disclose a social security number obtained under
sub. (1) (d) to the department of workforce development in the administration of
s. 49.22, as provided in a memorandum of understanding entered into under
s. 49.857.
633.14(2m)(a)(a) Notwithstanding
sub. (1), the commissioner may not issue a license under this section if the individual applying for the license is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the individual fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development or a county child support agency under
s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under
s. 49.857.
633.14(2m)(b)
(b) Notwithstanding
subs. (1) and
(2), the commissioner may not issue a license under this section if the department of revenue certifies under
s. 73.0301 that the applicant is liable for delinquent taxes.
633.14(3)
(3) The commissioner shall promulgate rules establishing the specifications that a bond supplied by an administrator under
sub. (1) (b) or
(2) (b) must satisfy to guarantee faithful performance of the administrator.
633.14 Cross-reference
Cross Reference: See also s.
Ins 8.28, Wis. adm. code.
633.15
633.15
License; renewal, suspension, limitation, revocation, penalty. 633.15(1)(a)(a)
Payment. An administrator shall pay the annual renewal fee under
s. 601.31 (1) (w) for each annual renewal of a license by the date specified by a schedule established under
par. (b).
633.15(1)(b)
(b)
Schedule by rule. The commissioner shall promulgate rules establishing a schedule for payment of the annual renewal fee.
633.15(1m)
(1m) Social security number, federal employer identification number or statement. At an annual renewal, an administrator shall provide his or her social security number, if the administrator is an individual unless he or she does not have a social security number, or its federal employer identification number, if the administrator is a corporation, limited liability company or partnership, if the social security number or federal employer identification number was not previously provided on the application for the license or at a previous renewal of the license. If an administrator who is an individual does not have a social security number, the individual shall provide to the commissioner, at each annual renewal and on a form prescribed by the department of workforce development, a statement made or subscribed under oath or affirmation that the administrator does not have a social security number.
633.15(2)
(2) Revocation, suspension, limitation. 633.15(2)(a)(a)
Nonpayment of annual renewal fee or failure to provide social security number or federal employer identification number. 633.15(2)(a)1.1. If an administrator fails to pay the annual renewal fee as provided under
sub. (1) or fails to provide a social security number, federal employer identification number or statement made or subscribed under oath or affirmation as required under
sub. (1m), the commissioner shall suspend the administrator's license effective the day following the last day when the annual renewal fee may be paid, if the commissioner has given the administrator reasonable notice of when the fee must be paid to avoid suspension.
633.15(2)(a)2.
2. If, within 60 days from the effective date of suspension under
subd. 1., an administrator pays the annual renewal fee or provides the social security number, federal employer identification number or statement made or subscribed under oath or affirmation, or both if the suspension was based upon a failure to do both, the commissioner shall reinstate the administrator's license effective as of the date of suspension.
633.15(2)(a)3.
3. If payment is not made or the social security number, federal employer identification number or statement made or subscribed under oath or affirmation is not provided within 60 days from the effective date of suspension under
subd. 1., the commissioner shall revoke the administrator's license.
633.15(2)(a)4.
4. A person whose license has been revoked under
subd. 3. may apply for a new license under
s. 633.14 at any time.
633.15(2)(b)1.1. Except as provided in
pars. (c) to
(e), the commissioner may revoke, suspend or limit the license of an administrator after a hearing if the commissioner makes any of the following findings:
633.15(2)(b)1.a.
a. That the administrator is unqualified to perform the responsibilities of an administrator.
633.15(2)(b)1.b.
b. That the administrator has repeatedly or knowingly violated an applicable law, rule or order of the commissioner.
633.15(2)(b)1.c.
c. That the administrator's methods or practices in administering a plan endanger the interests of insureds or the public, or that the financial resources of the administrator are inadequate to safeguard the interests of insureds or the public.
633.15(2)(b)2.
2. A person whose license has been revoked under
subd. 1. may apply for a new license under
s. 633.14 only after the expiration of 5 years from the date of the order revoking the administrator's license, unless the order specifies a lesser period.
633.15(2)(c)
(c)
Failure to pay support or to comply with subpoena or warrant. The commissioner shall suspend, limit or refuse to renew a license issued under this section to an individual if the individual is delinquent in court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse, or if the individual fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development or a county child support agency under
s. 59.53 (5) and related to paternity or child support proceedings, as provided in a memorandum of understanding entered into under
s. 49.857.
633.15(2)(d)
(d)
For liability for delinquent taxes. The commissioner shall revoke or refuse to renew a license issued under
s. 633.14 if the department of revenue certifies under
s. 73.0301 that the licensee is liable for delinquent taxes.
633.15(2)(e)
(e)
For providing false information in statement. The commissioner shall revoke a license issued under
s. 633.14 (1) if the commissioner determines, after a hearing, that the licensee provided false information in a statement provided under
sub. (1m) or
s. 633.14 (1) (e).
633.16
633.16
Regulation. Nothing in this chapter gives the commissioner the authority to impose requirements on a plan that is exempt from state law under
29 USC 1144 (b).
633.16 History
History: 1991 a. 39; Stats. 1991 s. 633.16.
633.16 Annotation
The commissioner lacks authority to regulate administrators of self-funded or self-insured employee benefit plans.
80 Atty. Gen. 290.
633.17
633.17
Rule-making authority. The commissioner shall promulgate rules necessary for the implementation of this chapter, in addition to the rules permitted under
s. 633.13 (2) and required under
ss. 633.14 (3) and
633.15 (1) (b).
633.17 History
History: 1991 a. 39.
