Ins 8.54(5)(b)1. 1. The reason for the decision not to renew.

Ins 8.54(5)(b)2. 2. The number of small employers and the total number of eligible employees affected by the decision not to renew.

Ins 8.54(5)(b)3. 3. The number of small employers in other classes of the small employer insurer’s business that are not affected by the decision not to renew.

Ins 8.54(5)(c) (c) The commissioner may order an examination under s. 601.43, Stats., in order to determine the premium rate history and obtain information on the profitability of the nonrenewed class of business.

Ins 8.54(5)(d) (d) At least one year before a small employer insurer ceases to renew policies under s. 635.07 (2), Stats., the small employer insurer shall provide written notice of that intent to all affected small employers and the insurance regulatory agency in each state in which an affected insured individual resides. The notice shall include all of the following:

Ins 8.54 Note Note: 1995 Wis. Act 289 repealed s. 635.07, Stats. See s. 632.749 (3), Stats.

Ins 8.54(5)(d)1. 1. The reason for the decision to terminate coverage for the class of business.

Ins 8.54(5)(d)2. 2. The date on which coverage will terminate.

Ins 8.54(5)(e) (e) In addition to the requirement under par. (d), the small employer insurer shall, at least 60 days but not more than 75 days before the date coverage will terminate, provide each affected small employer with written notice, complying with s. 631.36 (6) and (7), Stats., of the intent not to renew the policy. The notice shall also comply with the notice requirements of ss. 632.79 and 632.897, Stats.

Ins 8.54(6) (6) Conversion of assumed class of business. A small employer insurer that assumes a class of business from another small employer insurer shall, by the 2nd renewal date for each policy or one year from the date of assumption, whichever is later, convert each policy in the assumed class of business to a policy with the same or similar benefit design characteristics in another class of business specified under sub. (2) (a).

Ins 8.54 History History: Cr. Register, October, 1992, No. 442, eff. 11-1-92; am. (4) (a) to (c), Register, November, 1993, No. 455, eff. 2-1-94.

Ins 8.56 Ins 8.56 Certification of compliance; additional information required.

Ins 8.56(1) (1) The annual certification of compliance required under s. 635.13, Stats., shall be submitted in the form prescribed by the office.

Ins 8.56(2) (2) In addition to the annual certification required under sub. (1), the commissioner may require a small employer insurer to furnish additional information including, but not limited to, the following, using the form and method of transmittal prescribed by the commissioner:

Ins 8.56(2)(a) (a) Rate manuals or exhibits of all rating factors used for each class of business.

Ins 8.56(2)(b) (b) Sample data of small employers including premiums charged and rating factors applied for case characteristics and benefit design characteristics.

Ins 8.56(2)(c) (c) An inventory of case characteristics used by the small employer insurer since the last certification date.

Ins 8.56(2)(d) (d) An exhibit showing the difference in new business premium rates between the current certification date and the last certification date.

Ins 8.56(2)(e) (e) A description of how midpoint rates are determined.

Ins 8.56 Note Note: The form required under sub. (1), OCI 26-051, may be obtained from the Office of the Commissioner of Insurance, P. O. Box 7873, Madison, WI 53707-7873.

Ins 8.56 History History: Cr. Register, October, 1992, No. 442, eff. 11-1-92.

Ins 8.59 Ins 8.59 Small employer insurers shall offer an initial enrollment period to all members of small employer groups; riders and discriminatory coverage are prohibited.

Ins 8.59(1) (1) A small employer insurer that offers a policy shall provide an initial enrollment period during which each eligible employee and dependent of an eligible employee is entitled to enroll in coverage under the policy.

Ins 8.59(2) (2) Except as permitted under sub. (3), a small employer insurer shall provide the same policy coverage to each eligible employee, and dependent of an eligible employee of a small employer, who is covered under a policy.

Ins 8.59(3) (3) A small employer insurer may offer, or participate in an offer, to eligible employees of a choice by the eligible employee among 2 or more policies for coverage of the eligible employee and the eligible employee’s dependents, but only if:

Ins 8.59(3)(a) (a) The enrollment period is simultaneous for all the policies;

Ins 8.59(3)(b) (b) The eligible employee may choose any one of the offered policies; and

Ins 8.59(3)(c) (c) All the policies offered provide benefits similar to or exceeding the benefits provided under the basic health benefit plan as determined under s. Ins 8.66 (1).

Ins 8.59 History History: Cr. Register, November, 1993, No. 455, eff. 2-1-94; correction in (4) made under s. 13.93 (2m) (b) 7., Stats., Register October 2002 No. 562; CR 17-015: r. (4) Register December 2017 No. 744, eff. 1-1-18.