To furnish engineering, architectural, project management, and other 19
building construction services whenever requisitions therefor are presented to the 20
department by any agency. The department may deposit moneys received from the 21
provision of these services in the account under s. 20.505 (1) (kc) or in the general 22
fund as general purpose revenue — earned. In this subsection, “agency" means an 23
office, department, independent agency, institution of higher education, association, 24
society, or other body in state government created or authorized to be created by the 25
constitution or any law, which is entitled to expend moneys appropriated by law,
including the legislature and the courts, but not including an authority created in 2
subch. II of ch. 114 or subch. III of ch. 636
or in ch. 231, 233, 234, 237, 238, or 279.
16.865 (8) of the statutes is amended to read:
Annually in each fiscal year, allocate as a charge to each agency a 5
proportionate share of the estimated costs attributable to programs administered by 6
the agency to be paid from the appropriation under s. 20.505 (2) (k). The department 7
may charge premiums to agencies to finance costs under this subsection and pay the 8
costs from the appropriation on an actual basis. The department shall deposit all 9
collections under this subsection in the appropriation account under s. 20.505 (2) (k). 10
Costs assessed under this subsection may include judgments, investigative and 11
adjustment fees, data processing and staff support costs, program administration 12
costs, litigation costs, and the cost of insurance contracts under sub. (5). In this 13
subsection, “agency" means an office, department, independent agency, institution 14
of higher education, association, society, or other body in state government created 15
or authorized to be created by the constitution or any law, that is entitled to expend 16
moneys appropriated by law, including the legislature and the courts, but not 17
including an authority created in subch. II of ch. 114 or subch. III of ch. 636
or in ch. 18
231, 232, 233, 234, 237, 238, or 279.
25.50 (1) (d) of the statutes is amended to read:
(d) “Local government" means any county, town, village, city, power 21
district, sewerage district, drainage district, town sanitary district, public inland 22
lake protection and rehabilitation district, local professional baseball park district 23
created under subch. III of ch. 229, long-term care district under s. 46.2895, local 24
professional football stadium district created under subch. IV of ch. 229, local 25
cultural arts district created under subch. V of ch. 229, public library system, school
district or technical college district in this state, any commission, committee, board 2
or officer of any governmental subdivision of this state, any court of this state, other 3
than the court of appeals or the supreme court, or any authority created under s. 4
114.61, 231.02, 233.02, or
234.02, or 636.70
40.02 (54) (n) of the statutes is created to read:
(n) The Badger Health Benefit Authority.
49.45 (2) (a) 3. of the statutes is amended to read:
(a) 3. Determine
Subject to s. 636.30 (1) (o), determine
the eligibility 9
of persons for medical assistance, rehabilitative, and social services under ss. 49.46, 10
49.468, 49.47, and 49.471 and rules and policies adopted by the department and may, 11
under a contract under s. 49.78 (2), delegate all, or any portion, of this function to the 12
county department under s. 46.215, 46.22, or 46.23 or a tribal governing body.
70.11 (41c) of the statutes is created to read:
70.11 (41c) Badger Health Benefit Authority.
All property owned by the 15
Badger Health Benefit Authority, provided that the use of the property is primarily 16
related to the purposes of the authority.
71.26 (1) (be) of the statutes is amended to read:
(be) Certain authorities.
Income of the University of Wisconsin 19
Hospitals and Clinics Authority, of the Badger Health Benefit Authority,
of the Fox 20
River Navigational System Authority, of the Wisconsin Economic Development 21
Corporation, and of the Wisconsin Aerospace Authority.
77.54 (9a) (a) of the statutes is amended to read:
(a) This state or any agency thereof, the University of Wisconsin 24
Hospitals and Clinics Authority, the Wisconsin Aerospace Authority,
1Health Benefit Authority,
the Wisconsin Economic Development Corporation, and 2
the Fox River Navigational System Authority.
101.055 (2) (a) of the statutes is amended to read:
(a) “Agency" means an office, department, independent agency, 5
authority, institution, association, society, or other body in state government created 6
or authorized to be created by the constitution or any law, and includes the 7
legislature and the courts, but excludes the Badger Health Benefit Authority
230.03 (3) of the statutes is amended to read:
“Agency" means any board, commission, committee, council, or 10
department in state government or a unit thereof created by the constitution or 11
statutes if such board, commission, committee, council, department, unit, or the 12
head thereof, is authorized to appoint subordinate staff by the constitution or 13
statute, except the Board of Regents of the University of Wisconsin System, a 14
legislative or judicial board, commission, committee, council, department, or unit 15
thereof or an authority created under subch. II of ch. 114 or subch. III of ch. 636
under ch. 231, 232, 233, 234, 237, 238, or 279. “Agency" does not mean any local unit 17
of government or body within one or more local units of government that is created 18
by law or by action of one or more local units of government.
230.80 (4) of the statutes is amended to read:
“Governmental unit" means any association, authority, board, 21
commission, department, independent agency, institution, office, society, or other 22
body in state government created or authorized to be created by the constitution or 23
any law, including the legislature, the office of the governor, and the courts, but
24excluding the Badger Health Benefit Authority
. “Governmental unit" does not mean
any political subdivision of the state or body within one or more political subdivisions 2
that is created by law or by action of one or more political subdivisions.
230.90 (1) (c) of the statutes is amended to read:
(c) “Governmental unit" means any association, authority, board, 5
commission, department, independent agency, institution, office, society or other 6
body in state government created or authorized to be created by the constitution or 7
any law, including the legislature, the office of the governor and the courts. 8
“Governmental unit" does not mean the University of Wisconsin Hospitals and 9
Clinics Authority, the Badger Health Benefit Authority,
or any political subdivision 10
of the state or body within one or more political subdivisions which is created by law 11
or by action of one or more political subdivisions.
635.18 (1) of the statutes is amended to read:
635.18 (1) Every Any
small employer insurer shall may
actively market health 14
benefit plan coverage to small employers in the state.
Chapter 636 of the statutes is created to read:
health benefit plan exchange
In this chapter:
“Authority" means the Badger Health Benefit Authority.
“Educated health care consumer" means an individual who is 23
knowledgeable about the health care system and who has background or experience 24
in making informed decisions regarding health, medical, and scientific matters.
“Federal act" means the federal Patient Protection and Affordable Care Act, 2
, as amended by the federal Health Care and Education Reconciliation 3
Act of 2010, P.L. 111-152
, and any amendments to, or regulations or guidance issued 4
under, those acts.
(a) Except as provided in pars. (b) to (e), “health benefit plan" means a policy, 6
contract, certificate, or agreement offered or issued by a health carrier to provide, 7
deliver, arrange for, pay for, or reimburse any of the costs of health care services.
(b) “Health benefit plan" does not include any of the following:
1. Coverage only for accident, or disability income insurance, or any 10
combination of those.
2. Coverage issued as a supplement to liability insurance.
3. Liability insurance, including general liability insurance and automobile 13
4. Worker's compensation or similar insurance.
5. Automobile medical payment insurance.
6. Credit-only insurance.
7. Coverage for on-site medical clinics.
8. Other similar insurance coverage, specified in federal regulations issued 19
under P.L. 104-191
, under which benefits for health care services are secondary or 20
incidental to other insurance benefits.
(c) “Health benefit plan" does not include any of the following benefits if they 22
are provided under a separate policy, certificate, or contract of insurance or otherwise 23
not an integral part of the plan:
1. Limited scope dental or vision benefits.
2. Benefits for long-term care, nursing home care, home health care, 2
community-based care, or any combination of those.
3. Other similar, limited benefits specified in federal regulations issued under 4
(d) “Health benefit plan" does not include any of the following benefits if the 6
benefits are provided under a separate policy, certificate, or contract of insurance, 7
there is no coordination between the provision of the benefits and any exclusion of 8
benefits under any group health plan maintained by the same plan sponsor, and the 9
benefits are paid with respect to an event without regard to whether benefits are 10
provided with respect to such an event under any group health plan maintained by 11
the same plan sponsor:
1. Coverage only for a specified disease or illness.
2. Hospital indemnity or other fixed indemnity insurance.
(e) “Health benefit plan" does not include any of the following if offered as a 15
separate policy, certificate, or contract of insurance:
1. Medicare supplemental health insurance as defined under section 1882 (g) 17
(1) of the federal Social Security Act.
2. Coverage supplemental to the coverage provided under the Civilian Health 19
and Medical Program of the Uniformed Services 10 USC ch. 55
3. Similar coverage supplemental to coverage provided under a group health 21
“Health carrier" means an entity subject to the insurance laws and rules 23
of this state, or subject to the jurisdiction of the commissioner, that contracts or offers 24
to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of 25
health care services, including a sickness and accident insurance company, a health
maintenance organization, a nonprofit hospital and health service corporation, or 2
any other entity providing a plan of health insurance, health benefits, or health 3
“Minimum essential coverage" has the meaning given in 26 USC 5000A 5
“Qualified dental plan" means a limited scope dental plan that has been 7
certified in accordance with s. 636.42 (5).
“Qualified employer" means a small employer that elects to make its 9
full-time employees eligible for one or more qualified health plans offered through 10
the SHOP Exchange and, at the option of the employer, some or all of its part-time 11
employees, provided that the employer satisfies any of the following:
(a) The employer has its principal place of business in this state and elects to 13
provide coverage through the SHOP Exchange to all of its eligible employees, 14
(b) The employer elects to provide coverage through the SHOP Exchange to all 16
of its eligible employees who are principally employed in this state.
“Qualified health plan" means a health benefit plan that has in effect a 18
certification that the plan meets the criteria for certification described in section 19
1311 (c) of the federal act and s. 636.42.
“Qualified individual" means an individual, including a minor, who satisfies 21
all of the following:
(a) The individual is seeking to enroll in a qualified health plan offered to 23
individuals through the exchange under subch. II.
(b) The individual resides in this state.
(c) At the time of enrollment, the individual is not incarcerated in a correctional 2
facility, other than incarceration pending the disposition of charges.
(d) The individual is, and is reasonably expected to be for the entire period for 4
which enrollment is sought, a citizen or national of the United States or an alien 5
lawfully present in the United States.
“Secretary" means the secretary of the federal department of health and 7
“SHOP Exchange" means a small business health options program 9
established under s. 636.30 (1) (q).
(a) “Small employer" means an employer that employed an average of not 11
more than 100 employees during the preceding calendar year.
(b) For purposes of this subsection, all of the following apply:
1. All persons treated as a single employer under section 414
(b), (c), (m), or (o) 14
of the Internal Revenue Code shall be treated as a single employer.
2. An employer and any predecessor employer shall be treated as a single 16
3. All employees shall be counted, including part-time employees and 18
employees who are not eligible for coverage through the employer.
4. If an employer was not in existence during the entire preceding calendar 20
year, the determination of whether that employer is a small employer shall be based 21
on the average number of employees that it is reasonably expected that employer will 22
employ on business days in the current calendar year.
5. An employer that makes enrollment in qualified health plans available to 24
its employees through the SHOP Exchange and that would cease to be a small 25
employer by reason of an increase in the number of its employees shall continue to
be treated as a small employer for purposes of this chapter as long as it continuously 2
makes enrollment through the SHOP Exchange available to its employees.
operation of exchange
5636.25 General matters. (1)
The authority shall establish and operate a 6
Wisconsin Health Benefit Exchange and shall make qualified health plans, with 7
effective dates on or before January 1, 2018, available to qualified individuals and 8
(a) The authority may not make available any health benefit plan that is 10
not a qualified health plan.
(b) The authority shall allow a health carrier to offer a plan that provides 12
limited scope dental benefits meeting the requirements of section 9832
(c) (2) (A) of 13
the Internal Revenue Code through the exchange under sub. (1), either separately 14
or in conjunction with a qualified health plan, if the plan provides pediatric dental 15
benefits meeting the requirements of section 1302 (b) (1) (J) of the federal act.
Neither the authority nor a health carrier offering health benefit plans 17
through the exchange under sub. (1) may charge an individual a fee or penalty for 18
termination of coverage if the individual enrolls in another type of minimum 19
essential coverage because the individual has become newly eligible for that 20
coverage or because the individual's employer-sponsored coverage has become 21
affordable under the standards of section 36B
(c) (2) (C) of the Internal Revenue 22
The authority may enter into information-sharing agreements with federal 24
and state agencies and entities operating exchanges in other states to carry out its 25
responsibilities under this chapter, provided that such agreements include adequate
protections with respect to the confidentiality of the information to be shared and 2
comply with all state and federal laws and rules and regulations.
3636.30 Exchange duties and powers. (1)
In addition to all other duties 4
imposed under this chapter, the authority shall do all of the following relating to the 5
exchange under s. 636.25 (1):
(a) Implement procedures for the certification, recertification, and 7
decertification, consistent with guidelines developed by the secretary under section 8
1311 (c) of the federal act and s. 636.42, of health benefit plans as qualified health 9
(b) Provide for the operation of a toll-free telephone hotline to respond to 11
requests for assistance.
(c) Provide for enrollment periods, as provided under section 1311 (c) (6) of the 13
(d) Maintain an Internet site through which enrollees and prospective 15
enrollees of qualified health plans may obtain standardized comparative 16
information on such plans.
(e) Assign a rating to each qualified health plan offered through the exchange 18
in accordance with the criteria developed by the secretary under section 1311 (c) (3) 19
of the federal act, and determine each qualified health plan's level of coverage in 20
accordance with regulations issued by the secretary under section 1302 (d) (2) (A) of 21
the federal act.
(f) Use a standardized format for presenting health benefit options in the 23
exchange, including the use of the uniform outline of coverage established under 42
(g) Establish quality improvement standards for health benefit plans offered 2
through the exchange.
(h) Establish a system for enrolling eligible groups and individuals, using a 4
standard application form developed by the commissioner under s. 636.46 (2).