Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53703-3474
Text of Rule:
SECTION 1. Ins 9.08 (1) (intro.) is amended to read:
(1) Annual Statement. All insurers authorized to write health maintenance organization business and insurers licensed to write only limited service health organization business shall file with the commissioner by March 1 of each year an annual statement for the preceding year. A health maintenance organization insurer and limited service health organization insurer shall use the current health maintenance organization annual statement blank prepared by the national association of insurance commissioners.
SECTION 2. Ins 9.08 (1m) is created to read:
Ins 9.08 (1m) Medicare and Medicaid Health Maintenance Organizations. A health maintenance organization insurer that writes 100% of its business to Medicare or Medicaid recipients, or a combination of the two, is not required to include a special procedures opinion from a certified public accountant as required by sub. (1) (a) or an audit opinion concerning the statement of covered expenses as required by sub. (1) (c).
SECTION 3. Ins 9.08 (4) is repealed.
SECTION 4. Ins 9.08 (4) (note) is amended to read:
Note: The list of the forms form described in subs. sub. (1) and (4)may be obtained from the Office of the Commissioner of Insurance, P. O. Box 7873, Madison, WI 53707-7873.
SECTION 5. EFFECTIVE DATE. The rule takes effect on the first day of the month following publication in the Wisconsin Administrative Register as provided in s. 227.22 (2) (intro.), Stats. Section 1.
Section 2.
Nathan Houdek
Commissioner of Insurance
