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LRB-3980/1
TJD:emw
2017 - 2018 LEGISLATURE
March 12, 2018 - Introduced by Representatives Anderson, Riemer, Berceau,
Zamarripa, Sargent, Spreitzer, Sinicki, Subeck, Brostoff and Pope,
cosponsored by Senators Hansen, Vinehout, Risser and Larson. Referred to
Committee on Insurance.
AB1017,1,3 1An Act to amend 625.03 (1m) (e), 625.13 (1), 625.15 (2), 625.21 (1), 625.22 (1),
2625.22 (3) and 625.23; and to create 625.25 of the statutes; relating to:
3approval of certain rate increases for health insurance.
Analysis by the Legislative Reference Bureau
This bill requires that rates for health insurance policies and plans be filed
before the rate is applied and requires approval by the commissioner of insurance of
any rate that increases 10 percent or more. Currently, insurers must file premium
rates, and changes to premium rates, for all types of insurance with the Office of the
Commissioner of Insurance within 30 days after the rates or rate changes become
effective. Current law prohibits premium rates from being excessive, inadequate, or
unfairly discriminatory and provides guidelines for determining whether rates
comply with those standards. The commissioner of insurance may order that a rate
be discontinued for any policy issued or renewed after a date specified in the order
if, after a hearing, the commissioner determines that the rate does not comply with
those standards.
The bill requires that an insurer that writes health insurance must file with
OCI premium rates, and changes to premium rates, for health insurance before those
rates or changes to rates become effective. If a proposed rate is an increase of 10
percent or more, an insurer may not use the rate unless approved by the
commissioner. For any other rates or rate changes, unless the commissioner holds
a hearing on a rate or change to a rate, the rate or changed rate is approved if the
commissioner does not disapprove the rate within 30 days after it was filed with OCI.

For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB1017,1 1Section 1. 625.03 (1m) (e) of the statutes is amended to read:
AB1017,2,42 625.03 (1m) (e) Group Except for group health benefit plans, as defined in s.
3632.745 (9), group
and blanket accident and sickness insurance other than credit
4accident and sickness insurance.
AB1017,2 5Section 2. 625.13 (1) of the statutes is amended to read:
AB1017,2,116 625.13 (1) Filing procedure. Except as provided in sub. (2) and s. 625.25 (2)
7(a)
, every authorized insurer and every rate service organization licensed under s.
8625.31 which has been designated by any insurer for the filing of rates under s.
9625.15 (2) shall file with the commissioner all rates and supplementary rate
10information and all changes and amendments thereof made by it for use in this state
11within 30 days after they become effective.
AB1017,3 12Section 3. 625.15 (2) of the statutes is amended to read:
AB1017,2,2013 625.15 (2) Rate filing. An insurer may discharge its obligation under s. 625.13
14(1) or 625.25 (2) (a) by giving notice to the commissioner that it uses rates and
15supplementary rate information prepared by a designated rate service organization,
16with such information about modifications thereof as is necessary fully to inform the
17commissioner. The insurer's rates or proposed rates and supplementary rate
18information shall be those filed from time to time by the rate service organization,
19including any amendments or proposed amendments thereto as filed, subject,
20however, to the modifications filed by the insurer.
AB1017,4 21Section 4. 625.21 (1) of the statutes is amended to read:
AB1017,3,12
1625.21 (1) Rule instituting delayed effect. If the commissioner finds that
2competition is not an effective regulator of the rates charged or that a substantial
3number of companies are competing irresponsibly through the rates charged, or that
4there are widespread violations of this chapter, in any kind or line of insurance or
5subdivision thereof or in any rating class or rating territory, he or she may
6promulgate a rule requiring that in the kind or line of insurance or subdivision
7thereof or rating class or rating territory comprehended by the finding any
8subsequent changes in the rates or supplementary rate information be filed with the
9commissioner at least 15 days before they become effective. The commissioner may
10extend the waiting period for not to exceed 15 additional days by written notice to
11the filer before the first 15-day period expires. This subsection does not apply to a
12health benefit plan subject to s. 625.25 (2) (a).
AB1017,5 13Section 5. 625.22 (1) of the statutes is amended to read:
AB1017,3,1714 625.22 (1) Order in event of violation. If the commissioner finds after a
15hearing that a rate or proposed rate is not in compliance with s. 625.11, the
16commissioner shall order that its use be discontinued, or that it may not be used, for
17any policy issued or renewed after a date specified in the order.
AB1017,6 18Section 6. 625.22 (3) of the statutes is amended to read:
AB1017,3,2319 625.22 (3) Approval of substituted rate. Within Except for rates for health
20benefit plans subject to s. 625.25 (2) (a), within
one year after the effective date of an
21order under sub. (1), no rate promulgated to replace a disapproved one may be used
22until it has been filed with the commissioner and not disapproved within 30 days
23thereafter.
AB1017,7 24Section 7. 625.23 of the statutes is amended to read:
AB1017,4,11
1625.23 Special restrictions on individual insurers. The commissioner
2may by order require that a particular insurer file any or all of its rates and
3supplementary rate information 15 days prior to their effective date, if and to the
4extent that he or she finds, after a hearing, that the protection of the interests of its
5insureds and the public in this state requires closer supervision of its rates because
6of the insurer's financial condition or rating practices. The commissioner may extend
7the waiting period for any filing for not to exceed 15 additional days by written notice
8to the insurer before the first 15-day period expires. A filing not disapproved before
9the expiration of the waiting period shall be deemed to meet the requirements of this
10chapter, subject to the possibility of subsequent disapproval under s. 625.22. This
11section does not apply to health benefit plans subject to s. 625.25 (2).
AB1017,8 12Section 8. 625.25 of the statutes is created to read:
AB1017,4,13 13625.25 Rates for health insurance. (1) Definitions. In this section:
AB1017,4,1414 (a) “Group health benefit plan" has the meaning given in s. 632.745 (9).
AB1017,4,1515 (b) “Health benefit plan" has the meaning given in s. 632.745 (11).
AB1017,4,21 16(2) Filing of rates; hearing. (a) Every insurer organization designated to file
17rates for a health benefit plan shall file with the commissioner all proposed rates and
18supplementary rate information, and all proposed changes and amendments to rates
19and supplementary rate information, for use in this state for any health benefit plan,
20including a group health benefit plan, offered before the proposed rates or changes
21to rates become effective.
AB1017,4,2522 (b) If a proposed rate filed under par. (a) for a health benefit plan is an increase
23of 10 percent or more over the rate in effect for a health benefit plan, an insurer may
24not use a proposed rate or change to a rate until it has been approved by the
25commissioner.
AB1017,5,5
1(c) For a proposed rate filed under par. (a) that is not subject to par. (b), unless
2the commissioner holds a hearing on the proposed rate or change to a rate, a proposed
3rate or change to a rate is approved if the commissioner does not disapprove the
4proposed rate or change within 30 days after filing, or within a 30-day extension of
5that period ordered by the commissioner prior to the expiration of the first 30 days.
AB1017,5,66 (End)
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