SB59,2061
21Section 2061
. 462.02 (2) (d) of the statutes is amended to read:
SB59,1018,2422
462.02
(2) (d) A dentist licensed under s. 447.04 (1),
a dental therapist licensed
23under s. 447.04 (1m), a dental hygienist licensed under s. 447.04 (2), or a person
24under the direct supervision of a dentist.
SB59,2062
25Section 2062
. 462.04 of the statutes is amended to read:
SB59,1019,9
1462.04 Prescription or order required. A person who holds a license or
2limited X-ray machine operator permit under this chapter may not use diagnostic
3X-ray equipment on humans for diagnostic purposes unless authorized to do so by
4prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed
5under s. 447.04 (1),
a dental therapist licensed under s. 447.04 (1m), a podiatrist
6licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced
7practice nurse certified under s. 441.16 (2), a physician assistant licensed under s.
8448.04 (1) (f), or, subject to s. 448.56 (7) (a), a physical therapist licensed under s.
9448.53.
SB59,2063
10Section 2063
. 463.10 (5) of the statutes is amended to read:
SB59,1019,1411
463.10
(5) Exception. Subsections (2) to (4m) do not apply to a dentist
who is
12licensed under s. 447.03 (1) or to a , dental therapist, or physician who tattoos or
13offers to tattoo a person in the course of the dentist's
, dental therapist's, or physician's
14professional practice.
SB59,2064
15Section 2064
. 463.12 (5) of the statutes is amended to read:
SB59,1019,1916
463.12
(5) Exception. Subsections (2) to (4m) do not apply to a dentist
who is
17licensed under s. 447.03 (1) or to a , dental therapist, or physician who pierces the
18body of or offers to pierce the body of a person in the course of the dentist's
, dental
19therapist's, or physician's professional practice.
SB59,2065
20Section
2065. 565.10 (17) of the statutes is created to read:
SB59,1020,221
565.10
(17) Setoff against retailer compensation. The department shall
22setoff any debt or other amount owed to the department, regardless of the origin,
23nature, or date of the debt or amount, against any compensation or payment owed
24to a lottery retailer under this chapter, whether owed by statute, rule, or contract.
25If, after the setoff, additional compensation or payment is due, the department shall
1setoff the remaining amount against all certified debts owed by the lottery retailer
2under ss. 71.93 and 71.935.
SB59,2066
3Section
2066. 565.12 (1) (intro.) of the statutes is amended to read:
SB59,1020,64
565.12
(1) (intro.) A lottery retailer contract entered into under s. 565.10 may
5be terminated or suspended for a specified period if the department finds that the
6retailer has done any of the following
before or after the contract was entered into:
SB59,2067
7Section
2067. 565.30 (5) of the statutes is amended to read:
SB59,1021,138
565.30
(5) Withholding of delinquent state taxes, child support or debts
9owed the state. The administrator shall report the name, address and social security
10number or federal income tax number of each winner of a lottery prize equal to or
11greater than $600 and the name, address and social security number or federal
12income tax number of each person to whom a lottery prize equal to or greater than
13$600 has been assigned to the department of revenue to determine whether the
14payee or assignee of the prize is delinquent in the payment of state taxes under ch.
1571, 72, 76, 77, 78 or 139 or, if applicable, in the court-ordered payment of child
16support or has a debt
owing to the state under s. 71.93 or 71.935. Upon receipt of a
17report under this subsection, the department of revenue shall
first ascertain
based
18on certifications by the department of children and families or its designee under s.
1949.855 (1) whether any person named in the report is currently delinquent in
20court-ordered payment of child support, and shall
next certify to the administrator
, 21whether any person named in the report is delinquent in court-ordered payment of
22child support
or based on certifications by the department of children and families
23under s. 49.855 (1), is delinquent in the payment of state taxes under ch. 71, 72, 76,
2477, 78 or 139
, or has a debt under s. 71.93 or 71.935. Upon this certification by the
25department of revenue or upon court order the administrator shall withhold the
1certified amount and send it to the department of revenue for remittance to the
2appropriate agency or person. The department of revenue shall charge the winner
3or assignee of the lottery prize
for the department of revenue's administrative
4expenses associated with withholding and remitting debt owed to a state agency a
5collection fee and may withhold the amount of the
administrative expenses collection
6fee from the prize payment. The
administrative expenses collection fee received or
7withheld by the department of revenue shall be credited to the appropriation under
8s. 20.566 (1) (h). In instances in which the payee or assignee of the prize is delinquent
9both in payments for state taxes and in court-ordered payments of child support, or
10is delinquent in one or both of these payments and has a debt
owing to the state under
11s. 71.93 or 71.935, the amount remitted to the appropriate agency or person shall be
12in proportion to the prize amount as is the delinquency or debt owed by the payee or
13assignee setoff under s. 71.93 (3) (a).
SB59,2068
14Section
2068. 601.31 (1) (n) of the statutes is amended to read:
SB59,1021,1815
601.31
(1) (n) For appointing, or renewing an appointment of, an agent under
16s. 628.11, $16 annually for resident agents or
$30
$40 annually for nonresident
17agents, unless the commissioner sets a higher fee by rule, to be paid at times and
18under procedures set by the commissioner.
SB59,2069
19Section 2069
. 601.83 (1) (a) of the statutes is amended to read:
SB59,1022,720
601.83
(1) (a) The commissioner shall administer a state-based reinsurance
21program known as the healthcare stability plan in accordance with the specific terms
22and conditions approved by the federal department of health and human services
23dated July 29, 2018. Before December 31, 2023, the commissioner may not request
24from the federal department of health and human services a modification,
25suspension, withdrawal, or termination of the waiver under
42 USC 18052 under
1which the healthcare stability plan under this subchapter operates unless
2legislation has been enacted specifically directing the modification, suspension,
3withdrawal, or termination. Before December 31, 2023, the commissioner may
4request renewal, without substantive change, of the waiver under
42 USC 18052 5under which the health care stability plan operates
in accordance with s. 20.940 (4) 6unless legislation has been enacted that is contrary to such a renewal request.
The
7commissioner shall comply with applicable timing in and requirements of s. 20.940.
SB59,2070
8Section
2070. 609.713 of the statutes is created to read:
SB59,1022,10
9609.713 Essential health benefits; preventive services. Defined network
10plans and preferred provider plans are subject to s. 632.895 (13m) and (14m).
SB59,2071
11Section
2071. 609.847 of the statutes is created to read:
SB59,1022,14
12609.847 Preexisting condition discrimination and certain benefit
13limits prohibited. Limited service health organizations, preferred provider plans,
14and defined network plans are subject to s. 632.728.
SB59,2072
15Section
2072. 625.12 (1) (a) of the statutes is amended to read:
SB59,1022,1716
625.12
(1) (a) Past and prospective loss and expense experience within and
17outside of this state
, except as provided in s. 632.728.
SB59,2073
18Section
2073. 625.12 (1) (e) of the statutes is amended to read:
SB59,1022,2019
625.12
(1) (e) Subject to
s.
ss. 632.365
and 632.728, all other relevant factors,
20including the judgment of technical personnel.
SB59,2074
21Section
2074. 625.12 (2) of the statutes is amended to read:
SB59,1023,522
625.12
(2) Classification.
Risks Except as provided in s. 632.728, risks may
23be classified in any reasonable way for the establishment of rates and minimum
24premiums, except that no classifications may be based on race, color, creed or
25national origin, and classifications in automobile insurance may not be based on
1physical condition or developmental disability as defined in s. 51.01 (5). Subject to
2s. ss. 632.365
and 632.728, rates thus produced may be modified for individual risks
3in accordance with rating plans or schedules that establish reasonable standards for
4measuring probable variations in hazards, expenses, or both. Rates may also be
5modified for individual risks under s. 625.13 (2).
SB59,2075
6Section
2075. 625.15 (1) of the statutes is amended to read:
SB59,1023,147
625.15
(1) Rate making. An Except as provided in s. 632.728, an insurer may
8itself establish rates and supplementary rate information for one or more market
9segments based on the factors in s. 625.12 and, if the rates are for motor vehicle
10liability insurance, subject to s. 632.365, or the insurer may use rates and
11supplementary rate information prepared by a rate service organization, with
12average expense factors determined by the rate service organization or with such
13modification for its own expense and loss experience as the credibility of that
14experience allows.
SB59,2076
15Section
2076. 628.34 (3) (a) of the statutes is amended to read:
SB59,1023,2216
628.34
(3) (a) No insurer may unfairly discriminate among policyholders by
17charging different premiums or by offering different terms of coverage except on the
18basis of classifications related to the nature and the degree of the risk covered or the
19expenses involved, subject to ss. 632.365,
632.728, 632.746 and 632.748. Rates are
20not unfairly discriminatory if they are averaged broadly among persons insured
21under a group, blanket or franchise policy, and terms are not unfairly discriminatory
22merely because they are more favorable than in a similar individual policy.
SB59,2077
23Section 2077
. 632.35 of the statutes is amended to read:
SB59,1024,3
24632.35 Prohibited rejection, cancellation and nonrenewal. No insurer
25may cancel or refuse to issue or renew an automobile insurance policy wholly or
1partially because of one or more of the following characteristics of any person: age,
2sex, residence, race, color, creed, religion, national origin, ancestry, marital status
or, 3occupation
, or status as a holder or nonholder of a license under s. 343.03 (3m).
SB59,2078
4Section
2078. 632.697 of the statutes is amended to read:
SB59,1024,13
5632.697 Benefits subject to department's right to recover. Death
6benefits payable under a life insurance policy or an annuity are subject to the right
7of the department of health services to recover under s. 46.27 (7g)
, 2017 stats.,
849.496, 49.682, or 49.849 an amount equal to the medical assistance that is
9recoverable under s. 49.496 (3) (a), an amount equal to aid under s. 49.68, 49.683,
1049.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), or an amount
11equal to long-term community support services under s. 46.27
, 2017 stats., that is
12recoverable under s. 46.27 (7g) (c) 1.
, 2017 stats., and that was paid on behalf of the
13deceased policyholder or annuitant.
SB59,2079
14Section
2079. 632.728 of the statutes is created to read:
SB59,1024,16
15632.728 Coverage of persons with preexisting conditions; guaranteed
16issue; benefit limits. (1) Definitions. In this section:
SB59,1024,1717
(a) “Health benefit plan” has the meaning given in s. 632.745 (11).
SB59,1024,1818
(b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
SB59,1024,24
19(2) Guaranteed issue. (a) Every individual health benefit plan shall accept
20every individual in this state who, and every group health benefit plan shall accept
21every employer in this state that, applies for coverage, regardless of sexual
22orientation, gender identity, or whether or not any employee or individual has a
23preexisting condition. A health benefit plan may restrict enrollment in coverage
24described in this paragraph to open or special enrollment periods.
SB59,1025,3
1(b) The commissioner shall establish a statewide open enrollment period of no
2shorter than 30 days for every individual health benefit plan to allow individuals,
3including individuals who do not have coverage, to enroll in coverage.
SB59,1025,8
4(3) Prohibiting discrimination based on health status. (a) An individual
5health benefit plan or a self-insured health plan may not establish rules for the
6eligibility of any individual to enroll, or for the continued eligibility of any individual
7to remain enrolled, under the plan based on any of the following health
8status-related factors in relation to the individual or a dependent of the individual:
SB59,1025,99
1. Health status.
SB59,1025,1010
2. Medical condition, including both physical and mental illnesses.
SB59,1025,1111
3. Claims experience.
SB59,1025,1212
4. Receipt of health care.
SB59,1025,1313
5. Medical history.
SB59,1025,1414
6. Genetic information.
SB59,1025,1615
7. Evidence of insurability, including conditions arising out of acts of domestic
16violence.
SB59,1025,1717
8. Disability.
SB59,1025,2418
(b) An insurer offering an individual health benefit plan or a self-insured
19health plan may not require any individual, as a condition of enrollment or continued
20enrollment under the plan, to pay, on the basis of any health status-related factor
21under par. (a) with respect to the individual or a dependent of the individual, a
22premium or contribution or a deductible, copayment, or coinsurance amount that is
23greater than the premium or contribution or deductible, copayment, or coinsurance
24amount respectively for a similarly situated individual enrolled under the plan.
SB59,1026,4
1(c) Nothing in this subsection prevents an insurer offering an individual health
2benefit plan or a self-insured health plan from establishing premium discounts or
3rebates or modifying otherwise applicable cost sharing in return for adherence to
4programs of health promotion and disease prevention.
SB59,1026,7
5(4) Premium rate variation. A health benefit plan offered on the individual or
6small employer market or a self-insured health plan may vary premium rates for a
7specific plan based only on the following considerations:
SB59,1026,88
(a) Whether the policy or plan covers an individual or a family.
SB59,1026,99
(b) Rating area in the state, as established by the commissioner.
SB59,1026,1210
(c) Age, except that the rate may not vary by more than 3 to 1 for adults over
11the age groups and the age bands shall be consistent with recommendations of the
12National Association of Insurance Commissioners.
SB59,1026,1313
(d) Tobacco use, except that the rate may not vary by more than 1.5 to 1.
SB59,1026,15
14(5) Annual and lifetime limits. An individual or group health benefit plan or
15a self-insured health plan may not establish any of the following:
SB59,1026,1716
(a) Lifetime limits on the dollar value of benefits for an enrollee or a dependent
17of an enrollee under the plan.
SB59,1026,1918
(b) Annual limits on the dollar value of benefits for an enrollee or a dependent
19of an enrollee under the plan.
SB59,1027,2
20(6) Short-term plans. This section and s. 632.76 apply to every short-term,
21limited-duration health insurance policy. In this subsection, “short-term,
22limited-duration health insurance policy” means health coverage that is provided
23under a contract with an insurer, has an expiration date specified in the contract that
24is less than 12 months after the original effective date of the contract, and, taking
25into account renewals or extensions, has a duration of no longer than 36 months in
1total. “Short-term, limited-duration health insurance policy” includes any
2short-term policy subject to s. 632.7495 (4).
SB59,2080
3Section
2080. 632.746 (1) (a) of the statutes is renumbered 632.746 (1) and
4amended to read:
SB59,1027,115
632.746
(1) Subject to subs. (2) and (3), an An insurer that offers a group health
6benefit plan may
, with respect to a participant or beneficiary under the plan, not 7impose a preexisting condition exclusion
only if the exclusion relates to a condition,
8whether physical or mental, regardless of the cause of the condition, for which
9medical advice, diagnosis, care or treatment was recommended or received within
10the 6-month period ending on the participant's or beneficiary's enrollment date
11under the plan on a participant or beneficiary under the plan.
SB59,2081
12Section
2081. 632.746 (1) (b) of the statutes is repealed.
SB59,2082
13Section
2082. 632.746 (2) (a) of the statutes is amended to read:
SB59,1027,1714
632.746
(2) (a) An insurer offering a group health benefit plan may not
treat 15impose a preexisting condition exclusion based on genetic information
as a
16preexisting condition under sub. (1) without a diagnosis of a condition related to the
17information.
SB59,2083
18Section
2083. 632.746 (2) (c), (d) and (e) of the statutes are repealed.
SB59,2084
19Section
2084. 632.746 (3) (a) of the statutes is repealed.
SB59,2085
20Section 2085
. 632.746 (3) (d) 1. of the statutes is renumbered 632.746 (3) (d).
SB59,2086
21Section 2086
. 632.746 (3) (d) 2. and 3. of the statutes are repealed.
SB59,2087
22Section 2087
. 632.746 (5) of the statutes is repealed.
SB59,2088
23Section
2088. 632.746 (8) (a) (intro.) of the statutes is amended to read:
SB59,1028,224
632.746
(8) (a) (intro.) A health maintenance organization that offers a group
25health benefit plan
and that does not impose any preexisting condition exclusion
1under sub. (1) with respect to a particular coverage option may impose an affiliation
2period for that coverage option, but only if all of the following apply:
SB59,2089
3Section 2089
. 632.748 (2) of the statutes is amended to read:
SB59,1028,104
632.748
(2) An insurer offering a group health benefit plan may not require any
5individual, as a condition of enrollment or continued enrollment under the plan, to
6pay, on the basis of any health status-related factor with respect to the individual
7or a dependent of the individual, a premium or contribution
or a deductible,
8copayment, or coinsurance amount that is greater than the premium or contribution
9or deductible, copayment, or coinsurance amount respectively for a similarly
10situated individual enrolled under the plan.
SB59,2090
11Section
2090. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to
12read:
SB59,1028,2013
632.76
(2) (a) No claim for loss incurred or disability commencing after 2 years
14from the date of issue of the policy may be reduced or denied on the ground that a
15disease or physical condition existed prior to the effective date of coverage, unless the
16condition was excluded from coverage by name or specific description by a provision
17effective on the date of loss. This paragraph does not apply to a group health benefit
18plan, as defined in s. 632.745 (9), which is subject to s. 632.746
, a disability insurance
19policy, as defined in s. 632.895 (1) (a), or a self-insured health plan, as defined in s.
20632.85 (1) (c).
SB59,1029,221
(ac) 1.
Notwithstanding par. (a), no No claim or loss incurred or disability
22commencing
after 12 months from the date of issue of under an individual disability
23insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the
24ground that a disease or physical condition existed prior to the effective date of
1coverage
, unless the condition was excluded from coverage by name or specific
2description by a provision effective on the date of the loss.
SB59,1029,93
2.
Except as provided in subd. 3., an An individual disability insurance policy,
4as defined in s. 632.895 (1) (a),
other than a short-term policy subject to s. 632.7495
5(4) and (5), may not define a preexisting condition more restrictively than a condition
6that was present before the date of enrollment for the coverage, whether physical or
7mental, regardless of the cause of the condition,
for which and regardless of whether 8medical advice, diagnosis, care, or treatment was recommended or received
within
912 months before the effective date of coverage.
SB59,2091
10Section
2091. 632.76 (2) (ac) 3. of the statutes is repealed.
SB59,2092
11Section
2092. 632.795 (4) (a) of the statutes is amended to read:
SB59,1029,2312
632.795
(4) (a) An insurer subject to sub. (2) shall provide coverage under the
13same policy form and for the same premium as it originally offered in the most recent
14enrollment period, subject only to the medical underwriting used in that enrollment
15period. Unless otherwise prescribed by rule, the insurer may apply deductibles,
16preexisting condition limitations, waiting periods
, or other limits only to the extent
17that they would have been applicable had coverage been extended at the time of the
18most recent enrollment period and with credit for the satisfaction or partial
19satisfaction of similar provisions under the liquidated insurer's policy or plan. The
20insurer may exclude coverage of claims that are payable by a solvent insurer under
21insolvency coverage required by the commissioner or by the insurance regulator of
22another jurisdiction. Coverage shall be effective on the date that the liquidated
23insurer's coverage terminates.
SB59,2093
24Section
2093. 632.796 of the statutes is created to read:
SB59,1030,2
1632.796 Drug cost report. (1) Definition. In this section, “
disability
2insurance policy” has the meaning given in s. 632.895 (1) (a).
SB59,1030,8
3(2) Report required. Annually, at the time the insurer files its rate request
4with the commissioner, each insurer that offers a disability insurance policy that
5covers prescription drugs shall submit to the commissioner a report that identifies
6the 25 prescription drugs that are the highest cost to the insurer and the 25
7prescription drugs that have the highest cost increases over the 12 months before the
8submission of the report.
SB59,2094
9Section
2094. 632.865 (3) of the statutes is created to read:
SB59,1030,1210
632.865
(3) Registration required. (a) No person may perform any activities
11of a pharmacy benefit manager in this state without first registering with the
12commissioner under this subsection.
SB59,1030,1513
(b) The commissioner shall establish a registration procedure for pharmacy
14benefit managers. The commissioner may promulgate any rules necessary to
15implement the registration procedure under this paragraph.