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SB70-AA3,37,2014 632.746 (1) Subject to subs. (2) and (3), an An insurer that offers a group health
15benefit plan may, with respect to a participant or beneficiary under the plan, not
16impose a preexisting condition exclusion only if the exclusion relates to a condition,
17whether physical or mental, regardless of the cause of the condition, for which
18medical advice, diagnosis, care or treatment was recommended or received within
19the 6-month period ending on the participant's or beneficiary's enrollment date
20under the plan
on a participant or beneficiary under the plan.
SB70-AA3,13 21Section 13. 632.746 (1) (b) of the statutes is repealed.
SB70-AA3,14 22Section 14. 632.746 (2) (a) of the statutes is amended to read:
SB70-AA3,38,223 632.746 (2) (a) An insurer offering a group health benefit plan may not treat
24impose a preexisting condition exclusion based on genetic information as a

1preexisting condition under sub. (1) without a diagnosis of a condition related to the
2information
.
SB70-AA3,15 3Section 15. 632.746 (2) (c), (d) and (e) of the statutes are repealed.
SB70-AA3,16 4Section 16. 632.746 (3) (a) of the statutes is repealed.
SB70-AA3,17 5Section 17. 632.746 (3) (d) 1. of the statutes is renumbered 632.746 (3) (d).
SB70-AA3,18 6Section 18. 632.746 (3) (d) 2. and 3. of the statutes are repealed.
SB70-AA3,19 7Section 19. 632.746 (5) of the statutes is repealed.
SB70-AA3,20 8Section 20. 632.746 (8) (a) (intro.) of the statutes is amended to read:
SB70-AA3,38,129 632.746 (8) (a) (intro.) A health maintenance organization that offers a group
10health benefit plan and that does not impose any preexisting condition exclusion
11under sub. (1)
with respect to a particular coverage option may impose an affiliation
12period for that coverage option, but only if all of the following apply:
SB70-AA3,21 13Section 21. 632.748 (2) of the statutes is amended to read:
SB70-AA3,38,2014 632.748 (2) An insurer offering a group health benefit plan may not require any
15individual, as a condition of enrollment or continued enrollment under the plan, to
16pay, on the basis of any health status-related factor with respect to the individual
17or a dependent of the individual, a premium or contribution or a deductible,
18copayment, or coinsurance amount
that is greater than the premium or contribution
19or deductible, copayment, or coinsurance amount respectively for a similarly
20situated individual enrolled under the plan.
SB70-AA3,22 21Section 22. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to read:
SB70-AA3,39,422 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years
23from the date of issue of the policy may be reduced or denied on the ground that a
24disease or physical condition existed prior to the effective date of coverage, unless the
25condition was excluded from coverage by name or specific description by a provision

1effective on the date of loss. This paragraph does not apply to a group health benefit
2plan, as defined in s. 632.745 (9), which is subject to s. 632.746 , a disability insurance
3policy, as defined in s. 632.895 (1) (a), or a self-insured health plan, as defined in s.
4632.85 (1) (c)
.
SB70-AA3,39,105 (ac) 1. Notwithstanding par. (a), no No claim or loss incurred or disability
6commencing after 12 months from the date of issue of under an individual disability
7insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the
8ground that a disease or physical condition existed prior to the effective date of
9coverage, unless the condition was excluded from coverage by name or specific
10description by a provision effective on the date of the loss
.
SB70-AA3,39,1711 2. Except as provided in subd. 3., an An individual disability insurance policy,
12as defined in s. 632.895 (1) (a), other than a short-term policy subject to s. 632.7495
13(4) and (5), may not define a preexisting condition more restrictively than a condition
14that was present before the date of enrollment for the coverage, whether physical or
15mental, regardless of the cause of the condition, for which and regardless of whether
16medical advice, diagnosis, care, or treatment was recommended or received within
1712 months before the effective date of coverage
.
SB70-AA3,23 18Section 23. 632.795 (4) (a) of the statutes is amended to read:
SB70-AA3,40,519 632.795 (4) (a) An insurer subject to sub. (2) shall provide coverage under the
20same policy form and for the same premium as it originally offered in the most recent
21enrollment period, subject only to the medical underwriting used in that enrollment
22period. Unless otherwise prescribed by rule, the insurer may apply deductibles,
23preexisting condition limitations, waiting periods , or other limits only to the extent
24that they would have been applicable had coverage been extended at the time of the
25most recent enrollment period and with credit for the satisfaction or partial

1satisfaction of similar provisions under the liquidated insurer's policy or plan. The
2insurer may exclude coverage of claims that are payable by a solvent insurer under
3insolvency coverage required by the commissioner or by the insurance regulator of
4another jurisdiction. Coverage shall be effective on the date that the liquidated
5insurer's coverage terminates.
SB70-AA3,24 6Section 24. 632.895 (8) (d) of the statutes is amended to read:
SB70-AA3,40,137 632.895 (8) (d) Coverage is required under this subsection despite whether the
8woman shows any symptoms of breast cancer. Except as provided in pars. (b), (c), and
9(e), coverage under this subsection may only be subject to exclusions and limitations,
10including deductibles, copayments and restrictions on excessive charges, that are
11applied to other radiological examinations covered under the disability insurance
12policy. Coverage under this subsection may not be subject to any deductibles,
13copayments, or coinsurance.
SB70-AA3,25 14Section 25. 632.895 (13m) of the statutes is created to read:
SB70-AA3,40,1615 632.895 (13m) Preventive services. (a) In this section, “self-insured health
16plan” has the meaning given in s. 632.85 (1) (c).
SB70-AA3,40,1917 (b) Every disability insurance policy, except any disability insurance policy that
18is described in s. 632.745 (11) (b) 1. to 12., and every self-insured health plan shall
19provide coverage for all of the following preventive services:
SB70-AA3,40,2020 1. Mammography in accordance with sub. (8).
SB70-AA3,40,2221 2. Genetic breast cancer screening and counseling and preventive medication
22for adult women at high risk for breast cancer.
SB70-AA3,40,2423 3. Papanicolaou test for cancer screening for women 21 years of age or older
24with an intact cervix.
SB70-AA3,41,2
14. Human papillomavirus testing for women who have attained the age of 30
2years but have not attained the age of 66 years.
SB70-AA3,41,33 5. Colorectal cancer screening in accordance with sub. (16m).
SB70-AA3,41,64 6. Annual tomography for lung cancer screening for adults who have attained
5the age of 55 years but have not attained the age of 80 years and who have health
6histories demonstrating a risk for lung cancer.
SB70-AA3,41,87 7. Skin cancer screening for individuals who have attained the age of 10 years
8but have not attained the age of 22 years.
SB70-AA3,41,109 8. Counseling for skin cancer prevention for adults who have attained the age
10of 18 years but have not attained the age of 25 years.
SB70-AA3,41,1211 9. Abdominal aortic aneurysm screening for men who have attained the age of
1265 years but have not attained the age of 75 years and who have ever smoked.
SB70-AA3,41,1513 10. Hypertension screening for adults and blood pressure testing for adults, for
14children under the age of 3 years who are at high risk for hypertension, and for
15children 3 years of age or older.
SB70-AA3,41,1716 11. Lipid disorder screening for minors 2 years of age or older, adults 20 years
17of age or older at high risk for lipid disorders, and all men 35 years of age or older.
SB70-AA3,41,2018 12. Aspirin therapy for cardiovascular health for adults who have attained the
19age of 55 years but have not attained the age of 80 years and for men who have
20attained the age of 45 years but have not attained the age of 55 years.
SB70-AA3,41,2221 13. Behavioral counseling for cardiovascular health for adults who are
22overweight or obese and who have risk factors for cardiovascular disease.
SB70-AA3,41,2323 14. Type II diabetes screening for adults with elevated blood pressure.
SB70-AA3,41,2524 15. Depression screening for minors 11 years of age or older and for adults when
25follow-up supports are available.
SB70-AA3,42,2
116. Hepatitis B screening for minors at high risk for infection and adults at high
2risk for infection.
SB70-AA3,42,43 17. Hepatitis C screening for adults at high risk for infection and onetime
4hepatitis C screening for adults born in any year from 1945 to 1965.
SB70-AA3,42,85 18. Obesity screening and management for all minors and adults with a body
6mass index indicating obesity, counseling and behavioral interventions for obese
7minors who are 6 years of age or older, and referral for intervention for obesity for
8adults with a body mass index of 30 kilograms per square meter or higher.
SB70-AA3,42,109 19. Osteoporosis screening for all women 65 years of age or older and for women
10at high risk for osteoporosis under the age of 65 years.
SB70-AA3,42,1111 20. Immunizations in accordance with sub. (14).
SB70-AA3,42,1412 21. Anemia screening for individuals 6 months of age or older and iron
13supplements for individuals at high risk for anemia and who have attained the age
14of 6 months but have not attained the age of 12 months.
SB70-AA3,42,1615 22. Fluoride varnish for prevention of tooth decay for minors at the age of
16eruption of their primary teeth.
SB70-AA3,42,1817 23. Fluoride supplements for prevention of tooth decay for minors 6 months of
18age or older who do not have fluoride in their water source.
SB70-AA3,42,1919 24. Gonorrhea prophylaxis treatment for newborns.
SB70-AA3,42,2020 25. Health history and physical exams for prenatal visits and for minors.
SB70-AA3,42,2221 26. Length and weight measurements for newborns and height and weight
22measurements for minors.
SB70-AA3,42,2423 27. Head circumference and weight-for-length measurements for newborns
24and minors who have not attained the age of 3 years.
SB70-AA3,42,2525 28. Body mass index for minors 2 years of age or older.
SB70-AA3,43,2
129. Blood pressure measurements for minors 3 years of age or older and a blood
2pressure risk assessment at birth.
SB70-AA3,43,43 30. Risk assessment and referral for oral health issues for minors who have
4attained the age of 6 months but have not attained the age of 7 years.
SB70-AA3,43,65 31. Blood screening for newborns and minors who have not attained the age of
62 months.
SB70-AA3,43,77 32. Screening for critical congenital health defects for newborns.
SB70-AA3,43,88 33. Lead screenings in accordance with sub. (10).
SB70-AA3,43,109 34. Metabolic and hemoglobin screening and screening for phenylketonuria,
10sickle cell anemia, and congenital hypothyroidism for minors including newborns.
SB70-AA3,43,1211 35. Tuberculin skin test based on risk assessment for minors one month of age
12or older.
SB70-AA3,43,1413 36. Tobacco counseling and cessation interventions for individuals who are 5
14years of age or older.
SB70-AA3,43,1615 37. Vision and hearing screening and assessment for minors including
16newborns.
SB70-AA3,43,1817 38. Sexually transmitted infection and human immunodeficiency virus
18counseling for sexually active minors.
SB70-AA3,43,2119 39. Risk assessment for sexually transmitted infection for minors who are 10
20years of age or older and screening for sexually transmitted infection for minors who
21are 16 years of age or older.
SB70-AA3,43,2222 40. Alcohol misuse screening and counseling for minors 11 years of age or older.
SB70-AA3,43,2423 41. Autism screening for minors who have attained the age of 18 months but
24have not attained the age of 25 months.
SB70-AA3,43,2525 42. Developmental screening and surveillance for minors including newborns.
SB70-AA3,44,1
143. Psychosocial and behavioral assessment for minors including newborns.
SB70-AA3,44,32 44. Alcohol misuse screening and counseling for pregnant adults and a risk
3assessment for all adults.
SB70-AA3,44,54 45. Fall prevention and counseling and preventive medication for fall
5prevention for community-dwelling adults 65 years of age or older.
SB70-AA3,44,66 46. Screening and counseling for intimate partner violence for adult women.
SB70-AA3,44,97 47. Well-woman visits for women who have attained the age of 18 years but
8have not attained the age of 65 years and well-woman visits for recommended
9preventive services, preconception care, and prenatal care.
SB70-AA3,44,1110 48. Counseling on, consultations with a trained provider on, and equipment
11rental for breastfeeding for pregnant and lactating women.
SB70-AA3,44,1212 49. Folic acid supplement for adult women with reproductive capacity.
SB70-AA3,44,1313 50. Iron deficiency anemia screening for pregnant and lactating women.
SB70-AA3,44,1514 51. Preeclampsia preventive medicine for pregnant adult women at high risk
15for preeclampsia.
SB70-AA3,44,1716 52. Low-dose aspirin after 12 weeks of gestation for pregnant women at high
17risk for miscarriage, preeclampsia, or clotting disorders.
SB70-AA3,44,1818 53. Screenings for hepatitis B and bacteriuria for pregnant women.
SB70-AA3,44,2019 54. Screening for gonorrhea for pregnant and sexually active females 24 years
20of age or younger and females older than 24 years of age who are at risk for infection.
SB70-AA3,44,2321 55. Screening for chlamydia for pregnant and sexually active females 24 years
22of age and younger and females older than 24 years of age who are at risk for
23infection.
SB70-AA3,44,2524 56. Screening for syphilis for pregnant women and adults who are at high risk
25for infection.
SB70-AA3,45,3
157. Human immunodeficiency virus screening for adults who have attained the
2age of 15 years but have not attained the age of 66 years and individuals at high risk
3of infection who are younger than 15 years of age or older than 65 years of age.
SB70-AA3,45,44 58. All contraceptives and services in accordance with sub. (17).
SB70-AA3,45,65 59. Any services not already specified under this paragraph having an A or B
6rating in current recommendations from the U.S. preventive services task force.
SB70-AA3,45,97 60. Any preventive services not already specified under this paragraph that are
8recommended by the federal health resources and services administration's Bright
9Futures project.
SB70-AA3,45,1210 61. Any immunizations, not already specified under sub. (14), that are
11recommended and determined to be for routine use by the federal advisory
12committee on immunization practices.
SB70-AA3,45,1513 (c) Subject to par. (d), no disability insurance policy and no self-insured health
14plan may subject the coverage of any of the preventive services under par. (b) to any
15deductibles, copayments, or coinsurance under the policy or plan.
SB70-AA3,45,1916 (d) 1. If an office visit and a preventive service specified under par. (b) are billed
17separately by the health care provider, the disability insurance policy or self-insured
18health plan may apply deductibles to and impose copayments or coinsurance on the
19office visit but not on the preventive service.
SB70-AA3,45,2220 2. If the primary reason for an office visit is not to obtain a preventive service,
21the disability insurance policy or self-insured health plan may apply deductibles to
22and impose copayments or coinsurance on the office visit.
SB70-AA3,46,723 3. Except as otherwise provided in this subdivision, if a preventive service
24specified under par. (b) is provided by a health care provider that is outside the
25disability insurance policy's or self-insured health plan's network of providers, the

1policy or plan may apply deductibles to and impose copayments or coinsurance on the
2office visit and the preventive service. If a preventive service specified under par. (b)
3is provided by a health care provider that is outside the disability insurance policy's
4or self-insured health plan's network of providers because there is no available
5health care provider in the policy's or plan's network of providers that provides the
6preventive service, the policy or plan may not apply deductibles to or impose
7copayments or coinsurance on the preventive service.
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