Chapter Ins 25

Ins 25.77   Relationship to federal rules.

Ins 25.80   Insurers and agents compliance with s. 610.70, Stats.

Subchapter VI — Additional Provisions

Ins 25.90   Nondiscrimination.

Ins 25.95   Effective date.

subch. I of ch. Ins 25 Subchapter I — General Provisions

Ins 25.01 Ins 25.01 Authority. This chapter is promulgated pursuant to the authority granted by ss. 601.41 (3), 610.70, 628.34 (12), and 633.17, Stats.

Ins 25.01 History History: Cr. Register, June, 2001, No. 546, eff. 7-1-01.

Ins 25.02 Ins 25.02 Purpose and scope.

Ins 25.02(1) (1) Purposes. This chapter governs the treatment of nonpublic personal health information and nonpublic personal financial information about individuals by all licensees of the office of the commissioner of insurance except to the extent that a licensee is excepted from a provision of this chapter. This chapter does all of the following:

Ins 25.02(1)(a) (a) It requires a licensee to provide notice to individuals about its privacy policies and practices.

Ins 25.02(1)(b) (b) It describes the conditions under which a licensee may disclose nonpublic personal health information and nonpublic personal financial information about individuals to affiliates and nonaffiliated third parties.

Ins 25.02(1)(c) (c) It provides methods for individuals to prevent a licensee from disclosing that information.

Ins 25.02(2) (2) Compliance. This chapter applies to:

Ins 25.02(2)(a) (a) Nonpublic personal financial information about individuals who obtain or are beneficiaries of products or services primarily for personal, family or household purposes from licensees, about individuals who are beneficiaries under group health plans and claimants under workers’ compensation policies, and about individuals who are third-party claimants against products or services obtained for business, commercial or agricultural purposes. This chapter does not apply to information about companies or about individuals who obtain products or services for business, commercial or agricultural purposes; and

Ins 25.02(2)(b) (b) All nonpublic personal health information about individuals who obtain or are beneficiaries of products or services primarily for personal, family or household purposes from licensees, about individuals who are beneficiaries under group health plans and claimants under workers’ compensation policies, and about individuals who are third-party claimants against products or services obtained for business, commercial or agricultural purposes, except to the extent the information is subject to s. 51.30, 146.81 to 146.84 or 610.70, Stats.

Ins 25.02(3) (3) Extra-territorial application. A licensee domiciled in this state that is in compliance with this chapter in a state that has not enacted laws or regulations that meet the requirements of Title V of the Gramm-Leach-Bliley Act (PL 102-106) is in compliance with Title V of the Gramm-Leach-Bliley Act in such other state.

Ins 25.02 History History: Cr. Register, June, 2001, No. 546, eff. 7-1-01.

Ins 25.03 Ins 25.03 Rule of construction. The examples in this chapter and the sample clauses in Appendix A of this chapter are not exclusive. Compliance with an example or use of a sample clause, to the extent applicable, constitutes compliance with this chapter.

Ins 25.03 History History: Cr. Register, June, 2001, No. 546, eff. 7-1-01.

Ins 25.04 Ins 25.04 Definitions. As used in this chapter, unless the context requires otherwise:

Ins 25.04(1) (1) “Affiliate” means any company that controls, is controlled by or is under common control with another company.

Ins 25.04(2) (2) 

Ins 25.04(2)(a) (a) “Clear and conspicuous” means that a notice is reasonably understandable and designed to call attention to the nature and significance of the information in the notice.

Ins 25.04(2)(b) (b) The following are examples of the application of “clear and conspicuous:”

Ins 25.04(2)(b)1. 1. ‘Reasonably understandable.’ A licensee makes its notice reasonably understandable if it does all of the following:

Ins 25.04(2)(b)1.a. a. Presents the information in the notice in clear, concise sentences, paragraphs, and sections.

Ins 25.04(2)(b)1.b. b. Uses short explanatory sentences or bullet lists whenever possible.

Ins 25.04(2)(b)1.c. c. Uses definite, concrete, everyday words and active voice whenever possible.

Ins 25.04(2)(b)1.d. d. Avoids multiple negatives.

Ins 25.04(2)(b)1.e. e. Avoids legal and highly technical business terminology whenever possible.

Ins 25.04(2)(b)1.f. f. Avoids explanations that are imprecise and readily subject to different interpretations.

Ins 25.04(2)(b)2. 2. ‘Designed to call attention.’ A licensee designs its notice to call attention to the nature and significance of the information in it if the licensee does all of the following:

Ins 25.04(2)(b)2.a. a. Uses a plain-language heading to call attention to the notice.

Ins 25.04(2)(b)2.b. b. Uses typeface and type sizes that are easy to read.

Ins 25.04(2)(b)2.c. c. Provides wide margins and ample line spacing.

Ins 25.04(2)(b)2.d. d. Uses boldface or italics for key words.

Ins 25.04(2)(b)2.e. e. In a form that combines the licensee’s notice with other information, uses distinctive type size, style, and graphic devices, such as shading or sidebars.

Ins 25.04(2)(b)3. 3. ‘Notices on web sites.’ If a licensee provides a notice on a web page, the licensee designs its notice to call attention to the nature and significance of the information in it if the licensee uses text or visual cues to encourage scrolling down the page if necessary to view the entire notice and ensures that other elements on the web site, such as text, graphics, hyperlinks or sound, do not distract attention from the notice, and the licensee does any of the following:

Ins 25.04(2)(b)3.a. a. Places the notice on a screen that consumers frequently access, such as a page on which transactions are conducted.

Ins 25.04(2)(b)3.b. b. Places a link on a screen that consumers frequently access, such as a page on which transactions are conducted, that connects directly to the notice and is labeled appropriately to convey the importance, nature and relevance of the notice.

Ins 25.04(3) (3) “Collect” means to obtain information that the licensee organizes or can retrieve by the name of an individual or by identifying number, symbol or other identifying particular assigned to the individual, irrespective of the source of the underlying information.

Ins 25.04(4) (4) “Commissioner” means the commissioner of insurance.

Ins 25.04(5) (5) “Company” means a corporation, limited liability company, business trust, general or limited partnership, association, sole proprietorship or similar organization.

Ins 25.04(6) (6) 

Ins 25.04(6)(a) (a) “Consumer” means an individual about whom a licensee has nonpublic personal information, who:

Ins 25.04(6)(a)1. 1. Seeks to obtain, obtains or has obtained an insurance product or service from a licensee that is to be used primarily for personal, family or household purposes;

Ins 25.04(6)(a)2. 2. Is a claimant under a workers’ compensation policy;

Ins 25.04(6)(a)3. 3. Is insured under a group health plan; or

Ins 25.04(6)(a)4. 4. Is a third-party claimant under an insurance product or service obtained for business, commercial or agricultural purposes,.

Ins 25.04(6)(b) (b) The following are examples of consumers:

Ins 25.04(6)(b)1. 1. An individual who provides nonpublic personal information to a licensee in connection with obtaining or seeking to obtain financial, investment or economic advisory services relating to an insurance product or service is a consumer regardless of whether the licensee establishes an ongoing advisory relationship.

Ins 25.04(6)(b)2. 2. An applicant for insurance prior to the inception of insurance coverage is a licensee’s consumer.

Ins 25.04(6)(b)3. 3. An individual is a licensee’s consumer if all of the following conditions exist:

Ins 25.04(6)(b)3.a. a. The individual is a beneficiary of a life insurance policy underwritten by the licensee, a claimant under an insurance policy issued by the licensee, a named insured or an annuitant under an insurance policy or an annuity, respectively, issued by the licensee, or a mortgagor of a mortgage covered under a mortgage insurance policy.

Ins 25.04(6)(b)3.b. b. The licensee discloses nonpublic personal financial information about the individual to a nonaffiliated third party other than as permitted under ss. Ins 25.50, 25.55, and 25.60.

Ins 25.04(6)(c) (c) The following are examples of individuals who are not consumers:

Ins 25.04(6)(c)1. 1. Provided that the licensee provides the initial notice under s. Ins 25.10 to the plan sponsor, group or blanket insurance policyholder, group annuity contract-holder, or workers’ compensation policyholder and that the licensee does not disclose to a nonaffiliated third party nonpublic personal financial information about such an individual other than as permitted under ss. Ins 25.50, 25.55, and 25.60, an individual is not the consumer of the licensee solely because the individual is any of the following:

Ins 25.04(6)(c)1.a. a. A participant or a beneficiary of an employee benefit plan that the licensee administers or sponsors or for which the licensee acts as a trustee, insurer or fiduciary.

Ins 25.04(6)(c)1.b. b. Covered under a group or blanket insurance policy or group annuity contract issued by the licensee.

Ins 25.04(6)(c)1.c. c. A claimant under a workers’ compensation policy.

Ins 25.04(6)(c)2. 2.

Ins 25.04(6)(c)2.a. a. The individuals described in subd. 1. a. to c. are consumers of a licensee if the licensee does not meet all the conditions of subd. 1.

Ins 25.04(6)(c)2.b. b. In no event shall the individuals, solely by virtue of the status described in subd. 1. a. to c., be deemed to be customers for purposes of this chapter.

Ins 25.04(6)(c)3. 3. An individual is not a licensee’s consumer solely because he or she is a beneficiary of a trust for which the licensee is a trustee.

Ins 25.04(6)(c)4. 4. An individual is not a licensee’s consumer solely because he or she has designated the licensee as trustee for a trust.

Ins 25.04(6)(c)5. 5. An individual who is a consumer of another financial institution is not a licensee’s consumer solely because the licensee is acting as agent for, or provides processing or other services to, that financial institution.

Ins 25.04(6)(d) (d) “Consumer” includes the legal representative of an individual who is a consumer.

Ins 25.04(7) (7) “Consumer reporting agency” has the same meaning as in Section 603(f) of the federal Fair Credit Reporting Act (15 USC 1681a(f)).

Ins 25.04(8) (8) “Control” means any of the following:

Ins 25.04(8)(a) (a) Ownership, control or power to vote 25 % or more of the outstanding shares of any class of voting security of the company, directly or indirectly, or acting through one or more other persons.

Ins 25.04(8)(b) (b) Control in any manner over the election of a majority of the directors, trustees or general partners, or individuals exercising similar functions, of the company or by an agreement establishing an attorney in fact for a reciprocal as defined by s. 600.03 (41), Stats.

Ins 25.04(8)(c) (c) The power to exercise, directly or indirectly, a controlling influence over the management or policies of the company.

Ins 25.04(9) (9) “Customer” means a consumer who has a customer relationship with a licensee.

Ins 25.04(10) (10) 

Ins 25.04(10)(a) (a) “Customer relationship” means a continuing relationship between a consumer and a licensee under which the licensee provides one or more insurance products or services to the consumer that are to be used primarily for personal, family or household purposes.

Ins 25.04(10)(b) (b) The following are examples relating to customer relationship:.

Ins 25.04(10)(b)1. 1. A consumer has a continuing relationship with a licensee if any of the following conditions exist:

Ins 25.04(10)(b)1.a. a. The consumer is a current policyholder of an insurance product issued by or through the licensee.

Ins 25.04(10)(b)1.b. b. The consumer obtains financial, investment or economic advisory services relating to an insurance product or service from the licensee for a fee.

Ins 25.04(10)(b)2. 2. A consumer does not have a continuing relationship with a licensee under any of the following conditions:

Ins 25.04(10)(b)2.a. a. The consumer applies for insurance but does not purchase the insurance.

Ins 25.04(10)(b)2.b. b. The licensee sells the consumer airline travel insurance in an isolated transaction.

Ins 25.04(10)(b)2.c. c. The consumer is no longer a current policyholder of an insurance product or no longer obtains insurance services with or through the licensee.

Ins 25.04(10)(b)2.d. d. The consumer is a beneficiary or claimant under a policy and has submitted a claim under that policy, choosing a settlement option involving an ongoing relationship with the licensee.

Ins 25.04(10)(b)2.e. e. The consumer is a beneficiary or a claimant under a policy and has submitted a claim under that policy, choosing a lump sum settlement option.

Ins 25.04(10)(b)2.f. f. The customer’s policy is lapsed, expired, or otherwise inactive or dormant under the licensee’s business practices, and the licensee has not communicated with the customer about the relationship for a period of twelve consecutive months, other than annual privacy notices, material required by law or regulation, communication at the direction of a state or federal authority, or promotional materials.

Ins 25.04(10)(b)2.g. g. The consumer is an insured or an annuitant under an insurance policy or annuity, respectively, but is not the policyholder or owner of the insurance policy or annuity.