Wisconsin Legislature: 001 - CR 14-055 Rule Text

e. The services were not performed for a hospital, home or institution while the person was a patient or inmate.

SECTION 20. ETF 20.17 (4) (c) 8. is created to read:

ETF 20.17 (4) (c) 8. If the participating employee is applying to receive creditable service for service in the U.S. armed forces or national guard, evidence that the employee was discharged from the U.S. armed forces or national guard under honorable or general conditions.

SECTION 21. ETF 20.35 (3) (d) 4. is amended to read:

ETF 20.35 (3) (d) 4. `Rehired annuitant with reestablished suspended account.' If the participant's account has been reestablished since annuity was suspended prior to the decree date under the provisions of s. 40.26 (2), Stats., any memorandum account balance resulting from the annuity payments paid during the period in which the participant was an annuitant between prior to the decree date and after the effective date on which the account was reestablished suspended, plus accumulated interest on that amount, shall be divided in the same proportion as the other portions of the participant's account.

SECTION 22. ETF 20.35 (9) is repealed.

SECTION 23. ETF 20.37 (2) (e) is repealed.

SECTION 24. ETF 40.01 (1) (b) (title), (1) (b) and (c) (title) are amended to read:

ETF 40.01 (1) (b) Family coverage of all surviving insured dependents continues. The family coverage as in effect at the time of the death of the insured employee will continue in effect, covering the dependents who were duly insured under that coverage at the time of that death until all dependents lose eligibility or become insured under another health insurance policy and as approved by the department.

ETF 40.01 (1) (c) Other continuation coverage rights preserved. Nothing in this section shall be construed to interfere with any person's right to apply or eligibility for continued health insurance coverage under the terms and conditions of the group health insurance contract as expressly mandated by s. 40.51 (3), (4) or (5), Stats., referencing s. 632.897 (2) (b) 3., Stats., or under 42 USC 300bb-1 and federal regulations prescribed thereunder.

SECTION 25. ETF 40.01 (2m) (a) and (b) are amended to read:

ETF 40.01 (2m) (a) Multiple surviving insured dependents, with surviving spouse or domestic partner. If the deceased insured employee is survived by a spouse or domestic partner and other dependents of the deceased insured employee, then the family coverage shall continue in effect and the surviving spouse or domestic partner shall be the responsible person and have the same control and responsibilities with respect to the insurance coverage of the insured surviving dependents as the insured employee had while living except that the responsible person may split any converted sick leave credits among surviving insured dependents as approved by the department.

ETF 40.01 (2m) (b) Multiple surviving insured dependents, without surviving spouse or surviving domestic partner. If the deceased insured employee is not survived by a spouse or domestic partner but by more than one insured dependents, then the family coverage will continue in effect. The oldest surviving insured dependent, or that person's guardian, shall be the responsible person and have the same rights and responsibilities with respect to the insurance coverage of the insured surviving dependents as the insured employee had while living except that the responsible person may split any converted sick leave credits among surviving insured dependents as approved by the department. Upon reasonable request from any adult surviving insured dependent or the guardian of any minor surviving insured dependent, the department may designate another surviving insured dependent, or that person's guardian, as the responsible person.

SECTION 26. ETF Chapter 41 is repealed.

SECTION 27. ETF 50.48 (1), (2) (Note), (3) (a), (3) (b) 5., (4) (b) 3., and (4) (c) are amended to read:

ETF 50.48 (1) Claimant's application. A claimant shall establish that he or she meets all the requirements to receive benefits under this subchapter. A claimant shall apply for benefits by making an application on the form approved by the department or by contacting the third-party administrator.

ETF 50.48 (2) (Note): Form ET-5338, "LTDI Medical Report" is sent to the applicant with the LTDI claim form ET-5313. A second form is sent to the applicant by the department after the first completed form is received by the department. Form ET- 5353, "LTDI Special Disability Medical Report" will be sent with the LTDI claim form upon request of a protective occupation participant.

ETF 50.48 (3) (a) The department shall provide the employer with a description of the claimed disability on the department form for the employer to state the information necessary under s. ETF 50.50 (5).

ETF 50.48 (3) (b) 5. The employer shall state in writing on the employer statement form it intends to contest the employee’s application for disability benefits as provided in ch. ETF 50. the reason for the employee’s termination or leave of absence.

ETF 50.48 (4) (b) 3. The department receives a written statement from the employer on the employer statement form indicating they wish to contest the employee’s application for disability under ch. ETF 50. that the employee’s termination or leave of absence was for a reason other than a medical issue.

ETF 50.48 (4) (c) If the department's denial is based solely on par. (b) 1. or 3., or both, the claimant may appeal to the group insurance board. The group insurance board's decision shall include a finding as to whether the employer's certifying non-termination or contesting approval of the employee's disability claim was responses on the employer statement form were reasonable and correct. If the group insurance board determines that the employer's action was responses were unreasonable and incorrect, the group insurance board decision shall include an order to the employer to amend the statement and an order to the department to process the LTDI application when the amended statement is received.

SECTION 28. ETF 50.50 (1) (c) 2. and (5) (b) are amended to read:

ETF 50.50 (1) (c) 2. The claimant is not employed by any employer. "Employer" as used in this subdivision shall have its broadest plain meaning and is not limited to the definition as defined in s. 40.02 (28), Stats.

ETF 50.50 (5) (b) The requirement of par. (a) is not met if the employer certifies the employee was not terminated or not on leave of absence. The LTDI benefit will be denied if the employer contests the employee’s application for disability benefits under ch. ETF 50. or because the employee’s termination or leave of absence was for a reason other than a medical issue.

SECTION 29. ETF 50.52 (1) (b) 3. is amended to read:

ETF 50.52 (1) (b) 3. LTDI benefits shall be offset by the amount of any normal form retirement annuity or lump sum retirement benefit under s. 40.23 or 40.25, Stats., for which the recipient is eligible, including a separation benefit that the recipient is eligible to receive under s. 40.23 (2m) (er) or 40.23 (3) (b), Stats., excluding the portion of any annuity or lump sum benefit or separation benefit on which the recipient would not be subject to federal income tax, a separation benefit or a benefit funded by employee additional contributions. This Except for a protective occupation recipient, this offset shall be computed as of the recipient’s normal retirement age. This subdivision applies only after a recipient’s normal retirement date as defined by s. 40.02 (42), Stats. For a protective occupation recipient, the offset shall be computed as of the recipient’s 62nd birthday. This subdivision does not apply to an annuity for which the recipient is eligible solely as a beneficiary, alternate payee or joint survivor of another participant.

SECTION 30. ETF 52.16 (5) (c) is created to read:

ETF 52.16 (5) (c) Benefits payable to non-vested participants. Monthly duty disability benefits shall be reduced by benefits payable to a non-vested participant under s. 40.25 (2), Stats., at age 50.

SECTION 31. ETF 60.60 (5) (c) and (f) are amended to read:

ETF 60.60 (5) (c) Establish a conversion account in the insured's name from the appropriate reserve, as determined by the company and the department, held by the company for the policyholder. The company shall credit the account with the present value computed in par. (b) and debit the account each month periodically by the premium amount and for the prescribed period certified by the department.

ETF 60.60 (f) Remit to the department from each conversion account, by the 20th of the month preceding the coverage month period, the applicable premiums for health and long-term care insurance.

SECTION 32. ETF 70.02 (11) is amended to read:

ETF 70.02 (11) "Plan and trust document" means the document developed by the department and approved by the board to describe in detail the regulations of the program and ensure program compliance with section 457 of the internal revenue code which requires the availability of this document to members.

SECTION 33. ETF 70.05 (1) (a) 1. is amended to read:

ETF 70.05 (1) (a) 1. Participation level of 5,000 30,000 members or more.

SECTION 34. ETF 70.07 (1) (a) (d) (e) and (i) are amended to read:

ETF 70.07 (1) (a) Follow all requirements and regulations of the program as defined in the plan and trust document.

ETF 70.07 (1) (d) Provide monthly quarterly reports to the department to allow adequate monitoring of program administration and compliance with internal revenue code section 457 regulations.

ETF 70.07 (1) (e) Provide an annual independently audited financial statement of the administrator and the plan to the department within 120 days from the end of the calendar year.

ETF 70.07 (1) (i) Provide statements to members, at least annually quarterly, detailing member's year to date annual deferral amounts, account balance information and disclosure of all fees and charges affecting member's interest earnings or account balances.

SECTION 35. ETF 70.09 (5) is repealed.

SECTION 36. ETF 70.10 (2) (intro.) is amended to read:

ETF 70.10 (2) (intro.) The administrative plan provider as defined in s. 40.02 (18s), Stats., which is selected by the board under s. 40.80, Stats., and which administers the deferrals which are the subject of the withdrawal request administrator shall:

SECTION 37. ETF 70.10 (2) (c) is repealed.