AB50-ASA2-AA8,4721Section 47. 632.795 (4) (a) of the statutes is amended to read: AB50-ASA2-AA8,38,1022632.795 (4) (a) An insurer subject to sub. (2) shall provide coverage under the 23same policy form and for the same premium as it originally offered in the most
1recent enrollment period, subject only to the medical underwriting used in that 2enrollment period. Unless otherwise prescribed by rule, the insurer may apply 3deductibles, preexisting condition limitations, waiting periods, or other limits only 4to the extent that they would have been applicable had coverage been extended at 5the time of the most recent enrollment period and with credit for the satisfaction or 6partial satisfaction of similar provisions under the liquidated insurer’s policy or 7plan. The insurer may exclude coverage of claims that are payable by a solvent 8insurer under insolvency coverage required by the commissioner or by the 9insurance regulator of another jurisdiction. Coverage shall be effective on the date 10that the liquidated insurer’s coverage terminates. AB50-ASA2-AA8,4811Section 48. 632.895 (8) (d) of the statutes is amended to read: AB50-ASA2-AA8,38,1812632.895 (8) (d) Coverage is required under this subsection despite whether 13the woman shows any symptoms of breast cancer. Except as provided in pars. (b), 14(c), and (e), coverage under this subsection may only be subject to exclusions and 15limitations, including deductibles, copayments and restrictions on excessive 16charges, that are applied to other radiological examinations covered under the 17disability insurance policy. Coverage under this subsection may not be subject to 18any deductibles, copayments, or coinsurance. AB50-ASA2-AA8,38,2120632.895 (13m) Preventive services. (a) In this section, “self-insured health 21plan” has the meaning given in s. 632.85 (1) (c). AB50-ASA2-AA8,39,222(b) Every disability insurance policy, except any disability insurance policy
1that is described in s. 632.745 (11) (b) 1. to 12., and every self-insured health plan 2shall provide coverage for all of the following preventive services: AB50-ASA2-AA8,39,331. Mammography in accordance with sub. (8). AB50-ASA2-AA8,39,542. Genetic breast cancer screening and counseling and preventive medication 5for adult women at high risk for breast cancer. AB50-ASA2-AA8,39,763. Papanicolaou test for cancer screening for women 21 years of age or older 7with an intact cervix. AB50-ASA2-AA8,39,984. Human papillomavirus testing for women who have attained the age of 30 9years but have not attained the age of 66 years. AB50-ASA2-AA8,39,10105. Colorectal cancer screening in accordance with sub. (16m). AB50-ASA2-AA8,39,13116. Annual tomography for lung cancer screening for adults who have attained 12the age of 55 years but have not attained the age of 80 years and who have health 13histories demonstrating a risk for lung cancer. AB50-ASA2-AA8,39,15147. Skin cancer screening for individuals who have attained the age of 10 years 15but have not attained the age of 22 years. AB50-ASA2-AA8,39,17168. Counseling for skin cancer prevention for adults who have attained the age 17of 18 years but have not attained the age of 25 years. AB50-ASA2-AA8,39,19189. Abdominal aortic aneurysm screening for men who have attained the age of 1965 years but have not attained the age of 75 years and who have ever smoked. AB50-ASA2-AA8,39,222010. Hypertension screening for adults and blood pressure testing for adults, 21for children under the age of 3 years who are at high risk for hypertension, and for 22children 3 years of age or older. AB50-ASA2-AA8,40,2
111. Lipid disorder screening for minors 2 years of age or older, adults 20 years 2of age or older at high risk for lipid disorders, and all men 35 years of age or older. AB50-ASA2-AA8,40,5312. Aspirin therapy for cardiovascular health for adults who have attained the 4age of 55 years but have not attained the age of 80 years and for men who have 5attained the age of 45 years but have not attained the age of 55 years. AB50-ASA2-AA8,40,7613. Behavioral counseling for cardiovascular health for adults who are 7overweight or obese and who have risk factors for cardiovascular disease. AB50-ASA2-AA8,40,8814. Type II diabetes screening for adults with elevated blood pressure. AB50-ASA2-AA8,40,10915. Depression screening for minors 11 years of age or older and for adults 10when follow-up supports are available. AB50-ASA2-AA8,40,121116. Hepatitis B screening for minors at high risk for infection and adults at 12high risk for infection. AB50-ASA2-AA8,40,141317. Hepatitis C screening for adults at high risk for infection and onetime 14hepatitis C screening for adults born in any year from 1945 to 1965. AB50-ASA2-AA8,40,181518. Obesity screening and management for all minors and adults with a body 16mass index indicating obesity, counseling and behavioral interventions for obese 17minors who are 6 years of age or older, and referral for intervention for obesity for 18adults with a body mass index of 30 kilograms per square meter or higher. AB50-ASA2-AA8,40,201919. Osteoporosis screening for all women 65 years of age or older and for 20women at high risk for osteoporosis under the age of 65 years. AB50-ASA2-AA8,40,212120. Immunizations in accordance with sub. (14). AB50-ASA2-AA8,41,22221. Anemia screening for individuals 6 months of age or older and iron
1supplements for individuals at high risk for anemia who have attained the age of 6 2months but have not attained the age of 12 months. AB50-ASA2-AA8,41,4322. Fluoride varnish for prevention of tooth decay for minors at the age of 4eruption of their primary teeth. AB50-ASA2-AA8,41,6523. Fluoride supplements for prevention of tooth decay for minors 6 months of 6age or older who do not have fluoride in their water source. AB50-ASA2-AA8,41,7724. Gonorrhea prophylaxis treatment for newborns. AB50-ASA2-AA8,41,8825. Health history and physical exams for prenatal visits and for minors. AB50-ASA2-AA8,41,10926. Length and weight measurements for newborns and height and weight 10measurements for minors. AB50-ASA2-AA8,41,121127. Head circumference and weight-for-length measurements for newborns 12and minors who have not attained the age of 3 years. AB50-ASA2-AA8,41,131328. Body mass index for minors 2 years of age or older. AB50-ASA2-AA8,41,151429. Blood pressure measurements for minors 3 years of age or older and a 15blood pressure risk assessment at birth. AB50-ASA2-AA8,41,171630. Risk assessment and referral for oral health issues for minors who have 17attained the age of 6 months but have not attained the age of 7 years. AB50-ASA2-AA8,41,191831. Blood screening for newborns and minors who have not attained the age of 192 months. AB50-ASA2-AA8,41,202032. Screening for critical congenital health defects for newborns. AB50-ASA2-AA8,41,212133. Lead screenings in accordance with sub. (10). AB50-ASA2-AA8,41,232234. Metabolic and hemoglobin screening and screening for phenylketonuria, 23sickle cell anemia, and congenital hypothyroidism for minors including newborns. AB50-ASA2-AA8,42,2
135. Tuberculin skin test based on risk assessment for minors one month of age 2or older. AB50-ASA2-AA8,42,4336. Tobacco counseling and cessation interventions for individuals who are 5 4years of age or older. AB50-ASA2-AA8,42,6537. Vision and hearing screening and assessment for minors including 6newborns. AB50-ASA2-AA8,42,8738. Sexually transmitted infection and human immunodeficiency virus 8counseling for sexually active minors. AB50-ASA2-AA8,42,11939. Risk assessment for sexually transmitted infection for minors who are 10 10years of age or older and screening for sexually transmitted infection for minors 11who are 16 years of age or older. AB50-ASA2-AA8,42,131240. Alcohol misuse screening and counseling for minors 11 years of age or 13older. AB50-ASA2-AA8,42,151441. Autism screening for minors who have attained the age of 18 months but 15have not attained the age of 25 months. AB50-ASA2-AA8,42,161642. Developmental screening and surveillance for minors including newborns. AB50-ASA2-AA8,42,171743. Psychosocial and behavioral assessment for minors including newborns. AB50-ASA2-AA8,42,191844. Alcohol misuse screening and counseling for pregnant adults and a risk 19assessment for all adults. AB50-ASA2-AA8,42,212045. Fall prevention and counseling and preventive medication for fall 21prevention for community-dwelling adults 65 years of age or older. AB50-ASA2-AA8,42,222246. Screening and counseling for intimate partner violence for adult women. AB50-ASA2-AA8,43,22347. Well-woman visits for women who have attained the age of 18 years but
1have not attained the age of 65 years and well-woman visits for recommended 2preventive services, preconception care, and prenatal care. AB50-ASA2-AA8,43,4348. Counseling on, consultations with a trained provider on, and equipment 4rental for breastfeeding for pregnant and lactating women. AB50-ASA2-AA8,43,5549. Folic acid supplement for adult women with reproductive capacity. AB50-ASA2-AA8,43,6650. Iron deficiency anemia screening for pregnant and lactating women. AB50-ASA2-AA8,43,8751. Preeclampsia preventive medicine for pregnant adult women at high risk 8for preeclampsia. AB50-ASA2-AA8,43,10952. Low-dose aspirin after 12 weeks of gestation for pregnant women at high 10risk for miscarriage, preeclampsia, or clotting disorders. AB50-ASA2-AA8,43,111153. Screenings for hepatitis B and bacteriuria for pregnant women. AB50-ASA2-AA8,43,141254. Screening for gonorrhea for pregnant and sexually active females 24 years 13of age or younger and females older than 24 years of age who are at risk for 14infection. AB50-ASA2-AA8,43,171555. Screening for chlamydia for pregnant and sexually active females 24 years 16of age and younger and females older than 24 years of age who are at risk for 17infection. AB50-ASA2-AA8,43,191856. Screening for syphilis for pregnant women and adults who are at high risk 19for infection. AB50-ASA2-AA8,43,222057. Human immunodeficiency virus screening for adults who have attained 21the age of 15 years but have not attained the age of 66 years and individuals at high 22risk of infection who are younger than 15 years of age or older than 65 years of age. AB50-ASA2-AA8,43,232358. All contraceptives and services in accordance with sub. (17). AB50-ASA2-AA8,44,2
159. Any services not already specified under this paragraph having an A or B 2rating in current recommendations from the U.S. preventive services task force. AB50-ASA2-AA8,44,5360. Any preventive services not already specified under this paragraph that 4are recommended by the federal health resources and services administration’s 5Bright Futures project. AB50-ASA2-AA8,44,8661. Any immunizations, not already specified under sub. (14), that are 7recommended and determined to be for routine use by the federal advisory 8committee on immunization practices. AB50-ASA2-AA8,44,129(c) Subject to par. (d), no disability insurance policy, except any disability 10insurance policy that is described in s. 632.745 (11) (b) 1. to 12., and no self-insured 11health plan may subject the coverage of any of the preventive services under par. (b) 12to any deductibles, copayments, or coinsurance under the policy or plan. AB50-ASA2-AA8,44,1613(d) 1. If an office visit and a preventive service specified under par. (b) are 14billed separately by the health care provider, the disability insurance policy or self-15insured health plan may apply deductibles to and impose copayments or 16coinsurance on the office visit but not on the preventive service. AB50-ASA2-AA8,44,19172. If the primary reason for an office visit is not to obtain a preventive service 18specified under par. (b), the disability insurance policy or self-insured health plan 19may apply deductibles to and impose copayments or coinsurance on the office visit. AB50-ASA2-AA8,45,6203. Except as otherwise provided in this subdivision, if a preventive service 21specified under par. (b) is provided by a health care provider that is outside the 22disability insurance policy’s or self-insured health plan’s network of providers, the 23policy or plan may apply deductibles to and impose copayments or coinsurance on
1the office visit and the preventive service. If a preventive service specified under 2par. (b) is provided by a health care provider that is outside the disability insurance 3policy’s or self-insured health plan’s network of providers because there is no 4available health care provider in the policy’s or plan’s network of providers that 5provides the preventive service, the policy or plan may not apply deductibles to or 6impose copayments or coinsurance on the preventive service. AB50-ASA2-AA8,45,1174. If more than one well-woman visit described under par. (b) 47. is necessary 8to provide all necessary preventive services as determined by a qualified health 9care provider and in accordance with applicable recommendations for preventive 10services, the disability insurance policy or self-insured health plan may not apply a 11deductible to or impose a copayment or coinsurance on any such well-woman visit. AB50-ASA2-AA8,5012Section 50. 632.895 (14) (a) 1. i. and j. of the statutes are amended to read: AB50-ASA2-AA8,45,1313632.895 (14) (a) 1. i. Hepatitis A and B. AB50-ASA2-AA8,45,1414j. Varicella and herpes zoster. AB50-ASA2-AA8,5115Section 51. 632.895 (14) (a) 1. k. to o. of the statutes are created to read: AB50-ASA2-AA8,45,1616632.895 (14) (a) 1. k. Human papillomavirus. AB50-ASA2-AA8,45,1717L. Meningococcal meningitis. AB50-ASA2-AA8,45,1818m. Pneumococcal pneumonia. AB50-ASA2-AA8,5221Section 52. 632.895 (14) (b) of the statutes is amended to read: AB50-ASA2-AA8,46,422632.895 (14) (b) Except as provided in par. (d), every disability insurance 23policy, and every self-insured health plan of the state or a county, city, town, village,
1or school district, that provides coverage for a dependent of the insured shall 2provide coverage of appropriate and necessary immunizations, from birth to the age 3of 6 years, for an insured or plan participant, including a dependent who is a child 4of the insured or plan participant. AB50-ASA2-AA8,535Section 53. 632.895 (14) (c) of the statutes is amended to read: AB50-ASA2-AA8,46,106632.895 (14) (c) The coverage required under par. (b) may not be subject to any 7deductibles, copayments, or coinsurance under the policy or plan. This paragraph 8applies to a defined network plan, as defined in s. 609.01 (1b), only with respect to 9appropriate and necessary immunizations provided by providers participating, as 10defined in s. 609.01 (3m), in the plan. AB50-ASA2-AA8,5411Section 54. 632.895 (14) (d) 3. of the statutes is amended to read: AB50-ASA2-AA8,46,1412632.895 (14) (d) 3. A health care plan offered by a limited service health 13organization, as defined in s. 609.01 (3), or by a preferred provider plan, as defined 14in s. 609.01 (4), that is not a defined network plan, as defined in s. 609.01 (1b).
/2025/related/amendments/ab50/aa8_asa2_ab50
true
amends
/2025/related/amendments/ab50/aa8_asa2_ab50/49/_25
amends/2025/REG/AB50-ASA2-AA8,41,6
amends/2025/REG/AB50-ASA2-AA8,41,6
section
true