AB50,1441,8 (b) A health benefit plan on the individual or small employer market shall have a medical loss ratio of at least 80 percent.

AB50,1441,10 (c) A group health benefit plan other than one described under par. (b) shall have a medical loss ratio of at least 85 percent.

AB50,1441,14 (9) Actuarial values of plan tiers. Any health benefit plan offered on the individual or small employer market shall provide a level of coverage that is designed to provide benefits that are actuarially equivalent to at least 60 percent of the full actuarial value of the benefits provided under the plan.

AB50,2923 Section 2923. 632.746 (1) (a) of the statutes is renumbered 632.746 (1) and amended to read:

AB50,1441,23 632.746 (1) Subject to subs. (2) and (3), an An insurer that offers a group health benefit plan may, with respect to a participant or beneficiary under the plan, not impose a preexisting condition exclusion only if the exclusion relates to a condition, whether physical or mental, regardless of the cause of the condition, for which medical advice, diagnosis, care or treatment was recommended or received within the 6-month period ending on the participant’s or beneficiary’s enrollment date under the plan on a participant or beneficiary under the plan.

AB50,2924 Section 2924. 632.746 (1) (b) of the statutes is repealed.

AB50,2925 Section 2925. 632.746 (2) (a) of the statutes is amended to read:

AB50,1442,6 632.746 (2) (a) An insurer offering a group health benefit plan may not treat impose a preexisting condition exclusion based on genetic information as a preexisting condition under sub. (1) without a diagnosis of a condition related to the information.

AB50,2926 Section 2926. 632.746 (2) (c), (d) and (e) of the statutes are repealed.

AB50,2927 Section 2927. 632.746 (3) (a) of the statutes is repealed.

AB50,2928 Section 2928. 632.746 (3) (d) 1. of the statutes is renumbered 632.746 (3) (d).

AB50,2929 Section 2929. 632.746 (3) (d) 2. and 3. of the statutes are repealed.

AB50,2930 Section 2930. 632.746 (5) of the statutes is repealed.

AB50,2931 Section 2931. 632.746 (8) (a) (intro.) of the statutes is amended to read:

AB50,1442,16 632.746 (8) (a) (intro.) A health maintenance organization that offers a group health benefit plan and that does not impose any preexisting condition exclusion under sub. (1) with respect to a particular coverage option may impose an affiliation period for that coverage option, but only if all of the following apply:

AB50,2932 Section 2932. 632.748 (2) of the statutes is amended to read:

AB50,1443,2 632.748 (2) An insurer offering a group health benefit plan may not require any individual, as a condition of enrollment or continued enrollment under the plan, to pay, on the basis of any health status-related factor with respect to the individual or a dependent of the individual, a premium or contribution or a deductible, copayment, or coinsurance amount that is greater than the premium or contribution or deductible, copayment, or coinsurance amount, respectively, for a an otherwise similarly situated individual enrolled under the plan.

AB50,2933 Section 2933. 632.7495 (4) (b) of the statutes is amended to read:

AB50,1443,4 632.7495 (4) (b) The coverage has a term of not more than 12 3 months.

AB50,2934 Section 2934. 632.7495 (4) (c) of the statutes is amended to read:

AB50,1443,10 632.7495 (4) (c) The coverage term aggregated with all consecutive periods of the insurer’s coverage of the insured by individual health benefit plan coverage not required to be renewed under this subsection does not exceed 18 6 months. For purposes of this paragraph, coverage periods are consecutive if there are no more than 63 days between the coverage periods.

AB50,2935 Section 2935. 632.7496 of the statutes is created to read:

AB50,1443,14 632.7496 Coverage requirements for short-term plans. (1) Definition. In this section, “short-term, limited duration plan” means an individual health benefit plan described in s. 632.7495 (4).

AB50,1443,17 (2) Guaranteed issue. An insurer that offers a short-term, limited duration plan shall accept every individual in this state who applies for coverage regardless of whether the individual has a preexisting condition.

AB50,1443,23 (3) Prohibiting discrimination based on health status. (a) An insurer that offers a short-term, limited duration plan may not establish rules for the eligibility of any individual to enroll, or for the continued eligibility of any individual to remain enrolled, under a short-term, limited duration plan based on any of the following health status-related factors with respect to the individual or a dependent of the individual:

AB50,1444,1 1. Health status.

AB50,1444,2 2. Medical condition, including both physical and mental illnesses.

AB50,1444,3 3. Claims experience.

AB50,1444,4 4. Receipt of health care.