AB50,1443,2318(3) Prohibiting discrimination based on health status. (a) An insurer
19that offers a short-term, limited duration plan may not establish rules for the
20eligibility of any individual to enroll, or for the continued eligibility of any
21individual to remain enrolled, under a short-term, limited duration plan based on
22any of the following health status-related factors with respect to the individual or a
23dependent of the individual:
AB50,1444,1
11. Health status.
AB50,1444,222. Medical condition, including both physical and mental illnesses.
AB50,1444,333. Claims experience.
AB50,1444,444. Receipt of health care.
AB50,1444,555. Medical history.
AB50,1444,666. Genetic information.
AB50,1444,877. Evidence of insurability, including conditions arising out of acts of domestic
8violence.
AB50,1444,998. Disability.
AB50,1444,1710(b) An insurer that offers a short-term, limited duration plan may not require
11any individual, as a condition of enrollment or continued enrollment under the
12short-term, limited duration plan, to pay, on the basis of any health status-related
13factor described under par. (a) with respect to the individual or a dependent of the
14individual, a premium or contribution or a deductible, copayment, or coinsurance
15amount that is greater than the premium or contribution or deductible, copayment,
16or coinsurance amount respectively for a similarly situated individual enrolled
17under the short-term, limited duration plan.
AB50,1444,2018(4) Premium rate variation. An insurer that offers a short-term, limited
19duration plan may vary premium rates for a specific short-term, limited duration
20plan based only on the following considerations:
AB50,1444,2221(a) Whether the short-term, limited duration plan covers an individual or a
22family.
AB50,1444,2323(b) Rating area in the state, as established by the commissioner.
AB50,1445,3
1(c) Age, except that the rate may not vary by more than 3 to 1 for adults over
2the age groups and the age bands shall be consistent with recommendations of the
3National Association of Insurance Commissioners.
AB50,1445,44(d) Tobacco use, except that the rate may not vary by more than 1.5 to 1.
AB50,1445,65(5) Annual and lifetime limits. A short-term, limited duration plan may
6not establish any of the following:
AB50,1445,87(a) Lifetime limits on the dollar value of benefits for an enrollee or a
8dependent of an enrollee under the short-term, limited duration plan.
AB50,1445,119(b) Limits on the dollar value of benefits for an enrollee or a dependent of an
10enrollee under the short-term, limited duration plan for a term of coverage or for
11the aggregate duration of the short-term, limited duration plan.
AB50,293612Section 2936. 632.7498 of the statutes is created to read:
AB50,1445,1413632.7498 Special enrollment period for pregnancy. (1) Definitions. In
14this section:
AB50,1445,1515(a) Health benefit plan has the meaning given in s. 632.745 (11).
AB50,1445,1616(b) Self-insured health plan has the meaning given in s. 632.85 (1) (c).
AB50,1446,217(2) Special enrollment period. A health benefit plan or self-insured health
18plan shall allow a pregnant individual who is eligible for coverage under the plan,
19and any individual who is eligible for coverage under the plan because of a
20relationship to the pregnant individual, to enroll for coverage at any time during the
21pregnancy. The coverage shall begin no later than the first day of the first calendar
22month in which the pregnant individual receives medical verification of the

1pregnancy, except that a pregnant individual may direct coverage to begin on the
2first day of any month occurring during the pregnancy.
AB50,1446,63(3) Notice. An insurer offering group health insurance coverage in this state
4shall provide notice of the special enrollment period under sub. (2) at or before the
5time an individual is initially offered the opportunity to enroll for coverage under
6the plan.
AB50,29377Section 2937. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to
8read:
AB50,1446,169632.76 (2) (a) No claim for loss incurred or disability commencing after 2
10years from the date of issue of the policy may be reduced or denied on the ground
11that a disease or physical condition existed prior to the effective date of coverage,
12unless the condition was excluded from coverage by name or specific description by
13a provision effective on the date of loss. This paragraph does not apply to a group
14health benefit plan, as defined in s. 632.745 (9), which is subject to s. 632.746, a
15disability insurance policy, as defined in s. 632.895 (1) (a), or a self-insured health
16plan, as defined in s. 632.85 (1) (c).
AB50,1446,2217(ac) 1. Notwithstanding par. (a), no No claim or loss incurred or disability
18commencing after 12 months from the date of issue of under an individual disability
19insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the
20ground that a disease or physical condition existed prior to the effective date of
21coverage, unless the condition was excluded from coverage by name or specific
22description by a provision effective on the date of the loss.
AB50,1447,6232. Except as provided in subd. 3., an An individual disability insurance policy,

1as defined in s. 632.895 (1) (a), other than a short-term policy limited duration plan
2subject to s. 632.7495 (4) and (5), may not define a preexisting condition more
3restrictively than a condition that was present before the date of enrollment for the
4coverage, whether physical or mental, regardless of the cause of the condition, for
5which and regardless of whether medical advice, diagnosis, care, or treatment was
6recommended or received within 12 months before the effective date of coverage.
AB50,29387Section 2938. 632.76 (2) (ac) 3. (intro.) of the statutes is amended to read: