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.

AB50,1444,5 5. Medical history.

AB50,1444,6 6. Genetic information.

AB50,1444,8 7. Evidence of insurability, including conditions arising out of acts of domestic violence.

AB50,1444,9 8. Disability.

AB50,1444,17 (b) An insurer that offers a short-term, limited duration plan may not require any individual, as a condition of enrollment or continued enrollment under the short-term, limited duration plan, to pay, on the basis of any health status-related factor described under par. (a) 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 similarly situated individual enrolled under the short-term, limited duration plan.

AB50,1444,20 (4) Premium rate variation. An insurer that offers a short-term, limited duration plan may vary premium rates for a specific short-term, limited duration plan based only on the following considerations:

AB50,1444,22 (a) Whether the short-term, limited duration plan covers an individual or a family.

AB50,1444,23 (b) Rating area in the state, as established by the commissioner.

AB50,1445,3 (c) Age, except that the rate may not vary by more than 3 to 1 for adults over the age groups and the age bands shall be consistent with recommendations of the National Association of Insurance Commissioners.

AB50,1445,4 (d) Tobacco use, except that the rate may not vary by more than 1.5 to 1.

AB50,1445,6 (5) Annual and lifetime limits. A short-term, limited duration plan may not establish any of the following:

AB50,1445,8 (a) Lifetime limits on the dollar value of benefits for an enrollee or a dependent of an enrollee under the short-term, limited duration plan.

AB50,1445,11 (b) Limits on the dollar value of benefits for an enrollee or a dependent of an enrollee under the short-term, limited duration plan for a term of coverage or for the aggregate duration of the short-term, limited duration plan.

AB50,2936 Section 2936. 632.7498 of the statutes is created to read:

AB50,1445,14 632.7498 Special enrollment period for pregnancy. (1) Definitions. In this section:

AB50,1445,15 (a) “Health benefit plan” has the meaning given in s. 632.745 (11).

AB50,1445,16 (b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

AB50,1446,2 (2) Special enrollment period. A health benefit plan or self-insured health plan shall allow a pregnant individual who is eligible for coverage under the plan, and any individual who is eligible for coverage under the plan because of a relationship to the pregnant individual, to enroll for coverage at any time during the pregnancy. The coverage shall begin no later than the first day of the first calendar month in which the pregnant individual receives medical verification of the pregnancy, except that a pregnant individual may direct coverage to begin on the first day of any month occurring during the pregnancy.

AB50,1446,6 (3) Notice. An insurer offering group health insurance coverage in this state shall provide notice of the special enrollment period under sub. (2) at or before the time an individual is initially offered the opportunity to enroll for coverage under the plan.

AB50,2937 Section 2937. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to read:

AB50,1446,16 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years from the date of issue of the policy may be reduced or denied on the ground that a disease or physical condition existed prior to the effective date of coverage, unless the condition was excluded from coverage by name or specific description by a provision effective on the date of loss. This paragraph does not apply to a group health benefit plan, as defined in s. 632.745 (9), which is subject to s. 632.746, a disability insurance policy, as defined in s. 632.895 (1) (a), or a self-insured health plan, as defined in s. 632.85 (1) (c).

AB50,1446,22 (ac) 1. Notwithstanding par. (a), no No claim or loss incurred or disability commencing after 12 months from the date of issue of under an individual disability insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the ground that a disease or physical condition existed prior to the effective date of coverage, unless the condition was excluded from coverage by name or specific description by a provision effective on the date of the loss.

AB50,1447,6 2. Except as provided in subd. 3., an An individual disability insurance policy, as defined in s. 632.895 (1) (a), other than a short-term policy limited duration plan subject to s. 632.7495 (4) and (5), may not define a preexisting condition more restrictively than a condition that was present before the date of enrollment for the coverage, whether physical or mental, regardless of the cause of the condition, for which and regardless of whether medical advice, diagnosis, care, or treatment was recommended or received within 12 months before the effective date of coverage.

AB50,2938 Section 2938. 632.76 (2) (ac) 3. (intro.) of the statutes is amended to read: