AB43,,8601 609.713 Qualified treatment trainee coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (7).

AB43,3055 Section 3055. 609.714 of the statutes is created to read:

AB43,,8603 609.714 Substance abuse counselor coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (8).

AB43,3056 Section 3056. 609.719 of the statutes is created to read:

AB43,,8605 609.719 Coverage for telehealth services. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.871.

AB43,3057 Section 3057. 609.74 of the statutes is created to read:

AB43,,8607 609.74 Coverage of infertility services. Defined network plans and preferred provider plans are subject to s. 632.895 (15m).

AB43,3058 Section 3058. 609.83 of the statutes is amended to read:

AB43,,8609 609.83 Coverage of drugs and devices; application of payments. Limited service health organizations, preferred provider plans, and defined network plans are subject to ss. 632.853, 632.861, 632.862, and 632.895 (6) (b), (16t), and (16v).

****Note: This is reconciled s. 609.83. This Section has been affected by drafts with the following LRB numbers: -1152/P1 and -1157/P1.

AB43,3059 Section 3059. 609.847 of the statutes is created to read:

AB43,,8611 609.847 Preexisting condition discrimination and certain benefit limits prohibited. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.728.

AB43,3060 Section 3060. 611.11 (4) (a) of the statutes is amended to read:

AB43,,8613 611.11 (4) (a) In this subsection, “municipality” has the meaning given in s. 345.05 (1) (c), but also includes any transit authority created under s. 66.1039.

AB43,3061 Section 3061. 625.12 (1) (a) of the statutes is amended to read:

AB43,,8615 625.12 (1) (a) Past and prospective loss and expense experience within and outside of this state, except as provided in s. 632.728.

AB43,3062 Section 3062. 625.12 (1) (e) of the statutes is amended to read:

AB43,,8617 625.12 (1) (e) Subject to s. ss. 632.365 and 632.728, all other relevant factors, including the judgment of technical personnel.

AB43,3063 Section 3063. 625.12 (2) of the statutes is amended to read:

AB43,,8619 625.12 (2) Classification. Except as provided in s. ss. 632.728 and 632.729, risks may be classified in any reasonable way for the establishment of rates and minimum premiums, except that no classifications may be based on race, color, creed or national origin, and classifications in automobile insurance may not be based on physical condition or developmental disability as defined in s. 51.01 (5). Subject to ss. 632.365, 632.728, and 632.729, rates thus produced may be modified for individual risks in accordance with rating plans or schedules that establish reasonable standards for measuring probable variations in hazards, expenses, or both. Rates may also be modified for individual risks under s. 625.13 (2).

AB43,3064 Section 3064. 625.15 (1) of the statutes is amended to read:

AB43,,8621 625.15 (1) Rate making. An Except as provided in s. 632.728, an insurer may itself establish rates and supplementary rate information for one or more market segments based on the factors in s. 625.12 and, if the rates are for motor vehicle liability insurance, subject to s. 632.365, or the insurer may use rates and supplementary rate information prepared by a rate service organization, with average expense factors determined by the rate service organization or with such modification for its own expense and loss experience as the credibility of that experience allows.

AB43,3065 Section 3065. 628.34 (3) (a) of the statutes is amended to read:

AB43,,8623 628.34 (3) (a) No insurer may unfairly discriminate among policyholders by charging different premiums or by offering different terms of coverage except on the basis of classifications related to the nature and the degree of the risk covered or the expenses involved, subject to ss. 632.365, 632.728, 632.729, 632.746 and, 632.748, and 632.7496. Rates are not unfairly discriminatory if they are averaged broadly among persons insured under a group, blanket or franchise policy, and terms are not unfairly discriminatory merely because they are more favorable than in a similar individual policy.

****Note: This is reconciled s. 628.34 (3) (a). This Section has been affected by drafts with the following LRB numbers: -1153/P1 and -1154/P1.

AB43,3066 Section 3066. 628.495 of the statutes is created to read:

AB43,,8625 628.495 Pharmacy benefit management broker and consultant licenses. (1) Definition. In this section, “pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).

AB43,,8626 (2) License required. Beginning on the first day of the 12th month beginning after the effective date of this subsection .... [LRB inserts date], no individual may act as a pharmacy benefit management broker or consultant or any other individual who procures the services of a pharmacy benefit manager on behalf of a client without being licensed by the commissioner under this section.

AB43,,8627 (3) Rules. The commissioner may promulgate rules to establish criteria and procedures for initial licensure and renewal of licensure and to implement licensure under this section.