Ins 8.69(5)(a)9. 9. The total number of applications for any policy which the small employer insurer received in the previous quarter calendar year, regardless of whether, or what type of, a policy was issued, and which the small employer insurer:

Ins 8.69(5)(a)9.a. a. Rejected, or would have rejected, for each policy available from the small employer insurer, other than the basic health benefit plan or a policy that does not provide benefits similar to or exceeding benefits provided under the basic health benefit plan; or

Ins 8.69(5)(a)9.b. b. Assigned, or would have assigned, a rate for each policy available from the small employer insurer, other than the basic health benefit plan or a policy that does not provide benefits similar to or exceeding benefits provided under the basic health benefit plan, which exceeds the new business premium rate for the policy by 15% or more; and

Ins 8.69(5)(a)10. 10. The total number of applications for any policy which the small employer insurer received in the previous quarter calendar year, regardless of whether, or what type of, a policy was issued.

Ins 8.69(5)(b) (b) By March 1 of each year:

Ins 8.69(5)(b)1. 1. The number of risk characteristic basic health benefit plans it had in force at the end of the previous calendar year;

Ins 8.69(5)(b)2. 2. The number of risk characteristic basic health benefit plans it issued in the previous calendar year;

Ins 8.69(5)(b)3. 3. The number of basic health benefit plans it had in force at the end of the previous calendar year;

Ins 8.69(5)(b)4. 4. The number of basic health benefit plans it issued in the previous calendar year;

Ins 8.69(5)(b)5. 5. The total number of policies it had in force at the end of the previous calendar year;

Ins 8.69(5)(b)6. 6. The total number of policies it issued in the previous calendar year;

Ins 8.69(5)(b)7. 7. Its basic market share ratio for the previous calendar year;

Ins 8.69(5)(b)8. 8. Its market share ratio for the previous calendar year;

Ins 8.69(5)(b)9. 9. The total number of applications for any policy which the small employer insurer received in the previous calendar year, regardless of whether, or what type of, a policy was issued, and which the small employer insurer:

Ins 8.69(5)(b)9.a. a. Rejected, or would have rejected, for each policy available from the small employer insurer, other than the basic health benefit plan or a policy that does not provide benefits similar to or exceeding benefits provided under the basic health benefit plan; or

Ins 8.69(5)(b)9.b. b. Assigned, or would have assigned, a rate for each policy available from the small employer insurer, other than the basic health benefit plan or a policy that does not provide benefits similar to or exceeding benefits provided under the basic health benefit plan, which exceeds the new business premium rate for the policy by 15% or more; and

Ins 8.69(5)(b)10. 10. The total number of applications for any policy which the small employer insurer received in the previous calendar year, regardless of whether, or what type of, a policy was issued.

Ins 8.69(6) (6) A small employer insurer shall obtain sufficient information to comply with sub. (5) and shall maintain the information and the documentation required under sub. (5) for 3 years or until the issued policy, if any, terminates, whichever is later.

Ins 8.69(7) (7) A small employer insurer shall establish procedures for determining whether a basic health benefit plan is a risk characteristic basic health benefit plan and shall document the basis for each such determination.

Ins 8.69 Note Note: Copies of forms referred to in this section may be obtained without charge from the Office of the Commissioner of Insurance by sending a written request to P. O. Box 7873, Madison, Wisconsin 53707-7873.

Ins 8.69 History History: Cr. Register, November, 1993, No. 455, eff. 2-1-94.

subch. IV of ch. Ins 8 Subchapter IV — Basic Health Benefit Plan For Small Employers

Ins 8.70 Ins 8.70 Purpose. This subchapter implements ch. 635, Stats., by establishing the basic health benefit plan that small employer insurers shall actively market and offer to small employers.

Ins 8.70 History History: Cr. Register, June, 1993, No. 450, eff. 7-1-93; correction in (intro.) made under 13.93 (2m) (b) 7., Stats., Register, March, 2000, No. 531.

Ins 8.71 Ins 8.71 Definitions.

Ins 8.71(1) (1) The definitions in s. 635.02, Stats., apply to this subchapter.

Ins 8.71(2) (2) In this subchapter, “health care provider” means any of the following:

Ins 8.71(2)(a) (a) A medical or osteopathic physician, podiatrist, physical therapist or physician’s assistant licensed or certified under ch. 448, Stats.

Ins 8.71(2)(b) (b) A psychologist licensed under ch. 445, Stats.