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.

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: