AB68,1526,220 632.748 (2) An insurer offering a group health benefit plan may not require any
21individual, as a condition of enrollment or continued enrollment under the plan, to
22pay, on the basis of any health status-related factor with respect to the individual
23or a dependent of the individual, a premium or contribution or a deductible,
24copayment, or coinsurance amount
that is greater than the premium or contribution

1or deductible, copayment, or coinsurance amount respectively for a similarly
2situated individual enrolled under the plan.
AB68,2946 3Section 2946. 632.7495 (4) (b) of the statutes is amended to read:
AB68,1526,44 632.7495 (4) (b) The coverage has a term of not more than 12 3 months.
AB68,2947 5Section 2947. 632.7495 (4) (c) of the statutes is amended to read:
AB68,1526,106 632.7495 (4) (c) The coverage term aggregated with all consecutive periods of
7the insurer's coverage of the insured by individual health benefit plan coverage not
8required to be renewed under this subsection does not exceed 18 6 months. For
9purposes of this paragraph, coverage periods are consecutive if there are no more
10than 63 days between the coverage periods.
AB68,2948 11Section 2948 . 632.7496 of the statutes is created to read:
AB68,1526,14 12632.7496 Coverage requirements for short-term plans. (1) Definition.
13In this section, “short-term, limited duration plan” means an individual health
14benefit plan described in s. 632.7495 (4) that an insurer is not required to renew.
AB68,1526,17 15(2) Guaranteed issue. Every short-term, limited duration plan shall accept
16every individual in this state who applies for coverage whether or not any individual
17has a preexisting condition.
AB68,1526,22 18(3) Prohibiting discrimination based on health status. (a) A short-term,
19limited duration plan may not establish rules for the eligibility of any individual to
20enroll, or for the continued eligibility of any individual to remain enrolled, under the
21plan based on any of the following health status-related factors in relation to the
22individual or a dependent of the individual:
AB68,1526,2323 1. Health status.
AB68,1526,2424 2. Medical condition, including both physical and mental illnesses.
AB68,1526,2525 3. Claims experience.
AB68,1527,1
14. Receipt of health care.
AB68,1527,22 5. Medical history.
AB68,1527,33 6. Genetic information.
AB68,1527,54 7. Evidence of insurability, including conditions arising out of acts of domestic
5violence.
AB68,1527,66 8. Disability.
AB68,1527,137 (b) A short-term, limited duration plan may not require any individual, as a
8condition of enrollment or continued enrollment under the plan, to pay, on the basis
9of any health status-related factor under par. (a) with respect to the individual or a
10dependent of the individual, a premium or contribution or a deductible, copayment,
11or coinsurance amount that is greater than the premium or contribution or
12deductible, copayment, or coinsurance amount respectively for a similarly situated
13individual enrolled under the plan.
AB68,1527,15 14(4) Premium rate variation. A short-term, limited duration plan may vary
15premium rates for a specific plan based only on the following considerations:
AB68,1527,1616 (a) Whether the policy or plan covers an individual or a family.
AB68,1527,1717 (b) Rating area in the state, as established by the commissioner.
AB68,1527,2018 (c) Age, except that the rate may not vary by more than 3 to 1 for adults over
19the age groups and the age bands shall be consistent with recommendations of the
20National Association of Insurance Commissioners.
AB68,1527,2121 (d) Tobacco use, except that the rate may not vary by more than 1.5 to 1.
AB68,1527,23 22(5) Annual and lifetime limits. A short-term, limited duration plan may not
23establish any of the following:
AB68,1527,2524 (a) Lifetime limits on the dollar value of benefits for an enrollee or a dependent
25of an enrollee under the plan.
AB68,1528,2
1(b) Limits on the dollar value of benefits for an enrollee or a dependent of an
2enrollee under the plan for the initial or cumulative duration of the plan.
AB68,2949 3Section 2949. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to
4read:
AB68,1528,125 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years
6from the date of issue of the policy may be reduced or denied on the ground that a
7disease or physical condition existed prior to the effective date of coverage, unless the
8condition was excluded from coverage by name or specific description by a provision
9effective on the date of loss. This paragraph does not apply to a group health benefit
10plan, as defined in s. 632.745 (9), which is subject to s. 632.746 , a disability insurance
11policy, as defined in s. 632.895 (1) (a), or a self-insured health plan, as defined in s.
12632.85 (1) (c)
.
AB68,1528,1813 (ac) 1. Notwithstanding par. (a), no No claim or loss incurred or disability
14commencing after 12 months from the date of issue of under an individual disability
15insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the
16ground that a disease or physical condition existed prior to the effective date of
17coverage, unless the condition was excluded from coverage by name or specific
18description by a provision effective on the date of the loss
.