SB37,8,23 16(6) Short-term plans. This section and s. 632.76 apply to every short-term,
17limited-duration health insurance policy. In this subsection, “short-term,
18limited-duration health insurance policy” means health coverage that is provided
19under a contract with an insurer, has an expiration date specified in the contract that
20is less than 12 months after the original effective date of the contract, and, taking
21into account renewals or extensions, has a duration of no longer than 36 months in
22total. “Short-term, limited-duration health insurance policy” includes any
23short-term policy subject to s. 632.7495 (4).
SB37,14 24Section 14. 632.746 (1) (a) of the statutes is renumbered 632.746 (1) and
25amended to read:
SB37,9,7
1632.746 (1) Subject to subs. (2) and (3), an An insurer that offers a group health
2benefit plan may, with respect to a participant or beneficiary under the plan, not
3impose a preexisting condition exclusion only if the exclusion relates to a condition,
4whether physical or mental, regardless of the cause of the condition, for which
5medical advice, diagnosis, care or treatment was recommended or received within
6the 6-month period ending on the participant's or beneficiary's enrollment date
7under the plan
on a participant or beneficiary under the plan.
SB37,15 8Section 15. 632.746 (1) (b) of the statutes is repealed.
SB37,16 9Section 16. 632.746 (2) (a) of the statutes is amended to read:
SB37,9,1310 632.746 (2) (a) An insurer offering a group health benefit plan may not treat
11impose a preexisting condition exclusion based on genetic information as a
12preexisting condition under sub. (1) without a diagnosis of a condition related to the
13information
.
SB37,17 14Section 17. 632.746 (2) (c), (d) and (e) of the statutes are repealed.
SB37,18 15Section 18. 632.746 (3) (a) of the statutes is repealed.
SB37,19 16Section 19 . 632.746 (3) (d) 1. of the statutes is renumbered 632.746 (3) (d).
SB37,20 17Section 20 . 632.746 (3) (d) 2. and 3. of the statutes are repealed.
SB37,21 18Section 21 . 632.746 (5) of the statutes is repealed.
SB37,22 19Section 22. 632.746 (8) (a) (intro.) of the statutes is amended to read:
SB37,9,2320 632.746 (8) (a) (intro.) A health maintenance organization that offers a group
21health benefit plan and that does not impose any preexisting condition exclusion
22under sub. (1)
with respect to a particular coverage option may impose an affiliation
23period for that coverage option, but only if all of the following apply:
SB37,23 24Section 23 . 632.748 (2) of the statutes is amended to read:
SB37,10,7
1632.748 (2) An insurer offering a group health benefit plan may not require any
2individual, as a condition of enrollment or continued enrollment under the plan, to
3pay, on the basis of any health status-related factor with respect to the individual
4or a dependent of the individual, a premium or contribution or a deductible,
5copayment, or coinsurance amount
that is greater than the premium or contribution
6or deductible, copayment, or coinsurance amount respectively for a similarly
7situated individual enrolled under the plan.
SB37,24 8Section 24. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to read:
SB37,10,169 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years
10from the date of issue of the policy may be reduced or denied on the ground that a
11disease or physical condition existed prior to the effective date of coverage, unless the
12condition was excluded from coverage by name or specific description by a provision
13effective on the date of loss. This paragraph does not apply to a group health benefit
14plan, as defined in s. 632.745 (9), which is subject to s. 632.746 , a disability insurance
15policy, as defined in s. 632.895 (1) (a), or a self-insured health plan, as defined in s.
16632.85 (1) (c)
.
SB37,10,2217 (ac) 1. Notwithstanding par. (a), no No claim or loss incurred or disability
18commencing after 12 months from the date of issue of under an individual disability
19insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the
20ground that a disease or physical condition existed prior to the effective date of
21coverage, unless the condition was excluded from coverage by name or specific
22description by a provision effective on the date of the loss
.
SB37,11,423 2. Except as provided in subd. 3., an An individual disability insurance policy,
24as defined in s. 632.895 (1) (a), other than a short-term policy subject to s. 632.7495
25(4) and (5),
may not define a preexisting condition more restrictively than a condition

1that was present before the date of enrollment for the coverage, whether physical or
2mental, regardless of the cause of the condition, for which and regardless of whether
3medical advice, diagnosis, care, or treatment was recommended or received within
412 months before the effective date of coverage
.
SB37,25 5Section 25. 632.76 (2) (ac) 3. of the statutes is repealed.
SB37,26 6Section 26. 632.795 (4) (a) of the statutes is amended to read:
SB37,11,187 632.795 (4) (a) An insurer subject to sub. (2) shall provide coverage under the
8same policy form and for the same premium as it originally offered in the most recent
9enrollment period, subject only to the medical underwriting used in that enrollment
10period. Unless otherwise prescribed by rule, the insurer may apply deductibles,
11preexisting condition limitations, waiting periods , or other limits only to the extent
12that they would have been applicable had coverage been extended at the time of the
13most recent enrollment period and with credit for the satisfaction or partial
14satisfaction of similar provisions under the liquidated insurer's policy or plan. The
15insurer may exclude coverage of claims that are payable by a solvent insurer under
16insolvency coverage required by the commissioner or by the insurance regulator of
17another jurisdiction. Coverage shall be effective on the date that the liquidated
18insurer's coverage terminates.
SB37,27 19Section 27. 632.895 (8) (d) of the statutes is amended to read:
SB37,12,220 632.895 (8) (d) Coverage is required under this subsection despite whether the
21woman shows any symptoms of breast cancer. Except as provided in pars. (b), (c), and
22(e), coverage under this subsection may only be subject to exclusions and limitations,
23including deductibles, copayments and restrictions on excessive charges, that are
24applied to other radiological examinations covered under the disability insurance

1policy. Coverage under this subsection may not be subject to any deductibles,
2copayments, or coinsurance.
SB37,28 3Section 28. 632.895 (13m) of the statutes is created to read:
SB37,12,54 632.895 (13m) Preventive services. (a) In this section, “self-insured health
5plan” has the meaning given in s. 632.85 (1) (c).
SB37,12,86 (b) Every disability insurance policy, except any disability insurance policy that
7is described in s. 632.745 (11) (b) 1. to 12., and every self-insured health plan shall
8provide coverage for all of the following preventive services:
SB37,12,99 1. Mammography in accordance with sub. (8).
SB37,12,1110 2. Genetic breast cancer screening and counseling and preventive medication
11for adult women at high risk for breast cancer.