AB43,30578606Section 3057. 609.74 of the statutes is created to read: AB43,,86078607609.74 Coverage of infertility services. Defined network plans and preferred provider plans are subject to s. 632.895 (15m). AB43,30588608Section 3058. 609.83 of the statutes is amended to read: AB43,,86098609609.83 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.
AB43,30598610Section 3059. 609.847 of the statutes is created to read: AB43,,86118611609.847 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. AB43,30608612Section 3060. 611.11 (4) (a) of the statutes is amended to read: AB43,,86138613611.11 (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. AB43,30618614Section 3061. 625.12 (1) (a) of the statutes is amended to read: AB43,,86158615625.12 (1) (a) Past and prospective loss and expense experience within and outside of this state, except as provided in s. 632.728. AB43,30628616Section 3062. 625.12 (1) (e) of the statutes is amended to read: AB43,,86178617625.12 (1) (e) Subject to s. ss. 632.365 and 632.728, all other relevant factors, including the judgment of technical personnel. AB43,30638618Section 3063. 625.12 (2) of the statutes is amended to read: AB43,,86198619625.12 (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). AB43,30648620Section 3064. 625.15 (1) of the statutes is amended to read: AB43,,86218621625.15 (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. AB43,30658622Section 3065. 628.34 (3) (a) of the statutes is amended to read: AB43,,86238623628.34 (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.
AB43,30668624Section 3066. 628.495 of the statutes is created to read: AB43,,86258625628.495 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,,86268626(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,,86278627(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. AB43,30678628Section 3067. 632.35 of the statutes is amended to read: AB43,,86298629632.35 Prohibited rejection, cancellation and nonrenewal. No insurer may cancel or refuse to issue or renew an automobile insurance policy wholly or partially because of one or more of the following characteristics of any person: age, sex, residence, race, color, creed, religion, national origin, ancestry, marital status or, occupation, or status as a holder or nonholder of a license under s. 343.03 (3r). AB43,30688630Section 3068. 632.728 of the statutes is created to read: AB43,,86318631632.728 Coverage of persons with preexisting conditions; guaranteed issue; benefit limits. (1) Definitions. In this section: AB43,,86328632(a) “Cost sharing” includes deductibles, coinsurance, copayments, or similar charges.