AB56-SA2,68,1412 (c) Age, except that the rate may not vary by more than 3 to 1 for adults over
13the age groups and the age bands shall be consistent with recommendations of the
14National Association of Insurance Commissioners.
AB56-SA2,68,1515 (d) Tobacco use, except that the rate may not vary by more than 1.5 to 1.
AB56-SA2,68,17 16(5) Annual and lifetime limits. An individual or group health benefit plan or
17a self-insured health plan may not establish any of the following:
AB56-SA2,68,1918 (a) Lifetime limits on the dollar value of benefits for an enrollee or a dependent
19of an enrollee under the plan.
AB56-SA2,68,2120 (b) Annual limits on the dollar value of benefits for an enrollee or a dependent
21of an enrollee under the plan.
AB56-SA2,69,4 22(6) Short-term plans. This section and s. 632.76 apply to every short-term,
23limited-duration health insurance policy. In this subsection, “short-term,
24limited-duration health insurance policy” means health coverage that is provided
25under a contract with an insurer, has an expiration date specified in the contract that

1is less than 12 months after the original effective date of the contract, and, taking
2into account renewals or extensions, has a duration of no longer than 36 months in
3total. “Short-term, limited-duration health insurance policy” includes any
4short-term policy subject to s. 632.7495 (4).
AB56-SA2,2080i 5Section 2080i. 632.746 (1) (a) of the statutes is renumbered 632.746 (1) and
6amended to read:
AB56-SA2,69,137 632.746 (1) Subject to subs. (2) and (3), an An insurer that offers a group health
8benefit plan may, with respect to a participant or beneficiary under the plan, not
9impose a preexisting condition exclusion only if the exclusion relates to a condition,
10whether physical or mental, regardless of the cause of the condition, for which
11medical advice, diagnosis, care or treatment was recommended or received within
12the 6-month period ending on the participant's or beneficiary's enrollment date
13under the plan
on a participant or beneficiary under the plan.
AB56-SA2,2081i 14Section 2081i. 632.746 (1) (b) of the statutes is repealed.
AB56-SA2,2082i 15Section 2082i. 632.746 (2) (a) of the statutes is amended to read:
AB56-SA2,69,1916 632.746 (2) (a) An insurer offering a group health benefit plan may not treat
17impose a preexisting condition exclusion based on genetic information as a
18preexisting condition under sub. (1) without a diagnosis of a condition related to the
19information
.
AB56-SA2,2083i 20Section 2083i. 632.746 (2) (c), (d) and (e) of the statutes are repealed.
AB56-SA2,2084i 21Section 2084i. 632.746 (3) (a) of the statutes is repealed.
AB56-SA2,2085i 22Section 2085i. 632.746 (3) (d) 1. of the statutes is renumbered 632.746 (3) (d).
AB56-SA2,2086i 23Section 2086i. 632.746 (3) (d) 2. and 3. of the statutes are repealed.
AB56-SA2,2087i 24Section 2087i. 632.746 (5) of the statutes is repealed.
AB56-SA2,2088i 25Section 2088i. 632.746 (8) (a) (intro.) of the statutes is amended to read:
AB56-SA2,70,4
1632.746 (8) (a) (intro.) A health maintenance organization that offers a group
2health benefit plan and that does not impose any preexisting condition exclusion
3under sub. (1)
with respect to a particular coverage option may impose an affiliation
4period for that coverage option, but only if all of the following apply:
AB56-SA2,2089i 5Section 2089i. 632.748 (2) of the statutes is amended to read:
AB56-SA2,70,126 632.748 (2) An insurer offering a group health benefit plan may not require any
7individual, as a condition of enrollment or continued enrollment under the plan, to
8pay, on the basis of any health status-related factor with respect to the individual
9or a dependent of the individual, a premium or contribution or a deductible,
10copayment, or coinsurance amount
that is greater than the premium or contribution
11or deductible, copayment, or coinsurance amount respectively for a similarly
12situated individual enrolled under the plan.
AB56-SA2,2090i 13Section 2090i. 632.76 (2) (a) and (ac) 1. and 2. of the statutes are amended to
14read:
AB56-SA2,70,2215 632.76 (2) (a) No claim for loss incurred or disability commencing after 2 years
16from the date of issue of the policy may be reduced or denied on the ground that a
17disease or physical condition existed prior to the effective date of coverage, unless the
18condition was excluded from coverage by name or specific description by a provision
19effective on the date of loss. This paragraph does not apply to a group health benefit
20plan, as defined in s. 632.745 (9), which is subject to s. 632.746 , a disability insurance
21policy, as defined in s. 632.895 (1) (a), or a self-insured health plan, as defined in s.
22632.85 (1) (c)
.
AB56-SA2,71,323 (ac) 1. Notwithstanding par. (a), no No claim or loss incurred or disability
24commencing after 12 months from the date of issue of under an individual disability
25insurance policy, as defined in s. 632.895 (1) (a), may be reduced or denied on the

1ground that a disease or physical condition existed prior to the effective date of
2coverage, unless the condition was excluded from coverage by name or specific
3description by a provision effective on the date of the loss
.
AB56-SA2,71,104 2. Except as provided in subd. 3., an An individual disability insurance policy,
5as defined in s. 632.895 (1) (a), other than a short-term policy subject to s. 632.7495
6(4) and (5),
may not define a preexisting condition more restrictively than a condition
7that was present before the date of enrollment for the coverage, whether physical or
8mental, regardless of the cause of the condition, for which and regardless of whether
9medical advice, diagnosis, care, or treatment was recommended or received within
1012 months before the effective date of coverage
.
AB56-SA2,2091i 11Section 2091i. 632.76 (2) (ac) 3. of the statutes is repealed.
AB56-SA2,2092i 12Section 2092i. 632.795 (4) (a) of the statutes is amended to read:
AB56-SA2,71,2413 632.795 (4) (a) An insurer subject to sub. (2) shall provide coverage under the
14same policy form and for the same premium as it originally offered in the most recent
15enrollment period, subject only to the medical underwriting used in that enrollment
16period. Unless otherwise prescribed by rule, the insurer may apply deductibles,
17preexisting condition limitations, waiting periods , or other limits only to the extent
18that they would have been applicable had coverage been extended at the time of the
19most recent enrollment period and with credit for the satisfaction or partial
20satisfaction of similar provisions under the liquidated insurer's policy or plan. The
21insurer may exclude coverage of claims that are payable by a solvent insurer under
22insolvency coverage required by the commissioner or by the insurance regulator of
23another jurisdiction. Coverage shall be effective on the date that the liquidated
24insurer's coverage terminates.
AB56-SA2,2093k 25Section 2093k. 632.796 of the statutes is created to read:
AB56-SA2,72,2
1632.796 Drug cost report. (1) Definition. In this section, “disability
2insurance policy” has the meaning given in s. 632.895 (1) (a).