4 | 4 | | AN ACT to amend 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g) and 185.983 (1) (intro.); and to create 632.722 |
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5 | 5 | | of the statutes; relating to: assignment of dental benefits under health insurance. |
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6 | 6 | | The people of the state of Wisconsin, represented in |
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7 | 7 | | senate and assembly, do enact as follows: |
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8 | 8 | | SECTION 1. 40.51 (8) of the statutes is amended to |
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9 | 9 | | read: |
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10 | 10 | | 40.51 (8) Every health care coverage plan offered by |
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11 | 11 | | the state under sub. (6) shall comply with ss. 631.89, |
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12 | 12 | | 631.90, 631.93 (2), 631.95, 632.72 (2), 632.722, |
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13 | 13 | | 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, |
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14 | 14 | | 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, |
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15 | 15 | | 632.861, 632.867, 632.87 (3) to (6), 632.885, 632.89, |
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16 | 16 | | 632.895 (5m) and (8) to (17), and 632.896. |
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17 | 17 | | SECTION 2. 40.51 (8m) of the statutes is amended to |
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18 | 18 | | read: |
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19 | 19 | | 40.51 (8m) Every health care coverage plan offered |
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20 | 20 | | by the group insurance board under sub. (7) shall comply |
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21 | 21 | | with ss. 631.95, 632.722, 632.729, 632.746 (1) to (8) and |
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22 | 22 | | (10), 632.747, 632.748, 632.798, 632.83, 632.835, |
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23 | 23 | | 632.85, 632.853, 632.855, 632.861, 632.867, 632.885, |
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24 | 24 | | 632.89, and 632.895 (11) to (17). |
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25 | 25 | | SECTION 3. 66.0137 (4) of the statutes is amended to |
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26 | 26 | | read: |
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27 | 27 | | 66.0137 (4) SELF−INSURED HEALTH PLANS. If a city, |
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28 | 28 | | including a 1st class city, or a village provides health care |
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29 | 29 | | benefits under its home rule power, or if a town provides |
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30 | 30 | | health care benefits, to its officers and employees on a |
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31 | 31 | | self−insured basis, the self−insured plan shall comply |
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32 | 32 | | with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), |
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33 | 33 | | 632.722, 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 |
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34 | 34 | | (3), 632.798, 632.85, 632.853, 632.855, 632.861, |
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35 | 35 | | 632.867, 632.87 (4) to (6), 632.885, 632.89, 632.895 (9) |
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36 | 36 | | to (17), 632.896, and 767.513 (4). |
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37 | 37 | | SECTION 4. 120.13 (2) (g) of the statutes is amended |
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38 | 38 | | to read: |
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39 | 39 | | 120.13 (2) (g) Every self−insured plan under par. (b) |
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40 | 40 | | shall comply with ss. 49.493 (3) (d), 631.89, 631.90, |
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41 | 41 | | 631.93 (2), 632.722, 632.729, 632.746 (10) (a) 2. and (b) |
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42 | 42 | | 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, |
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43 | 43 | | 632.861, 632.867, 632.87 (4) to (6), 632.885, 632.89, |
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44 | 44 | | 632.895 (9) to (17), 632.896, and 767.513 (4). |
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45 | 45 | | SECTION 5. 185.983 (1) (intro.) of the statutes is |
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46 | 46 | | amended to read: |
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47 | 47 | | 185.983 (1) (intro.) Every voluntary nonprofit health |
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48 | 48 | | care plan operated by a cooperative association orga- |
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49 | 49 | | nized under s. 185.981 shall be exempt from chs. 600 to |
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50 | 50 | | 646, with the exception of ss. 601.04, 601.13, 601.31, |
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51 | 51 | | 601.41, 601.42, 601.43, 601.44, 601.45, 611.26, 611.67, |
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52 | 52 | | 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, |
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53 | 53 | | 631.93, 631.95, 632.72 (2), 632.722, 632.729, 632.745 to |
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54 | 54 | | 632.749, 632.775, 632.79, 632.795, 632.798, 632.85, |
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55 | 55 | | 632.853, 632.855, 632.861, 632.867, 632.87 (2) to (6), |
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56 | 56 | | 632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, |
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57 | 57 | | * Section 991.11, WISCONSIN STATUTES: Effective date of acts. “Every act and every portion of an act enacted by the legislature over the governor’s |
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59 | 59 | | and 632.897 (10) and chs. 609, 620, 630, 635, 645, and |
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60 | 60 | | 646, but the sponsoring association shall: |
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61 | 61 | | SECTION 6. 632.722 of the statutes is created to read: |
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62 | 62 | | 632.722 Assignment of dental benefits. (1) An |
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63 | 63 | | insured may assign the right to receive reimbursement for |
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64 | 64 | | dental care and related services under a policy, as defined |
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65 | 65 | | under s. 632.873 (1) (b), directly to a provider of dental |
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66 | 66 | | care or related services. An insured may revoke an |
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67 | 67 | | assignment under this subsection at any time. |
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68 | 68 | | (2) If the right to receive reimbursement for dental |
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69 | 69 | | care and related services is assigned to a provider of den- |
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70 | 70 | | tal care or related services, if the assignment has not been |
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71 | 71 | | revoked, and if the assignment is known to the insurer at |
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72 | 72 | | the time that a claim is received, the insurer shall directly |
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73 | 73 | | pay the provider the amount of the claim under the same |
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74 | 74 | | criteria and payment schedule under which the insurer |
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75 | 75 | | would have reimbursed the insured. |
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76 | 76 | | (3) An insurer may require an assignment or revoca- |
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77 | 77 | | tion of an assignment under this section to be docu- |
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78 | 78 | | mented in writing or submitted electronically. |
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79 | 79 | | SECTION 7.0Initial applicability. |
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80 | 80 | | (1) For policies and plans containing provisions |
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81 | 81 | | inconsistent with this act, the act first applies to policy or |
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82 | 82 | | plan years beginning on January 1 of the year following |
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83 | 83 | | the year in which this subsection takes effect, except as |
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84 | 84 | | provided in sub. (2). |
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85 | 85 | | (2) For policies or plans that are affected by a collec- |
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86 | 86 | | tive bargaining agreement containing provisions incon- |
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87 | 87 | | sistent with this act, this act first applies to policy or plan |
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88 | 88 | | years beginning on the effective date of this subsection or |
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89 | 89 | | on the day on which the collective bargaining agreement |
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90 | 90 | | is newly established, extended, modified, or renewed, |
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91 | 91 | | whichever is later. |
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92 | 92 | | SECTION 8.0Effective date. |
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93 | 93 | | (1) This act takes effect on the first day of the 7th |
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94 | 94 | | month beginning after publication. |
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