Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB791 Compare Versions

Only one version of the bill is available at this time.

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3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 791
5	5	December 8, 2023 - Introduced by Representatives J. ANDERSON, CLANCY, DRAKE,
6	6	EMERSON, JACOBSON, JOERS, MADISON, MOORE OMOKUNDE, ORTIZ-VELEZ,
7	7	RATCLIFF, SHANKLAND, SHELTON and SNODGRASS, cosponsored by Senators
8	8	LARSON and SPREITZER. Referred to Committee on Insurance.
9	9	*AUTHORS SUBJECT TO CHANGE*
10	10	AN ACT to amend 625.03 (1m) (e), 625.13 (1), 625.15 (2), 625.21 (1), 625.22 (1),
11	11	625.22 (3) and 625.23; and to create 625.25 of the statutes; relating to:
12	12	approval of certain rate increases for health insurance.
13	13	Analysis by the Legislative Reference Bureau
14	14	Currently, insurers must file premium rates, and changes to premium rates, for
15	15	all types of insurance with the Office of the Commissioner of Insurance within 30
16	16	days after the rates or rate changes become effective. Current law prohibits
17	17	premium rates from being excessive, inadequate, or unfairly discriminatory and
18	18	provides guidelines for determining whether rates comply with those standards. The
19	19	commissioner of insurance may order that a rate be discontinued for any policy
20	20	issued or renewed after a date specified in the order if, after a hearing, the
21	21	commissioner determines that the rate does not comply with those standards.
22	22	This bill requires that an insurer that writes health insurance must file with
23	23	OCI premium rates, and changes to premium rates, for health insurance before those
24	24	rates or changes to rates become effective. If a proposed rate is an increase of 10
25	25	percent or more, an insurer may not use the rate unless it is approved by the
26	26	commissioner. For any other rates or rate changes, unless the commissioner holds
27	27	a hearing on a rate or change to a rate, the rate or changed rate is approved if the
28	28	commissioner does not disapprove the rate within 30 days after it was filed with OCI.
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33	33	ASSEMBLY BILL 791
34	34	For further information see the state fiscal estimate, which will be printed as
35	35	an appendix to this bill.
36	36	The people of the state of Wisconsin, represented in senate and assembly, do
37	37	enact as follows:
38	38	SECTION 1. 625.03 (1m) (e) of the statutes is amended to read:
39	39	625.03 (1m) (e) Group Except for group health benefit plans, as defined in s.
40	40	632.745 (9), group and blanket accident and sickness insurance other than credit
41	41	accident and sickness insurance.
42	42	SECTION 2. 625.13 (1) of the statutes is amended to read:
43	43	625.13 (1) FILING PROCEDURE. Except as provided in sub. (2) and s. 625.25 (2)
44	44	(a), every authorized insurer and every rate service organization licensed under s.
45	45	625.31 which has been designated by any insurer for the filing of rates under s.
46	46	625.15 (2) shall file with the commissioner all rates and supplementary rate
47	47	information and all changes and amendments thereof made by it for use in this state
48	48	within 30 days after they become effective.
49	49	SECTION 3. 625.15 (2) of the statutes is amended to read:
50	50	625.15 (2) RATE FILING. An insurer may discharge its obligation under s. 625.13
51	51	(1) or 625.25 (2) (a) by giving notice to the commissioner that it uses rates and
52	52	supplementary rate information prepared by a designated rate service organization,
53	53	with such information about modifications thereof as is necessary fully to inform the
54	54	commissioner. The insurer's rates or proposed rates and supplementary rate
55	55	information shall be those filed from time to time by the rate service organization,
56	56	including any amendments or proposed amendments thereto as filed, subject,
57	57	however, to the modifications filed by the insurer.
58	58	SECTION 4. 625.21 (1) of the statutes is amended to read:
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82	82	SECTION 4
83	83	ASSEMBLY BILL 791
84	84	625.21 (1) RULE INSTITUTING DELAYED EFFECT. If the commissioner finds that
85	85	competition is not an effective regulator of the rates charged or that a substantial
86	86	number of companies are competing irresponsibly through the rates charged, or that
87	87	there are widespread violations of this chapter, in any kind or line of insurance or
88	88	subdivision thereof or in any rating class or rating territory, he or she may
89	89	promulgate a rule requiring that in the kind or line of insurance or subdivision
90	90	thereof or rating class or rating territory comprehended by the finding any
91	91	subsequent changes in the rates or supplementary rate information be filed with the
92	92	commissioner at least 15 days before they become effective. The commissioner may
93	93	extend the waiting period for not to exceed 15 additional days by written notice to
94	94	the filer before the first 15-day period expires. This subsection does not apply to a
95	95	health benefit plan subject to s. 625.25 (2) (a).
96	96	SECTION 5. 625.22 (1) of the statutes is amended to read:
97	97	625.22 (1) ORDER IN EVENT OF VIOLATION. If the commissioner finds after a
98	98	hearing that a rate or proposed rate is not in compliance with s. 625.11, the
99	99	commissioner shall order that its use be discontinued, or that it may not be used, for
100	100	any policy issued or renewed after a date specified in the order.
101	101	SECTION 6. 625.22 (3) of the statutes is amended to read:
102	102	625.22 (3) APPROVAL OF SUBSTITUTED RATE. Within Except for rates for health
103	103	benefit plans subject to s. 625.25 (2) (a), within one year after the effective date of an
104	104	order under sub. (1), no rate promulgated to replace a disapproved one may be used
105	105	until it has been filed with the commissioner and not disapproved within 30 days
106	106	thereafter.
107	107	SECTION 7. 625.23 of the statutes is amended to read:
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133	133	SECTION 7 ASSEMBLY BILL 791
134	134	625.23 Special restrictions on individual insurers. The commissioner
135	135	may by order require that a particular insurer file any or all of its rates and
136	136	supplementary rate information 15 days prior to their effective date, if and to the
137	137	extent that he or she finds, after a hearing, that the protection of the interests of its
138	138	insureds and the public in this state requires closer supervision of its rates because
139	139	of the insurer's financial condition or rating practices. The commissioner may extend
140	140	the waiting period for any filing for not to exceed 15 additional days by written notice
141	141	to the insurer before the first 15-day period expires. A filing not disapproved before
142	142	the expiration of the waiting period shall be deemed to meet the requirements of this
143	143	chapter, subject to the possibility of subsequent disapproval under s. 625.22. This
144	144	section does not apply to health benefit plans subject to s. 625.25 (2) (a).
145	145	SECTION 8. 625.25 of the statutes is created to read:
146	146	625.25 Rates for health insurance. (1) DEFINITIONS. In this section:
147	147	(a) “Group health benefit plan" has the meaning given in s. 632.745 (9).
148	148	(b) “Health benefit plan" has the meaning given in s. 632.745 (11).
149	149	(2) FILING OF RATES; HEARING. (a) Every insurer organization designated to file
150	150	rates for a health benefit plan shall file with the commissioner all proposed rates and
151	151	supplementary rate information, and all proposed changes and amendments to rates
152	152	and supplementary rate information, for use in this state for any health benefit plan,
153	153	including a group health benefit plan, offered before the proposed rates or changes
154	154	to rates become effective.
155	155	(b) If a proposed rate or change to a rate filed under par. (a) for a health benefit
156	156	plan is an increase of 10 percent or more over the rate in effect for the health benefit
157	157	plan, an insurer may not use the proposed rate or change to a rate until it has been
158	158	approved by the commissioner.
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184	184	LRB-0434/1
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186	186	SECTION 8
187	187	ASSEMBLY BILL 791
188	188	(c) For a proposed rate filed under par. (a) that is not subject to par. (b), unless
189	189	the commissioner holds a hearing on the proposed rate or change to a rate, a proposed
190	190	rate or change to a rate is approved if the commissioner does not disapprove the
191	191	proposed rate or change within 30 days after filing or within a 30-day extension of
192	192	that period ordered by the commissioner prior to the expiration of the first 30 days.
193	193	(END)
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