632.71 Estoppel from medical examination, assignability and change of beneficiary. Sections 632.47 to 632.50 apply to disability insurance policies. History: 1975 c. 373, 375, 422.
632.715 Reports of action against health care provider. Every insurer that has taken any action against a person who holds a license granted by the medical examining board or an affiliated credentialing board attached to the medical examining board shall notify the board or affiliated credentialing board of the action taken against the person if […]
632.72 Medical benefits or assistance; assignment. (1g) In this section: (a) “Department or contract provider” means the department of health services, the county providing the medical benefits or assistance or a health maintenance organization that has contracted with the department of health services to provide the medical benefits or assistance. (b) “Medical benefits or assistance” […]
632.726 Current procedural terminology code changes. (1) In this section, “current procedural terminology code” means a number established by the American Medical Association that a health care provider puts on a health insurance claim form to describe the services that he or she performed. (2) If an insurer changes a current procedural terminology code that […]
632.729 Prohibiting discrimination based on COVID-19. (1) Definitions. In this section: (a) “COVID-19” means an infection caused by the SARS-CoV-2 coronavirus. (b) “Health benefit plan” has the meaning given in s. 632.745 (11). (c) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c). (d) “Self-insured health plan” has the meaning given in […]
632.73 Right to return policy. (1) Right of return. A policyholder may return an individual or franchise disability policy within 10 days after receipt. If the policyholder does so, the contract is void, and all payments made under it shall be refunded. This subsection does not apply to medicare supplement policies, medicare replacement policies or […]
632.74 Reinstatement of individual or franchise disability insurance policies. (1) Conditions of reinstatement. If an insurer, after termination of an individual or franchise disability insurance policy for nonpayment of premium, within one year after the termination accepts without reservation a premium payment, the policy is reinstated as of the date of the acceptance. There is […]
632.745 Coverage requirements for group and individual health benefit plans; definitions. In this section and ss. 632.746 to 632.7495: (1) “Affiliation period” means the period which, under the terms of health insurance coverage offered by a health maintenance organization, must expire before the health insurance coverage becomes effective. (2) “Beneficiary” has the meaning given in […]
632.746 Preexisting condition; portability; restrictions; and special enrollment periods. (1) (a) Subject to subs. (2) and (3), an insurer that offers a group health benefit plan may, with respect to a participant or beneficiary under the plan, impose a preexisting condition exclusion only if the exclusion relates to a condition, whether physical or mental, regardless […]
632.747 Guaranteed acceptance. (1) Employee becomes eligible after commencement of coverage. Unless otherwise permitted by rule of the commissioner, if an insurer provides coverage under a group health benefit plan, the insurer shall provide coverage under the group health benefit plan to an eligible employee who becomes eligible for coverage after the commencement of the […]
632.748 Prohibiting discrimination. (1) (a) Subject to subs. (3) and (4), an insurer may not establish rules for the eligibility of any individual to enroll, or for the continued eligibility of any individual to remain enrolled, under a group health benefit plan based on any of the following factors with respect to the individual or […]
632.749 Contract termination and renewability. (1) (a) Except as provided in subs. (2) to (4) and notwithstanding s. 631.36 (2) to (4m), an insurer that offers a group health benefit plan shall renew such coverage or continue such coverage in force at the option of the employer and, if applicable, plan sponsor. (b) At the […]
632.7495 Guaranteed renewability of individual health insurance coverage. (1) (a) Except as provided in subs. (2) to (4) and notwithstanding s. 631.36 (2) to (4m), an insurer that provides individual health benefit plan coverage shall renew such coverage or continue such coverage in force at the option of the insured individual and, if applicable, the […]
632.7497 Modifications at renewal. (1) In this section, “individual major medical or comprehensive health benefit plan” includes coverage under a group policy that is underwritten on an individual basis and issued to individuals or families. (2) An insurer that issues an individual major medical or comprehensive health benefit plan shall, at the time of a […]
632.75 Prohibited provisions for disability insurance. (1) Death presumed from extended absence. Section 813.22 (1) applies to any disability insurance policy providing a death benefit. (2) Dividends conditioned on continuation of policy or payment of premiums. Except on the first or second anniversary, no dividend payable on a disability insurance policy may be made contingent […]
632.755 Public assistance and early intervention services. (1g) (a) A disability insurance policy may not exclude a person or a person’s dependent from coverage because the person or the dependent is eligible for assistance under ch. 49 or because the dependent is eligible for early intervention services under s. 51.44. (b) A disability insurance policy […]
632.76 Incontestability for disability insurance. (1) Avoidance for misrepresentations. No statement made by an applicant in the application for individual disability insurance coverage and no statement made respecting the person’s insurability by a person insured under a group policy, except fraudulent misrepresentation, is a basis for avoidance of the policy or denial of a claim […]
632.77 Permitted provisions for disability insurance policies. If any provisions are contained in a disability insurance policy dealing with the following subjects, they shall conform to the requirements specified: (1) Change of occupation. Any provision respecting change of occupation may provide only for a lower maximum payment and for reduction of loss payments proportionate to […]
632.775 Effect of power of attorney for health care. (1) Insurer may not require. An insurer may not require an individual to execute a power of attorney for health care under ch. 155 as a condition of coverage under a disability insurance policy. (2) Effect on disability policies. Executing a power of attorney for health […]
632.78 Required grace period for disability insurance policies. Every disability insurance policy shall contain clauses providing for a grace period of at least 7 days for weekly premium policies, 10 days for monthly premium policies and 31 days for all other policies, for each premium after the first, during which the policy shall continue in […]
