632.745 – Coverage requirements for group and individual health benefit plans; definitions.
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.
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.
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.
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.
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 […]
632.726 – Current procedural terminology code changes.
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.
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.
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.
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 […]
632.715 – Reports of action against health care provider.
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 […]