633.09 – Accounts.
633.09 Accounts. (1) Moneys held in fiduciary capacity. An administrator shall hold in a fiduciary capacity all moneys that the administrator collects or receives on behalf of other persons. Within 2 business days after collection or receipt of such moneys, the administrator either shall pay the moneys to the persons entitled to them or shall […]
633.10 – Payment of claims.
633.10 Payment of claims. An administrator shall pay claims from funds paid to the claims paying account under s. 633.09 (4) (b) 5. on drafts or checks authorized in advance by the principal. History: 1991 a. 39.
633.11 – Claim adjustment compensation.
633.11 Claim adjustment compensation. If an administrator adjusts or settles claims under an employee benefit plan, the commission, fees or charges that the principal pays the administrator may not be based on the employee benefit plan’s loss experience. This section does not prohibit compensation based on the number or amount of premiums or charges collected, […]
633.12 – Notification required.
633.12 Notification required. (1) An administrator shall prepare sufficient copies of a written notice approved in advance by the principal for distribution to all insured employees of the principal and either shall distribute the copies to the insured employees or shall provide the copies to the principal for distribution to the insured employees. The written […]
633.13 – License required.
633.13 License required. (1) General. Except as provided in sub. (2), a person may not perform, offer to perform or advertise any service as an administrator or a pharmacy benefit manager unless the person has obtained a license under s. 633.14. A pharmacy benefit manager that also performs services as an administrator need only obtain […]
633.14 – Issuance of license.
633.14 Issuance of license. (1) The commissioner shall issue a license to act as an administrator to an individual who does all of the following: (a) Subject to s. 601.31 (2m), pays the fee under s. 601.31 (1) (w). (b) Supplies a bond meeting the specifications established under sub. (3). (c) Shows to the satisfaction […]
633.15 – License; renewal, suspension, limitation, revocation, penalty.
633.15 License; renewal, suspension, limitation, revocation, penalty. (1) Annual renewal fee. (a) Payment. An administrator or pharmacy benefit manager shall pay the annual renewal fee under s. 601.31 (1) (w) for each annual renewal of a license by the date specified by a schedule established under par. (b). (b) Schedule by rule. The commissioner shall […]
633.16 – Regulation.
633.16 Regulation. Nothing in this chapter gives the commissioner the authority to impose requirements on an employee benefit plan that is exempt from state law under 29 USC 1144 (b). History: 1991 a. 39; Stats. 1991 s. 633.16; 2021 a. 9. The commissioner lacks authority to regulate administrators of self-funded or self-insured employee benefit plans. […]
633.17 – Rule-making authority.
633.17 Rule-making authority. The commissioner shall promulgate rules necessary for the implementation of this chapter, in addition to the rules permitted under s. 633.13 (2) and required under ss. 633.14 (3) and 633.15 (1) (b). History: 1991 a. 39.
633.07 – Approval of advertising.
633.07 Approval of advertising. An administrator may not use any advertising for an employee benefit plan underwritten by an insurer unless the insurer approves the advertising in advance. History: 1991 a. 39; 2021 a. 9.