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.
635.01 – Scope.
635.01 Scope. This chapter applies to all group health insurance plans, policies or certificates, written on risks or operations in this state, providing coverage for employees of a small employer, or employees of a small employer and the employer, and to individual health insurance policies, written on risks or operations in this state, providing coverage […]
633.06 – Examination and inspection of books and records.
633.06 Examination and inspection of books and records. (1) The commissioner may examine, audit or accept an audit of the books and records of an administrator or pharmacy benefit manager as provided for examination of licensees under s. 601.43 (1), (3), (4) and (5), to be conducted as provided in s. 601.44, and with costs […]
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.
633.08 – Underwriting responsibilities.
633.08 Underwriting responsibilities. If a principal is an insurer, any underwriting responsibilities regarding eligibility that the insurer has delegated to an administrator shall be set forth in the written agreement required under s. 633.04. History: 1991 a. 39.
633.04 – Written agreement required.
633.04 Written agreement required. An administrator may not administer an employee benefit plan in the absence of a written agreement between the administrator and a principal. The administrator and principal shall each retain a copy of the written agreement for the duration of the agreement and for 5 years thereafter. The written agreement shall contain […]
633.05 – Payment to administrator.
633.05 Payment to administrator. If a principal is an insurer, payment to the administrator of a premium or charge by or on behalf of an insured employee is payment to the insurer, but payment of a return premium or claim by the insurer to the administrator is not payment to an insured employee until the […]