632.785 Notice of Health Insurance Risk-Sharing Plan. - Wisconsin Statutes

632.785

632.785 Notice of Health Insurance Risk-Sharing Plan.

632.785(1)

(1) If an insurer issues one or more of the following or takes any other action based wholly or partially on medical underwriting considerations which is likely to render any person eligible under s. 149.12 for coverage under ch. 149, the insurer shall notify all persons affected of the existence of the mandatory health insurance risk-sharing plan under ch. 149, as well as the eligibility requirements and method of applying for coverage under the plan:

632.785(1)(a)

(a) A notice of rejection or cancellation of coverage.

632.785(1)(b)

(b) A notice of reduction or limitation of coverage, including restrictive riders, if the effect of the reduction or limitation is to substantially reduce coverage compared to the coverage available to a person considered a standard risk for the type of coverage provided by the plan.

632.785(1)(c)

(c) A notice of increase in premium exceeding the premium then in effect for the insured person by 50% or more, unless the increase applies to substantially all of the insurer's health insurance policies then in effect.

632.785(1)(d)

(d) A notice of premium for a policy not yet in effect which exceeds the premium applicable to a person considered a standard risk by 50% or more for the types of coverage provided by the plan.

632.785(2)

(2) Any notice issued under sub. (1) shall also state the reasons for the rejection, termination, cancellation or imposition of underwriting restrictions.

632.785 - ANNOT.

History: 1979 c. 313; 1981 c. 83; 1991 a. 315; 1997 a. 27; 2005 a. 74.