June 26, 1995 - Introduced by Representatives Carpenter, Wasserman, Baldwin,
Robson, R. Young, Baldus, Gronemus, Notestein, Grobschmidt, Plombon,
Bock, L. Young, Boyle, Wirch, Dueholm
and R. Potter, cosponsored by
Senator Burke. Referred to Committee on Health.
AB456,1,4 1An Act to amend 40.51 (8), 60.23 (25), 66.184, 111.70 (1) (a), 120.13 (2) (g),
2185.981 (4t) and 185.983 (1) (intro.); and to create 40.52 (1) (c), 111.70 (4) (m),
3111.91 (2) (k) and 632.895 (11) of the statutes; relating to: requiring insurance
4coverage of preventive pediatric health care services.
Analysis by the Legislative Reference Bureau
This bill requires every health insurance policy (called "disability insurance
policy" in the statutes), including health care plans offered by health maintenance
organizations, preferred provider plans and the state, and every self-insured health
plan of the state or a county, city, town, village or school district, to provide coverage
of preventive pediatric health care services, from birth to age 19, for a dependent
child of the insured if the policy or plan covers a dependent. (Under current law,
health insurance policies are required to cover a newly born child of the insured, even
if the policy did not provide coverage for dependents at the time of the birth.) Under
the bill, preventive pediatric health care services include specified immunizations
and other services that are in accord with the prevailing medical standards of the
American Academy of Pediatrics, such as developmental assessments, sensory
screening, laboratory tests and initial dental referrals. Coverage of preventive
pediatric health care services may not be subject to any deductibles, coinsurance or
copayments. Specifically excluded from this coverage requirement are health
insurance policies that cover only certain specified diseases, health care plans
offered by limited service health organizations, medicare replacement or
supplement policies and long-term care insurance policies.

For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB456, s. 1 1Section 1. 40.51 (8) of the statutes is amended to read:
AB456,2,42 40.51 (8) Every health care coverage plan offered by the state under sub. (6)
3shall comply with ss. 631.89, 631.90, 631.93 (2), 632.72 (2), 632.87 (3) to (5), 632.895
4(5m) and (8) to (10) (11) and 632.896.
AB456, s. 2 5Section 2. 40.52 (1) (c) of the statutes is created to read:
AB456,2,66 40.52 (1) (c) The coverage required under s. 632.895 (11).
AB456, s. 3 7Section 3. 60.23 (25) of the statutes is amended to read:
AB456,2,108 60.23 (25) Self-insured health plans. Provide health care benefits to its
9officers and employes on a self-insured basis if the self-insured plan complies with
10ss. 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (11) and 632.896.
AB456, s. 4 11Section 4. 66.184 of the statutes is amended to read:
AB456,2,17 1266.184 Self-insured health plans. If a city, including a 1st class city, or a
13village provides health care benefits under its home rule power, or if a town provides
14health care benefits, to its officers and employes on a self-insured basis, the
15self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
16632.87 (4) and (5), 632.895 (9) and (10) to (11), 632.896, 767.25 (4m) (d) and 767.51
17(3m) (d).
AB456, s. 5 18Section 5. 111.70 (1) (a) of the statutes is amended to read:
AB456,3,1819 111.70 (1) (a) "Collective bargaining" means the performance of the mutual
20obligation of a municipal employer, through its officers and agents, and the
21representatives of its employes, to meet and confer at reasonable times, in good faith,

1with the intention of reaching an agreement, or to resolve questions arising under
2such an agreement, with respect to wages, hours and conditions of employment, and
3with respect to a requirement of the municipal employer for a municipal employe to
4perform law enforcement and fire fighting services under s. 61.66, except as provided
5in sub. (4) (m) and s. 40.81 (3) and except that a municipal employer shall not meet
6and confer with respect to any proposal to diminish or abridge the rights guaranteed
7to municipal employes under ch. 164. The duty to bargain, however, does not compel
8either party to agree to a proposal or require the making of a concession. Collective
9bargaining includes the reduction of any agreement reached to a written and signed
10document. The employer shall not be required to bargain on subjects reserved to
11management and direction of the governmental unit except insofar as the manner
12of exercise of such functions affects the wages, hours and conditions of employment
13of the employes. In creating this subchapter the legislature recognizes that the
14public employer must exercise its powers and responsibilities to act for the
15government and good order of the municipality, its commercial benefit and the
16health, safety and welfare of the public to assure orderly operations and functions
17within its jurisdiction, subject to those rights secured to public employes by the
18constitutions of this state and of the United States and by this subchapter.
AB456, s. 6 19Section 6. 111.70 (4) (m) of the statutes is created to read:
AB456,3,2320 111.70 (4) (m) Health insurance coverage of preventive pediatric health care
21services.
The municipal employer is prohibited from bargaining collectively with
22respect to the provision of the health insurance coverage required under s. 632.895
23(11).
AB456, s. 7 24Section 7. 111.91 (2) (k) of the statutes is created to read:
AB456,4,2
1111.91 (2) (k) The provision to employes of the health insurance coverage
2required under s. 632.895 (11).
AB456, s. 8 3Section 8. 120.13 (2) (g) of the statutes is amended to read:
AB456,4,64 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
549.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.87 (4) and (5), 632.895 (9) and (10) to
6(11)
, 632.896, 767.25 (4m) (d) and 767.51 (3m) (d).
AB456, s. 9 7Section 9. 185.981 (4t) of the statutes is amended to read:
AB456,4,108 185.981 (4t) A sickness care plan operated by a cooperative association is
9subject to ss. 252.14, 631.89, 632.72 (2), 632.87 (2m), (3), (4) and (5), 632.895 (10) and
10(11)
and 632.897 (10) and ch. 155.
AB456, s. 10 11Section 10. 185.983 (1) (intro.) of the statutes is amended to read:
AB456,4,1712 185.983 (1) (intro.)  Every such voluntary nonprofit sickness care plan shall be
13exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41,
14601.42, 601.43, 601.44, 601.45, 611.67, 619.04, 628.34 (10), 631.89, 631.93, 632.72
15(2), 632.775, 632.79, 632.795, 632.87 (2m), (3), (4) and (5), 632.895 (5), (9) and (10)
16and (9) to (11), 632.896 and 632.897 (10), subch. II of ch. 619 and chs. 609, 630, 635,
17645 and 646, but the sponsoring association shall:
AB456, s. 11 18Section 11. 632.895 (11) of the statutes is created to read:
AB456,4,2019 632.895 (11) Preventive pediatric health care services. (a) In this
20subsection:
AB456,4,2321 1. "Appropriate and necessary immunizations" means the administration of
22vaccine that meets the standards approved by the U.S. public health service for such
23biological products against at least all of the following:
AB456,4,2424 a. Diphtheria.
AB456,4,2525 b. Pertussis.
AB456,5,1
1c. Tetanus.
AB456,5,22 d. Polio.
AB456,5,33 e. Measles.
AB456,5,44 f. Mumps.
AB456,5,55 g. Rubella.
AB456,5,66 h. Haemophilus influenza type b.
AB456,5,77 i. Hepatitis B.
AB456,5,98 j. Any other disease for which immunization is recommended by the American
9Academy of Pediatrics.
AB456,5,1010 2. "Dependent" has the meaning given in s. 635.02 (3c).
AB456,5,1511 3. "Preventive pediatric health care services" includes appropriate and
12necessary immunizations and such other services that are in accord with the
13prevailing medical standards of the American Academy of Pediatrics as physical
14examinations, developmental assessments, sensory screening, anticipatory
15guidance, initial dental referral and appropriate laboratory tests.
AB456,5,2016 (b) Except as provided in par. (d), every disability insurance policy, and every
17self-insured health plan of the state or a county, city, town, village or school district,
18that provides coverage for a dependent of the insured shall provide coverage of
19preventive pediatric health care services, from birth to the age of 19 years, for a
20dependent who is a child of the insured.
AB456,5,2221 (c) The coverage required under par. (b) may not be subject to any deductibles,
22copayments or coinsurance.
AB456,5,2323 (d) This subsection does not apply to any of the following:
AB456,5,2424 1. A disability insurance policy that covers only certain specified diseases.
AB456,6,2
12. A health care plan offered by a limited service health organization, as defined
2in s. 609.01 (3).
AB456,6,33 3. A long-term care insurance policy, as defined in s. 600.03 (28g).
AB456,6,44 4. A medicare replacement policy, as defined in s. 600.03 (28p).
AB456,6,55 5. A medicare supplement policy, as defined in s. 600.03 (28r).
AB456, s. 12 6Section 12. Initial applicability.
AB456,6,9 7(1) This act first applies to insurance policies that are issued or renewed, and
8self-insured health plans that are extended, modified or renewed under collective
9bargaining agreements, on the effective date of this subsection. 
AB456, s. 13 10Section 13. Effective date.
AB456,6,12 11(1) This act takes effect on the first day of the 5th month beginning after
12publication.
AB456,6,1313 (End)
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