LRB-3008/1
PJK:jld:rs
2013 - 2014 LEGISLATURE
November 4, 2013 - Introduced by Senators Lassa, Carpenter, L. Taylor, Lehman
and Harris, cosponsored by Representatives Vruwink, Berceau, Hebl,
Bewley, Young, Ringhand, Ohnstad and Jorgensen. Referred to Committee
on Health and Human Services.
SB386,1,2 1An Act to create 632.843 of the statutes; relating to: special enrollment periods
2for Medicare supplement policies.
Analysis by the Legislative Reference Bureau
Generally, Medicare Part A provides coverage for inpatient care and Medicare
Part B provides coverage for outpatient care. Generally, a person is eligible for
Medicare when he or she reaches age 65 or if he or she is under age 65 and disabled.
Medicare supplement policies are private insurance policies that may be purchased
by persons who are enrolled in Medicare and that provide supplemental coverage to
that provided under Medicare, such as coverage for additional services, for the
portion of the cost of services not paid by Medicare, or for deductibles required under
Medicare.
This bill creates two special enrollment periods under Medicare supplement
policies. Under the bill, an insurer offering a Medicare supplement policy may not
deny coverage under the policy on the basis of health status, claims experience,
receipt of health care, medical condition, disability, or age to a person under age 65
who is eligible for Medicare Part B during the six-month period beginning on the
first day of the month in which the person first enrolls in Medicare Part B. The bill
also requires every insurer offering a Medicare supplement policy to provide an
annual open enrollment period during which no person who is covered under another
Medicare supplement policy and no person who is under age 65 and enrolled in
Medicare Part B may be denied coverage under the insurer's Medicare supplement
policy on the basis of a preexisting condition. In addition, the insurer may not impose
on any person who obtains coverage during the annual open enrollment period any

preexisting condition exclusion. The annual open enrollment period must begin and
end on the same dates as the federal Medicare annual open enrollment period, also
known as the annual election period.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB386,1 1Section 1. 632.843 of the statutes is created to read:
SB386,2,4 2632.843 Special enrollment periods for Medicare supplement policies.
3(1) Definition. In this section, "Medicare Part B" means Part B of Medicare under
442 USC 1395j to 1395L.
SB386,2,8 5(2) Initial 6-month enrollment period. (a) During the initial enrollment
6period specified in par. (b), an insurer offering a Medicare supplement policy may not
7deny coverage under the policy on the basis of any of the following to an individual
8under the age of 65 who is eligible for Medicare Part B:
SB386,2,99 1. Health status.
SB386,2,1010 2. Claims experience.
SB386,2,1111 3. Receipt of health care.
SB386,2,1212 4. Medical condition.
SB386,2,1313 5. Disability.
SB386,2,1414 6. Age.
SB386,2,1715 (b) The initial enrollment period referred to in par. (a) for an individual
16described in par. (a) shall begin on the first day of the month in which the individual
17first enrolls in Medicare Part B and shall last for 6 months.
SB386,2,19 18(3) Annual open enrollment period. (a) In this subsection, "preexisting
19condition" includes a preexisting disability.
SB386,3,13
1(b) Beginning in 2014, every insurer offering a Medicare supplement policy
2shall provide an annual open enrollment period during which any individual who has
3coverage under another Medicare supplement policy or who is under age 65 and
4enrolled in Medicare Part B may obtain coverage under the insurer's Medicare
5supplement policy without regard to any preexisting condition. Notwithstanding s.
6632.76 (2), an insurer may not impose any preexisting condition exclusion on an
7individual who obtains coverage under the insurer's Medicare supplement policy
8during the open enrollment period under this subsection. The beginning and ending
9dates for the annual open enrollment period under this subsection in any year shall
10be the same as the beginning and ending dates in that year of the Medicare annual,
11coordinated election period, as defined in 42 USC 1395w-21 (e) (3) (B). Each insurer
12offering a Medicare supplement policy shall post on its Internet site the beginning
13and ending dates for the annual open enrollment period under this subsection.
SB386,2 14Section 2. Initial applicability.
SB386,3,1615 (1) The treatment of section 632.843 (2) of the statutes first applies to
16individuals who enroll in Medicare Part B on the effective date of this subsection.
SB386,3,1717 (End)
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