609.97 Compulsory and security surplus.
(1) Amount of compulsory surplus. Except as otherwise provided by rule or order under sub. (2), a health maintenance organization insurer, whether first licensed or organized before, on or after July 1, 1989, shall maintain a compulsory surplus in an amount determined as follows:
(a) Beginning on July 1, 1989, and ending on December 31, 1989, the compulsory surplus shall be equal to at least the greater of $200,000 or 3 percent of the premiums earned by the health maintenance organization insurer in the previous 12 months.
(b) Beginning on January 1, 1990, and ending on December 31, 1991, the compulsory surplus shall be equal to at least the greater of $500,000 or:
1. If before January 1, 1991, 3 percent of the premiums earned by the health maintenance organization insurer in the previous 12 months.
2. If on or after January 1, 1991:
a. If the percentage of the liabilities of the health maintenance organization insurer that are covered liabilities is less than 90 percent, 4.5 percent of the premiums earned by the health maintenance organization insurer in the previous 12 months.
b. If the percentage of the liabilities of the health maintenance organization insurer that are covered liabilities is at least 90 percent, 3 percent of the premiums earned by the health maintenance organization insurer in the previous 12 months.
(c) Beginning on January 1, 1992, the compulsory surplus shall be equal to at least the greater of $750,000 or:
1. If the percentage of the liabilities of the health maintenance organization insurer that are covered liabilities is less than 90 percent, 6 percent of the premiums earned by the health maintenance organization insurer in the previous 12 months.
2. If the percentage of the liabilities of the health maintenance organization insurer that are covered liabilities is at least 90 percent, 3 percent of the premiums earned by the health maintenance organization insurer in the previous 12 months.
(2) Modification by rule or order. The commissioner may require a greater amount or permit a lesser amount than that specified under sub. (1) by rule promulgated, or order issued, on or after July 1, 1989. The commissioner may consider the risks and factors described under s. 623.11 (1) (a) and (b) in promulgating a rule or issuing an order under this subsection.
(3) Amount of security surplus. A health maintenance organization insurer, whether first licensed or organized before, on or after July 1, 1989, shall maintain a security surplus in the amount set by the commissioner under s. 623.12.
History: 1989 a. 23.
Structure Wisconsin Statutes & Annotations
Wisconsin Statutes & Annotations
Chapter 609 - Defined network plans.
609.001 - Joint ventures; legislative findings.
609.03 - Indication of operations.
609.05 - Primary provider and referrals.
609.10 - Standard plan and point-of-service option plan required.
609.17 - Reports of disciplinary action.
609.20 - Rules for preferred provider and defined network plans.
609.205 - Public health emergency for COVID-19.
609.30 - Provider disclosures.
609.34 - Clinical decision-making; medical director.
609.35 - Applicability of requirements to preferred provider plans.
609.36 - Data systems and confidentiality.
609.65 - Coverage for court-ordered services for the mentally ill.
609.655 - Coverage of certain services provided to dependent students.
609.70 - Chiropractic coverage.
609.71 - Disclosure of payments.
609.715 - Coverage of alcoholism and other diseases.
609.717 - Mental health services provided by a recovery charter school.
609.75 - Adopted children coverage.
609.755 - Coverage of dependents.
609.76 - Coverage of student on medical leave.
609.77 - Coverage of breast reconstruction.
609.78 - Coverage of treatment for the correction of temporomandibular disorders.
609.79 - Coverage of hospital and ambulatory surgery center charges and anesthetics for dental care.
609.80 - Coverage of mammograms.
609.805 - Coverage of contraceptives.
609.81 - Coverage related to HIV infection.
609.82 - Coverage without prior authorization for emergency medical condition treatment.
609.83 - Coverage of drugs and devices.
609.837 - Copayment equality for oral and injected chemotherapy.
609.84 - Experimental treatment.
609.846 - Discrimination based on COVID-19 prohibited.
609.85 - Coverage of lead screening.
609.87 - Coverage of treatment for autism spectrum disorders.
609.875 - Coverage of colorectal cancer screening.
609.88 - Coverage of immunizations.
609.885 - Coverage of COVID-19 testing.
609.89 - Written reason for coverage denial.
609.90 - Restrictions related to domestic abuse.
609.91 - Restrictions on recovering health care costs.
609.92 - Hospitals, individual practice associations and providers of physician services.
609.925 - Election to be subject to restrictions.
609.93 - Scope of election by an individual practice association or clinic.
609.935 - Notices of election and termination.
609.94 - Summary of restrictions.
609.95 - Minimum covered liabilities.
609.96 - Initial capital and surplus requirements.