609.98 Special deposit.
(1) Definition. In this section, “premiums" has the meaning given under s. 646.51 (1c) (c).
(2) Duty; amount.
(a) Before April 1, 1990, and before April 1 of each following year, a health maintenance organization insurer shall deposit under s. 601.13 an amount that is at least equal to the lesser of the following:
1. An amount necessary to establish or maintain a deposit equaling 1 percent of premiums written in this state by the health maintenance organization insurer in the preceding calendar year.
2. With respect to the amount due before April 1, 1990, 0.5 percent of premiums written in this state by the health maintenance organization insurer in the preceding calendar year, unless otherwise provided by rule or order under par. (b).
3. With respect to the amount due in the years after 1990, one-third of 1 percent of the premiums written in this state by the health maintenance organization insurer in the preceding calendar year, unless otherwise provided by rule or order under par. (b).
(b) The commissioner may, by rule or order, require that the deposit under par. (a) be in an amount greater than that provided under par. (a) 2. or 3., but the commissioner may not require an amount exceeding the amount provided under par. (a) 1.
(3) Status of deposit. A deposit under this section is in addition to any deposit otherwise required or permitted by law or the commissioner. An amount deposited under this section is not available for the purpose of determining permanent capital or surplus, compulsory surplus or the financial condition, including insolvency, of the health maintenance organization insurer.
(4) Release of deposit. A deposit under this section may be released only with the approval of the commissioner under s. 601.13 (10) and only in any of the following circumstances:
(a) To pay an assessment under s. 646.51 (3) (am).
(b) To the extent that the amount on deposit exceeds 1 percent of premiums written in this state by the health maintenance organization insurer in the preceding calendar year and the deposit is not necessary to pay an assessment under s. 646.51 (3) (am).
(c) To pay claimants and creditors as provided by s. 601.13 (2).
History: 1989 a. 23; 2003 a. 261.
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.