Wisconsin Statutes & Annotations
Chapter 632 - Insurance contracts in specific lines.
632.7497 - Modifications at renewal.

632.7497 Modifications at renewal.
(1) In this section, “individual major medical or comprehensive health benefit plan" includes coverage under a group policy that is underwritten on an individual basis and issued to individuals or families.
(2) An insurer that issues an individual major medical or comprehensive health benefit plan shall, at the time of a coverage renewal, at the request of an insured, permit the insured to do either of the following:
(a) Change his or her coverage to any of the following:
1. A different but comparable individual major medical or comprehensive health benefit plan currently offered by the insurer.
2. An individual major medical or comprehensive health benefit plan currently offered by the insurer with more limited benefits.
3. An individual major medical or comprehensive health benefit plan currently offered by the insurer with higher deductibles.
(b) Modify his or her existing coverage by electing an optional higher deductible, if any, under the individual major medical or comprehensive health benefit plan.
(3)
(a) The insurer may not impose any new preexisting condition exclusion under the new or modified coverage under sub. (2) that did not apply to the insured's original coverage and shall allow the insured credit under the new or modified coverage for the period of original coverage.
(b) For the new or modified coverage, the insurer may not rate for health status other than on the insured's health status at the time the insured applied for the original coverage and as the insured disclosed on the original application.
(4)
(a) Annually, the insurer shall mail to each insured under an individual major medical or comprehensive health benefit plan issued by the insurer, a notice that includes all of the following information:
1. That the insured has the right to elect alternative coverage as described in sub. (2).
2. A description of the alternatives available to the insured.
3. The procedure for making the election.
(b) The insurer shall mail the notice under par. (a) not more than 3 months nor less than 60 days before the renewal date of the insured's plan.
(5)
(a) Nothing in this section requires an insurer to issue alternative coverage under sub. (2) if the insured's coverage may be nonrenewed or discontinued under s. 632.7495 (2), (3) (b), or (4).
(b) Notwithstanding s. 600.01 (1) (b) 3. and 4., this section applies to a group health benefit plan described in s. 600.01 (1) (b) 3. or 4. if that group health benefit plan is an individual major medical or comprehensive health benefit plan as defined in sub. (1).
History: 2009 a. 28.

Structure Wisconsin Statutes & Annotations

Wisconsin Statutes & Annotations

Chapter 632 - Insurance contracts in specific lines.

632.05 - Indemnity amounts.

632.07 - Prohibiting requiring property insurance in excess of replacement value.

632.08 - Mortgage clause.

632.09 - Choice of law.

632.10 - Definitions applicable to property insurance escrow.

632.101 - Policy terms.

632.102 - Payment of final settlement.

632.103 - Procedure for payment of withheld funds.

632.104 - Funds released to mortgagee.

632.14 - Bonds need not be under seal.

632.17 - Validity of surety bonds.

632.18 - Rustproofing warranties insurance.

632.185 - Vehicle protection product warranty insurance policy.

632.22 - Required provisions of liability insurance policies.

632.23 - Prohibited exclusions in aircraft insurance policies.

632.24 - Direct action against insurer.

632.25 - Limited effect of conditions in employer's liability policies.

632.26 - Notice provisions.

632.32 - Provisions of motor vehicle insurance policies.

632.34 - Defense of noncooperation.

632.35 - Prohibited rejection, cancellation and nonrenewal.

632.36 - Accident in the course of business or employment.

632.365 - Use of emission inspection data in setting rates.

632.37 - Motor vehicle glass repair practices; restriction on specifying vendor.

632.375 - Motor vehicle repair practices; restriction on specifying vendor.

632.38 - Nonoriginal manufacturer replacement parts.

632.41 - Prohibited provisions in life insurance.

632.415 - Funeral policies.

632.42 - Trustee and deposit agreements in life insurance.

632.43 - Standard nonforfeiture law for life insurance.

632.435 - Standard nonforfeiture law for individual deferred annuities.

632.44 - Required provisions in life insurance.

632.45 - Contracts providing variable benefits.

632.46 - Incontestability and misstated age.

632.47 - Assignment of life insurance rights.

632.475 - Life insurance policy loans.

632.48 - Designation of beneficiary.

632.50 - Estoppel from medical examination.

632.56 - Required group life insurance provisions.

632.57 - Conversion option in group and franchise life insurance.

632.60 - Limitation on credit life insurance.

632.62 - Participating and nonparticipating policies.

632.63 - Unclaimed life insurance and annuities.

632.64 - Certification of disability.

632.65 - Annuities exempt from regulation.

632.66 - Annuity contracts without life contingencies.

632.67 - Effect of power of attorney for health care.

632.69 - Life settlements.

632.695 - Applicability of general transfers at death provisions.

632.697 - Benefits subject to department's right to recover.

632.71 - Estoppel from medical examination, assignability and change of beneficiary.

632.715 - Reports of action against health care provider.

632.72 - Medical benefits or assistance; assignment.

632.725 - Standardization of health care billing and insurance claim forms.

632.726 - Current procedural terminology code changes.

632.729 - Prohibiting discrimination based on COVID-19.

632.73 - Right to return policy.

632.74 - Reinstatement of individual or franchise disability insurance policies.

632.745 - Coverage requirements for group and individual health benefit plans; definitions.

632.746 - Preexisting condition; portability; restrictions; and special enrollment periods.

632.747 - Guaranteed acceptance.

632.748 - Prohibiting discrimination.

632.749 - Contract termination and renewability.

632.7495 - Guaranteed renewability of individual health insurance coverage.

632.7497 - Modifications at renewal.

632.75 - Prohibited provisions for disability insurance.

632.755 - Public assistance and early intervention services.

632.76 - Incontestability for disability insurance.

632.77 - Permitted provisions for disability insurance policies.

632.775 - Effect of power of attorney for health care.

632.78 - Required grace period for disability insurance policies.

632.79 - Notice of termination of group hospital, surgical or medical expense insurance coverage due to cessation of business or default in payment of premiums.

632.793 - Notice of loss of primary insurance coverage due to age.

632.795 - Open enrollment upon liquidation.

632.797 - Disclosure of group health claims experience.

632.798 - Out-of-pocket costs.

632.80 - Restrictions on medical payments insurance.

632.81 - Minimum standards for certain disability policies.

632.82 - Renewability of long-term care insurance policies.

632.825 - Midterm termination of long-term care insurance policy by insured.

632.83 - Internal grievance procedure.

632.835 - Independent review of coverage denial determinations.

632.84 - Benefit appeals under certain policies.

632.845 - Prohibiting refusal to cover services because liability policy may cover.

632.85 - Coverage without prior authorization for treatment of an emergency medical condition.

632.853 - Coverage of drugs and devices.

632.855 - Requirements if experimental treatment limited.

632.857 - Explanation required for restriction or termination of coverage.

632.861 - Prescription drug charges.

632.865 - Pharmacy benefit managers.

632.866 - Step therapy protocols.

632.867 - Oral and injected chemotherapy.

632.87 - Restrictions on health care services.

632.873 - Restrictions relating to fees for dental services.

632.875 - Independent evaluations relating to chiropractic treatment.

632.88 - Policy extension for handicapped children.

632.885 - Coverage of dependents.

632.89 - Coverage of mental disorders, alcoholism, and other diseases.

632.895 - Mandatory coverage.

632.896 - Mandatory coverage of adopted children.

632.897 - Hospital and medical coverage for persons insured under individual and group policies.

632.8985 - Prohibiting abortion coverage.

632.899 - Medical savings accounts study.

632.91 - Definition.

632.93 - The fraternal contract.

632.95 - Fraud in obtaining membership.

632.96 - Beneficiaries in fraternal contracts.

632.97 - Application of proceeds of credit insurance policy.

632.975 - Portable electronics insurance.

632.977 - Travel insurance.

632.98 - Worker's compensation insurance.

632.99 - Certifications of disability.