Wis. Admin. Code Office of the Commissioner of Insurance Ins 6.96

Current through October 28, 2024
Section Ins 6.96 - Prohibited business practices

In addition to the prohibited acts contained in s. 628.95(2), Stats., navigators, navigator entities, nonnavigator assisters and nonnavigator assister entities are prohibited from all of the following:

(1) Providing enrollment or other specific information regarding a health benefit plan that is not offered in the federal exchange.
(2) Providing a recommendation comparing health benefit plans that may be better or worse for the consumer or employer.
(3) Making misleading statements to a consumer or employer regarding or otherwise misrepresenting one's qualifications or services.
(4) Offering a recommendation directly to a consumer or employer regarding a particular health benefit plan concerning deductible, coinsurance, or any substantive benefits, terms, or conditions of the contract.
(5) Asking or urging a consumer to apply for a particular health benefit plan from a particular insurance company.
(6) Distributing cards, documents or advertisements regarding a particular health insurer.
(7) Recommending a particular health benefit plan or insurer.
(8) Receiving consideration directly or indirectly from any health insurer in connection with the enrollment of individual or employees into a qualified health plan as defined, as amended.
(9) Using a single appointment for selling, soliciting or advising a consumer or employer about a product other than health benefit plans by a navigator or nonnavigator assister who is also a licensed insurance agent. Insurance agents shall make a separate appointment with the consumer or employer for selling, soliciting, or advising about a product other than a health benefit plan.

Wis. Admin. Code Office of the Commissioner of Insurance Ins 6.96

EmR1314: emerg. cr. eff. 9-10-13; CR 13-113: cr. Register August 2014 No. 704, eff. 9-1-14; correction in (8) made under s. 13.92(4) (b) 7 Register August 2014 No. 704.