Wis. Admin. Code Office of the Commissioner of Insurance Ins 9.20

Current through November 25, 2024

Section Ins 9.20 - Scope

This subchapter applies to all insurers offering a defined network plan, preferred provider plan or limited service health organization in this state. The insurer shall ensure that the requirements of this subchapter are met by all defined network plans, preferred provider plans or limited service health organizations issued by the insurer. The commissioner may approve an exemption to this subchapter for an insurer to market a defined network plan, preferred provider plan or limited service health organization if the insurer files the plan with the commissioner and the commissioner determines that all of the following conditions are met:

(1) The coverage involves ancillary coverage with minimal cost controls, such as minimal cost controls involving vision, prescription cards or transplant centers.

(2) The cost controls are unlikely to significantly affect the pattern of practice.

(3) The exemption is consistent with the purpose of this subchapter.

Wis. Admin. Code Office of the Commissioner of Insurance Ins 9.20

Cr. Register, February, 2000, No. 530, eff. 3-1-00; CR 05-059: renum. from Ins 9.31 and am. (intro.) Register February 2006 No. 602, eff. 3-1-06; CR 06-083: am. (intro.) Register December 2006 No. 612, eff. 1-1-07.