Wis. Admin. Code Office of the Commissioner of Insurance Ins 8.63

Current through May 28, 2024
Section Ins 8.63 - Small employer insurers shall offer coverage to late enrollees
(1) A small employer insurer shall provide under a policy for an enrollment period during which a late enrollee is entitled to enroll in coverage under the policy. The small employer insurer shall provide an enrollment period of at least 30 days after the date the late enrollee requests coverage and is notified of the opportunity to enroll.
(2) A small employer insurer may exclude coverage of a late enrollee who elects coverage for no more than 18 months or provide for up to an 18-month preexisting condition exclusion, but if both a period of exclusion from coverage and a preexisting condition exclusion are applied by the small employer insurer under the policy the combined period may not exceed 18 months from the date the individual applies for coverage under the policy. A small employer insurer may require that the late enrollee remain continuously employed by, or remain a dependent of an eligible employee continuously employed by, the small employer for the entire period of exclusion permitted under this subsection. A small employer insurer may not impose a preexisting condition exclusion under s. 635.17(1), Stats., in addition to an exclusion permitted under this subsection.

Note: 1995 Wis. Act 289 repealed s. 635.17, Stats. See s. 632.746(1), Stats.

(3) A small employer insurer may assess a risk load to the premium rate associated with a late entrant, consistent with the requirements of s. 635.05, Stats., and s. Ins 8.52(3) (d).

Wis. Admin. Code Office of the Commissioner of Insurance Ins 8.63

Cr. Register, November, 1993, No. 455, eff. 2-1-94.