Section 6.62. Filing requirements for multiple employer trusts and associations.

 

(1)  In this section:

(a) "Intermediary" has the meaning provided under s. 628.02 (1) , Stats.

(b)

1. "Multiple employer trust or association," except as provided by subd. 2. , means a trust, association or other person which provides or offers to provide health care benefits or coverage to employees of 2 or more employers and which is:

a. A multiple employer welfare arrangement as defined by 29 USC 1002 (40);

b. Represented as an employee welfare benefit plan which is subject to the Employee Retirement Income Security Act, 29 USC 1001 to 1461 ; or

c. Located outside this state and is not organized and regulated as an insurer domiciled in the United States.

2. "Multiple employer trust or association" does not include a person which:

a. Provides benefits or coverage under or pursuant to a collective bargaining agreement;

b. Is, or which provides benefits or coverage which are fully insured by, an insurer licensed to do business in this state;

c. Provides health care benefits or coverage solely to employees of governmental units;

d. Is an individual; or

e. The commissioner exempts in writing.

(2)  No intermediary may solicit, advertise, or market in this state or accept an application or place coverage for a person who resides in this state with a multiple employer trust or association unless prior to solicitation, advertising, marketing, acceptance of the application, or placing the coverage:

(a) The multiple employer trust or association files with the office the information required under sub. (5) ; or

(b) The intermediary files the information required under sub. (5) .

(3)  No multiple employer trust or association may solicit, advertise, or market in this state or accept an application for coverage from a person who is a resident, or who has employees who are residents, of this state unless prior to soliciting, advertising, marketing, or accepting an application it files with the office the information required under sub. (5) .

(4)  If subsequent to a filing under sub. (2) or (3) changes occur so that the information contained in the filing is no longer accurate, the multiple employer trust or association or intermediary which made the filing shall within 15 days of the date the change is effective make a filing under sub. (5) with the correct information.

(5)  A multiple employer trust or association or intermediary required to file information under sub. (2) , (3) , or (4) shall file a properly completed form prescribed by the commissioner and shall attach:

(a) A copy of any insurance policy or contract covering benefits or coverage offered by the multiple employer trust or association;

(b) A copy of the organizational documents of the multiple employer trust or association, including the articles of incorporation, bylaws or trust instrument; and

(c) A statement that the benefits or coverage are fully insured or a description of the extent to which they are not fully insured.

(6)  A violation of sub. (2) , (3) , or (4) is an unfair and deceptive trade practice under s. 628.34 (12) , Stats., constitutes a method or practice in the conduct of business which endangers the legitimate interests of customers and the public under s. 628.10 (2) , Stats., and, if the multiple employer trust or association is an unauthorized insurer, establishes that the person violating the rule should have known that the multiple employer trust or association is an unauthorized insurer for the purpose of ss. 618.39 and 618.44 , Stats.

(7)  This section is in addition to any provision of chs. 600 to 646 , Stats.

History: Emerg. cr. eff. 1-1-90; cr. Register, May, 1990, No. 413 , eff. 6-1-90

Note

This rule requires use of a reporting form "Multiple Employer Trust Filing" which may be obtained from the Office of the Commissioner of Insurance, 121 E. Wilson Street, P.O. Box 7873, Madison, Wisconsin, 53707-7873. Microsoft Windows NT 6.1.7601 Service Pack 1