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Wisconsin Administrative Code (Last Updated: January 10, 2017) |
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Agency Ins. Office of the Commissioner of Insurance |
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Chapter 9. Defined Network Plans |
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SubChapter III. Market Conduct Standards for Defined Network Plans, Preferred Provider Plans and Limited Service Health Organizations |
Section 9.26. Preferred provider plan subject to defined network plan regulations.
Latest version.
- An insurer offering a preferred provider plan that does not cover the same services when performed by a nonparticipating provider that it covers when those services are performed by a participating provider is subject to the requirements of a defined network plan that is not a preferred provider plan including ss. Ins 9.31 , 9.32 (1) , 9.35 (1) , 9.37 (4) , 9.40 (2) , (4) and (6) , and 18.03 (2) (c) 1. , and ss. 609.22 (2) , (3) , (4) and (7) , 609.32 (1) and 609.34 (1) , Stats.