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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 9.33. Enrollee election of nonparticipating provider reimbursement.
Latest version.
- Nothing in s. Ins 9.32 changes the reimbursement payable or the amounts due, including co-payments, coinsurance, deductibles and other cost-sharing provisions from an enrollee when the enrollee of a preferred provider plan that is not a defined network plan elects to utilize the services of a nonparticipating provider when a participating provider is available in accordance with s. Ins 9.32 (2) (a) and (b) and the requirements of s. Ins 9.32 (2) (d) , are provided to the enrollee.
History:
CR 05-059
: cr.
Register February 2006 No. 602
, eff. 3-1-06;
CR 06-083
: am.
Register December 2006 No. 612
, eff. 1-1-07.