Wisconsin Administrative Code (Last Updated: January 10, 2017) |
Agency Ins. Office of the Commissioner of Insurance |
Chapter 9. Defined Network Plans |
SubChapter III. Market Conduct Standards for Defined Network Plans, Preferred Provider Plans and Limited Service Health Organizations |
SubChapter III. Market Conduct Standards for Defined Network Plans, Preferred Provider Plans and Limited Service Health Organizations
Section 9.20. Scope. |
Section 9.21. Limited exemptions. |
Section 9.25. Preferred provider plan same service provisions. |
Section 9.26. Preferred provider plan subject to defined network plan regulations. |
Section 9.27. Preferred provider plan requirements. |
Section 9.30. Group and blanket health insurers compliance. |
Section 9.31. Annual certification of access standards. |
Section 9.32. Defined network plan requirements. |
Section 9.33. Enrollee election of nonparticipating provider reimbursement. |
Section 9.35. Continuity of care. |
Section 9.36. Gag clauses. |
Section 9.37. Notice requirements. |
Section 9.38. Policy and certificate language requirements. |
Section 9.39. Disenrollment. |
Section 9.40. Required quality assurance and remedial action plans. |
Section 9.41. Right of the commissioner to request OCI complaints be handled as grievances. |
Section 9.42. Compliance program requirements. |