Wisconsin Administrative Code
Office of the Commissioner of Insurance
Chapter Ins 8 - Employee Welfare Funds; Employee Benefit Plan Administrators; Small Employer Health Insurance
Subchapter IV - Basic Health Benefit Plan For Small Employers
Section Ins 8.76 - Policy terms; exclusions; limitations
Current through August 26, 2024
(1) Except as otherwise provided in this subchapter, a plan's policy terms shall be defined consistently with the definitions in the small employer insurer's other small group health benefit plans.
(2) A plan may exclude from coverage or limit coverage for specified conditions and services other than those required under s. Ins 8.72 butmayexclude or limit only those conditions and services which are generally excluded from coverage or limited under the small employer insurer's other small group health benefit plans.
(3) A plan may apply the same limitations on provider choice, coverage and geographical service area that apply under the small employer insurer's other small group health benefit plans.
