Insights

On April 15, 2020, the 2019 Wisconsin Act 185 (COVID-19 law) was signed into law by Gov. Evers. Further, on April 21, 2020, the Office of the Commissioner of Insurance issued a bulletin summarizing the COVID-19 law. Highlights of the newly enacted law are summarized below.

• Insurers who offer a defined network plan (or preferred provider plan) are required to provide coverage from nonparticipating providers when there are limitations on access to participating providers due to the public health emergency for services, treatment or supplies related to COVID-19. In the event an insured receives services, treatment or supplies related to COVID-19 from a nonparticipating provider, the plan may not require the insured to pay more than the insured would have from a participating provider.
• Insurers are prohibited from creating eligibility rules related to diagnosis of COVID-19. In addition, coverage cannot be cancelled, rate filing cannot be modified and a grace period cannot be refused based on an insured’s current or past COVID-19 diagnosis.
• Coverage for COVID-19 testing is required without cost sharing if the plan includes coverage for testing of infectious disease.
• Policies are prohibited from 1) requiring prior authorization for early refills of prescription drugs; 2) restricting the period of time that a prescription drug may be refilled; and 3) imposing a limitation on the quantity of the refill if the quantity is less than a 90-day supply.

Employers should be aware of these requirements.

2019 Wisconsin Act 185 »
Bulletin: April 21, 2020 »