Chapter 633, EMPLOYEE BENEFIT PLAN ADMINISTRATORS, PRINCIPALS, AND PHARMACY BENEFIT MANAGERS
15 sections in this chapter.
Wis. Stat. § 633.01 Definitions
3.0K chars
633.01 Definitions. In this chapter: (1) “Administrator” means a person who directly or indirectly solicits or collects premiums or charges or otherwise effects coverage or adjusts or settles claims for an employee benefit plan, but does not include the following persons if they …
Wis. Stat. § 633.04 Written agreement required
2.3K chars
633.04 Written agreement required. An administrator may not administer an employee benefit plan in the absence of a written agreement between the administrator and a principal. The administrator and principal shall each retain a copy of the written agreement for the duration of t…
Wis. Stat. § 633.05 Payment to administrator
0.5K chars
633.05 Payment to administrator. If a principal is an insurer, payment to the administrator of a premium or charge by or on behalf of an insured employee is payment to the insurer, but payment of a return premium or claim by the insurer to the administrator is not payment to an i…
Wis. Stat. § 633.06 Examination and inspection of books and records
0.7K chars
633.06 Examination and inspection of books and records. (1) The commissioner may examine, audit or accept an audit of the books and records of an administrator or pharmacy benefit manager as provided for examination of licensees under s. 601.43 (1), (3), (4) and (5), to be conduc…
Wis. Stat. § 633.07 Approval of advertising
0.2K chars
633.07 Approval of advertising. An administrator may not use any advertising for an employee benefit plan underwritten by an insurer unless the insurer approves the advertising in advance. History: 1991 a. 39; 2021 a. 9.
Wis. Stat. § 633.08 Underwriting responsibilities
0.3K chars
633.08 Underwriting responsibilities. If a principal is an insurer, any underwriting responsibilities regarding eligibility that the insurer has delegated to an administrator shall be set forth in the written agreement required under s. 633.04. History: 1991 a. 39.
Wis. Stat. § 633.09 Accounts
2.3K chars
633.09 Accounts. (1) MONEYS HELD IN FIDUCIARY CAPACITY. An administrator shall hold in a fiduciary capacity all moneys that the administrator collects or receives on behalf of other persons. Within 2 business days after collection or receipt of such moneys, the administrator eith…
Wis. Stat. § 633.10 Payment of claims
0.2K chars
633.10 Payment of claims. An administrator shall pay claims from funds paid to the claims paying account under s. 633.09 (4) (b) 5. on drafts or checks authorized in advance by the principal. History: 1991 a. 39.
Wis. Stat. § 633.11 Claim adjustment compensation
0.5K chars
633.11 Claim adjustment compensation. If an administrator adjusts or settles claims under an employee benefit plan, the commission, fees or charges that the principal pays the administrator may not be based on the employee benefit plan’s loss experience. This section does not pro…
Wis. Stat. § 633.12 Notification required
1.1K chars
633.12 Notification required. (1) An administrator shall prepare sufficient copies of a written notice approved in advance by the principal for distribution to all insured employees of the principal and either shall distribute the copies to the insured employees or shall provide …
Wis. Stat. § 633.13 License required
1.2K chars
633.13 License required. (1) GENERAL. Except as provided in sub. (2), a person may not perform, offer to perform or advertise any service as an administrator or a pharmacy benefit manager unless the person has obtained a license under s. 633.14. A pharmacy benefit manager that al…
Wis. Stat. § 633.14 Issuance of license
4.9K chars
633.14 Issuance of license. (1) The commissioner shall issue a license to act as an administrator to an individual who does all of the following: (a) Subject to s. 601.31 (2m), pays the fee under s. 601.31 (1) (w). (b) Supplies a bond meeting the specifications established under …
Wis. Stat. § 633.15 License; renewal, suspension, limitation, revocation, penalty
6.3K chars
633.15 License; renewal, suspension, limitation, revocation, penalty. (1) ANNUAL RENEWAL FEE. (a) Payment. An administrator or pharmacy benefit manager shall pay the annual renewal fee under s. 601.31 (1) (w) for each annual renewal of a license by the date specified by a schedul…
Wis. Stat. § 633.16 Regulation
0.4K chars
633.16 Regulation. Nothing in this chapter gives the commissioner the authority to impose requirements on an employee benefit plan that is exempt from state law under 29 USC 1144 (b). History: 1991 a. 39; Stats. 1991 s. 633.16; 2021 a. 9. The commissioner lacks authority to regul…
Wis. Stat. § 633.17 Rule-making authority
0.2K chars
633.17 Rule-making authority. The commissioner shall promulgate rules necessary for the implementation of this chapter, in addition to the rules permitted under s. 633.13 (2) and required under ss. 633.14 (3) and 633.15 (1) (b). History: 1991 a. 39.