reglab/statecodes huggingface dataset:
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 19 - Wisconsin Healthcare Stability Plan › Section Ins 19.20 - Verification audit

Current through June 24, 2024
(1) The commissioner
			 shall conduct a verification audit of the data submitted for reinsurance
			 payment. The commissioner shall request eligible health carriers to provide
			 information, pursuant to s.
			 601.42,
			 Stats., including all of the following:
(a)
			 Supporting claims information that includes the following information:
1. A sample number of claims and specific
			 claims documentation supporting the claim for reinsurance payment. The sample
			 of underlying claims data shall demonstrate that the claims were eligible for
			 reinsurance payment.
2. Additional
			 documentation for a select number of claims, including proof of payment and
			 payment invoices for certain identified claims as specified by the
			 commissioner.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 19 - Wisconsin Healthcare Stability Plan › Section Ins 19.21 - Reinsurance payment calculation

Current through June 24, 2024
The commissioner shall calculate the dollar amounts eligible
				for reinsurance payment under s.
				601.83(4)
				(a), Stats., utilizing the information
				provided by the eligible health carriers. The commissioner shall consider all
				of the following information:
(1) The
			 commissioner shall calculate the reinsurance payment by applying the payment
			 parameters as contained in s.
			 601.83(4)
			 (a), Stats., to each eligible claim. The
			 commissioner shall provide a preliminary estimate of the reinsurance payments
			 by or before June 30, in the calendar year following the applicable benefit
			 year.
(2) In accordance with s.
			 601.83(3)
			 (c), Stats., the aggregate reinsurance
			 payments shall not exceed $200,000,000, or the amount available for the
			 applicable benefit year. If the cumulative total amount of claims across all
			 participating eligible health carriers exceeds $200,000,000, or the amount
			 available for the given benefit year under s.
			 601.83(1)
			 (h), Stats., the commissioner shall make
			 reinsurance payments in accordance with s.
			 601.83(3)
			 (c), Stats., to each eligible health carrier
			 as follows:
(a) The commissioner shall
			 calculate each carrier's eligible claims after application of the applicable
			 payment parameters and s.
			 601.83(4),
			 Stats.
(b) The commissioner shall
			 distribute reinsurance payments in an amount that is directly proportional to
			 the total available amount then apply the proportion to every participating
			 carrier's eligible paid claims amounts.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 19 - Wisconsin Healthcare Stability Plan › Section Ins 19.22 - WIHSP payment reconciliation

Current through June 24, 2024
The reconciliation period in this section means the time
				between June 30, or the date the commissioner notifies eligible health carriers
				of reinsurance payments, through December 31, of the calendar year following
				the applicable benefit year. For example, the reconciliation period for benefit
				year 2019 starts June 30, 2020, and continues through December 31, 2020. The
				following provisions apply during the reconciliation period:
(1) Eligible health carriers that receive
			 additional adjustments in claim payments or identify additional data
			 corrections during the reconciliation period shall notify the commissioner
			 within 30 days of identifying the overpayment or no later than December 31. If
			 the adjustment or data correction resulted in a WIHSP overpayment, the eligible
			 health carrier shall fully identify the claim, the amount of overpayment, and
			 either of the following as applicable:
(a) For
			 eligible health carriers submitting claims for reinsurance payment during the
			 benefit year in which the reconciliation occurs, the commissioner may reduce
			 that benefit year's reinsurance payment by the amount of overpayment.
(b) If a health carrier does not submit
			 claims for reinsurance payment during the benefit year in which the
			 reconciliation occurs, the amount of overpayment shall be remitted to the
			 commissioner at the commissioner's request.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 19 - Wisconsin Healthcare Stability Plan › Section Ins 19.24 - Compliance audit

Current through June 24, 2024
(1) The commissioner
			 may, at the commissioner's sole discretion, conduct an audit in accordance with
			 s.
			 601.83(5)
			 (f), Stats., with the reasonable audit costs
			 paid by the audited carrier pursuant to s.
			 601.45(1),
			 Stats. The commissioner shall give the carrier reasonable notice and identify
			 the scope of the audit to be conducted.
(2) Upon findings by the commissioner that an
			 eligible health carrier provided falsified data or intentionally provided
			 incomplete data, the commissioner may determine, at the commissioner's sole
			 discretion, that health carrier is ineligible for reinsurance payments for
			 subsequent benefit years. The health carrier shall be issued an order of the
			 commissioner with administrative hearing rights as contained in s.
			 227.44,
			 Stats.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 20 - Insurance marketing › Section Ins 20.01 - Home solicitation selling

Current through June 24, 2024
(1) PURPOSE.
(a) The purpose of this section is to require
			 certain disclosures by an insurance agent making home solicitation of
			 insurance.
(b) The office of the
			 commissioner of insurance has received numerous complaints indicating that
			 certain presentations may be misleading to consumers unless disclosures are
			 required. The public interest requires that these disclosures be made. The
			 commissioner finds that without these disclosures, such presentations are
			 misleading and deceptive.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 21 - Worker's compensation insurance › Section Ins 21.01 - Termination of worker's compensation insurance policies

Current through June 24, 2024
(1) PURPOSE. In
			 accordance with s.
			 631.36(1)
			 (c), Stats., this rule exempts worker's
			 compensation insurance, as defined in s.
			 Ins 6.75(2)
			 (k), from the requirements of s.
			 631.36,
			 Stats., and establishes specific requirements concerning termination of
			 worker's compensation insurance contracts.
(2) SCOPE. This section applies to all
			 worker's compensation insurance policies issued in Wisconsin. Worker's
			 compensation insurance policies may provide terms more favorable to
			 policyholders than are required by this rule.
(3) EXEMPTION. Worker's compensation
			 insurance policies are exempt from the requirements of s.
			 631.36,
			 Stats.
(4) MIDTERM CANCELLATIONS.
(a) Permissible grounds. Except as provided
			 by par. (c), no worker's compensation insurance policy may be cancelled by the
			 insurer prior to the expiration of the agreed term except for failure to pay a
			 premium due or on grounds stated in the policy, which must be comprehended
			 within one of the following classes:
1.
			 Material misrepresentation;
2.
			 Substantial change in the risk assumed, except to the extent that the insurer
			 should reasonably have foreseen the change or contemplated the risk in writing
			 the contract; or
3. Substantial
			 breaches of contractual duties, conditions or warranties.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 22 - Legal expense insurance › Section Ins 22.01 - Purpose

Current through June 24, 2024
(1) FINDINGS. The commissioner of insurance
			 finds that certain plans of legal expense coverage, although they may
			 constitute insurance plans, do not require regulation by the commissioner of
			 insurance. The conduct of the lawyers is regulated by the state supreme court
			 and, given the minimal coverage aspects of these plans, they do not require
			 regulation by the commissioner. All other forms of legal expense insurance are
			 subject to full insurance regulation.
(2) PURPOSE. This section exempts certain
			 legal expense insurance from regulation and limits the regulation of other
			 legal expense insurance plans.
(3)
			 SCOPE. This chapter applies to all legal expense insurance written in the state
			 of Wisconsin.
(4) STATUTES
			 INTERPRETED. Wisconsin Statutes interpreted and implemented by this rule are:
			 ss.
			 600.01(1)
			 (b) 5, 600.13, 601.41, 618.21, 623.11, 623.12
			 and 628.34(12), Stats.
(5)
			 DEFINITIONS.
(a) "Commissioner" means the
			 commissioner of insurance.
(b)
			 "Insurer" means any person doing an insurance business in the state as defined
			 in s.
			 618.02,
			 Stats.
(c) "Legal expense
			 insurance" means the contractual obligation to provide specific legal services
			 or to reimburse for specific legal expenses in consideration of specified
			 payment for an interval of time, regardless of whether the payment is made by
			 the beneficiary individually or by a third person for the beneficiary but does
			 not include the provision of, or reimbursement for, legal services incidental
			 to other insurance coverages.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 22 - Legal expense insurance › Section Ins 22.02 - Exemptions

Current through June 24, 2024
The provisions of chs. 600 to 655, Stats., do not apply
				to:
(1) Any lawyer referral service
			 operated by the Wisconsin state bar or a local bar association.
(2) The furnishing of legal assistance by
			 labor unions or other employe organizations to their members for matters
			 relating to employment or occupation.
(3) The furnishing of legal assistance to
			 members or their dependents by a church, cooperative, educational institution,
			 credit union, or organization of employes if:
(a) The organization is established primarily
			 for purposes other than to obtain insurance or to provide legal assistance or
			 both;
(b) The organization
			 contracts directly with a lawyer or law firm for the provision of legal
			 services; and
(c) The
			 administration and marketing of the legal services are conducted wholly by the
			 organization and solely to individuals who are members of the
			 organization.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 22 - Legal expense insurance › Section Ins 22.03 - Limited regulation

Current through June 24, 2024
(1) Legal expense insurance plans which
			 market plans which comply with all the following provisions are subject only to
			 the requirements listed in subs. (2) and (3):
(a) Except as provided by par. (c), the
			 plan's legal services are limited to advice, consultation, preparation of a
			 simple will or power of attorney or other simple, routine legal documents, and
			 do not include representation in litigation except as provided in par.
			 (c);
(b) The total annual cost
			 including all fees, charges, or other consideration for one year of coverage
			 under the plan does not exceed $200 per contract holder;
(c) Legal services other than those described
			 under par. (a) provided under the plan are charged at predetermined or reduced
			 rates which are not substantially below the usual charge by the same attorney
			 for those services, but not less than 70% of the rate usually charged
			 nonparticipants for the same service;
(d) A participant in the plan is not
			 obligated to continue participation in the plan or to make further payments or
			 to pay any fee or penalty to the plan if the participant wishes to withdraw
			 from the plan at any time;
(e) A
			 copy of the legal expense insurance contract and the form of agreement utilized
			 under par. (f) is filed with the commissioner; and
(f) All legal services are to be provided
			 either by partners, members, or employes of the plan or by individuals who have
			 a written agreement to provide legal services to plan participants, which
			 agreement includes provisions which:
1. Waive
			 any liability of plan participants for compensation for services provided by
			 the contractor if the services are covered by the plan; and
2. Require legal services must be rendered to
			 the participants regardless of any breach of the contract by the plan
			 including, but not limited to, the plan's failure to make payments or the
			 plan's insolvency.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 22 - Legal expense insurance › Section Ins 22.04 - Plans included

Current through June 24, 2024
Any legal expense insurance contract made by attorneys-at-law
				or law firms which are both promoted by mass-marketing techniques and charge a
				fee for the plan which is not based on an individual estimate of the nature,
				quantity, complexity, and amount of services to be provided each client are
				subject to this chapter unless otherwise exempted by s.
				Ins
				22.02.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 22 - Legal expense insurance › Section Ins 22.05 - Other legal expense insurance not authorized

Current through June 24, 2024
This chapter does not authorize an insurer to transact any
				insurance business, other than that of legal expense insurance exempted under
				this chapter, unless it is authorized under a certificate of authority issued
				by the commissioner under the provisions of chs. 600 to 655,
				Stats.
This rule does not preempt any plan from compliance with
				  supreme court rules including 11.06.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.10 - Definitions

Current through June 24, 2024
In this chapter:
(1)
			 "Advertisement" has the meaning given in s.
			 Ins
			 2.16(3) (a) 1.
(2) "Consideration" means remuneration of any
			 kind including, but not limited to, commission payments, cash, services,
			 benefits, bonuses, goods or the benefit of marketing efforts.
(3) "Cumulative premiums" means all sums paid
			 as consideration, net of dividends paid in cash in an orderly progression, for
			 the coverage during the first 10 years of the policy, excluding amounts which
			 are designated in the policy or certificate as providing for annuity
			 benefits.
(4) "Funeral director"
			 has the meaning given in s.
			 445.01(5),
			 Stats.
(5) "Funeral establishment"
			 has the meaning given in s.
			 445.01(6),
			 Stats.
(6) "Funeral policy" means a
			 life insurance or annuity policy sold for the purpose of funding a prearranged
			 funeral plan which is sold by an insurance intermediary who is the authorized
			 and appointed agent of the funeral director or funeral establishment providing
			 the prearranged funeral plan.
(7)
			 "Prearranged funeral plan" has the meaning given in s.
			 445.125(3m)
			 (a) 2, Stats.
(8) "Solicitation" means offering a policy
			 for sale by telephone or personal contact or by written or printed
			 communication at any location including the insurance intermediary's regular
			 place of business.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.20 - General

Current through June 24, 2024
(1) An insurance intermediary may sell a life
			 insurance or annuity policy for the purpose of funding a prearranged funeral
			 plan only if:
(a) The insurance intermediary
			 is an authorized and appointed agent under s.
			 445.125(3m),
			 Stats. of the funeral director or funeral establishment which provides the
			 prearranged funeral plan; or
(b)
			 The insurance intermediary does not, directly or indirectly, receive referrals
			 or other marketing information from a funeral director or operator of a funeral
			 establishment or an agent of the funeral director or funeral establishment,
			 sell the prearranged funeral plan, or participate in the sale of the
			 prearranged funeral plan.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.25 - Agent representation of affiliation

Current through June 24, 2024
(1) No insurance
			 intermediary may represent that he or she is affiliated with or representing a
			 funeral operator or funeral establishment unless he or she is an authorized
			 agent of the funeral operator or funeral establishment under s.
			 445.125(3m),
			 Stats.
(2) An insurer shall
			 establish reasonable procedures to prevent violations of sub. (1).
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.30 - Requirements for funeral policies

Current through June 24, 2024
(1) No insurer may
			 sell or issue a policy as a funeral policy unless all of the following occur:
(a) The policy is an individual whole life or
			 group whole life or an annuity policy.
(b) The funeral policy if issued on a
			 multi-premium basis provides an unintentional lapse provision which requires
			 written notification to the insured and to one person designated by the insured
			 to receive notification if no premium is received by the insurer during a grace
			 period of no less than 30 days.
(c)
			 The funeral policy provides that death benefits which exceed the actual final
			 costs of the burial expenses shall be paid to the insured's beneficiary or if
			 no beneficiary is named, the insured's estate.
(d) The funeral policy provides the
			 unrestricted right to return the policy or certificate within 30 days of the
			 date it is received by the policyholder. If the policyholder returns the policy
			 or certificate, the insurance contract is void and all payments made under it
			 shall be refunded directly to the policyholder by the insurer.
(e) Notification of the right to return is
			 conspicuously printed on the front page of the funeral policy or conspicuously
			 attached to the funeral policy.
(f)
			 The insurance intermediary obtains a delivery receipt from the insured when the
			 policy is given to the insured.
(g)
			 The funeral policy provides that cancellation of the prearranged funeral plan
			 does not automatically cancel the policy.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.50 - Minimum standards for claims payments under a funeral policy

Current through June 24, 2024
(1) The insurer
			 shall not pay policy death benefits to a funeral director or funeral
			 establishment unless the prearranged funeral plan is in effect at the time of
			 the insured's death.
(2) In the
			 event of the insured's death, the insurer shall not pay to the funeral director
			 or establishment more than the actual final costs billed by the funeral
			 director or funeral establishment. The remainder or excess due under the policy
			 is to be paid to the beneficiary designated by the insured to receive any
			 policy benefits which exceed the actual final costs or, if no beneficiary has
			 been designated by the insured, the insured's estate.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.60 - Requirements for advertisements of funeral policies

Current through June 24, 2024
(1) Advertisements
			 for funeral policies shall comply with all relevant statutes and rules,
			 including but not limited to ch. Ins 2.
(2) An insurer or insurance intermediary
			 placing or using or publishing an advertisement which may be utilized directly
			 or indirectly in the solicitation or sale of a funeral policy shall disclose
			 the following in a clear and conspicuous manner:
(a) That a purpose of the advertisement is
			 the solicitation of insurance.
(b)
			 That an insurance intermediary may contact any person who responds to the
			 advertisement.
(c) The identity of
			 the insurer.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.70 - Marketing procedures

Current through June 24, 2024
(1) The insurer shall establish and implement
			 written marketing procedures for funeral policies to ensure compliance with
			 solicitation, disclosure, and suitability requirements.
(2) The insurer shall train and monitor its
			 agent force to ensure compliance with the written marketing procedures and
			 provide each a copy of the written procedures.
(3) The insurer shall maintain a copy of the
			 marketing procedures.
(4) The
			 insurer shall maintain a copy of the list of funeral goods and services
			 contracted for in the prearranged funeral plan at the time of the
			 application.
(5) No insurer may
			 accept an application unless the application is complete and on a form approved
			 under s.
			 631.20,
			 Stats., and in compliance with this section.
(6) The insurer shall provide the following
			 disclosures and statements and ask the following questions on the application
			 form in print no less than 12 point type:
[Disclosures]
The total price of the prearranged funeral plan.
Whether the cost of the final expenses is or is not
				guaranteed.
The minimum dollar amount of the death benefit payable under
				the funeral policy.
1. The total
			 amount of premium the applicant will pay for the funeral policy, including
			 total premium to be paid for a multi-pay policy.
[Statements]
You should not need more than one life insurance policy to
				fund a prearranged funeral plan.
If you have an existing life insurance policy or annuity, you
				may be able to assign some or all of an existing policy's benefits to fund the
				prearranged funeral plan rather than purchase an additional insurance policy.
It may not be in your best interests to borrow on the cash
				value of an existing life insurance policy to pay the premium on a funeral
				policy that will be used to fund a prearranged funeral plan.
The life insurance or annuity policy you are purchasing may
				not fully fund the costs of the funeral goods and services provided.
[Questions]
Do you have another life insurance or annuity policy in force?
a. If so, with which company?
b. If so, do you intend to replace
			 your current insurance policy with this policy?
Do you presently have a prearranged funeral plan of any kind
				with a funeral home?
If so, do you intend to replace the funding of your existing
				prearranged plan with this policy?
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.80 - Suitability

Current through June 24, 2024
(1) An insurer shall establish written
			 suitability standards to assure that inappropriate, unsuitable or excessive
			 insurance is not sold or issued to fund prearranged funeral plans.
(2) An insurer shall require that the
			 suitability standards include, but not limited to the following:
(a) The appropriateness of using a funeral
			 policy to fund a prearranged funeral plan.
(b) The appropriateness of using an existing
			 insurance policy to fund the prearranged funeral plan.
(c) The appropriateness of replacing any
			 existing policy with a funeral policy.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 23 - Standards for insurance marketed to fund prearranged funeral plans › Section Ins 23.90 - Solicitation and disclosure requirements

Current through June 24, 2024
(1) Any insurance
			 intermediary who solicits funeral policies shall comply with all applicable
			 statutes and rules, including but not limited to s.
			 628.34(1),
			 Stats. and ch. Ins 20.
(2) Every
			 insurance intermediary intending to solicit the sale of a funeral policy shall
			 at the time of the initial contact or communication with the prospective buyer,
			 clearly and expressly disclose:
(a) The name
			 of the individual insurance intermediary who solicited the sale of the funeral
			 policy.
(b) The name of the funeral
			 home represented.
(c) A statement
			 that insurance is being sold.
(d)
			 The identity of the insurer.
(e)
			 The type of insurance being solicited.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter I - General Provisions › Section Ins 25.01 - Authority

Current through June 24, 2024
This chapter is promulgated pursuant to the authority granted
				  by ss.
				  601.41(3),
				  610.70,
				  628.34(12),
				  and
				  633.17,
				  Stats.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter I - General Provisions › Section Ins 25.02 - Purpose and scope

Current through June 24, 2024
(1) PURPOSES. This chapter governs the
				treatment of nonpublic personal health information and nonpublic personal
				financial information about individuals by all licensees of the office of the
				commissioner of insurance except to the extent that a licensee is excepted from
				a provision of this chapter. This chapter does all of the following:
(a) It requires a licensee to provide notice
				to individuals about its privacy policies and practices.
(b) It describes the conditions under which a
				licensee may disclose nonpublic personal health information and nonpublic
				personal financial information about individuals to affiliates and
				nonaffiliated third parties.
(c) It
				provides methods for individuals to prevent a licensee from disclosing that
				information.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter I - General Provisions › Section Ins 25.03 - Rule of construction

Current through June 24, 2024
The examples in this chapter and the sample clauses in
				  Appendix A of this chapter are not exclusive. Compliance with an example or use
				  of a sample clause, to the extent applicable, constitutes compliance with this
				  chapter .
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter I - General Provisions › Section Ins 25.04 - Definitions

Current through June 24, 2024
As used in this chapter, unless the context requires
				  otherwise:
(1) "Affiliate" means any
				company that controls, is controlled by or is under common control with another
				company.
(2)
(a) "Clear and conspicuous" means that a
				notice is reasonably understandable and designed to call attention to the
				nature and significance of the information in the notice.
(b) The following are examples of the
				application of "clear and conspicuous:"
1.
				`Reasonably understandable.' A licensee makes its notice reasonably
				understandable if it does all of the following:
a. Presents the information in the notice in
				clear, concise sentences, paragraphs, and sections.
b. Uses short explanatory sentences or bullet
				lists whenever possible.
c. Uses
				definite, concrete, everyday words and active voice whenever
				possible.
d. Avoids multiple
				negatives.
e. Avoids legal and
				highly technical business terminology whenever possible.
f. Avoids explanations that are imprecise and
				readily subject to different interpretations.
2. `Designed to call attention.' A licensee
				designs its notice to call attention to the nature and significance of the
				information in it if the licensee does all of the following:
a. Uses a plain-language heading to call
				attention to the notice.
b. Uses
				typeface and type sizes that are easy to read.
c. Provides wide margins and ample line
				spacing.
d. Uses boldface or
				italics for key words.
e. In a form
				that combines the licensee's notice with other information, uses distinctive
				type size, style, and graphic devices, such as shading or sidebars.
3. `Notices on web sites.' If a
				licensee provides a notice on a web page, the licensee designs its notice to
				call attention to the nature and significance of the information in it if the
				licensee uses text or visual cues to encourage scrolling down the page if
				necessary to view the entire notice and ensures that other elements on the web
				site, such as text, graphics, hyperlinks or sound, do not distract attention
				from the notice, and the licensee does any of the following:
a. Places the notice on a screen that
				consumers frequently access, such as a page on which transactions are
				conducted.
b. Places a link on a
				screen that consumers frequently access, such as a page on which transactions
				are conducted, that connects directly to the notice and is labeled
				appropriately to convey the importance, nature and relevance of the
				notice.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter II - Privacy and Opt-Out Notices for Financial Information › Section Ins 25.10 - Initial privacy notice to consumers required

Current through June 24, 2024
(1) INITIAL NOTICE
				REQUIREMENT. A licensee shall provide a clear and conspicuous notice that
				accurately reflects its privacy policies and practices regarding nonpublic
				personal financial information to all of the following:
(a) Customer. An individual who becomes the
				licensee's customer, not later than when the licensee establishes a customer
				relationship, except as provided in sub. (5).
(b) Consumer. A consumer, before the licensee
				discloses any nonpublic personal financial information about the consumer to
				any nonaffiliated third party, if the licensee makes a disclosure other than as
				authorized by ss.
				Ins
				25.55 and
				25.60.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter II - Privacy and Opt-Out Notices for Financial Information › Section Ins 25.13 - Annual privacy notice to customers required

Current through June 24, 2024
(1) ANNUAL NOTICE.
(a)
General rule.
A licensee
				shall provide a clear and conspicuous notice to customers that accurately
				reflects its privacy policies and practices with regard to nonpublic personal
				financial information not less than annually during the continuation of the
				customer relationship. Annually means at least once in any period of twelve
				consecutive months during which that relationship exists. A licensee may define
				the twelve consecutive-month period, but the licensee shall apply it to the
				customer on a consistent basis.
(b)
Example.
A licensee provides a notice annually if it defines
				the twelve consecutive-month period as a calendar year and provides the annual
				notice to the customer once in each calendar year following the calendar year
				in which the licensee provided the initial notice. For example, if a customer
				opens an account on any day of year 1, the licensee shall provide an annual
				notice to that customer by December 31 of year 2.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter II - Privacy and Opt-Out Notices for Financial Information › Section Ins 25.15 - Information to be included in privacy notices

Current through June 24, 2024
(1) GENERAL RULE.
				The initial, annual and revised privacy notices that a licensee provides under
				ss.
				Ins
				25.10,
				25.13, and shall include 25.20 all of
				the following items of information, in addition to any other information the
				licensee wishes to provide, that applies to the licensee and to the consumers
				to whom the licensee sends its privacy notice:
(a) The categories of nonpublic personal
				financial information that the licensee collects.
Note: See sample clause A-1 in Appendix A
(b) The categories of nonpublic personal
				financial information that the licensee discloses.
Note: See sample clauses A-2 and A-3 in Appendix A
(c) The categories of affiliates
				and nonaffiliated third parties to which the licensee discloses nonpublic
				personal financial information, other than those parties to whom the licensee
				discloses information under ss.
				Ins
				25.55 and
				25.60.
Note: See sample clauses A-2, A-3 and A-4 in Appendix
				  A
(d) The categories of
				nonpublic personal financial information about the licensee's former customers
				that the licensee discloses and the categories of affiliates and nonaffiliated
				third parties to whom the licensee discloses nonpublic personal financial
				information about the licensee's former customers, other than those parties to
				whom the licensee discloses information under ss.
				Ins
				25.55 and
				25.60.
Note: See sample clauses A-2 and A-3 in Appendix A
(e) If a licensee discloses
				nonpublic personal financial information to a nonaffiliated third party under
				s.
				Ins
				25.50 (and no other exception in ss.
				Ins
				25.55 and applies 25.60 to that disclosure), a
				separate description of the categories of information the licensee discloses
				and the categories of third parties with whom the licensee has contracted.
Note: See sample clauses A-5 in Appendix A
(f) An explanation of the consumer's right
				under s.
				Ins
				25.30(1) to opt out of the disclosure
				of nonpublic personal financial information to nonaffiliated third parties,
				including the methods by which the consumer may exercise that right at that
				time.
Note: See sample clauses A-6 in Appendix A
(g) Any disclosures that the licensee makes
				under Section 603(d)(2)(A)(iii) of the federal Fair Credit Reporting Act (
				15 USC
				1681 a(d)(2)(A)(iii) ) (that is, notices
				regarding the ability to opt out of disclosures of information among
				affiliates).
(h) The licensee's
				policies and practices with respect to protecting the confidentiality and
				security of nonpublic personal financial information.
Note: See sample clauses A-7 in Appendix A
(i) Any disclosure that the licensee makes
				under sub. (2).
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter II - Privacy and Opt-Out Notices for Financial Information › Section Ins 25.17 - Form of opt out notice to consumers and opt out methods

Current through June 24, 2024
(1) FORM.
(a) Form of opt out notice. If a licensee is
				required to provide an opt out notice under s.
				Ins
				25.30(1), it shall provide a clear
				and conspicuous notice to each of its consumers that accurately explains the
				right to opt out under that section. The notice shall include all of the
				following:
1. That the licensee discloses or
				reserves the right to disclose nonpublic personal financial information about
				its consumer to a nonaffiliated third party.
2. That the consumer has the right to opt out
				of that disclosure.
3. A reasonable
				means by which the consumer may exercise the opt out right.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter II - Privacy and Opt-Out Notices for Financial Information › Section Ins 25.20 - Revised privacy notices

Current through June 24, 2024
(1) GENERAL RULE. Except as otherwise
				authorized in this chapter, a licensee shall not, directly or through an
				affiliate, disclose any nonpublic personal financial information about a
				consumer to a nonaffiliated third party other than as described in the initial
				notice that the licensee provided to that consumer under s.
				Ins
				25.10, unless all of the following have occurred:
(a) The licensee has provided to the consumer
				a clear and conspicuous revised notice that accurately describes its policies
				and practices.
(b) The licensee has
				provided to the consumer a new opt out notice.
(c) The licensee has given the consumer a
				reasonable opportunity, before the licensee discloses the information to the
				nonaffiliated third party, to opt out of the disclosure.
(d) The consumer does not opt out.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter II - Privacy and Opt-Out Notices for Financial Information › Section Ins 25.25 - Delivery

Current through June 24, 2024
(1) HOW TO PROVIDE NOTICES. A licensee shall
				provide any notices that this chapter requires so that each consumer can
				reasonably be expected to receive actual notice in writing or, if the consumer
				agrees, electronically.
(2)
				EXAMPLES.
(a) Examples of reasonable
				expectation of actual notice. A licensee may reasonably expect that a consumer
				will receive actual notice of its privacy policies and practices if the
				licensee does any of the following:
1.
				Hand-delivers a printed copy of the notice to the consumer.
2. Mails a printed copy of the notice to the
				last known address of the consumer separately, or in a policy, billing or other
				written communication.
3. For a
				consumer who conducts transactions electronically, posts the notice on the
				electronic site and requires the consumer to acknowledge receipt of the notice
				as a necessary step to obtaining a particular insurance product or
				service.
4. For an isolated
				transaction with a consumer, such as the licensee providing an insurance quote
				or selling the consumer travel insurance, posts the notice and requires the
				consumer to acknowledge receipt of the notice as a necessary step to obtaining
				the particular insurance product or service.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter III - Limits on Disclosures of Financial Information › Section Ins 25.30 - Limits on disclosure of nonpublic personal financial information to nonaffiliated third parties

Current through June 24, 2024
(1) PROCESS.
(a) Conditions for disclosure. Except as
				otherwise authorized in this chapter, a licensee may not, directly or through
				any affiliate, disclose any nonpublic personal financial information about a
				consumer to a nonaffiliated third party unless all of the following have
				occurred:
1. The licensee has provided to the
				consumer an initial notice as required under s.
				Ins
				25.10.
2.
				The licensee has provided to the consumer an opt out notice as required in s.
				Ins
				25.17.
3.
				The licensee has given the consumer a reasonable opportunity, before it
				discloses the information to the nonaffiliated third party, to opt out of the
				disclosure.
4. The consumer does
				not opt out.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter III - Limits on Disclosures of Financial Information › Section Ins 25.35 - Limits on re-disclosure and reuse of nonpublic personal financial information

Current through June 24, 2024
(1) REDISCLOSURE UNDER EXCEPTION.
(a) Information the licensee receives under
				an exception. If a licensee receives nonpublic personal financial information
				from a nonaffiliated financial institution under an exception in s.
				Ins
				25.55 or
				25.60, the licensee may use or
				disclose that information only under the following conditions:
1. The licensee may disclose the information
				to the affiliates of the financial institution from which the licensee received
				the information.
2. The licensee
				may disclose the information to its affiliates, but the licensee's affiliates
				may, in turn, disclose and use the information only to the extent that the
				licensee may disclose and use the information.
3. The licensee may disclose and use the
				information pursuant to an exception in s.
				Ins
				25.55 or
				25.60, in the ordinary course of
				business to carry out the activity covered by the exception under which the
				licensee received the information.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter III - Limits on Disclosures of Financial Information › Section Ins 25.40 - Limits on sharing account number information for marketing purposes

Current through June 24, 2024
(1)
				GENERAL PROHIBITION ON DISCLOSURE OF ACCOUNT NUMBERS. A licensee shall not,
				directly or through an affiliate, disclose, other than to a consumer reporting
				agency, a policy number or similar form of access number or access code for a
				consumer's policy or transaction account to any nonaffiliated third party for
				use in telemarketing, direct mail marketing or other marketing through
				electronic mail to the consumer.
(2) EXCEPTIONS. Subsection (1) does not apply
				if a licensee discloses a policy number or similar form of access number or
				access code to any of the following:
(a) To
				the licensee's service provider solely in order to perform marketing for the
				licensee's own products or services, as long as the service provider is not
				authorized to directly initiate charges to the account.
(b) To a licensee who is a producer solely in
				order to perform marketing for the licensee's own products or
				services.
(c) To a participant in
				an affinity or similar program where the participants in the program are
				identified to the customer when the customer enters into the program.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter IV - Exceptions to Limits on Disclosure of Financial Information › Section Ins 25.50 - Exception to opt out requirements for disclosure of nonpublic personal financial information for service providers and joint marketing

Current through June 24, 2024
(1) SERVICES.
(a) General rule. The opt out requirements in
				ss.
				Ins
				25.17 and do not 25.30 apply when a licensee provides
				nonpublic personal financial information to either of the following:
1. A nonaffiliated third party to perform
				services for the licensee or functions on the licensee's behalf, if the
				licensee complies with all of the following:
a. It provides the initial notice in
				accordance with s.
				Ins
				25.10.
b.
				It enters into a contractual agreement with the third party that prohibits the
				third party from disclosing or using the information other than to carry out
				the purposes for which the licensee disclosed the information, including use
				under an exception in s.
				Ins
				25.55 or in the 25.60 ordinary course of business to
				carry out those purposes.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter IV - Exceptions to Limits on Disclosure of Financial Information › Section Ins 25.55 - Exceptions to notice and opt out requirements for disclosure of nonpublic personal financial information for processing and servicing transactions

Current through June 24, 2024
(1)
				EXCEPTIONS FOR PROCESSING TRANSACTIONS AT A CONSUMER'S REQUEST. The
				requirements for initial notice in s.
				Ins
				25.10(1) (b), the opt out in ss.
				Ins
				25.17 and
				25.30, and service providers and joint
				marketing in s.
				Ins
				25.50 do not apply if the licensee discloses nonpublic
				personal financial information as necessary to effect, administer or enforce a
				transaction that a consumer requests or authorizes, or in connection with any
				of the following:
(a) Servicing or processing
				an insurance product or service that a consumer requests or
				authorizes.
(b) Maintaining or
				servicing the consumer's account with a licensee, or with another entity as
				part of a private label credit card program or other extension of credit on
				behalf of such entity.
(c) A
				proposed or actual securitization, secondary market sale (including sales of
				servicing rights) or similar transaction related to a transaction of the
				consumer.
(d) Reinsurance or stop
				loss or excess loss insurance, including, but not limited to, for the purpose
				of placing, replacing or making a claim under reinsurance or stop-loss or
				excess loss insurance.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter V - Health Information › Section Ins 25.73 - Authorizations

Current through June 24, 2024
(1) A valid authorization to disclose
				nonpublic personal health information pursuant to this subchapter shall be in
				written or electronic form and shall contain all of the following:
(a) The identity of the consumer or customer
				who is the subject of the nonpublic personal health information.
(b) A general description of the types of
				nonpublic personal health information to be disclosed.
(c) General descriptions of the parties to
				whom the licensee discloses nonpublic personal health information, the purpose
				of the disclosure and how the information will be used.
(d) The signature of the consumer or customer
				who is the subject of the nonpublic personal health information or the
				individual who is legally empowered to grant authority and the date
				signed.
(e) Notice of the length of
				time for which the authorization is valid and that the consumer or customer may
				revoke the authorization at any time and the procedure for making a
				revocation.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter V - Health Information › Section Ins 25.75 - Authorization request delivery

Current through June 24, 2024
A request for authorization and an authorization form may be
				  delivered to a consumer or a customer as part of an opt-out notice pursuant to
				  s.
				  Ins 25.25, provided that
				  the request and the authorization form are clear and conspicuous. An
				  authorization form is not required to be delivered to the consumer or customer
				  or included in any other notices unless the licensee intends to disclose
				  protected health information pursuant to s.
				  Ins
				  25.70(1).
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 25 - Privacy Of Consumer Financial And Health Information › Subchapter V - Health Information › Section Ins 25.77 - Relationship to federal rules

Current through June 24, 2024
Irrespective of whether a licensee is subject to the federal
				  Health Insurance Portability and Accountability Act privacy rule as promulgated
				  by the U.S. Department of Health and Human Services, if a licensee complies
				  with all requirements of that rule, regardless of whether it currently applies
				  to the licensee, the licensee shall not be subject to the provisions of this
				  subchapter.