Section 601.42. Reports and replies.

 

(1g)   Reports. The commissioner may require any of the following from any person subject to regulation under chs. 600 to 655 :

(a) Statements, reports, answers to questionnaires and other information, and evidence thereof, in whatever reasonable form the commissioner designates, and at such reasonable intervals as the commissioner chooses, or from time to time.

(b) Full explanation of the programming of any data storage or communication system in use.

(c) That information from any books, records, electronic data processing systems, computers or any other information storage system be made available to the commissioner at any reasonable time and in any reasonable manner.

(d) Statements, reports, answers to questionnaires or other information, or reports, audits or certification from a certified public accountant or an actuary approved by the commissioner, relating to the extent liabilities of a health maintenance organization insurer are or will be liabilities for health care costs for which an enrollee or policyholder of the health maintenance organization is not liable to any person under s. 609.91 .

(1r)   Reports by individual practice associations. The commissioner may by rule require that an individual practice association submit to the commissioner information reasonably necessary to determine the financial condition of the individual practice association. The information required under this subsection may include, but is not limited to, financial statements of the individual practice association, except the commissioner may not require members of the individual practice association or other health care providers who contract with the individual practice association to submit individual financial statements.

(2)   Forms. The commissioner may prescribe forms for the reports under subs. (1g) and (1r) and specify who shall execute or certify such reports. The forms for the reports required under sub. (1g) shall be consistent, so far as practicable, with those prescribed by other jurisdictions.

(3)   Accounting methods. The commissioner may prescribe reasonable minimum standards and techniques of accounting and data handling to ensure that timely and reliable information will exist and will be available to the commissioner.

(4)   Replies. Any officer, manager or general agent of any insurer authorized to do or doing an insurance business in this state, any person controlling or having a contract under which the person has a right to control such an insurer, whether exclusively or otherwise, any person with executive authority over or in charge of any segment of such an insurer's affairs, any individual practice association or officer, director or manager of an individual practice association, any insurance agent or other person licensed under chs. 600 to 646 , any provider of services under a continuing care contract, as defined in s. 647.01 (2) , any independent review organization certified or recertified under s. 632.835 (4) or any health care provider, as defined in s. 655.001 (8) , shall reply promptly in writing or in other designated form, to any written inquiry from the commissioner requesting a reply.

(5)   Verification. The commissioner may require that any communication made to the commissioner under this section be verified.

(6)   Immunity.

(a) In the absence of actual malice, no communication to the commissioner required by law or by the commissioner shall subject the person making it to an action for damages for defamation. This paragraph applies to communications received by the commissioner before May 11, 1990, or on or after June 1, 1994.

(b) In the absence of actual malice, no communication to the commissioner or office required by law or by the commissioner shall subject the person making it to an action for damages for the communication. This paragraph applies to communications received by the commissioner or office on or after May 11, 1990, and before June 1, 1994.

(7)   Experts. The commissioner may employ experts to assist the commissioner in an examination or in the review of any transaction subject to approval under chs. 600 to 646 . The person that is the subject of the examination, or that is a party to a transaction under review, including the person acquiring, controlling or attempting to acquire the insurer, shall pay the reasonable costs incurred by the commissioner for the expert and related expenses.

1977 c. 339 s. 43 ; 1979 c. 89 ; 1979 c. 102 ss. 69 , 236 (8) , (21); 1979 c. 177 ; 1983 a. 358 ss. 9 , 14 ; 1987 a. 247 ; 1989 a. 23 ; 1989 a. 187 ss. 1m , 29 ; 1989 a. 332 ; 1991 a. 316 ; 1997 a. 237 ; 1999 a. 30 , 155 . Cross-reference: See also s. 623.02 as to standards for accounting rules. Cross-reference: See also ss. Ins 6.61 , 6.62 , and 6.63 , Wis. adm. code.