Section 611.67. Management contract services.

 

(1)  In this section:

(a) “Health maintenance organization" has the meaning given under s. 609.01 (2) .

(b) “Limited service health organization" has the meaning given under s. 609.01 (3) .

(c) “Management authority" means the authority to exercise any management control of the corporation or of its underwriting, loss adjustment, investment, general servicing or production function or other major corporate function.

(d) “Preferred provider plan" has the meaning given under s. 609.01 (4) .

(2)  Except as provided in sub. (3) , a corporation may not be a party to a contract which has the effect of delegating management authority to a person to the substantial exclusion of the board.

(3)  An insurer that offers a health maintenance organization, limited service health organization or preferred provider plan may delegate management authority with regard to the health maintenance organization, limited service health organization or preferred provider plan to a person other than an officer, director or employee of the insurer if the person exercises the management authority according to the terms of a written contract between the insurer and the person and if the contract is filed with the commissioner and not disapproved by the commissioner under sub. (4) .

(4)  

(a) The commissioner may disapprove a contract under sub. (3) within a 30-day period after the date of filing or within a reasonable extension period following the 30-day period if the extension period is specified by notice to the health care plan within the 30-day period.

(b) The commissioner may disapprove a contract under sub. (3) only if the commissioner makes one of the findings specified in s. 618.22 (2) .

1985 a. 29 . Cross-reference: See also s. Ins 42.07 , Wis. adm. code.