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Wisconsin - Compensation & Benefit Legislation

WISCONSIN - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

WISCONSIN - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children and newborns of insured's covered dependents are included in state's newborn health care mandate.

Preventive care for children: Blood tests for lead in children under age 6.

(Wisconsin Stat. Ann. Sections 632.88, 632.895(5), 632.895(5m), 932.895(10), 632-896)

 

WISCONSIN - ALCOHOLISM & DRUG ABUSE

Mandatory coverage.

 

Minimum yearly inpatient coverage: Lesser of 30 days or $7,000 (applies to nervous and mental disorders combined with alcoholism and drug treatment).

 

Minimum yearly outpatient coverage: $2,000 (applies to nervous and mental disorders combined with alcoholism and drug treatment).

 

Minimum lifetime coverage: $10,000 or 25% of the lifetime policy limit, whichever is less.

 

(Wisconsin Stat. Ann Section 632.89)

 

WISCONSIN - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: No. Follows FUTA.

 

WISCONSIN - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

WISCONSIN - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Wisconsin Admin. Code Ins. 3.40)

 

WISCONSIN - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

WISCONSIN - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has no statutory requirements.

 

WISCONSIN - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Disability policies providing family coverage must cover adopted children as of the date of final decree or date of placement, whichever is first. (Wisconsin Stat. Ann. Section 632.896.)

 

Alcoholism, Drug Abuse, and Mental Health: Group or blanket disability policies covering hospital treatment must cover 30 days per year of inpatient treatment of mental and nervous disorders, alcoholism, and drug abuse. Policies covering outpatient treatment must cover partial hospitalization, prescribed drugs, and family interviews related to diagnosed conditions. (Wisconsin Stat. Ann. Section 632.89.)

 

Coverage Continuation and Conversion: Accident and sickness policies must provide continuation and conversion rights to employees -- other than those discharged for misconduct -- and to spouses and dependents ineligible due to a break in the marital relationship. (Wisconsin Stat. Ann. Section 632.895.)

 

Dependent Children: Disability policies may not exclude dependent children solely because they do not reside with the insureds. (Wisconsin Stat. Ann. Section 632.75(3).)

 

Grandchildren: Disability policies covering a child of the insured must cover children of that child until the child reaches age 18. (Wisconsin Stat. Ann. Section 632.895(5m).)

 

Diabetes: Disability policies covering treatment of diabetes must cover costs of installation and use of insulin infusion pumps and all other equipment or supplies, including insulin, and the cost of diabetic self-management education programs subject to the same deductible and co-insurance provisions as other covered expenses. Insulin infusion pump coverage may be limited to one pump per year. Insurer may require to use pump for 30 days before purchase. (Wisconsin Stat. Ann. Section 632.895(6).)

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while a person is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Wisconsin Stat. Ann. Section 632.88.)

 

HIV Treatment: Disability policies covering prescription medication must cover drugs prescribed for an HIV infection or related condition. (Wisconsin Stat. Ann. Section 632.895(9).)

 

Home Health Care: Disability policies covering hospital inpatient treatment on an expense incurred basis must cover at least 40 home health care visits per year on the same basis as other covered services. (Wisconsin Stat. Ann. Section 632.895(2).)

 

Kidney Disease: Disability policies covering hospital treatment on an expense incurred basis must cover hospital inpatient and outpatient kidney disease dialysis, transplants, and donor related services of at least $3,000 per year. (Wisconsin Stat. Ann. Section 632.895(4).)

 

Mammography Screening: Disability policies must cover mammography screening as described. (Wisconsin Stat. Ann. Section 632.895(8).)

 

Maternity: Group disability policies providing maternity coverage must provide such coverage to all covered persons. (Wisconsin Stat. Ann. Section 632.895(7).)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury sickness, including treatment of medically diagnosed congenital defects and birth abnormalities. (Wisconsin Stat. Ann. Section 632.895(5).) Every cooperative sickness and care association organized under this section shall provide coverage for newborn infants as required under Section 632.895(5). (Wisconsin Stat. Ann. Section 185.981.) Every disability insurance policy shall provide coverage for a newly born child of the insured from the moment of birth. (Wisconsin Stat. Ann. Section 632.895.)

 

Providers: Optometrists and Chiropractors: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Wisconsin Stat. Ann. Section 632.87(2), (3).) Health Care Practitioners: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy, unless the policy clearly excludes services rendered by such practitioners. (Wisconsin Stat. Ann. Section 632.87(1).)

 

Skilled Nursing Care: Disability policies covering hospital care must cover at least 30 days of skilled nursing care to patients entering a skilled nursing facility within 24 hours after discharge from a general hospital. (Wisconsin Stat. Ann. Section 632.895(3).)

 

Tuberculosis: Disability policies covering hospital and medical expenses must cover at least 90 days of TB inpatient treatment and outpatient dispensary charges or fees. (Wisconsin Stat. Ann. Section 632.90.)

 

WISCONSIN - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

WISCONSIN - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: No statutory requirements.

 

Minimum number of employees in group plan: No statutory requirements.

 

Employer prohibited as beneficiary: No.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: Insurer may not deny or limit coverage solely because death is caused by, or related to HIV infection.

 

(Wisconsin Stat. Ann. Sections 631.93, 632.56(5), 632.57)

 

WISCONSIN - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving. Other: If any holiday falls on Sunday, following Monday is a holiday. (Wisconsin Stat. Ann. Section 895.20)

 

WISCONSIN - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

WISCONSIN - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator may be fined not more than $200 an may be required to make full restitution to the discharged employee, including back pay and reinstatement.

 

Other Requirements: Public employees are entitled to paid leave. (Wisconsin Stat. Ann. Sections 230.35(3)(c), 756.25.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes.

 

Remedies and Penalties: Violator may be fined not more than $200 an may be required to make full restitution to the discharged employee, including back pay and reinstatement.

 

Other Requirements: If leave is due to employee's testimony in a criminal case on behalf of the employer, leave must be paid.

 

WISCONSIN - LEAVES OF ABSENCE

Employers Subject to Leave Laws: Employers with more than 50 employees.

 

Criteria for Eligibility: Employed for more than 1 year; worked 1,000 hours in 52 weeks prior to leave.

 

Maximum length of leave: Length depends upon reason for leave. 8 weeks in a 12 month period; up to 6 weeks for birth/adoption of child or care of foster child, 2 weeks for care of child/spouse/parent, and 2 weeks for employee illness.

 

Paid Leave: State does not require paid leave.

 

Acceptable Reasons for Leave: Birth/adoption of child or care of foster child; care for family member; employee's own illness.

 

Employment Guarantees After Leave: Employee is entitled to reinstatement in the position held prior to the leave or equivalent position.

 

Use of Vacation or other Time-off Benefits: Sick leave may be used first for employee illness. Vacation and sick leave may be substituted for the leave, but this will not extend the leave benefits.

 

Certification Required: Certification may be required for medical leave or to care for ill family member.

 

Effect Of Leave on Other Benefits: Health care continues during leave.

 

Effect of Seniority Accrual During Leave: Seniority does not accrue during leave.

 

Minimum Requirements for Notification to Employer: Prior notice, if possible, is required.

 

Conditions for Denial of a Request For Leave: If employee fails to properly notify employer or to provide requested certification.

 

(Wisconsin Stat. Ann. Section 103.10.)

 

See U.S. Federal Family and Medical Leave Act

 

WISCONSIN - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

WISCONSIN - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, and nurse practitioners. (Wisconsin Stat. Ann. Section 632.87)

 

WISCONSIN - MENTAL HEALTH CARE

Mandatory coverage.

 

Minimum yearly inpatient coverage: Lesser of 30 days or $7,000 (limits apply to treatment for substance abuse and mental disorders).

 

Minimum yearly outpatient coverage: $2,000 (limits apply to treatment for substance abuse and mental disorders).

 

Minimum lifetime coverage: No statutory requirements.

 

(Wisconsin Stat. Ann. Section 632.89)

 

WISCONSIN - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Minors ($3.90) and certain agriculture workers and domestics. Apprentices wages may be lowered by regulation and handicapped workers in special environments may be exempt by special license. (Wisconsin Stat. Ann. Sections 104.02, 104.04, 104.07, 104.08)

 

See U.S. Minimum Wage

 

WISCONSIN - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All employees and new hires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 or state tax withholding form (WT-4); information may be submitted by fax, magnetically, or electronically.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and federal EIN.

 

Employee information to be included: Name, address, SSN, date of birth, and date of hire.

 

Penalty for failure to report: N/A

 

(Wis. Stat. Ann. Section 103.05)

 

WISCONSIN - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: Blood tests for lead in children under age 6. (Wisconsin Stat. Ann. Sections 632.88, 632.895(5), 632.895(5m), 932.895(10), 632-896)

 

WISCONSIN - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

WISCONSIN - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, plan may not deny coverage for losses incurred more than 12 months following the effective date of coverage due to a pre-existing condition. (Wisconsin Stat. Ann. Sections 635.02, 635.05, 635.07, 635.17, 635.23, 635.29)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

WISCONSIN - PROTECTED CLASSIFICATIONS

Age:  Yes, age 40 and over.

Race:  Yes.

Color:  Yes.

National Origin: Yes.

Ancestry:  Yes.

Religion:  Yes.

Sex:  Yes.

Pregnancy:  Yes.

Sexual Harassment:  Yes.

 

(Wis. Stat. Ann. Sections 111.31, 111.32, 111.33, 111.36, 111.321, 111.322, 111.337.)

 

WISCONSIN - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

WISCONSIN - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

WISCONSIN - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Regular payday or within a month (quarter for logging and farm employees), whichever is earlier. In the event of a plant closing, all wages must be paid within 24 hours.

 

Date due if employee resigns: Regular payday or within a month (quarter for logging and farm employees), whichever is earlier.

 

Wages: Yes.

 

Vacation Pay: This benefit is not regulated in Wisconsin; Wisconsin requires an employer to honor its commitments to employees, but there is no legal requirement to pay terminated employees for unused vacation leave.

 

Holiday: This benefit is not regulated in Wisconsin; Wisconsin requires an employer to honor its commitments to employees, but there is no legal requirement to pay terminated employees for unused holiday leave.

 

Sick leave: No.

 

Severance: This benefit is not regulated in Wisconsin; Wisconsin requires an employer to honor its commitments to employees, but there is no legal requirement to pay terminated employees for severance.

 

(Wisconsin Stat. Ann. 109.01, 109.03)

 

WISCONSIN - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. During November.

 

(Wisconsin Stat. Ann. Sections 108.04, 108.09, 108.18.)

 

WISCONSIN - VACATION PAY

State reports no statutory requirements.

 

WISCONSIN - VOTING TIME OFF

3 hours. (Wisconsin Stat. Ann. Sections 6.76, 12.07, 103.18, 103.20.)

 

WISCONSIN - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments (except farm labor) if payroll is $500 or more in any calendar quarter for services in the state. Mandatory as to farmers with 6 or more employees.

 

Public Employers: Mandatory as to all employees, including state legislators. Includes certain vocational education students.

 

Exceptions: Domestic servants and casual employees.

 

Special Coverage Provisions: Voluntary as to excluded employments. Elective as to working sole proprietors, partners, and members of limited liability companies. Elective for up to 2 officers in a closely held corporation. Includes participants in community work experience program. Independent contractor is considered employee of any employer for whom they are working, except when the independent meets certain enumerated conditions.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)