1. (1)

   1. (a) State and local governmental entities or any persons acting on behalf of a state or local governmental entity are exempt from ss. Ins 6.91 to 6.98 provided all of the following are met:

      1. 1. All communications, advertisements, notices, or other marketing materials including verbal communications must identify the entity as working on behalf of the state or local unit of government.
      2. 2. The state or local unit of government, upon request, confirms to the commissioner that the entity is responsible or has an agreement or contract that establishes financial responsibility for the acts of the entity and the individual navigators, and nonnavigator assisters employed, supervised, or affiliated with the entity.
      3. 3. The state or local governmental entity shall not use any term or designation denoting that it is certified as a navigator, nonnavigator assister or related entity unless the person, persons, or entity using the term or designation is in compliance with ss. Ins 6.92 or 6.95 and any other applicable sections.

   2. (b) Federal governmental entities or any persons acting on behalf of a federal governmental entity through a federal contract are exempt from ss. Ins 6.91 to 6.98 provided all of the following are met:

      1. 1. All communications, advertisements, notices or other marketing materials including verbal communications must identify the entity as working on behalf of the federal government.
      2. 2. The federal government, upon request, confirms to the commissioner that the federal governmental is responsible or has an agreement or contract that establishes financial responsibility for the acts of the entity and the individual navigators, and nonnavigator assisters employed, supervised or affiliated with the entity.

      3. 3. The state or local unit of [federal] governmental entity shall not use any term or designation denoting that it is certified as a navigator, nonnavigator assister or related entity unless the person, persons, or entity using the term or designation is in compliance with ss. Ins 6.92 or 6.95 and any other applicable sections.

         Note: “Federal” shown in brackets should have replaced “state or local unit of”. The office intends to correct this error in future rulemaking.

   3. (c)

      1. 1. Employees of a health care facility, including hospitals, clinics and other health care facilities are exempt from ss. Ins 6.91 to 6.98 if as part of their employment they provide assistance to patients including assistance with enrollment in state or federal assistance programs.

      2. 2. The health care facility, including hospitals, clinics and other health care facilities shall not use any term or designation denoting that it is certified as a navigator, nonnavigator assister or related entity unless the person, persons or entity using the term or designation is in compliance with ss. Ins 6.92 or 6.95 and any other applicable sections.

         APPENDIX I
         KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS
         PROBLEMS WITH YOUR INSURANCE?—If you are having problems with your insurance company or agent, do not hesitate to contact the insurance company or agent to resolve your problem.
         (INSURER NAME)
         (CUSTOMER SERVICE)
         (ADDRESS)
         (CITY, STATE, ZIP)
         (TOLL FREE TELEPHONE NUMBER, if available)
         (TELEPHONE NUMBER)
         You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a state agency which enforces Wisconsin’s insurance laws, and file a complaint. You can file a complaint electronically with the OFFICE OF THECOMMISSIONER OF INSURANCE at its website at http://oci.wi.gov/, or by contacting:
         Office of the Commissioner of Insurance
         Complaints Department
         P. O. Box 7873
         Madison, WI 53707-7873
         1-800-236-8517
         608-266-0103.
         

         APPENDIX 2
         You may resolve your problem by taking the steps outlined in your HMO grievance procedure. You may also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a state agency which enforces
         Wisconsin’s insurance laws, and file a complaint. You can file a complaint electronically with the OFFICE OF THE
         COMMISSIONER OF INSURANCE at its website at http://oci.wi.gov/, or by writing to:

         Office of the Commissioner of Insurance
         Complaints Department
         P. O. Box 7873
         Madison, WI 53707-7873

         or you can call 1-800-236-8517 outside of Madison or 266-0103 in Madison, and request a complaint form.

History

History: EmR1314: emerg. cr. eff. 9-10-13; CR 13-113: cr. Register August 2014 No. 704, eff. 9-1-14.