rule implements and interprets applicable statutes for the purpose of
establishing procedures and requirements to expedite the review and approval of
blanket accident and sickness policies permitted by s.
Stats., and s.
Ins 6.75(1) (c) or
(3)RATE FILINGS. Schedules of premium rates
shall be filed in accordance with the requirements of ch. 601, Stats., and s.
Stats. The schedules of premium rates shall bear the insurer's name and shall
identify the coverages to which such rates are applicable.
In accordance with the provisions of s.
Stats., the following are eligible for blanket accident and health insurance:
1. Volunteer fire departments,
2. National guard units,
3. Newspaper delivery carriers,
4. Dependents of students,
5. Volunteer civil defense organizations,
6. Volunteer auxiliary police
7. Law enforcement
8. Cooperatives organized
under ch. 185, Stats., on a membership basis without capital stock,
9. Registered guests in a motel, hotel, or
10. Members or members and
advisors of fraternal organizations including women's auxiliaries of such
organizations and fraternal youth organizations,
11. Associations of sports officials,
12. Purchasers of protective
14. Participants in racing
15. Patrons or guests of a
recreational facility or resort.
(b) A company may submit any other risk or
class of risks, subject to approval by the commissioner, which it believes is
properly eligible for blanket accident and health insurance.
(a) Surgical benefit provisions or schedules
shall provide that the benefit for any covered surgical procedure not
specifically listed in the schedule and not excluded by the provisions of the
policy shall be determined by the company on a basis consistent with the
benefit provided for a comparable listed procedure.
(b) A policy which contains any provision
under which the claimant may elect one benefit in lieu of another shall not
limit to a specified period the time within which election may be
Wis. Admin. Code Office of the Commissioner of Insurance § Ins 3.15
Cr. Register, March,
1958, no. 27, eff. 4-1-58; am. (4) (a), cr. (5), Register, November, 1959, No.
47, eff. 12-1-59; am. (1), (3) and (4) (a), Register, October, 1961, No. 70,
eff. 11-1-61; am. (4) (a), Register, April, 1963, No. 88, eff. 5-1-63; am. (4)
(a), Register, June, 1963, No. 90, eff. 7-1-63; am. (4) (a), Register, October,
1963, No. 94, eff. 11-1-63; am. (4) (a), Register, August, 1964, No. 104, eff.
9-1-64; am. (4) (a), Register, August, 1968, No. 152, eff. 9-1-68; am. (4) (a),
Register, March, 1969, No. 159, eff. 4-1-69; am. (4) (a), Register, August,
1970, No. 176, eff. 9-1-70; am. (4) (a), renum. (5) to be (5) (a), and cr. (b),
Register, June, 1971, No. 186, eff. 7-1-71; emerg. am. (1), (3) and (4) (a),
eff. 6-22-76; am. (1), (3) and (4) (a), Register, September, 1976, No. 249,
eff. 10-1-76; r. (2), Register, January, 1980, No. 289, eff. 2-1-80; am. (1),
Register, September, 1986, No. 369, eff. 10-1-86; corrections to (4) made under
s. 13.93(2m) (b) 5 and 7., Stats., Register, April, 1992, No.