Wisconsin Passes COVID-19 Response Bill
Director of Employee Benefits Compliance
On April 15, 2020, the Wisconsin State Senate passed and Governor Evers signed 2019 Act 185 into law. The Act contains several provision designed to provide relief to state residents in a variety of areas during the COVID-19 pandemic. Below are the provision of the bill that impact employers and their offers of employee benefits:
- Waiting period: The bill suspends the one-week waiting period for unemployment benefits for benefit years that began after March 12, 2020, and before February 7, 2021.
- Benefit charging: Unemployment claims related to the public health emergency for weeks after March 12, 2020 and before December 31, 2020 will not be charged as normally provided. The benefits for those weeks will be charged to the unemployment reserve fund or will be paid according to the current process for benefits chargeable to reimbursable employers for those employers that do not pay contributions.
- Schedule D: The bill requires the Department of Workforce Development to request advances to the state’s unemployment reserve fund from the federal government so that Schedule D employer contribution (tax) rates remain in effect until December 31, 2021.
- Work-share programs: The bill allows changes to the program, including allowing an employer to have a work-share plan that covers any employees of the employer.
This bill provides that, for the purposes of workers’ compensation, an injury caused to a first responder, during any public health emergency declared by the governor on March 12, 2020 and ending 30 days after the termination of the order, is presumed to be caused by the individual’s employment.
The presumption requires a diagnosis or positive test for COVID-19, and may be rebutted by specific evidence that the injury was caused outside of employment.
Under the bill, the requirements that an employer provide an employee’s personnel record within seven working days after receiving the request, that the inspection be at a location near the employee’s place of employment, and that the inspection be during normal working hours are suspended during the public health emergency declared on March 12, 2020.
Prescription Order Extensions
Under the bill, pharmacists may extend a prescription during the public health emergency declared on March 12, 2020 and for 30 days after the conclusion of that public health emergency. Pharmacists will not have to contact the prescribing physician or healthcare provider for such an extension, unless the physician or healthcare provider has indicated that no refills are permitted. The pharmacist may extend the prescription by up to a 30-day supply, except that if the drug is typically packaged in a form that requires a pharmacist to dispense the drug in a quantity greater than a 30-day supply, the pharmacist may extend the prescription order as necessary to dispense the drug in the smallest quantity in which it is typically packaged. The bill allows only one extension of a prescription by a pharmacist during a public health emergency period.
Payments for Services by Out-of-Network Providers
During the public health emergency a defined network plan, including a health maintenance organization, or preferred provider plan is prohibited from requiring an enrollee of the plan to pay more for a service, treatment, or supply provided by an out-of-network provider than if the service, treatment, or supply is provided by an in-network provider. This applies to any service, treatment, or supply that is related to diagnosis or treatment for COVID-19 and any service, treatment, or supply that is provided by a provider that is not a participating provider because a participating provider is unavailable due to the public health emergency.
For a service, treatment, or supply provided under those circumstances, the bill requires the plan to reimburse the out-of-network provider at 225 percent of the federal Medicare program rate. Also under those circumstances, any health care provider or facility that provides a service, treatment, or supply to an enrollee of a plan but is not a participating provider of that plan shall accept as payment in full any payment by a plan that is at least 225 percent of the federal Medicare program rate and may not charge the enrollee an amount that exceeds the amount the provider or facility is reimbursed by the plan.
Prohibiting Coverage Discrimination Based on COVID-19 Diagnosis
Insurers that offer an individual or group health benefit plan, pharmacy benefit managers, or self-insured governmental health plans are prohibited from doing any of the following based on a current or past diagnosis or suspected diagnosis of COVID-19:
- Establishing rules for the eligibility of any individual, employer, or group to enroll or remain enrolled in a plan or for the renewal of coverage under the plan;
- Cancelling coverage during a contract term; setting rates for coverage; or refusing to grant a grace period for payment of a premium that would generally be granted.
Prohibiting Certain Prescription Drug Coverage Limits
Insurers that offer health insurance, self-insured governmental health plans, and pharmacy benefit managers are prohibited from requiring prior authorization for early refills of a prescription drug or otherwise restricting the period of time in which a prescription drug may be refilled and from imposing a limit on the quantity of prescription drugs that may be obtained if the quantity is no more than a 90-day supply. These prohibitions do not apply if the prescription drug is a controlled substance.
Coverage of COVID-19 Testing Without Cost Sharing
Every health insurance policy and every self-insured governmental health plan that generally covers testing for infectious disease is required to provide coverage of testing for COVID-19 without imposing any copayment or coinsurance before March 13, 2021.
Wisconsin Tax Law Changes
The bill includes the following changes to current Wisconsin tax law:
- Retirement Accounts: Exempts from otherwise applicable penalties certain taxable year 2020 distributions from a retirement account qualified under the Internal Revenue Code, and exempts from income taxation these distributions subject to a number of conditions.
- Charitable Contributions: Creates additional deductions, for taxable year 2020, for certain individual charitable contributions, and suspends the limitations on certain individual and corporate charitable deductions. The suspension of limitations applies to contributions made in calendar year 2020 only, although certain amounts donated in 2020 may be carried forward to future years.
- High Deductible Health Plans: Clarifies that an individual’s health insurance plan is still treated as a high deductible plan even if it fails to provide a deductible for telehealth and other remote care services.
- Paycheck Protection Loans: Conforms state law to federal law regarding the treatment of paycheck protection loans to businesses and employees under the small business administration’s loan guarantee program for the period of time from February 15, 2020, through June 30, 2020. A portion of the loans may be forgiven on a tax-free basis under certain conditions.
- Student Loan Payments: Provides an exclusion from income for certain student loan principal and interest payments made by an employer on behalf of an employee, subject to the same current law cap of $5,250 in payments for qualified educational expenses made on behalf of an employee by an employer. This provision applies to payments made from March 28, 2020, through December 31, 2020.
Wisconsin Act 185 helps codify many federal legislation provisions from the Families First Coronavirus Act (FFCRA) and the CARES Act into state law and offers several new provisions for organizations to follow during this pandemic. Organizations are encouraged to review these changes and understand how they apply to your operations.