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AB623: Bill Text
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2025 - 2026 LEGISLATURE
LRB-5161/1
EKL:ads&cdc
2025 ASSEMBLY BILL 623
November 7, 2025 - Introduced by Representatives
Callahan
and
Dittrich
, cosponsored by Senator
Quinn
, by request of Office of the Commissioner of Insurance. Referred to Committee on Insurance.
AB623,1,5
1
An Act
to repeal
628.90 (3) (b);
to renumber and amend
628.90 (3) (a)
2
(intro.);
to amend
601.83 (1) (a), 628.095 (3) and (5), 628.10 (2), (3) and (5) (a)
3
and (b), 628.91, 628.92 (1) (intro.) and (d), (2) (intro.), (a) and (b), (6) and (7)
4
and 628.95 (title), (1), (2) (intro.) and (c);
to create
628.90 (3m) of the statutes;
5
relating to:
various changes to insurance laws.
Analysis by the Legislative Reference Bureau
This bill modifies various insurance statutes that are generally administered by the Office of the Commissioner of Insurance.
First, under current law, OCI administers the Wisconsin Healthcare Stability Plan pursuant to state law and a waiver from the federal government. The federal waiver was approved in 2018 and, since being renewed in 2022, is set to expire on December 31, 2028. Current law provides that, before December 31, 2023, OCI may request the waiver’s renewal so long as legislation contrary to such a request is not enacted and may not request any other change to the waiver unless directed by the legislature. The bill deletes the deadline of December 31, 2023.
Second, current law defines “navigator” to mean a natural person or entity that engages in certain activities aimed at helping people understand their options when purchasing health insurance through the federal exchange website. Current law requires that natural persons be licensed, and entities be registered, to act as navigators. Current law frequently uses the terms “individual navigator” when referring to a natural person and “navigator entity” when referring to an entity, with neither term defined in statute. Also under current law, applicants for a navigator license must submit to state and federal background checks. To clarify that the background check requirement applies only to applicants who are natural persons, the bill defines “individual navigator” to refer to natural persons and “navigator entity” to refer to entities, and substitutes these terms for the generic term “navigator.” The bill amends various statutes to consistently use this terminology, without changing their substance.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
AB623,1
1
Section
1
.
601.83 (1) (a) of the statutes is amended to read:
AB623,2,15
2
601.83
(1)
(a) The commissioner shall administer a state-based reinsurance
3
program known as the healthcare stability plan in accordance with the specific
4
terms and conditions approved by the federal department of health and human
5
services dated July 29, 2018.
Before December 31, 2023, the
The
commissioner may
6
not request from the federal department of health and human services a
7
modification, suspension, withdrawal, or termination of the waiver under
42 USC
8
18052
under which the healthcare stability plan under this subchapter operates
9
unless legislation has been enacted specifically directing the modification,
10
suspension, withdrawal, or termination.
Before December 31, 2023, the
The
11
commissioner may request renewal, without substantive change, of the waiver
12
under
42 USC 18052
under which the health care stability plan operates in
13
accordance with s. 20.940 (4) unless legislation has been enacted that is contrary to
14
such a renewal request. The commissioner shall comply with applicable timing in
15
and requirements of s. 20.940.
AB623,2
16
Section
2
.
628.095 (3) and (5) of the statutes are amended to read:
AB623,3,8
17
628.095
(3)
Required when annual fee paid.
At the time that the annual
1
fee is paid under s. 601.31 (1) (m), (nm) 2., or (np) 2., an intermediary
or navigator
2
who is a natural person
, or an individual navigator,
shall provide his or her social
3
security number unless
the intermediary or navigator
he or she
does not have a
4
social security number, and an intermediary
or navigator
that is not a natural
5
person
, or a navigator entity,
shall provide its federal employer identification
6
number, if the social security number or federal employer identification number
7
was not provided on the application for the license or registration or previously
8
when the annual fee was paid.
AB623,3,21
9
(5)
If
applicant or intermediary or navigator
natural person
has no
10
social security number.
If an
An
applicant who is a natural person
and who
does
11
not have a social security number
, the applicant
shall provide to the commissioner,
12
along with the application for a license and on a form prescribed by the department
13
of children and families, a statement made or subscribed under oath or affirmation
14
that the applicant does not have a social security number.
If an
An
intermediary
or
15
navigator
who is a natural person
and who
does not have a social security number,
16
the intermediary
or
an individual
navigator
who does not have a social security
17
number,
shall provide to the commissioner, each time that the annual fee is paid
18
under s. 601.31 (1) (m) or (nm) 2. and on a form prescribed by the department of
19
children and families, a statement made or subscribed under oath or affirmation
20
that the intermediary or
individual
navigator does not have a social security
21
number.
AB623,3
22
Section
3
.
628.10 (2), (3) and (5) (a) and (b) of the statutes are amended to
23
read:
AB623,4,10
24
628.10
(2)
Revocation, suspension, and limitation of licenses.
(a)
For
1
failure to comply with continuing education or annual training requirements.
The
2
license of any intermediary or individual navigator who fails to produce evidence of
3
compliance with continuing education standards set by the commissioner or with
4
annual training requirements is revoked, effective on the date on which the
5
evidence of compliance is due. At least 60 days before that date, the commissioner
6
shall notify the intermediary or
individual
navigator of the date by which the
7
evidence of compliance is due and that the
intermediary’s or navigator’s
license will
8
be revoked if the evidence is not received by that date. An intermediary or
9
individual
navigator whose license is revoked under this paragraph may have his or
10
her license reinstated, or may be relicensed, as provided in sub. (5).
AB623,4,18
11
(am)
Nonpayment of fees.
The license of an intermediary or individual
12
navigator who fails to pay a fee when due is revoked, effective on the date on which
13
the fee is due. At least 60 days before that date, the commissioner shall notify the
14
intermediary or
individual
navigator of the date by which the fee is due and that the
15
intermediary’s or navigator’s
license will be revoked if timely payment is not made.
16
An intermediary who is a natural person, or an individual navigator, whose license
17
is revoked under this paragraph may have his or her license reinstated, or may be
18
relicensed, as provided in sub. (5).
AB623,5,6
19
(b)
For other reasons.
Except as provided in pars. (c) to (d), after a hearing, the
20
commissioner may revoke, suspend, or limit in whole or in part the license of any
21
intermediary or individual navigator if the commissioner finds that the licensee is
22
unqualified as an intermediary or
individual
navigator, is not competent or
23
trustworthy under s. 628.04 (1) (b) 2., or has repeatedly or knowingly violated an
24
insurance statute or rule or a valid order of the commissioner under s. 601.41 (4), or
1
if the intermediary’s or
individual
navigator’s methods and practices in the conduct
2
of business endanger, or financial resources are inadequate to safeguard, the
3
legitimate interests of customers and the public. Nothing in this paragraph limits
4
the authority of the commissioner to suspend summarily
an intermediary’s or
5
individual navigator’s
the
license
of an intermediary or individual navigator
under
6
s. 227.51 (3).
AB623,5,23
7
(c)
For failure to pay support or to comply with subpoena or warrant.
The
8
commissioner shall suspend or limit the license
, including a temporary license
9
under s. 628.09,
of an intermediary who is a natural person,
the license of
or
an
10
individual navigator,
or a temporary license of a natural person under s. 628.09, if
11
the natural person
who
is delinquent in court-ordered payments of child or family
12
support, maintenance, birth expenses, medical expenses, or other expenses related
13
to the support of a child or former spouse, or
if the natural person
who
fails to
14
comply, after appropriate notice, with a subpoena or warrant issued by the
15
department of children and families or a county child support agency under s. 59.53
16
(5) and related to paternity or child support proceedings, as provided in a
17
memorandum of understanding entered into under s. 49.857.
A natural person
18
whose license or temporary license is suspended under this paragraph
An
19
intermediary or individual navigator
who satisfies the requirements under this
20
paragraph for which the license
or temporary license
was suspended may have his
21
or her license or temporary license reinstated by satisfactorily completing a
22
reinstatement application and paying the application fee for original licensure as
23
specified by rule.
AB623,6,9
24
(cm)
For liability for delinquent taxes or unemployment insurance
1
contributions.
The commissioner shall revoke the license
, including a temporary
2
license under s. 628.09,
of an intermediary or individual navigator
, including a
3
temporary license under s. 628.09,
if the department of revenue certifies under s.
4
73.0301 that the intermediary or
individual
navigator is liable for delinquent taxes
5
or if the department of workforce development certifies under s. 108.227 that the
6
intermediary or
individual
navigator is liable for delinquent unemployment
7
insurance contributions. An intermediary who is a natural person, or an individual
8
navigator, whose license is revoked under this paragraph may have his or her
9
license reinstated, or may be relicensed, as provided in sub. (5).
AB623,6,16
10
(cr)
For providing false information in statement.
The commissioner shall
11
revoke the license
, including a temporary license under s. 628.09,
of an
12
intermediary or individual navigator
, including a temporary license under s.
13
628.09,
if the commissioner determines, after a hearing, that the intermediary or
14
individual
navigator provided false information in
a
any
statement provided under
15
s. 628.095 (5)
with the intermediary’s or navigator’s application or at the time that
16
the annual fee was paid under s. 601.31 (1) (m) or (nm) 2
.
AB623,7,5
17
(d)
For failure to provide social security number, federal employer
18
identification number or statement.
If an intermediary or individual navigator fails
19
to provide a social security number or federal employer identification number as
20
required under s. 628.095 (3) or a statement as required under s. 628.095 (5), the
21
commissioner shall suspend or limit the license of the intermediary or
individual
22
navigator, effective the day following the last day on which the annual fee under s.
23
601.31 (1) (m) or (nm) 2. may be paid, if the commissioner has given the
24
intermediary or
individual
navigator reasonable notice of when the fee must be
1
paid to avoid suspension or limitation. If the intermediary or
individual
navigator
2
provides the social security number, federal employer identification number, or
3
statement within 60 days from the effective date of the suspension, the
4
commissioner shall reinstate the
intermediary’s or navigator’s
license effective as of
5
the date of suspension.
AB623,7,10
6
(e)
For changing state of residence.
The license of an intermediary or
7
individual navigator who changes residence from one state to another is revoked 60
8
days after the change of residence. The intermediary or
individual
navigator may
9
be relicensed only after satisfying any requirements under s. 628.04 or 628.92 that
10
are specified by the commissioner by rule.
AB623,7,15
11
(3)
Delay for new application.
An order revoking
an intermediary’s or
12
individual navigator’s
a
license under sub. (2) (b) or (cr) may specify a time not to
13
exceed 5 years within which the former intermediary or
individual
navigator may
14
not apply for a new license. If no time is specified, the intermediary or
individual
15
navigator may not apply for 5 years.
AB623,8,6
16
(5)
(a)
Reinstatement within 12 months.
An intermediary who is a natural
17
person, or an individual navigator, whose license is revoked under sub. (2) (a), (am),
18
or (cm) may have his or her license reinstated within 12 months after the date on
19
which the license was revoked without having to satisfy any prelicensing education
20
or examination requirements under s. 628.04 or any prelicensing training or
21
examination requirements under s. 628.92 (7). To have his or her license
22
reinstated, the intermediary or
individual
navigator must satisfy the requirement
23
under sub. (2) (a), (am), or (cm) for which the license was revoked, satisfactorily
24
complete a reinstatement application, and pay twice the amount of the applicable
1
license renewal fee. The reinstatement is effective on the date on which the
2
commissioner actually reinstates the license.
If the
An
intermediary or
individual
3
navigator
who
is
also
a resident
and
who is required to complete continuing
4
education or annual training
, the intermediary or navigator
must have satisfied all
5
previous continuing education or annual training requirements to have his or her
6
license reinstated under this paragraph.
AB623,8,13
7
(b)
Relicensing required after 12 months.
An intermediary or individual
8
navigator specified in par. (a) whose license has been revoked for more than 12
9
months is not eligible to have his or her license reinstated under par. (a) but may
10
apply for relicensing at any time after 12 months have elapsed from the date of
11
revocation. To be relicensed, the intermediary or
individual
navigator must satisfy
12
any requirements under s. 628.04 or 628.92 that are specified by the commissioner
13
by rule.
AB623,4
14
Section
4
.
628.90 (3) (a) (intro.) of the statutes is renumbered 628.90 (3)
15
(intro.) and amended to read:
AB623,8,19
16
628.90
(3)
(intro.)
Except as provided in par. (b), “navigator”
“Individual
17
navigator”
means a natural person,
or an entity that supervises or employs
18
including
a natural person
who is supervised or employed by an entity
, who does all
19
of the following:
AB623,5
20
Section
5
.
628.90 (3) (b) of the statutes is repealed.
AB623,6
21
Section
6
.
628.90 (3m) of the statutes is created to read:
AB623,8,23
22
628.90
(3m)
“Navigator entity” means an entity or organization that does all
23
of the following:
AB623,8,24
24
(a) Employs, supervises, or is affiliated with at least one individual navigator.
AB623,9,2
1
(b) Performs, and receives funding to perform, any of the activities and duties
2
identified in
42 USC 1803
1 (i) and
45 CFR 155.21
0 on behalf of the exchange.
AB623,7
3
Section
7
.
628.91 of the statutes is amended to read:
AB623,9,7
4
628.91
Requirement of licensure or registration.
No
natural
person
or
5
entity
, including an intermediary licensed under subch. II,
may act
as a navigator
6
in this state
as an individual navigator
unless licensed
under s. 628.92 (1)
or
as a
7
navigator entity unless
registered
as a navigator
under s. 628.92
(2)
.
AB623,8
8
Section
8
.
628.92 (1) (intro.) and (d), (2) (intro.), (a) and (b), (6) and (7) of the
9
statutes are amended to read:
AB623,9,16
10
628.92
(1)
Individual
navigator
license.
(intro.) A natural person
11
applying for
a
an individual
navigator license shall
make application
apply
to the
12
commissioner on a form developed by the commissioner and shall declare under
13
penalty of refusal, suspension, or revocation of the license that the statements made
14
in the application are true, correct, and complete to the best of the
individual’s
15
applicant’s
knowledge and belief. Before approving the application, the
16
commissioner shall find that the
person
applicant
satisfies all of the following:
AB623,9,20
17
(d) Has successfully passed a written examination approved by the
18
commissioner under sub. (7) that tests the applicant’s knowledge concerning the
19
duties and responsibilities of
a
an individual
navigator, the insurance laws and
20
regulations of this state, and state public assistance programs and eligibility.
AB623,9,24
21
(2)
Entity registration.
(intro.) An entity that acts or intends to operate as
22
a navigator
, supervises the activities of individual navigators, or receives funding to
23
perform such activities
entity
shall first register
as a navigator entity
with the
24
commissioner. This registration shall be on an application form developed by the
1
commissioner, which shall include such documentation as the commissioner
2
determines is necessary and appropriate. Before the commissioner may register
3
the entity
as a navigator entity
, the entity
must
shall
establish to the satisfaction of
4
the commissioner that it satisfies all of the following:
AB623,10,8
5
(a) The entity has policies and procedures in place to ensure that all acts that
6
may be performed only by
a
an individual
navigator or licensed intermediary are
7
performed by persons who are appropriately licensed under this subchapter or
8
subch. II, or both.
AB623,10,12
9
(b) The entity will assume full legal responsibility for the acts of the
10
individual navigators that it employs, supervises, or is affiliated with that are
11
performed in this state and that are within the scope of the
individual
navigator’s
12
apparent authority.
AB623,10,20
13
(6)
Fingerprints and criminal and regulatory background check
for
14
licensure as individual navigator
.
Each
applicant
natural person who applies
15
under sub. (1)
for licensure as an individual navigator shall provide fingerprints in
16
a format specified by the commissioner and complete a criminal and regulatory
17
background check as a condition for being granted
a
the
license
to act as a
18
navigator
. The commissioner shall use the fingerprints to conduct a state criminal
19
history background investigation of the applicant and a national criminal history
20
background investigation of the applicant with the federal bureau of investigation.
AB623,11,7
21
(7)
Training and examination.
An individual navigator shall complete at
22
least 16 hours of prelicensing training and satisfactorily complete an approved
23
written examination
for navigators
before applying for
an individual navigator’s
a
24
license
under sub. (1)
. After licensure, an individual navigator shall complete a
1
course of study of at least 8 hours of approved training every one-year period. The
2
commissioner may approve and designate courses and programs that an applicant
3
for a navigator’s license
may complete to fulfill the prelicensing training
4
requirement or that a
licensed navigator
licensee
may complete to fulfill the annual
5
training requirement. The commissioner may make arrangements, including
6
contracting with an outside testing service or other appropriate entity, to
7
administer examinations and collect fees.
AB623,9
8
Section
9
.
628.95 (title), (1) and (2) (intro.) and (c) of the statutes are
9
amended to read:
AB623,11,14
10
628.95
(title)
Navigator
Individual navigator, navigator entity,
and
11
nonnavigator assister conduct. (1)
General.
For purposes of this subchapter,
12
a
an individual
navigator
, navigator entity,
or nonnavigator assister, in the
13
performance of its duties, shall be considered to be transacting the business of
14
insurance.
AB623,11,16
15
(2)
Prohibited practices.
(intro.)
A
An individual
navigator
, navigator
16
entity,
or nonnavigator assister may not do any of the following:
AB623,11,21
17
(c) Make or cause to be made any communication relating to the exchange,
18
health benefit plans, an insurance contract, the insurance business, any insurer,
19
any
individual
navigator,
any navigator entity,
any nonnavigator assister, or any
20
intermediary that contains false, deceptive, or misleading information, including
21
information that is misleading because of incompleteness.
AB623,11,22
22
(end)
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