Private Insurance Data Requirements in Wisconsin
Wisconsin regulates private insurance data and has set standards to protect enrollees’ rights and privacy. Insurers must provide a clear and conspicuous notice outlining their privacy policies regarding nonpublic personal financial information to customers.1 The privacy notice must include information about the types of information the insurer collects and the third parties to whom the insurer may disclose the information.2 The law also requires insurers to provide consumers notice of their right to opt-out of disclosure of nonpublic personal financial information to third parties.3 The law provides certain exceptions for the notice and opt-out requirements.4 Insurers are also prohibited from disclosing a consumer’s nonpublic health information unless the insurer obtains an authorization to disclose or the disclosure is for the performance of insurance functions.5 The regulations outline the requirements of an authorization and what must be included.6 Wisconsin also prohibits insurers from disclosing a consumer’s policy number or similar account code to any nonaffiliated third party for any type of marketing purposes.7
While Wisconsin imposes extensive privacy and confidentiality requirements on private health insurers, health plans have reporting obligations under the law as well. Insurers are required to retain records of consumer grievances for at least three years, and submit a grievance report to the Commissioner of Insurance annually.8 In addition, health plans must collect and turn over to the Department of Health Services, financial data, market conduct, quality indicators, and grievance data.9
Footnotes
- 1. Wis. Admin. Code Ins. §25.10
- 2. Wis. Admin. Code Ins. §25.15
- 3. Wis. Admin. Code Ins. §25.17
- 4. Wis. Admin. Code Ins. §25.50; Wis. Admin. Code Ins. §25.55; Wis. Admin. Code Ins. §25.60
- 5. W.S.A. 610.70; Wis. Admin. Code Ins. §25.70
- 6. Wis. Admin. Code Ins. §25.73
- 7. Wis. Admin. Code Ins. §25.40
- 8. Wis. Admin. Code Ins. §18.06
- 9. Wis. Admin. Code DHS §120.16