HB3719 98TH GENERAL ASSEMBLY

  
  

 


 
98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB3719

 

Introduced , by Rep. Raymond Poe

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/5  from Ch. 127, par. 525

    Amends the State Employees Group Insurance Act of 1971. Deletes language exempting contracts entered into to provide a program of group health benefits for Medicare-primary members and their Medicare-primary dependents from a 30-day waiting period where the Commission may request information concerning the proposed contract. Effective immediately.


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A BILL FOR

 

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1    AN ACT concerning government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 5 as follows:
 
6    (5 ILCS 375/5)  (from Ch. 127, par. 525)
7    Sec. 5. Employee benefits; declaration of State policy. The
8General Assembly declares that it is the policy of the State
9and in the best interest of the State to assure quality
10benefits to members and their dependents under this Act. The
11implementation of this policy depends upon, among other things,
12stability and continuity of coverage, care, and services under
13benefit programs for members and their dependents.
14Specifically, but without limitation, members should have
15continued access, on substantially similar terms and
16conditions, to trusted family health care providers with whom
17they have developed long-term relationships through a benefit
18program under this Act. Therefore, the Director must administer
19this Act consistent with that State policy, but may consider
20affordability, cost of coverage and care, and competition among
21health insurers and providers. All contracts for provision of
22employee benefits, including those portions of any proposed
23collective bargaining agreement that would require

 

 

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1implementation through contracts entered into under this Act,
2are subject to the following requirements:
3        (i) By April 1 of each year, the Director must report
4    and provide information to the Commission concerning the
5    status of the employee benefits program to be offered for
6    the next fiscal year. Information includes, but is not
7    limited to, documents, reports of negotiations, bid
8    invitations, requests for proposals, specifications,
9    copies of proposed and final contracts or agreements, and
10    any other materials concerning contracts or agreements for
11    the employee benefits program. By the first of each month
12    thereafter, the Director must provide updated, and any new,
13    information to the Commission until the employee benefits
14    program for the next fiscal year is determined. In addition
15    to these monthly reporting requirements, at any time the
16    Commission makes a written request, the Director must
17    promptly, but in no event later than 5 business days after
18    receipt of the request, provide to the Commission any
19    additional requested information in the possession of the
20    Director concerning employee benefits programs. The
21    Commission may waive any of the reporting requirements of
22    this item (i) upon the written request by the Director. Any
23    waiver granted under this item (i) must be in writing.
24    Nothing in this item is intended to abrogate any
25    attorney-client privilege.
26        (ii) Within 30 days after notice of the awarding or

 

 

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1    letting of a contract has appeared in the Illinois
2    Procurement Bulletin in accordance with subsection (b) of
3    Section 15-25 of the Illinois Procurement Code, the
4    Commission may request in writing from the Director and the
5    Director shall promptly, but in no event later than 5
6    business days after receipt of the request, provide to the
7    Commission information in the possession of the Director
8    concerning the proposed contract. Nothing in this item is
9    intended to waive or abrogate any privilege or right of
10    confidentiality authorized by law.
11        (iii) No Except as otherwise provided in this item
12    (iii), no contract subject to this Section may be entered
13    into until the 30-day period described in item (ii) has
14    expired, unless the Director requests in writing that the
15    Commission waive the period and the Commission grants the
16    waiver in writing. This item (iii) does not apply to any
17    contract entered into after the effective date of this
18    amendatory Act of the 98th General Assembly and through
19    January 1, 2014 to provide a program of group health
20    benefits for Medicare-primary members and their
21    Medicare-primary dependents that is comparable in
22    stability and continuity of coverage, care, and services to
23    the program of health benefits offered to other members and
24    their dependents under this Act.
25        (iv) If the Director seeks to make any substantive
26    modification to any provision of a proposed contract after

 

 

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1    it is submitted to the Commission in accordance with item
2    (ii), the modified contract shall be subject to the
3    requirements of items (ii) and (iii) unless the Commission
4    agrees, in writing, to a waiver of those requirements with
5    respect to the modified contract.
6        (v) By the date of the beginning of the annual benefit
7    choice period, the Director must transmit to the Commission
8    a copy of each final contract or agreement for the employee
9    benefits program to be offered for the next fiscal year.
10    The annual benefit choice period for an employee benefits
11    program must begin on May 1 of the fiscal year preceding
12    the year for which the program is to be offered. If,
13    however, in any such preceding fiscal year collective
14    bargaining over employee benefit programs for the next
15    fiscal year remains pending on April 15, the beginning date
16    of the annual benefit choice period shall be not later than
17    15 days after ratification of the collective bargaining
18    agreement.
19        (vi) The Director must provide the reports,
20    information, and contracts required under items (i), (ii),
21    (iv), and (v) by electronic or other means satisfactory to
22    the Commission. Reports, information, and contracts in the
23    possession of the Commission pursuant to items (i), (ii),
24    (iv), and (v) are exempt from disclosure by the Commission
25    and its members and employees under the Freedom of
26    Information Act. Reports, information, and contracts

 

 

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1    received by the Commission pursuant to items (i), (ii),
2    (iv), and (v) must be kept confidential by and may not be
3    disclosed or used by the Commission or its members or
4    employees if such disclosure or use could compromise the
5    fairness or integrity of the procurement, bidding, or
6    contract process. Commission meetings, or portions of
7    Commission meetings, in which reports, information, and
8    contracts received by the Commission pursuant to items (i),
9    (ii), (iv), and (v) are discussed must be closed if
10    disclosure or use of the report or information could
11    compromise the fairness or integrity of the procurement,
12    bidding, or contract process.
13    All contracts entered into under this Section are subject
14to appropriation and shall comply with Section 20-60(b) of the
15Illinois Procurement Code (30 ILCS 500/20-60(b)).
16    The Director shall contract or otherwise make available
17group life insurance, health benefits and other employee
18benefits to eligible members and, where elected, their eligible
19dependents. Any contract or, if applicable, contracts or other
20arrangement for provision of benefits shall be on terms
21consistent with State policy and based on, but not limited to,
22such criteria as administrative cost, service capabilities of
23the carrier or other contractor and premiums, fees or charges
24as related to benefits.
25    Notwithstanding any other provisions of this Act, by
26January 1, 2014, the Department of Central Management Services,

 

 

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1in consultation with and subject to the approval of the Chief
2Procurement Officer, shall contract or make otherwise
3available a program of group health benefits for
4Medicare-primary members and their Medicare-primary
5dependents. The Director may procure a single contract or
6multiple contracts that provide a program of group health
7benefits that is comparable in stability and continuity of
8coverage, care, and services to the program of health benefits
9offered to other members and their dependents under this Act.
10The initial procurement of a contract or contracts under this
11paragraph is not subject to the provisions of the Illinois
12Procurement Code, except for Sections 20-60, 20-65, 20-70, and
1320-160 and Article 50 of that Code, provided that the Chief
14Procurement Officer may, in writing with justification, waive
15any certification required under Article 50.
16    The Director may prepare and issue specifications for group
17life insurance, health benefits, other employee benefits and
18administrative services for the purpose of receiving proposals
19from interested parties.
20    The Director is authorized to execute a contract, or
21contracts, for the programs of group life insurance, health
22benefits, other employee benefits and administrative services
23authorized by this Act (including, without limitation,
24prescription drug benefits). All of the benefits provided under
25this Act may be included in one or more contracts, or the
26benefits may be classified into different types with each type

 

 

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1included under one or more similar contracts with the same or
2different companies.
3    The term of any contract may not extend beyond 5 fiscal
4years. Upon recommendation of the Commission, the Director may
5exercise renewal options of the same contract for up to a
6period of 5 years. Any increases in premiums, fees or charges
7requested by a contractor whose contract may be renewed
8pursuant to a renewal option contained therein, must be
9justified on the basis of (1) audited experience data, (2)
10increases in the costs of health care services provided under
11the contract, (3) contractor performance, (4) increases in
12contractor responsibilities, or (5) any combination thereof.
13    Any contractor shall agree to abide by all requirements of
14this Act and Rules and Regulations promulgated and adopted
15thereto; to submit such information and data as may from time
16to time be deemed necessary by the Director for effective
17administration of the provisions of this Act and the programs
18established hereunder, and to fully cooperate in any audit.
19(Source: P.A. 98-19, eff. 6-10-13.)
 
20    Section 99. Effective date. This Act takes effect upon
21becoming law.