HB3784sam001 98TH GENERAL ASSEMBLY

Sen. William R. Haine

Filed: 5/8/2014

09800HB3784sam001 LRB098 15215 RPM 59192 a

AMENDMENT TO HOUSE BILL 3784

AMENDMENT NO. ______. Amend House Bill 3784 by replacing everything after the enacting clause with the following:

"Section 5. The Illinois Insurance Code is amended by adding Section 357.32 as follows:

(215 ILCS 5/357.32 new)

Sec. 357.32. Coordination of benefits.

(a) No hospital, medical, or surgical expense policy shall contain any provision whereby benefits otherwise payable under the policy are subject to reduction solely on account of the existence of similar benefits provided under other accident and sickness insurance policies where such reduction would operate to reduce total benefits payable under the policies below an amount equal to 100% of the total allowable expenses provided under any of the policies.

(b) The Director may adopt rules to further implement this Section that may include an exemption for certain excepted benefits as defined in paragraph (2) of subsection (C) of Section 20 of the Illinois Health Insurance Portability and Accountability Act.

Section 10. The Health Maintenance Organization Act is amended by changing Section 5-7 as follows:

(215 ILCS 125/5-7) (from Ch. 111 1/2, par. 1415)

Sec. 5-7. Rules and regulations to carry out provisions of Act. The Director may, after notice and hearing, promulgate reasonable rules and regulations as are necessary and proper to:

(1) Establish minimum coverage standards for basic health care services, the application of which standards discriminate against no class of physician;

(2) Establish specific standards, including standards for the full and fair disclosure of health care services provided by group or nongroup contracts or evidences of coverage which may cover but shall not be limited to:

(a) Coordination of benefits

(b) Conversion

(c) Cancellation and termination

(d) Deductibles and co-payments

(e) Pre-existing conditions; and

(3) Otherwise carry out the provisions of this Act.

(Source: P.A. 86-620.)".