093_HB3595 LRB093 09876 JLS 10124 b 1 AN ACT concerning pharmaceutical benefits. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Illinois Insurance Code is amended by 5 adding Section 356z.4 as follows: 6 (215 ILCS 5/356z.4 new) 7 Sec. 356z.4. Immunosuppresive agents. A group or 8 individual policy of accident and health insurance amended, 9 delivered, issued, or renewed after the effective date of 10 this amendatory Act of the 93rd General Assembly that 11 provides coverage for organ transplants must provide coverage 12 for immunosuppresive agents (anti-rejection medications). If 13 the policy provides coverage for prescription drugs through 14 the use of a drug formulary, the generic immunosuppresive 15 agents must be included with the drug formulary. If the 16 immunosuppresive agent is non-generic it must be included in 17 the drug formulary as the least expensive co-payment level 18 higher than the co-payment required for generic drugs. 19 Section 10. The Comprehensive Health Insurance Plan Act 20 is amended by changing Section 8 as follows: 21 (215 ILCS 105/8) (from Ch. 73, par. 1308) 22 Sec. 8. Minimum benefits. 23 a. Availability. The Plan shall offer in an annually 24 renewable policy major medical expense coverage to every 25 eligible person who is not eligible for Medicare. Major 26 medical expense coverage offered by the Plan shall pay an 27 eligible person's covered expenses, subject to limit on the 28 deductible and coinsurance payments authorized under 29 paragraph (4) of subsection d of this Section, up to a 30 lifetime benefit limit of $1,000,000 per covered individual. -2- LRB093 09876 JLS 10124 b 1 The maximum limit under this subsection shall not be altered 2 by the Board, and no actuarial equivalent benefit may be 3 substituted by the Board. Any person who otherwise would 4 qualify for coverage under the Plan, but is excluded because 5 he or she is eligible for Medicare, shall be eligible for any 6 separate Medicare supplement policy or policies which the 7 Board may offer. 8 b. Outline of benefits. Covered expenses shall be 9 limited to the usual and customary charge, including 10 negotiated fees, in the locality for the following services 11 and articles when prescribed by a physician and determined by 12 the Plan to be medically necessary for the following areas of 13 services, subject to such separate deductibles, co-payments, 14 exclusions, and other limitations on benefits as the Board 15 shall establish and approve, and the other provisions of this 16 Section: 17 (1) Hospital services, except that any services 18 provided by a hospital that is located more than 75 miles 19 outside the State of Illinois shall be covered only for a 20 maximum of 45 days in any calendar year. With respect to 21 covered expenses incurred during any calendar year ending 22 on or after December 31, 1999, inpatient hospitalization 23 of an eligible person for the treatment of mental illness 24 at a hospital located within the State of Illinois shall 25 be subject to the same terms and conditions as for any 26 other illness. 27 (2) Professional services for the diagnosis or 28 treatment of injuries, illnesses or conditions, other 29 than dental and mental and nervous disorders as described 30 in paragraph (17), which are rendered by a physician, or 31 by other licensed professionals at the physician's 32 direction. This includes reconstruction of the breast on 33 which a mastectomy was performed; surgery and 34 reconstruction of the other breast to produce a -3- LRB093 09876 JLS 10124 b 1 symmetrical appearance; and prostheses and treatment of 2 physical complications at all stages of the mastectomy, 3 including lymphedemas. 4 (2.5) Professional services provided by a physician 5 to children under the age of 16 years for physical 6 examinations and age appropriate immunizations ordered by 7 a physician licensed to practice medicine in all its 8 branches. 9 (3) (Blank). 10 (4) Outpatient prescription drugs that by law 11 require a prescription written by a physician licensed to 12 practice medicine in all its branches subject to such 13 separate deductible, copayment, and other limitations or 14 restrictions as the Board shall approve, including the 15 use of a prescription drug card or any other program, or 16 both. 17 (5) Skilled nursing services of a licensed skilled 18 nursing facility for not more than 120 days during a 19 policy year. 20 (6) Services of a home health agency in accord with 21 a home health care plan, up to a maximum of 270 visits 22 per year. 23 (7) Services of a licensed hospice for not more 24 than 180 days during a policy year. 25 (8) Use of radium or other radioactive materials. 26 (9) Oxygen. 27 (10) Anesthetics. 28 (11) Orthoses and prostheses other than dental. 29 (12) Rental or purchase in accordance with Board 30 policies or procedures of durable medical equipment, 31 other than eyeglasses or hearing aids, for which there is 32 no personal use in the absence of the condition for which 33 it is prescribed. 34 (13) Diagnostic x-rays and laboratory tests. -4- LRB093 09876 JLS 10124 b 1 (14) Oral surgery (i) for excision of partially or 2 completely unerupted impacted teeth when not performed in 3 connection with the routine extraction or repair of 4 teeth; (ii) for excision of tumors or cysts of the jaws, 5 cheeks, lips, tongue, and roof and floor of the mouth; 6 (iii) required for correction of cleft lip and palate and 7 other craniofacial and maxillofacial birth defects; or 8 (iv) for treatment of injuries to natural teeth or a 9 fractured jaw due to an accident. 10 (15) Physical, speech, and functional occupational 11 therapy as medically necessary and provided by 12 appropriate licensed professionals. 13 (16) Emergency and other medically necessary 14 transportation provided by a licensed ambulance service 15 to the nearest health care facility qualified to treat a 16 covered illness, injury, or condition, subject to the 17 provisions of the Emergency Medical Systems (EMS) Act. 18 (17) Outpatient services for diagnosis and 19 treatment of mental and nervous disorders provided that a 20 covered person shall be required to make a copayment not 21 to exceed 50% and that the Plan's payment shall not 22 exceed such amounts as are established by the Board. 23 (18) Human organ or tissue transplants specified by 24 the Board that are performed at a hospital designated by 25 the Board as a participating transplant center for that 26 specific organ or tissue transplant, including 27 immunosuppresive agents as required under Section 356z.4 28 of the Illinois Insurance Code. 29 (19) Naprapathic services, as appropriate, provided 30 by a licensed naprapathic practitioner. 31 c. Exclusions. Covered expenses of the Plan shall not 32 include the following: 33 (1) Any charge for treatment for cosmetic purposes 34 other than for reconstructive surgery when the service is -5- LRB093 09876 JLS 10124 b 1 incidental to or follows surgery resulting from injury, 2 sickness or other diseases of the involved part or 3 surgery for the repair or treatment of a congenital 4 bodily defect to restore normal bodily functions. 5 (2) Any charge for care that is primarily for rest, 6 custodial, educational, or domiciliary purposes. 7 (3) Any charge for services in a private room to 8 the extent it is in excess of the institution's charge 9 for its most common semiprivate room, unless a private 10 room is prescribed as medically necessary by a physician. 11 (4) That part of any charge for room and board or 12 for services rendered or articles prescribed by a 13 physician, dentist, or other health care personnel that 14 exceeds the reasonable and customary charge in the 15 locality or for any services or supplies not medically 16 necessary for the diagnosed injury or illness. 17 (5) Any charge for services or articles the 18 provision of which is not within the scope of licensure 19 of the institution or individual providing the services 20 or articles. 21 (6) Any expense incurred prior to the effective 22 date of coverage by the Plan for the person on whose 23 behalf the expense is incurred. 24 (7) Dental care, dental surgery, dental treatment, 25 any other dental procedure involving the teeth or 26 periodontium, or any dental appliances, including crowns, 27 bridges, implants, or partial or complete dentures, 28 except as specifically provided in paragraph (14) of 29 subsection b of this Section. 30 (8) Eyeglasses, contact lenses, hearing aids or 31 their fitting. 32 (9) Illness or injury due to acts of war. 33 (10) Services of blood donors and any fee for 34 failure to replace the first 3 pints of blood provided to -6- LRB093 09876 JLS 10124 b 1 a covered person each policy year. 2 (11) Personal supplies or services provided by a 3 hospital or nursing home, or any other nonmedical or 4 nonprescribed supply or service. 5 (12) Routine maternity charges for a pregnancy, 6 except where added as optional coverage with payment of 7 an additional premium for pregnancy resulting from 8 conception occurring after the effective date of the 9 optional coverage. 10 (13) (Blank). 11 (14) Any expense or charge for services, drugs, or 12 supplies that are: (i) not provided in accord with 13 generally accepted standards of current medical practice; 14 (ii) for procedures, treatments, equipment, transplants, 15 or implants, any of which are investigational, 16 experimental, or for research purposes; (iii) 17 investigative and not proven safe and effective; or (iv) 18 for, or resulting from, a gender transformation 19 operation. 20 (15) Any expense or charge for routine physical 21 examinations or tests except as provided in item (2.5) of 22 subsection b of this Section. 23 (16) Any expense for which a charge is not made in 24 the absence of insurance or for which there is no legal 25 obligation on the part of the patient to pay. 26 (17) Any expense incurred for benefits provided 27 under the laws of the United States and this State, 28 including Medicare, Medicaid, and other medical 29 assistance, maternal and child health services and any 30 other program that is administered or funded by the 31 Department of Human Services, Department of Public Aid, 32 or Department of Public Health, military 33 service-connected disability payments, medical services 34 provided for members of the armed forces and their -7- LRB093 09876 JLS 10124 b 1 dependents or employees of the armed forces of the United 2 States, and medical services financed on behalf of all 3 citizens by the United States. 4 (18) Any expense or charge for in vitro 5 fertilization, artificial insemination, or any other 6 artificial means used to cause pregnancy. 7 (19) Any expense or charge for oral contraceptives 8 used for birth control or any other temporary birth 9 control measures. 10 (20) Any expense or charge for sterilization or 11 sterilization reversals. 12 (21) Any expense or charge for weight loss 13 programs, exercise equipment, or treatment of obesity, 14 except when certified by a physician as morbid obesity 15 (at least 2 times normal body weight). 16 (22) Any expense or charge for acupuncture 17 treatment unless used as an anesthetic agent for a 18 covered surgery. 19 (23) Any expense or charge for or related to organ 20 or tissue transplants other than those performed at a 21 hospital with a Board approved organ transplant program 22 that has been designated by the Board as a preferred or 23 exclusive provider organization for that specific organ 24 or tissue transplant. 25 (24) Any expense or charge for procedures, 26 treatments, equipment, or services that are provided in 27 special settings for research purposes or in a controlled 28 environment, are being studied for safety, efficiency, 29 and effectiveness, and are awaiting endorsement by the 30 appropriate national medical speciality college for 31 general use within the medical community. 32 d. Deductibles and coinsurance. 33 The Plan coverage defined in Section 6 shall provide for 34 a choice of deductibles per individual as authorized by the -8- LRB093 09876 JLS 10124 b 1 Board. If 2 individual members of the same family household, 2 who are both covered persons under the Plan, satisfy the same 3 applicable deductibles, no other member of that family who is 4 also a covered person under the Plan shall be required to 5 meet any deductibles for the balance of that calendar year. 6 The deductibles must be applied first to the authorized 7 amount of covered expenses incurred by the covered person. A 8 mandatory coinsurance requirement shall be imposed at the 9 rate authorized by the Board in excess of the mandatory 10 deductible, the coinsurance in the aggregate not to exceed 11 such amounts as are authorized by the Board per annum. At 12 its discretion the Board may, however, offer catastrophic 13 coverages or other policies that provide for larger 14 deductibles with or without coinsurance requirements. The 15 deductibles and coinsurance factors may be adjusted annually 16 according to the Medical Component of the Consumer Price 17 Index. 18 e. Scope of coverage. 19 (1) In approving any of the benefit plans to be 20 offered by the Plan, the Board shall establish such 21 benefit levels, deductibles, coinsurance factors, 22 exclusions, and limitations as it may deem appropriate 23 and that it believes to be generally reflective of and 24 commensurate with health insurance coverage that is 25 provided in the individual market in this State. 26 (2) The benefit plans approved by the Board may 27 also provide for and employ various cost containment 28 measures and other requirements including, but not 29 limited to, preadmission certification, prior approval, 30 second surgical opinions, concurrent utilization review 31 programs, individual case management, preferred provider 32 organizations, health maintenance organizations, and 33 other cost effective arrangements for paying for covered 34 expenses. -9- LRB093 09876 JLS 10124 b 1 f. Preexisting conditions. 2 (1) Except for federally eligible individuals 3 qualifying for Plan coverage under Section 15 of this Act 4 or eligible persons who qualify for the waiver authorized 5 in paragraph (3) of this subsection, plan coverage shall 6 exclude charges or expenses incurred during the first 6 7 months following the effective date of coverage as to any 8 condition for which medical advice, care or treatment was 9 recommended or received during the 6 month period 10 immediately preceding the effective date of coverage. 11 (2) (Blank). 12 (3) Waiver: The preexisting condition exclusions as 13 set forth in paragraph (1) of this subsection shall be 14 waived to the extent to which the eligible person (a) has 15 satisfied similar exclusions under any prior individual 16 health insurance policy that was involuntarily terminated 17 because of the insolvency of the issuer of the policy and 18 (b) has applied for Plan coverage within 90 days 19 following the involuntary termination of that individual 20 health insurance coverage. 21 g. Other sources primary; nonduplication of benefits. 22 (1) The Plan shall be the last payor of benefits 23 whenever any other benefit or source of third party 24 payment is available. Subject to the provisions of 25 subsection e of Section 7, benefits otherwise payable 26 under Plan coverage shall be reduced by all amounts paid 27 or payable by Medicare or any other government program or 28 through any health insurance coverage or group health 29 plan, whether by insurance, reimbursement, or otherwise, 30 or through any third party liability, settlement, 31 judgment, or award, regardless of the date of the 32 settlement, judgment, or award, whether the settlement, 33 judgment, or award is in the form of a contract, 34 agreement, or trust on behalf of a minor or otherwise and -10- LRB093 09876 JLS 10124 b 1 whether the settlement, judgment, or award is payable to 2 the covered person, his or her dependent, estate, 3 personal representative, or guardian in a lump sum or 4 over time, and by all hospital or medical expense 5 benefits paid or payable under any worker's compensation 6 coverage, automobile medical payment, or liability 7 insurance, whether provided on the basis of fault or 8 nonfault, and by any hospital or medical benefits paid or 9 payable under or provided pursuant to any State or 10 federal law or program. 11 (2) The Plan shall have a cause of action against 12 any covered person or any other person or entity for the 13 recovery of any amount paid to the extent the amount was 14 for treatment, services, or supplies not covered in this 15 Section or in excess of benefits as set forth in this 16 Section. 17 (3) Whenever benefits are due from the Plan because 18 of sickness or an injury to a covered person resulting 19 from a third party's wrongful act or negligence and the 20 covered person has recovered or may recover damages from 21 a third party or its insurer, the Plan shall have the 22 right to reduce benefits or to refuse to pay benefits 23 that otherwise may be payable by the amount of damages 24 that the covered person has recovered or may recover 25 regardless of the date of the sickness or injury or the 26 date of any settlement, judgment, or award resulting from 27 that sickness or injury. 28 During the pendency of any action or claim that is 29 brought by or on behalf of a covered person against a 30 third party or its insurer, any benefits that would 31 otherwise be payable except for the provisions of this 32 paragraph (3) shall be paid if payment by or for the 33 third party has not yet been made and the covered person 34 or, if incapable, that person's legal representative -11- LRB093 09876 JLS 10124 b 1 agrees in writing to pay back promptly the benefits paid 2 as a result of the sickness or injury to the extent of 3 any future payments made by or for the third party for 4 the sickness or injury. This agreement is to apply 5 whether or not liability for the payments is established 6 or admitted by the third party or whether those payments 7 are itemized. 8 Any amounts due the plan to repay benefits may be 9 deducted from other benefits payable by the Plan after 10 payments by or for the third party are made. 11 (4) Benefits due from the Plan may be reduced or 12 refused as an offset against any amount otherwise 13 recoverable under this Section. 14 h. Right of subrogation; recoveries. 15 (1) Whenever the Plan has paid benefits because of 16 sickness or an injury to any covered person resulting 17 from a third party's wrongful act or negligence, or for 18 which an insurer is liable in accordance with the 19 provisions of any policy of insurance, and the covered 20 person has recovered or may recover damages from a third 21 party that is liable for the damages, the Plan shall have 22 the right to recover the benefits it paid from any 23 amounts that the covered person has received or may 24 receive regardless of the date of the sickness or injury 25 or the date of any settlement, judgment, or award 26 resulting from that sickness or injury. The Plan shall 27 be subrogated to any right of recovery the covered person 28 may have under the terms of any private or public health 29 care coverage or liability coverage, including coverage 30 under the Workers' Compensation Act or the Workers' 31 Occupational Diseases Act, without the necessity of 32 assignment of claim or other authorization to secure the 33 right of recovery. To enforce its subrogation right, the 34 Plan may (i) intervene or join in an action or proceeding -12- LRB093 09876 JLS 10124 b 1 brought by the covered person or his personal 2 representative, including his guardian, conservator, 3 estate, dependents, or survivors, against any third party 4 or the third party's insurer that may be liable or (ii) 5 institute and prosecute legal proceedings against any 6 third party or the third party's insurer that may be 7 liable for the sickness or injury in an appropriate court 8 either in the name of the Plan or in the name of the 9 covered person or his personal representative, including 10 his guardian, conservator, estate, dependents, or 11 survivors. 12 (2) If any action or claim is brought by or on 13 behalf of a covered person against a third party or the 14 third party's insurer, the covered person or his personal 15 representative, including his guardian, conservator, 16 estate, dependents, or survivors, shall notify the Plan 17 by personal service or registered mail of the action or 18 claim and of the name of the court in which the action or 19 claim is brought, filing proof thereof in the action or 20 claim. The Plan may, at any time thereafter, join in the 21 action or claim upon its motion so that all orders of 22 court after hearing and judgment shall be made for its 23 protection. No release or settlement of a claim for 24 damages and no satisfaction of judgment in the action 25 shall be valid without the written consent of the Plan to 26 the extent of its interest in the settlement or judgment 27 and of the covered person or his personal representative. 28 (3) In the event that the covered person or his 29 personal representative fails to institute a proceeding 30 against any appropriate third party before the fifth 31 month before the action would be barred, the Plan may, in 32 its own name or in the name of the covered person or 33 personal representative, commence a proceeding against 34 any appropriate third party for the recovery of damages -13- LRB093 09876 JLS 10124 b 1 on account of any sickness, injury, or death to the 2 covered person. The covered person shall cooperate in 3 doing what is reasonably necessary to assist the Plan in 4 any recovery and shall not take any action that would 5 prejudice the Plan's right to recovery. The Plan shall 6 pay to the covered person or his personal representative 7 all sums collected from any third party by judgment or 8 otherwise in excess of amounts paid in benefits under the 9 Plan and amounts paid or to be paid as costs, attorneys 10 fees, and reasonable expenses incurred by the Plan in 11 making the collection or enforcing the judgment. 12 (4) In the event that a covered person or his 13 personal representative, including his guardian, 14 conservator, estate, dependents, or survivors, recovers 15 damages from a third party for sickness or injury caused 16 to the covered person, the covered person or the personal 17 representative shall pay to the Plan from the damages 18 recovered the amount of benefits paid or to be paid on 19 behalf of the covered person. 20 (5) When the action or claim is brought by the 21 covered person alone and the covered person incurs a 22 personal liability to pay attorney's fees and costs of 23 litigation, the Plan's claim for reimbursement of the 24 benefits provided to the covered person shall be the full 25 amount of benefits paid to or on behalf of the covered 26 person under this Act less a pro rata share that 27 represents the Plan's reasonable share of attorney's fees 28 paid by the covered person and that portion of the cost 29 of litigation expenses determined by multiplying by the 30 ratio of the full amount of the expenditures to the full 31 amount of the judgement, award, or settlement. 32 (6) In the event of judgment or award in a suit or 33 claim against a third party or insurer, the court shall 34 first order paid from any judgement or award the -14- LRB093 09876 JLS 10124 b 1 reasonable litigation expenses incurred in preparation 2 and prosecution of the action or claim, together with 3 reasonable attorney's fees. After payment of those 4 expenses and attorney's fees, the court shall apply out 5 of the balance of the judgment or award an amount 6 sufficient to reimburse the Plan the full amount of 7 benefits paid on behalf of the covered person under this 8 Act, provided the court may reduce and apportion the 9 Plan's portion of the judgement proportionate to the 10 recovery of the covered person. The burden of producing 11 evidence sufficient to support the exercise by the court 12 of its discretion to reduce the amount of a proven charge 13 sought to be enforced against the recovery shall rest 14 with the party seeking the reduction. The court may 15 consider the nature and extent of the injury, economic 16 and non-economic loss, settlement offers, comparative 17 negligence as it applies to the case at hand, hospital 18 costs, physician costs, and all other appropriate costs. 19 The Plan shall pay its pro rata share of the attorney 20 fees based on the Plan's recovery as it compares to the 21 total judgment. Any reimbursement rights of the Plan 22 shall take priority over all other liens and charges 23 existing under the laws of this State with the exception 24 of any attorney liens filed under the Attorneys Lien Act. 25 (7) The Plan may compromise or settle and release 26 any claim for benefits provided under this Act or waive 27 any claims for benefits, in whole or in part, for the 28 convenience of the Plan or if the Plan determines that 29 collection would result in undue hardship upon the 30 covered person. 31 (Source: P.A. 91-639, eff. 8-20-99; 91-735, eff. 6-2-00; 32 92-2, eff. 5-1-01; 92-630, eff. 7-11-02.) 33 Section 15. The Health Maintenance Organization Act is -15- LRB093 09876 JLS 10124 b 1 amended by changing Section 5-3 as follows: 2 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2) 3 Sec. 5-3. Insurance Code provisions. 4 (a) Health Maintenance Organizations shall be subject to 5 the provisions of Sections 133, 134, 137, 140, 141.1, 141.2, 6 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 7 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356v, 356w, 356x, 8 356y, 356z.2, 356z.4, 367i, 368a, 401, 401.1, 402, 403, 403A, 9 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of 10 subsection (2) of Section 367, and Articles IIA, VIII 1/2, 11 XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the Illinois 12 Insurance Code. 13 (b) For purposes of the Illinois Insurance Code, except 14 for Sections 444 and 444.1 and Articles XIII and XIII 1/2, 15 Health Maintenance Organizations in the following categories 16 are deemed to be "domestic companies": 17 (1) a corporation authorized under the Dental 18 Service Plan Act or the Voluntary Health Services Plans 19 Act; 20 (2) a corporation organized under the laws of this 21 State; or 22 (3) a corporation organized under the laws of 23 another state, 30% or more of the enrollees of which are 24 residents of this State, except a corporation subject to 25 substantially the same requirements in its state of 26 organization as is a "domestic company" under Article 27 VIII 1/2 of the Illinois Insurance Code. 28 (c) In considering the merger, consolidation, or other 29 acquisition of control of a Health Maintenance Organization 30 pursuant to Article VIII 1/2 of the Illinois Insurance Code, 31 (1) the Director shall give primary consideration 32 to the continuation of benefits to enrollees and the 33 financial conditions of the acquired Health Maintenance -16- LRB093 09876 JLS 10124 b 1 Organization after the merger, consolidation, or other 2 acquisition of control takes effect; 3 (2)(i) the criteria specified in subsection (1)(b) 4 of Section 131.8 of the Illinois Insurance Code shall not 5 apply and (ii) the Director, in making his determination 6 with respect to the merger, consolidation, or other 7 acquisition of control, need not take into account the 8 effect on competition of the merger, consolidation, or 9 other acquisition of control; 10 (3) the Director shall have the power to require 11 the following information: 12 (A) certification by an independent actuary of 13 the adequacy of the reserves of the Health 14 Maintenance Organization sought to be acquired; 15 (B) pro forma financial statements reflecting 16 the combined balance sheets of the acquiring company 17 and the Health Maintenance Organization sought to be 18 acquired as of the end of the preceding year and as 19 of a date 90 days prior to the acquisition, as well 20 as pro forma financial statements reflecting 21 projected combined operation for a period of 2 22 years; 23 (C) a pro forma business plan detailing an 24 acquiring party's plans with respect to the 25 operation of the Health Maintenance Organization 26 sought to be acquired for a period of not less than 27 3 years; and 28 (D) such other information as the Director 29 shall require. 30 (d) The provisions of Article VIII 1/2 of the Illinois 31 Insurance Code and this Section 5-3 shall apply to the sale 32 by any health maintenance organization of greater than 10% of 33 its enrollee population (including without limitation the 34 health maintenance organization's right, title, and interest -17- LRB093 09876 JLS 10124 b 1 in and to its health care certificates). 2 (e) In considering any management contract or service 3 agreement subject to Section 141.1 of the Illinois Insurance 4 Code, the Director (i) shall, in addition to the criteria 5 specified in Section 141.2 of the Illinois Insurance Code, 6 take into account the effect of the management contract or 7 service agreement on the continuation of benefits to 8 enrollees and the financial condition of the health 9 maintenance organization to be managed or serviced, and (ii) 10 need not take into account the effect of the management 11 contract or service agreement on competition. 12 (f) Except for small employer groups as defined in the 13 Small Employer Rating, Renewability and Portability Health 14 Insurance Act and except for medicare supplement policies as 15 defined in Section 363 of the Illinois Insurance Code, a 16 Health Maintenance Organization may by contract agree with a 17 group or other enrollment unit to effect refunds or charge 18 additional premiums under the following terms and conditions: 19 (i) the amount of, and other terms and conditions 20 with respect to, the refund or additional premium are set 21 forth in the group or enrollment unit contract agreed in 22 advance of the period for which a refund is to be paid or 23 additional premium is to be charged (which period shall 24 not be less than one year); and 25 (ii) the amount of the refund or additional premium 26 shall not exceed 20% of the Health Maintenance 27 Organization's profitable or unprofitable experience with 28 respect to the group or other enrollment unit for the 29 period (and, for purposes of a refund or additional 30 premium, the profitable or unprofitable experience shall 31 be calculated taking into account a pro rata share of the 32 Health Maintenance Organization's administrative and 33 marketing expenses, but shall not include any refund to 34 be made or additional premium to be paid pursuant to this -18- LRB093 09876 JLS 10124 b 1 subsection (f)). The Health Maintenance Organization and 2 the group or enrollment unit may agree that the 3 profitable or unprofitable experience may be calculated 4 taking into account the refund period and the immediately 5 preceding 2 plan years. 6 The Health Maintenance Organization shall include a 7 statement in the evidence of coverage issued to each enrollee 8 describing the possibility of a refund or additional premium, 9 and upon request of any group or enrollment unit, provide to 10 the group or enrollment unit a description of the method used 11 to calculate (1) the Health Maintenance Organization's 12 profitable experience with respect to the group or enrollment 13 unit and the resulting refund to the group or enrollment unit 14 or (2) the Health Maintenance Organization's unprofitable 15 experience with respect to the group or enrollment unit and 16 the resulting additional premium to be paid by the group or 17 enrollment unit. 18 In no event shall the Illinois Health Maintenance 19 Organization Guaranty Association be liable to pay any 20 contractual obligation of an insolvent organization to pay 21 any refund authorized under this Section. 22 (Source: P.A. 91-357, eff. 7-29-99; 91-406, eff. 1-1-00; 23 91-549, eff. 8-14-99; 91-605, eff. 12-14-99; 91-788, eff. 24 6-9-00; 92-764, eff. 1-1-03.) 25 Section 20. The Voluntary Health Services Plans Act is 26 amended by changing Section 10 as follows: 27 (215 ILCS 165/10) (from Ch. 32, par. 604) 28 Sec. 10. Application of Insurance Code provisions. 29 Health services plan corporations and all persons interested 30 therein or dealing therewith shall be subject to the 31 provisions of Articles IIA and XII 1/2 and Sections 3.1, 133, 32 140, 143, 143c, 149, 155.37, 354, 355.2, 356r, 356t, 356u, -19- LRB093 09876 JLS 10124 b 1 356v, 356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 367.2, 368a, 2 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, and 3 paragraphs (7) and (15) of Section 367 of the Illinois 4 Insurance Code. 5 (Source: P.A. 91-406, eff. 1-1-00; 91-549, eff. 8-14-99; 6 91-605, eff. 12-14-99; 91-788, eff. 6-9-00; 92-130, eff. 7 7-20-01; 92-440, eff. 8-17-01; 92-651, eff. 7-11-02; 92-764, 8 eff. 1-1-03.) 9 Section 25. The Senior Citizens and Disabled Persons 10 Property Tax Relief and Pharmaceutical Assistance Act is 11 amended by changing Section 3.15 as follows: 12 (320 ILCS 25/3.15) (from Ch. 67 1/2, par. 403.15) 13 Sec. 3.15. "Covered prescription drug" means (1) any 14 cardiovascular agent or drug; (2) any insulin or other 15 prescription drug used in the treatment of diabetes, 16 including syringe and needles used to administer the insulin; 17 (3) any prescription drug used in the treatment of arthritis, 18 (4) beginning on January 1, 2001, any prescription drug used 19 in the treatment of cancer, (5) beginning on January 1, 2001, 20 any prescription drug used in the treatment of Alzheimer's 21 disease, (6) beginning on January 1, 2001, any prescription 22 drug used in the treatment of Parkinson's disease, (7) 23 beginning on January 1, 2001, any prescription drug used in 24 the treatment of glaucoma, (8) beginning on January 1, 2001, 25 any prescription drug used in the treatment of lung disease 26 and smoking related illnesses,and(9) beginning on July 1, 27 2001, any prescription drug used in the treatment of 28 osteoporosis, and (10) beginning January 1, 2004, 29 immunosuppresive agents (anti-rejection medication) used in 30 connection with organ transplants. The specific agents or 31 products to be included under such categories shall be listed 32 in a handbook to be prepared and distributed by the -20- LRB093 09876 JLS 10124 b 1 Department. The general types of covered prescription drugs 2 shall be indicated by rule. 3 (Source: P.A. 91-699, eff. 1-1-01; 92-10, eff. 6-11-01; 4 92-790, eff. 8-6-02.)