Sen. William R. Haine
Filed: 5/8/2014
 
 

 

 

 
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1
AMENDMENT TO HOUSE BILL 3784




2    AMENDMENT NO. ______. Amend House Bill 3784 by replacing 
3everything after the enacting clause with the following:

 
4    "Section 5. The Illinois Insurance Code is amended  by 
5adding Section 357.32 as follows:
 
6    (215 ILCS 5/357.32 new)
7    Sec. 357.32. Coordination of benefits.
8    (a) No hospital, medical, or surgical expense policy shall 
9contain any provision whereby benefits otherwise payable under 
10the policy are subject to reduction solely on account of the 
11existence of similar benefits provided under other accident and 
12sickness insurance policies where such reduction would operate 
13to reduce total benefits payable under the policies below an 
14amount equal to 100% of the total allowable expenses provided 
15under any of the policies.
16    (b) The Director may adopt rules to further implement this 
 
 
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1Section that may include an exemption for certain excepted 
2benefits as defined in paragraph (2) of subsection (C) of 
3Section 20 of the Illinois Health Insurance Portability and 
4Accountability Act.
 
5    Section 10. The Health Maintenance Organization Act is 
6amended  by changing Section 5-7 as follows:
 



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



8    Sec. 5-7. Rules and regulations to carry out provisions of 
9Act. The Director may, after notice and hearing, promulgate 
10reasonable rules
and regulations as are necessary and proper 
11to:

12    (1) Establish minimum coverage standards for basic health 
13care services,
the application of which standards discriminate 
14against no class of physician;

15    (2) Establish specific standards, including standards for 
16the full and
fair disclosure of health care services provided 
17by group or nongroup contracts or
evidences of coverage which 
18may cover but shall not be limited to:

19    (a) Coordination of benefits

20    (b) Conversion

21    (c) Cancellation and termination

22    (d) Deductibles and co-payments

23    (e) Pre-existing conditions; and

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

 
 
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1(Source: P.A. 86-620.)".