|
| | HB2088 Engrossed | | LRB103 04781 BMS 49791 b |
|
|
1 | | AN ACT concerning regulation.
|
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 155.49 as follows: |
6 | | (215 ILCS 5/155.49 new) |
7 | | Sec. 155.49. Insurance company supplier diversity report. |
8 | | (a) Every company authorized to do business in this State |
9 | | or accredited by this State with assets of at least |
10 | | $50,000,000 shall submit a 2-page report on its voluntary |
11 | | supplier diversity program, or the company's procurement |
12 | | program if there is no supplier diversity program, to the |
13 | | Department. The report shall set forth all of the following: |
14 | | (1) The name, address, phone number, and email address |
15 | | of the point of contact for the supplier diversity program |
16 | | for vendors to register with the program. |
17 | | (2) Local and State certifications the company accepts |
18 | | or recognizes for minority-owned, women-owned, LGBT-owned, |
19 | | or veteran-owned business status. |
20 | | (3) On the second page, a narrative explaining the |
21 | | results of the program and the tactics to be employed to |
22 | | achieve the goals of its voluntary supplier diversity |
23 | | program. |
|
| | HB2088 Engrossed | - 2 - | LRB103 04781 BMS 49791 b |
|
|
1 | | (4) The voluntary goals for the calendar year for |
2 | | which the report is made in each category for the entire |
3 | | budget of the company and the commodity codes or a |
4 | | description of particular goods and services for the area |
5 | | of procurement in which the company expects most of those |
6 | | goals to focus on in that year. |
7 | | Each company is required to submit a searchable report, in |
8 | | Portable Document Format (PDF), to the Department on or before |
9 | | April 1, 2024 and on or before April 1 every year thereafter. |
10 | | (b) For each report submitted under subsection (a), the |
11 | | Department shall publish the results on its Internet website |
12 | | for 5 years after submission. The Department is not |
13 | | responsible for collecting the reports or for the content of |
14 | | the reports. |
15 | | (c) The Department shall hold an annual insurance company |
16 | | supplier diversity workshop in July of 2024 and every July |
17 | | thereafter to discuss the reports with representatives of the |
18 | | companies and vendors. |
19 | | (d) The Department shall prepare a one-page template, not |
20 | | including the narrative section, for the voluntary supplier |
21 | | diversity reports. |
22 | | (e) The Department may adopt such rules as it deems |
23 | | necessary to implement this Section. |
24 | | Section 10. The Dental Service Plan Act is amended by |
25 | | changing Section 25 as follows:
|
|
| | HB2088 Engrossed | - 3 - | LRB103 04781 BMS 49791 b |
|
|
1 | | (215 ILCS 110/25) (from Ch. 32, par. 690.25)
|
2 | | Sec. 25. Application of Insurance Code provisions. Dental |
3 | | service
plan corporations and all persons interested therein |
4 | | or dealing therewith
shall be subject to the provisions of |
5 | | Articles IIA, XI, and XII 1/2
and
Sections 3.1,
133, 136, 139, |
6 | | 140, 143, 143c, 149, 155.49, 355.2, 355.3, 367.2, 401, 401.1, |
7 | | 402, 403, 403A, 408,
408.2, and 412, and subsection (15) of |
8 | | Section 367 of the Illinois Insurance
Code.
|
9 | | (Source: P.A. 99-151, eff. 7-28-15.)
|
10 | | Section 15. The Health Maintenance Organization Act is |
11 | | amended by changing Section 5-3 as follows:
|
12 | | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
|
13 | | Sec. 5-3. Insurance Code provisions.
|
14 | | (a) Health Maintenance Organizations
shall be subject to |
15 | | the provisions of Sections 133, 134, 136, 137, 139, 140, |
16 | | 141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, |
17 | | 154, 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 155.49, |
18 | | 355.2, 355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, |
19 | | 356x, 356y,
356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, |
20 | | 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, |
21 | | 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, |
22 | | 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33, |
23 | | 356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48, |
|
| | HB2088 Engrossed | - 4 - | LRB103 04781 BMS 49791 b |
|
|
1 | | 356z.50, 356z.51, 256z.53, 356z.54, 356z.56, 356z.57, 356z.59, |
2 | | 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, |
3 | | 368d, 368e, 370c,
370c.1, 401, 401.1, 402, 403, 403A,
408, |
4 | | 408.2, 409, 412, 444,
and
444.1,
paragraph (c) of subsection |
5 | | (2) of Section 367, and Articles IIA, VIII 1/2,
XII,
XII 1/2, |
6 | | XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois |
7 | | Insurance Code.
|
8 | | (b) For purposes of the Illinois Insurance Code, except |
9 | | for Sections 444
and 444.1 and Articles XIII and XIII 1/2, |
10 | | Health Maintenance Organizations in
the following categories |
11 | | are deemed to be "domestic companies":
|
12 | | (1) a corporation authorized under the
Dental Service |
13 | | Plan Act or the Voluntary Health Services Plans Act;
|
14 | | (2) a corporation organized under the laws of this |
15 | | State; or
|
16 | | (3) a corporation organized under the laws of another |
17 | | state, 30% or more
of the enrollees of which are residents |
18 | | of this State, except a
corporation subject to |
19 | | substantially the same requirements in its state of
|
20 | | organization as is a "domestic company" under Article VIII |
21 | | 1/2 of the
Illinois Insurance Code.
|
22 | | (c) In considering the merger, consolidation, or other |
23 | | acquisition of
control of a Health Maintenance Organization |
24 | | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
|
25 | | (1) the Director shall give primary consideration to |
26 | | the continuation of
benefits to enrollees and the |
|
| | HB2088 Engrossed | - 5 - | LRB103 04781 BMS 49791 b |
|
|
1 | | financial conditions of the acquired Health
Maintenance |
2 | | Organization after the merger, consolidation, or other
|
3 | | acquisition of control takes effect;
|
4 | | (2)(i) the criteria specified in subsection (1)(b) of |
5 | | Section 131.8 of
the Illinois Insurance Code shall not |
6 | | apply and (ii) the Director, in making
his determination |
7 | | with respect to the merger, consolidation, or other
|
8 | | acquisition of control, need not take into account the |
9 | | effect on
competition of the merger, consolidation, or |
10 | | other acquisition of control;
|
11 | | (3) the Director shall have the power to require the |
12 | | following
information:
|
13 | | (A) certification by an independent actuary of the |
14 | | adequacy
of the reserves of the Health Maintenance |
15 | | Organization sought to be acquired;
|
16 | | (B) pro forma financial statements reflecting the |
17 | | combined balance
sheets of the acquiring company and |
18 | | the Health Maintenance Organization sought
to be |
19 | | acquired as of the end of the preceding year and as of |
20 | | a date 90 days
prior to the acquisition, as well as pro |
21 | | forma financial statements
reflecting projected |
22 | | combined operation for a period of 2 years;
|
23 | | (C) a pro forma business plan detailing an |
24 | | acquiring party's plans with
respect to the operation |
25 | | of the Health Maintenance Organization sought to
be |
26 | | acquired for a period of not less than 3 years; and
|
|
| | HB2088 Engrossed | - 6 - | LRB103 04781 BMS 49791 b |
|
|
1 | | (D) such other information as the Director shall |
2 | | require.
|
3 | | (d) The provisions of Article VIII 1/2 of the Illinois |
4 | | Insurance Code
and this Section 5-3 shall apply to the sale by |
5 | | any health maintenance
organization of greater than 10% of its
|
6 | | enrollee population (including without limitation the health |
7 | | maintenance
organization's right, title, and interest in and |
8 | | to its health care
certificates).
|
9 | | (e) In considering any management contract or service |
10 | | agreement subject
to Section 141.1 of the Illinois Insurance |
11 | | Code, the Director (i) shall, in
addition to the criteria |
12 | | specified in Section 141.2 of the Illinois
Insurance Code, |
13 | | take into account the effect of the management contract or
|
14 | | service agreement on the continuation of benefits to enrollees |
15 | | and the
financial condition of the health maintenance |
16 | | organization to be managed or
serviced, and (ii) need not take |
17 | | into account the effect of the management
contract or service |
18 | | agreement on competition.
|
19 | | (f) Except for small employer groups as defined in the |
20 | | Small Employer
Rating, Renewability and Portability Health |
21 | | Insurance Act and except for
medicare supplement policies as |
22 | | defined in Section 363 of the Illinois
Insurance Code, a |
23 | | Health Maintenance Organization may by contract agree with a
|
24 | | group or other enrollment unit to effect refunds or charge |
25 | | additional premiums
under the following terms and conditions:
|
26 | | (i) the amount of, and other terms and conditions with |
|
| | HB2088 Engrossed | - 7 - | LRB103 04781 BMS 49791 b |
|
|
1 | | respect to, the
refund or additional premium are set forth |
2 | | in the group or enrollment unit
contract agreed in advance |
3 | | of the period for which a refund is to be paid or
|
4 | | additional premium is to be charged (which period shall |
5 | | not be less than one
year); and
|
6 | | (ii) the amount of the refund or additional premium |
7 | | shall not exceed 20%
of the Health Maintenance |
8 | | Organization's profitable or unprofitable experience
with |
9 | | respect to the group or other enrollment unit for the |
10 | | period (and, for
purposes of a refund or additional |
11 | | premium, the profitable or unprofitable
experience shall |
12 | | be calculated taking into account a pro rata share of the
|
13 | | Health Maintenance Organization's administrative and |
14 | | marketing expenses, but
shall not include any refund to be |
15 | | made or additional premium to be paid
pursuant to this |
16 | | subsection (f)). The Health Maintenance Organization and |
17 | | the
group or enrollment unit may agree that the profitable |
18 | | or unprofitable
experience may be calculated taking into |
19 | | account the refund period and the
immediately preceding 2 |
20 | | plan years.
|
21 | | The Health Maintenance Organization shall include a |
22 | | statement in the
evidence of coverage issued to each enrollee |
23 | | describing the possibility of a
refund or additional premium, |
24 | | and upon request of any group or enrollment unit,
provide to |
25 | | the group or enrollment unit a description of the method used |
26 | | to
calculate (1) the Health Maintenance Organization's |
|
| | HB2088 Engrossed | - 8 - | LRB103 04781 BMS 49791 b |
|
|
1 | | profitable experience with
respect to the group or enrollment |
2 | | unit and the resulting refund to the group
or enrollment unit |
3 | | or (2) the Health Maintenance Organization's unprofitable
|
4 | | experience with respect to the group or enrollment unit and |
5 | | the resulting
additional premium to be paid by the group or |
6 | | enrollment unit.
|
7 | | In no event shall the Illinois Health Maintenance |
8 | | Organization
Guaranty Association be liable to pay any |
9 | | contractual obligation of an
insolvent organization to pay any |
10 | | refund authorized under this Section.
|
11 | | (g) Rulemaking authority to implement Public Act 95-1045, |
12 | | if any, is conditioned on the rules being adopted in |
13 | | accordance with all provisions of the Illinois Administrative |
14 | | Procedure Act and all rules and procedures of the Joint |
15 | | Committee on Administrative Rules; any purported rule not so |
16 | | adopted, for whatever reason, is unauthorized. |
17 | | (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; |
18 | | 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff. |
19 | | 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, |
20 | | eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; |
21 | | 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. |
22 | | 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, |
23 | | eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; |
24 | | 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. |
25 | | 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, |
26 | | eff. 1-1-23; revised 12-13-22.) |
|
| | HB2088 Engrossed | - 9 - | LRB103 04781 BMS 49791 b |
|
|
1 | | Section 20. The Limited Health Service Organization Act is |
2 | | amended by changing Section 4003 as follows:
|
3 | | (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
|
4 | | Sec. 4003. Illinois Insurance Code provisions. Limited |
5 | | health service
organizations shall be subject to the |
6 | | provisions of Sections 133, 134, 136, 137, 139,
140, 141.1, |
7 | | 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, |
8 | | 154.5,
154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 355.2, |
9 | | 355.3, 355b, 356q, 356v, 356z.10, 356z.21, 356z.22, 356z.25, |
10 | | 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.41, |
11 | | 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57, 356z.59, |
12 | | 364.3, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, 409, 412, |
13 | | 444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2,
XIII,
|
14 | | XIII 1/2, XXV, and XXVI of the Illinois Insurance Code. For |
15 | | purposes of the
Illinois Insurance Code, except for Sections |
16 | | 444 and 444.1 and Articles XIII
and XIII 1/2, limited health |
17 | | service organizations in the following categories
are deemed |
18 | | to be domestic companies:
|
19 | | (1) a corporation under the laws of this State; or
|
20 | | (2) a corporation organized under the laws of another |
21 | | state, 30% or more
of the enrollees of which are residents |
22 | | of this State, except a corporation
subject to |
23 | | substantially the same requirements in its state of |
24 | | organization as
is a domestic company under Article VIII |
|
| | HB2088 Engrossed | - 10 - | LRB103 04781 BMS 49791 b |
|
|
1 | | 1/2 of the Illinois Insurance Code.
|
2 | | (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
3 | | 101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. |
4 | | 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, |
5 | | eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; |
6 | | 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. |
7 | | 1-1-23; 102-1093, eff. 1-1-23; revised 12-13-22.)
|