94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB4293

 

Introduced 12/21/05, by Rep. Mark H. Beaubien, Jr.

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 125/2-3   from Ch. 111 1/2, par. 1405

    Amends the Health Maintenance Organization Act. Provides that nothing in the powers granted to health maintenance organizations shall be construed to prohibit a health care plan that qualifies as a high deductible health plan under the Internal Revenue Code from requiring the application of deductibles to benefits provided under the plan. Effective immediately.


LRB094 16124 LJB 51364 b

 

 

A BILL FOR

 

HB4293 LRB094 16124 LJB 51364 b

1     AN ACT concerning insurance.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Health Maintenance Organization Act is
5 amended by changing Section 2-3 as follows:
 
6     (215 ILCS 125/2-3)  (from Ch. 111 1/2, par. 1405)
7     Sec. 2-3. Powers of health maintenance organizations. The
8 powers of a health maintenance organization include, but are
9 not limited to the following:
10         (a) The purchase, lease, construction, renovation,
11     operation, or maintenance of hospitals, medical facilities
12     or both, and their ancillary equipment, and such property
13     as may reasonably be required for its principal office or
14     for such other purposes as may be necessary in the
15     transaction of the business of the organization.
16         (b) The making of loans to a medical group under
17     contract with it and in furtherance of its program or the
18     making of loans to a corporation or corporations under its
19     control for the purpose of acquiring or constructing
20     medical facilities at hospitals or in furtherance of a
21     program providing health care services for enrollees.
22         (c) The furnishing of health care services through
23     providers which are under contract with or employed by the
24     health maintenance organization.
25         (d) The contracting with any person for the performance
26     on its behalf of certain functions such as marketing,
27     enrollment and administration.
28         (e) The contracting with an insurance company licensed
29     in this State, or with a hospital, medical, dental, vision
30     or pharmaceutical service corporation authorized to do
31     business in this State, for the provision of insurance,
32     indemnity, or reimbursement against the cost of health care

 

 

HB4293 - 2 - LRB094 16124 LJB 51364 b

1     service provided by the health maintenance organization.
2         (f) The offering, in addition to basic health care
3     services, of (1) health care services, (2) indemnity
4     benefits covering out of area or emergency services, (3)
5     indemnity benefits provided through insurers or hospital,
6     medical, dental, vision, or pharmaceutical service
7     corporations, and (4) health maintenance organization
8     point-of-service benefits as authorized under Article 4.5.
9         (g) Rendering services related to the functions
10     involved in the operating of its health maintenance
11     organization business including but not limited to
12     providing health services, data processing, accounting, or
13     claims.
14         (g-5) Indemnification for services provided to a child
15     as required under subdivision (e)(3) of Section 4-2.
16         (h) Any other business activity reasonably
17     complementary or supplementary to its health maintenance
18     organization business to the extent approved by the
19     Director.
20     Nothing in this Section shall be construed or interpreted
21 to prohibit or prevent a health care plan that qualifies as a
22 high deductible health plan, as defined by Section 223 of the
23 federal Internal Revenue Code, as now or hereafter amended,
24 from requiring the application of deductibles to benefits
25 provided under the plan.
26 (Source: P.A. 92-135, eff. 1-1-02.)
 
27     Section 99. Effective date. This Act takes effect upon
28 becoming law.