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1 | AN ACT concerning insurance.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Insurance Code is amended by adding | |||||||||||||||||||||||
5 | Section 44.1 as follows: | |||||||||||||||||||||||
6 | (215 ILCS 5/44.1 new) | |||||||||||||||||||||||
7 | Sec. 44.1. Health care cooperatives. | |||||||||||||||||||||||
8 | (a) In addition to all other provisions of this Article not | |||||||||||||||||||||||
9 | in conflict with this Section, a company seeking to organize | |||||||||||||||||||||||
10 | under this Article as a health care cooperative shall meet all | |||||||||||||||||||||||
11 | of the following requirements: | |||||||||||||||||||||||
12 | (1) The company shall comply with all provisions | |||||||||||||||||||||||
13 | applicable to domestic mutual insurance companies under | |||||||||||||||||||||||
14 | this Code. | |||||||||||||||||||||||
15 | (2) The articles of incorporation of the company shall | |||||||||||||||||||||||
16 | demonstrate that the company is to be organized as a | |||||||||||||||||||||||
17 | nonprofit member corporation and that the governance of the | |||||||||||||||||||||||
18 | company shall be subject to a majority vote of all members. | |||||||||||||||||||||||
19 | (3) The activities of the company shall be limited to | |||||||||||||||||||||||
20 | the issuance of health care plans in the individual and | |||||||||||||||||||||||
21 | small group markets. | |||||||||||||||||||||||
22 | (4) Either the articles of incorporation or the bylaws | |||||||||||||||||||||||
23 | of the company shall incorporate ethics and conflict of |
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1 | interest standards and the governance requirements set | ||||||
2 | forth in Section 1322(c)(3)(C) of the federal Patient | ||||||
3 | Protection and Affordable Care Act. | ||||||
4 | (5) The company or a related entity or any predecessor | ||||||
5 | of either shall not have been a health insurance issuer on | ||||||
6 | July 16, 2009. | ||||||
7 | (6) The company shall not be sponsored by a State or | ||||||
8 | local government, any political subdivision thereof, or | ||||||
9 | any instrumentality of such government or political | ||||||
10 | subdivision. | ||||||
11 | (7) Excess surplus shall be used to lower premiums, to | ||||||
12 | improve benefits, or for other programs intended to improve | ||||||
13 | the quality of health care delivered to its members. | ||||||
14 | (8) No representative of a federal, State, or local | ||||||
15 | government, or any political instrumentality thereof, and | ||||||
16 | no representative of a company described in paragraph (5) | ||||||
17 | of subsection (a) of this Section may serve on the board of | ||||||
18 | directors of the company. | ||||||
19 | (b) Notwithstanding Section 37 of this Article, the | ||||||
20 | corporate name of any organization seeking to organize under | ||||||
21 | this Article as a health care cooperative need not contain the | ||||||
22 | word "Mutual" but shall contain the phrase "Health Care | ||||||
23 | Cooperative". The corporate name shall not be the same as, or | ||||||
24 | deceptively similar to, the name of any domestic organization | ||||||
25 | or of any foreign or alien organization authorized to transact | ||||||
26 | business in this State. |
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1 | (c) A company seeking to be organized as a health care | ||||||
2 | cooperative shall submit an application to the Director | ||||||
3 | according to procedures and meeting such requirements as the | ||||||
4 | Director shall adopt by rule. No company shall transact any | ||||||
5 | business of insurance until it has received a certificate of | ||||||
6 | authority as set forth in Section 51 of this Article. | ||||||
7 | Section 10. The Co-operative Act is amended by changing | ||||||
8 | Section 22 and by adding Section 30 as follows:
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9 | (805 ILCS 310/22) (from Ch. 32, par. 326)
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10 | Sec. 22. No corporation or association hereafter organized | ||||||
11 | or doing
business for profit in this State shall be entitled to | ||||||
12 | use the term
"Co-operative" as a part of its corporate or other | ||||||
13 | business name or title
unless it has complied with the | ||||||
14 | provisions of this Act, except (1) a corporation
organized | ||||||
15 | under the Business Corporation Act of 1983 for the purpose of | ||||||
16 | ownership or administration of residential property on
a | ||||||
17 | cooperative basis, or (2) a cooperative corporation organized | ||||||
18 | under the General Not For Profit Corporation Act of 1986 or its | ||||||
19 | predecessor or successor statutes , or (3) a domestic mutual | ||||||
20 | insurance company licensed as a health care cooperative by the | ||||||
21 | Director of Insurance under Article III of the Illinois | ||||||
22 | Insurance Code . Any corporation
or association violating the | ||||||
23 | provision of this Section may be enjoined from
doing business | ||||||
24 | under such name at the instance of any shareholder of any
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1 | association or corporation organized under this Act.
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2 | (Source: P.A. 95-368, eff. 8-23-07.)
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3 | (805 ILCS 310/30 new) | ||||||
4 | Sec. 30. Health benefit purchasing cooperative. | ||||||
5 | (a) Notwithstanding any other provisions of this Act, | ||||||
6 | health benefit purchasing cooperatives may be organized under | ||||||
7 | this Section by one or more persons. | ||||||
8 | (b) The purpose of a health benefit purchasing cooperative | ||||||
9 | is to provide health care benefits for the individuals | ||||||
10 | specified in subsection (h) of this Section, under a single | ||||||
11 | group health care policy or plan through a contract between the | ||||||
12 | health benefit purchasing cooperative and an insurer | ||||||
13 | authorized to do health insurance business in this State. | ||||||
14 | (c) A health benefit purchasing cooperative shall be | ||||||
15 | designed so that all of the following are accomplished: | ||||||
16 | (1) The members become better informed about health | ||||||
17 | care trends and cost increases. | ||||||
18 | (2) All members receive their health care benefits | ||||||
19 | under the group health care policy or plan negotiated under | ||||||
20 | subsection (h) of this Section. | ||||||
21 | (3) The members are actively engaged in designing | ||||||
22 | health care benefit options that are offered by the insurer | ||||||
23 | and that meet the needs of their community. | ||||||
24 | (4) The health insurance risk of all of the members is | ||||||
25 | pooled. |
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1 | (5) The members actively participate in health | ||||||
2 | improvement decisions for their community. | ||||||
3 | (d) The articles of a health benefit purchasing cooperative | ||||||
4 | shall set forth the name and address of at least one | ||||||
5 | incorporator who will act as the temporary board. | ||||||
6 | (e) Each health benefit purchasing cooperative shall be | ||||||
7 | organized on a membership basis with no capital stock. | ||||||
8 | (f) Any person that does business in, is located in, has a | ||||||
9 | principal office in, or resides in the geographic area in which | ||||||
10 | a health benefit purchasing cooperative is organized, that | ||||||
11 | meets the membership criteria established by the health benefit | ||||||
12 | purchasing cooperative in its bylaws, and that pays the | ||||||
13 | membership fee may be a member of the health benefit purchasing | ||||||
14 | cooperative. | ||||||
15 | (g) Each health benefit purchasing cooperative shall file | ||||||
16 | its membership criteria, as well as any amendments to the | ||||||
17 | criteria, with the Director. | ||||||
18 | (h) The health care benefits offered by a health benefit | ||||||
19 | purchasing cooperative shall be negotiated between the health | ||||||
20 | benefit purchasing cooperative and the insurer. Eligible | ||||||
21 | members include: | ||||||
22 | (1) An individual who is a member, officer, or eligible | ||||||
23 | employee of a member of the health benefit purchasing | ||||||
24 | cooperative. | ||||||
25 | (2) A self-employed individual who is a member of the | ||||||
26 | health benefit purchasing cooperative. |
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1 | (3) A dependent of an individual under items (1) and | ||||||
2 | (2) of this subsection (h) who receives coverage. | ||||||
3 | (i) Each health benefit purchasing cooperative shall | ||||||
4 | submit to the Director annually, no later than September 30, a | ||||||
5 | report on the progress of the health benefit purchasing | ||||||
6 | arrangement described in this Section. | ||||||
7 | (j) As used in this Section, "Director" means the Director | ||||||
8 | of Insurance.
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9 | Section 99. Effective date. This Act takes effect upon | ||||||
10 | becoming law.
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