Illinois General Assembly - Full Text of HB3783
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Full Text of HB3783  97th General Assembly




State of Illinois
2011 and 2012


Introduced 5/20/2011, by Rep. Frank J. Mautino - Chapin Rose - Naomi D. Jakobsson - Chad Hays, Dwight Kay, et al.


5 ILCS 375/5  from Ch. 127, par. 525

    Amends the State Employees Group Insurance Act of 1971. Requires the Director of Central Management Services and the Director of Healthcare and Family Services to renew, through June 30, 2013, Health Maintenance Organization (HMO) and Open Access Plan (OAP) health benefit contracts that were in place on April 1, 2011. Effective immediately.

LRB097 12016 JDS 55701 b






HB3783LRB097 12016 JDS 55701 b

1    AN ACT concerning State government.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 5 as follows:
6    (5 ILCS 375/5)  (from Ch. 127, par. 525)
7    Sec. 5. Employee benefits; declaration of State policy. The
8General Assembly declares that it is the policy of the State
9and in the best interest of the State to assure quality
10benefits to members and their dependents under this Act. The
11implementation of this policy depends upon, among other things,
12stability and continuity of coverage, care, and services under
13benefit programs for members and their dependents.
14Specifically, but without limitation, members should have
15continued access, on substantially similar terms and
16conditions, to trusted family health care providers with whom
17they have developed long-term relationships through a benefit
18program under this Act. Therefore, the Director must administer
19this Act consistent with that State policy, but may consider
20affordability, cost of coverage and care, and competition among
21health insurers and providers. All contracts for provision of
22employee benefits, including those portions of any proposed
23collective bargaining agreement that would require



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1implementation through contracts entered into under this Act,
2are subject to the following requirements:
3        (i) By April 1 of each year, the Director must report
4    and provide information to the Commission concerning the
5    status of the employee benefits program to be offered for
6    the next fiscal year. Information includes, but is not
7    limited to, documents, reports of negotiations, bid
8    invitations, requests for proposals, specifications,
9    copies of proposed and final contracts or agreements, and
10    any other materials concerning contracts or agreements for
11    the employee benefits program. By the first of each month
12    thereafter, the Director must provide updated, and any new,
13    information to the Commission until the employee benefits
14    program for the next fiscal year is determined. In addition
15    to these monthly reporting requirements, at any time the
16    Commission makes a written request, the Director must
17    promptly, but in no event later than 5 business days after
18    receipt of the request, provide to the Commission any
19    additional requested information in the possession of the
20    Director concerning employee benefits programs. The
21    Commission may waive any of the reporting requirements of
22    this item (i) upon the written request by the Director. Any
23    waiver granted under this item (i) must be in writing.
24    Nothing in this item is intended to abrogate any
25    attorney-client privilege.
26        (ii) Within 30 days after notice of the awarding or



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1    letting of a contract has appeared in the Illinois
2    Procurement Bulletin in accordance with subsection (b) of
3    Section 15-25 of the Illinois Procurement Code, the
4    Commission may request in writing from the Director and the
5    Director shall promptly, but in no event later than 5
6    business days after receipt of the request, provide to the
7    Commission information in the possession of the Director
8    concerning the proposed contract. Nothing in this item is
9    intended to waive or abrogate any privilege or right of
10    confidentiality authorized by law.
11        (iii) No contract subject to this Section may be
12    entered into until the 30-day period described in item (ii)
13    has expired, unless the Director requests in writing that
14    the Commission waive the period and the Commission grants
15    the waiver in writing.
16        (iv) If the Director seeks to make any substantive
17    modification to any provision of a proposed contract after
18    it is submitted to the Commission in accordance with item
19    (ii), the modified contract shall be subject to the
20    requirements of items (ii) and (iii) unless the Commission
21    agrees, in writing, to a waiver of those requirements with
22    respect to the modified contract.
23        (v) By the date of the beginning of the annual benefit
24    choice period, the Director must transmit to the Commission
25    a copy of each final contract or agreement for the employee
26    benefits program to be offered for the next fiscal year.



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1    The annual benefit choice period for an employee benefits
2    program must begin on May 1 of the fiscal year preceding
3    the year for which the program is to be offered. If,
4    however, in any such preceding fiscal year collective
5    bargaining over employee benefit programs for the next
6    fiscal year remains pending on April 15, the beginning date
7    of the annual benefit choice period shall be not later than
8    15 days after ratification of the collective bargaining
9    agreement.
10        (vi) The Director must provide the reports,
11    information, and contracts required under items (i), (ii),
12    (iv), and (v) by electronic or other means satisfactory to
13    the Commission. Reports, information, and contracts in the
14    possession of the Commission pursuant to items (i), (ii),
15    (iv), and (v) are exempt from disclosure by the Commission
16    and its members and employees under the Freedom of
17    Information Act. Reports, information, and contracts
18    received by the Commission pursuant to items (i), (ii),
19    (iv), and (v) must be kept confidential by and may not be
20    disclosed or used by the Commission or its members or
21    employees if such disclosure or use could compromise the
22    fairness or integrity of the procurement, bidding, or
23    contract process. Commission meetings, or portions of
24    Commission meetings, in which reports, information, and
25    contracts received by the Commission pursuant to items (i),
26    (ii), (iv), and (v) are discussed must be closed if



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1    disclosure or use of the report or information could
2    compromise the fairness or integrity of the procurement,
3    bidding, or contract process.
4    All contracts entered into under this Section are subject
5to appropriation and shall comply with Section 20-60(b) of the
6Illinois Procurement Code (30 ILCS 500/20-60(b)).
7    The Director shall contract or otherwise make available
8group life insurance, health benefits and other employee
9benefits to eligible members and, where elected, their eligible
10dependents. Any contract or, if applicable, contracts or other
11arrangement for provision of benefits shall be on terms
12consistent with State policy and based on, but not limited to,
13such criteria as administrative cost, service capabilities of
14the carrier or other contractor and premiums, fees or charges
15as related to benefits.
16    The Director may prepare and issue specifications for group
17life insurance, health benefits, other employee benefits and
18administrative services for the purpose of receiving proposals
19from interested parties.
20    The Director is authorized to execute a contract, or
21contracts, for the programs of group life insurance, health
22benefits, other employee benefits and administrative services
23authorized by this Act (including, without limitation,
24prescription drug benefits). All of the benefits provided under
25this Act may be included in one or more contracts, or the
26benefits may be classified into different types with each type



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1included under one or more similar contracts with the same or
2different companies.
3    The term of any contract may not extend beyond 5 fiscal
4years. Upon recommendation of the Commission, the Director may
5exercise renewal options of the same contract for up to a
6period of 5 years. Notwithstanding the contract duration
7limitations contained in this Section, or in the Illinois
8Procurement Code, or any other statutory provision or
9administrative rule, the Director of Central Management
10Services and the Director of Healthcare and Family Services
11shall renew, through June 30, 2013, Health Maintenance
12Organization (HMO) and Open Access Plan (OAP) health benefit
13contracts that were in place on April 1, 2011. Any increases in
14premiums, fees or charges requested by a contractor whose
15contract may be renewed pursuant to a renewal option contained
16therein, must be justified on the basis of (1) audited
17experience data, (2) increases in the costs of health care
18services provided under the contract, (3) contractor
19performance, (4) increases in contractor responsibilities, or
20(5) any combination thereof.
21    Any contractor shall agree to abide by all requirements of
22this Act and Rules and Regulations promulgated and adopted
23thereto; to submit such information and data as may from time
24to time be deemed necessary by the Director for effective
25administration of the provisions of this Act and the programs
26established hereunder, and to fully cooperate in any audit.



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1(Source: P.A. 93-839, eff. 7-30-04.)
2    Section 99. Effective date. This Act takes effect upon
3becoming law.