Full Text of SB2592 94th General Assembly
SB2592sam001 94TH GENERAL ASSEMBLY
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Sen. Jeffrey M. Schoenberg
Filed: 2/1/2006
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LRB094 18970 LJB 54825 a |
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| AMENDMENT TO SENATE BILL 2592
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| AMENDMENT NO. ______. Amend Senate Bill 2592 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Comprehensive Health Insurance Plan Act is | 5 |
| amended by changing Section 12 and by adding Sections 16, 17, | 6 |
| and 18 as follows:
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| (215 ILCS 105/12) (from Ch. 73, par. 1312)
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| Sec. 12. Deficit or surplus.
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| a. If premiums or other receipts by the
Board exceed the | 10 |
| amount required for the
operation
of the Plan, including actual | 11 |
| losses and administrative
expenses of the Plan, the Board shall | 12 |
| direct that the excess be held at
interest, in a bank | 13 |
| designated by the Board, or used to offset future
losses or to | 14 |
| reduce Plan premiums. In this
subsection, the term "future | 15 |
| losses" includes reserves for incurred but not
reported claims.
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| b. Any deficit incurred or expected to be incurred on | 17 |
| behalf of eligible
persons who qualify for Plan
plan coverage | 18 |
| under Section 7 of this Act or federally
eligible individuals | 19 |
| who qualify for Plan coverage under Section 15 of this Act | 20 |
| shall be
recouped from the Plan fund and
by an
appropriation | 21 |
| made by the General Assembly.
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| c. For the purposes of this Section, a deficit shall be | 23 |
| incurred when
anticipated losses and incurred but not reported | 24 |
| claims expenses exceed
anticipated income from earned premiums |
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| net of administrative expenses.
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| d. Any deficit incurred or expected to be incurred on | 3 |
| behalf of eligible
persons who qualify for Plan coverage under | 4 |
| Section 7 of this Act or federally
eligible individuals who | 5 |
| qualify for Plan coverage under Section 15 of this Act
that | 6 |
| exceeds the amount of funds in the Plan fund and the amount | 7 |
| appropriated by the General Assembly shall be recouped by an | 8 |
| assessment of all insurers , as defined in Section 2 of this | 9 |
| Act, made in accordance with the
provisions of this Section. | 10 |
| The Board shall within 90 days of the effective
date of this | 11 |
| amendatory Act of 1997 and within the first quarter of each | 12 |
| fiscal
year thereafter assess all insurers for the anticipated | 13 |
| deficit in accordance
with the provisions of this Section. The | 14 |
| board may also make additional
assessments no more than 4 times | 15 |
| a year to fund unanticipated deficits,
implementation | 16 |
| expenses, and cash flow needs.
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| e. An insurer's assessment shall be determined by | 18 |
| multiplying the total
assessment, as determined in subsection | 19 |
| d. of this Section, by a fraction, the
numerator of which | 20 |
| equals that insurer's direct Illinois premiums during the
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| preceding calendar year and the denominator of which equals the | 22 |
| total of all
insurers' direct Illinois premiums. The Board may | 23 |
| exempt those insurers whose
share as determined under this | 24 |
| subsection would be so minimal as to not exceed
the estimated | 25 |
| cost of levying the assessment.
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| f. The Board shall charge and collect from each insurer the | 27 |
| amounts
determined to be due under this Section. The assessment | 28 |
| shall be billed by
Board invoice based upon the insurer's | 29 |
| direct Illinois premium income as shown
in its annual
statement | 30 |
| for the preceding calendar year as filed with the Director. The
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| invoice shall be due upon
receipt and must be paid no later | 32 |
| than 30 days after receipt by the insurer.
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| g. When an insurer fails to pay the full amount of any | 34 |
| assessment of $100 or
more
due under this Section there shall |
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| be added to the amount due as a penalty the
greater of $50 or an | 2 |
| amount equal to 5% of the deficiency for each month or
part of | 3 |
| a month that the deficiency remains unpaid.
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| h. Amounts collected under this Section shall be paid to | 5 |
| the Board for
deposit into the Plan Fund authorized by Section | 6 |
| 3 of this Act.
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| i. An insurer may petition the Director for an abatement or | 8 |
| deferment of
all or part of an assessment imposed by the Board. | 9 |
| The Director may abate or
defer, in whole or in part, the | 10 |
| assessment if, in the opinion of the Director,
payment of the | 11 |
| assessment would endanger the ability of the insurer to fulfill
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| its contractual obligations. In the event an assessment against | 13 |
| an insurer is
abated or deferred in whole or in part, the | 14 |
| amount by which the assessment is
abated or deferred shall be | 15 |
| assessed against the other insurers in a manner
consistent with | 16 |
| the basis for assessments set forth in this subsection. The
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| insurer receiving a deferment shall remain liable to the plan | 18 |
| for the
deficiency for 4 years.
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| j. The board shall establish procedures for appeal by any | 20 |
| insurer subject
to assessment pursuant to this
Section. Such | 21 |
| procedures shall require that:
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| (1) Any insurer that wishes to appeal all or any part | 23 |
| of an assessment
made pursuant to this Section shall first | 24 |
| pay the amount of the assessment as
set forth in the | 25 |
| invoice provided by the board within the time provided in
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| subsection f. of this Section.
The board shall hold such | 27 |
| payments
in a separate interest-bearing account.
The | 28 |
| payments shall be accompanied by a
statement in writing | 29 |
| that the payment is made under appeal.
The statement
shall | 30 |
| specify the grounds for the appeal.
The insurer may be | 31 |
| represented in its appeal by counsel or other | 32 |
| representative
of its choosing.
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| (2) Within 90 days following the payment of an | 34 |
| assessment under appeal by
any insurer, the board shall |
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| notify the insurer or representative designated by
the | 2 |
| insurer in writing of its determination with respect to the | 3 |
| appeal
and the basis or bases for that determination unless
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| the Board notifies the insurer that
a reasonable amount of | 5 |
| additional
time is required to resolve the issues raised by | 6 |
| the appeal.
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| (3) The board shall refer to the Director any question | 8 |
| concerning the
amount of direct Illinois premium income as | 9 |
| shown in an insurer's annual
statement for the preceding | 10 |
| calendar year on file with the Director on the
invoice date | 11 |
| of the assessment. Unless additional time is required to | 12 |
| resolve
the question, the Director shall within 60 days | 13 |
| report to the board in writing
his determination respecting | 14 |
| the amount of direct Illinois premium income on
file on the | 15 |
| invoice date of the assessment.
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| (4) In the event the board determines that the insurer | 17 |
| is entitled to a
refund, the refund shall be paid within 30 | 18 |
| days following the date upon which
the board makes its | 19 |
| determination, together with the accrued interest.
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| Interest on any
refund due an insurer shall be paid at the | 21 |
| rate actually earned by the Board on
the separate account.
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| (5) The amount of any such refund shall then be | 23 |
| assessed against all
insurers in a manner consistent with | 24 |
| the basis for assessment as otherwise
authorized
by this | 25 |
| Section.
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| (6) The board's determination with respect to any | 27 |
| appeal received pursuant
to this subsection shall be a | 28 |
| final administrative decision as defined in
Section 3-101 | 29 |
| of the Code of Civil Procedure. The provisions of the
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| Administrative
Review Law shall apply to and govern all
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| proceedings for the judicial review of final | 32 |
| administrative decisions of the
board.
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| (7) If an insurer fails to appeal an assessment in | 34 |
| accordance with the
provisions of this subsection, the |
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| insurer shall be deemed
to have waived its right of appeal.
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| The provisions of this subsection apply to all assessments | 3 |
| made in any
calendar year ending on or after December 31, 1997.
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| (Source: P.A. 90-30, eff. 7-1-97; 90-567, eff. 1-23-98.)
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| (215 ILCS 105/16 new) | 6 |
| Sec. 16. Disease management program; required | 7 |
| participation. | 8 |
| (a) The Board shall develop baseline statistics for asthma, | 9 |
| diabetes, coronary artery disease, and congestive heart | 10 |
| failure and the co-morbidity of these and other commonly | 11 |
| occurring peripheral diseases among covered persons as part of | 12 |
| any disease management program instituted by the Board. | 13 |
| (b) All covered persons diagnosed with any of the diseases | 14 |
| listed in subsection (a) of this Section shall participate in | 15 |
| any disease management program instituted by the Board. A | 16 |
| covered person who refuses to participate in a disease | 17 |
| management program as required by this subsection (b) shall (i) | 18 |
| have his benefits reduced or (ii) be terminated from the Plan, | 19 |
| at the discretion of the Board.
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| (215 ILCS 105/17 new)
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| Sec. 17. Patient hotline. The Board shall contract with the | 22 |
| Plan administrator to provide 24-hour telephone access for | 23 |
| covered persons to a trained nurse in order to facilitate | 24 |
| better patient self-care and to reduce avoidable care and | 25 |
| emergency room visits. | 26 |
| (215 ILCS 105/18 new)
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| Sec. 18. Unclaimed insurance moneys. An amount of money | 28 |
| representing the total net receipt of moneys from health | 29 |
| insurers by the State as unclaimed property shall be deposited | 30 |
| into the Plan fund as provided in Section 18 of the Uniform | 31 |
| Disposition of Unclaimed Property Act.
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| Section 10. The Uniform Disposition of Unclaimed Property | 2 |
| Act is amended by changing Section 18 as follows:
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| (765 ILCS 1025/18) (from Ch. 141, par. 118)
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| Sec. 18. Deposit of funds received under the Act.
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| (a) The State Treasurer shall retain all funds received | 6 |
| under this Act,
including the proceeds from
the sale of | 7 |
| abandoned property under Section 17, in a trust fund and shall,
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| on April 15 and October 15 of each year, deposit any amount in | 9 |
| the trust fund
exceeding $2,500,000 as follows: 95% of that | 10 |
| amount shall be deposited into the State Pensions Fund , and 5% | 11 |
| of that amount shall be deposited into the Plan fund | 12 |
| established under Section 3 of the Comprehensive Health | 13 |
| Insurance Plan Act . He or she shall make prompt payment of | 14 |
| claims he or she
duly allows as provided for in this Act for | 15 |
| the trust fund.
Before making the deposit the State Treasurer
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| shall record the name and last known address of each person | 17 |
| appearing from the
holders' reports to be entitled to the | 18 |
| abandoned property. The record shall be
available for public | 19 |
| inspection during reasonable business
hours.
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| (b) Before making any deposit to the credit of the State | 21 |
| Pensions Fund or the Plan fund established under Section 3 of | 22 |
| the Comprehensive Health Insurance Plan Act ,
the State | 23 |
| Treasurer may deduct: (1) any costs in connection with sale of
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| abandoned property, (2) any costs of mailing and publication in | 25 |
| connection with
any abandoned property, and (3) any costs in | 26 |
| connection with the maintenance of
records or disposition of | 27 |
| claims made pursuant to this Act. The State
Treasurer shall | 28 |
| semiannually file an itemized report of all such expenses with
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| the Legislative Audit Commission.
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| (Source: P.A. 93-531, eff. 8-14-03.)
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| Section 99. Effective date. This Act takes effect upon |
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| becoming law.".
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