Full Text of SB1729 97th General Assembly
SB1729sam001 97TH GENERAL ASSEMBLY | Sen. David Koehler Filed: 3/17/2011
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| 1 | | AMENDMENT TO SENATE BILL 1729
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1729 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Illinois Health Coverage Exchange Establishment Act of 2011. | 6 | | Section 5. Purpose and intent; application. | 7 | | (a) The General Assembly hereby declares as follows: | 8 | | (1) The purpose of this Act is to provide for the | 9 | | establishment of an Illinois Health Coverage Exchange to | 10 | | facilitate the purchase and sale of qualified health plans | 11 | | in the individual market in this State, to provide for the | 12 | | establishment of the Small Business Health Options Program | 13 | | to assist qualified small employers in this State in | 14 | | facilitating the enrollment of employees and their family | 15 | | members in qualified health plans, and to provide an | 16 | | efficient, cost-effective process to test eligibility and |
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| 1 | | enroll eligible individuals in public health care coverage | 2 | | such as Medicaid or the Children's Health Insurance | 3 | | Program. | 4 | | (2) The intent of the Exchange is to offer private | 5 | | health plans that provide financial security and | 6 | | appropriate access to health care for individuals, | 7 | | families, and employers in this State and in a manner that | 8 | | is in the best interest of such individuals, reduce the | 9 | | number of uninsured, provide a transparent marketplace and | 10 | | consumer education, assist eligible individuals with | 11 | | enrollment in public health care programs such as Medicaid | 12 | | or the Children's Health Insurance Program, premium | 13 | | assistance tax credits, cost-sharing reductions, and to | 14 | | promote an innovative delivery system and payment reforms | 15 | | referring to lower cost and improve quality. | 16 | | (3) The federal Patient Protection and Affordable Care | 17 | | Act (ACA) requires states to establish an operational | 18 | | Exchange on or before January 1, 2014. In the event a state | 19 | | does not demonstrate significant progress in the | 20 | | implementation of an Exchange by January 1, 2013, then the | 21 | | federal government will establish an Exchange for the | 22 | | non-compliant state. Pursuant to the ACA, an Exchange will | 23 | | determine eligibility and facilitate enrollment in public | 24 | | health programs, including Medicaid and the Children's | 25 | | Health Insurance Program. The Exchange will also provide a | 26 | | marketplace for individuals, families, and employers to |
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| 1 | | shop for and purchase private health plans. The State of | 2 | | Illinois finds that it is in the State's best interest to | 3 | | establish an Exchange rather than defer to the federal | 4 | | government. | 5 | | (b) This Act shall be null and void if Congress and the | 6 | | President take action to repeal or replace, or both, Section | 7 | | 1311 of the Affordable Care Act. | 8 | | Section 10. Definitions. As used in this Act: | 9 | | "Board" means the Illinois Health Benefits Exchange Board | 10 | | established pursuant to this Act. | 11 | | "Director" means the Director of Insurance. | 12 | | "Educated health care consumer" means an individual who is | 13 | | knowledgeable about the health care system and has background | 14 | | or experience in making informed decisions regarding health, | 15 | | medical, and scientific matters. | 16 | | "Employee" has the meaning given that term in the Illinois | 17 | | Health Insurance Portability and Accountability Act. | 18 | | "Exchange" means the Illinois Health Benefits Exchange | 19 | | established pursuant to this Act. | 20 | | "Federal Act" means the federal Patient Protection and | 21 | | Affordable Care Act (Public Law 111-148), as amended by the | 22 | | federal Health Care and Education Reconciliation Act of 2010 | 23 | | (Public Law 111-152), and any amendments thereto or regulations | 24 | | or guidance issued under those Acts. | 25 | | "Health benefit plan" means a policy, contract, |
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| 1 | | certificate, or agreement offered or issued by a health carrier | 2 | | to provide, deliver, arrange for, pay for, or reimburse any of | 3 | | the costs of health care services. "Health benefit plan" does | 4 | | not include: | 5 | | (1) coverage only for accident or disability income | 6 | | insurance or any combination thereof; | 7 | | (2) coverage issued as a supplement to liability | 8 | | insurance; | 9 | | (3) liability insurance, including general liability | 10 | | insurance and automobile liability insurance; | 11 | | (4) workers' compensation or similar insurance; | 12 | | (5) automobile medical payment insurance; | 13 | | (6) credit-only insurance; | 14 | | (7) coverage for only on-site medical clinics; or | 15 | | (8) other similar insurance coverage specified in | 16 | | federal regulations issued pursuant to Pub. L. No. 104-191, | 17 | | under which benefits for health care services are secondary | 18 | | or incidental to other insurance benefits. | 19 | | "Health benefit plan" does not include the following benefits | 20 | | if they are provided under a separate policy, certificate, or | 21 | | contract of insurance or are otherwise not an integral part of | 22 | | the plan: | 23 | | (a) limited scope dental or vision benefits; | 24 | | (b) benefits for long-term care, nursing home care, | 25 | | home health care, community-based care, or any combination | 26 | | thereof; or |
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| 1 | | (c) other similar, limited benefits specified in | 2 | | federal regulations issued pursuant to Pub. L. No. 104-191. | 3 | | "Health benefit plan" does not include the following benefits | 4 | | if the benefits are provided under a separate policy, | 5 | | certificate, or contract of insurance, there is no coordination | 6 | | between the provision of the benefits and any exclusion of | 7 | | benefits under any group health plan maintained by the same | 8 | | plan sponsor, and the benefits are paid with respect to an | 9 | | event without regard to whether benefits are provided with | 10 | | respect to such an event under any group health plan maintained | 11 | | by the same plan sponsor: | 12 | | (i) coverage only for a specified disease or illness; | 13 | | or | 14 | | (ii) hospital indemnity or other fixed indemnity | 15 | | insurance. | 16 | | "Health benefit plan" does not include the following if offered | 17 | | as a separate policy, certificate, or contract of insurance: | 18 | | (A) medicare supplemental health insurance as defined | 19 | | under Section 1882(g)(1) of the Social Security Act; | 20 | | (B) coverage supplemental to the coverage provided | 21 | | under Chapter 55 of Title 10, United States Code (Civilian | 22 | | Health and Medical Program of the Uniformed Services | 23 | | (CHAMPUS)); or | 24 | | (C) similar supplemental coverage provided as coverage | 25 | | under a group health plan. | 26 | | "Health carrier" or "carrier" means an entity subject to |
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| 1 | | the insurance laws and regulations of this State, or subject to | 2 | | the jurisdiction of the Director, that contracts or offers to | 3 | | contract to provide, deliver, arrange for, pay for, or | 4 | | reimburse any of the costs of health care services, including a | 5 | | sickness and accident insurance company, a health maintenance | 6 | | organization, or any other entity providing a plan of health | 7 | | insurance, health benefits, or health services. | 8 | | "Qualified dental plan" means a limited scope dental plan | 9 | | that has been certified in accordance with this Act. | 10 | | "Qualified employer" means a small employer that elects to | 11 | | make its full-time employees eligible for one or more qualified | 12 | | health plans offered through the SHOP Exchange, and at the | 13 | | option of the employer, some or all of its part-time employees, | 14 | | provided that the employer: | 15 | | (1) has its principal place of business in this State | 16 | | and elects to provide coverage through the SHOP Exchange to | 17 | | all of its eligible employees, wherever employed; or | 18 | | (2) elects to provide coverage through the SHOP | 19 | | Exchange to all of its eligible employees who are | 20 | | principally employed in this State. | 21 | | "Qualified health plan" means a health benefit plan that | 22 | | has in effect a certification that the plan meets the criteria | 23 | | for certification described in Section 1311(c) of the Federal | 24 | | Act and this Act. | 25 | | "Qualified individual" means an individual, including a | 26 | | minor, who: |
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| 1 | | (1) is seeking to enroll in a qualified health plan | 2 | | offered to individuals through the Exchange; | 3 | | (2) resides in this State; | 4 | | (3) At the time of enrollment, is not incarcerated, | 5 | | other than incarceration pending the disposition of | 6 | | charges; and | 7 | | (4) is and is reasonably expected to be for the entire | 8 | | period for which enrollment is sought a citizen or national | 9 | | of the United States or an alien lawfully present in the | 10 | | United States. | 11 | | "Secretary" means the Secretary of the federal Department | 12 | | of Health and Human Services. | 13 | | "SHOP Exchange" means the Small Business Health Options | 14 | | Program established under Section 30 of this Act. | 15 | | "Small employer" has the meaning given that term in the | 16 | | Illinois Health Insurance Portability and Accountability Act. | 17 | | An employer that makes enrollment in qualified health plans | 18 | | available to its employees through the SHOP Exchange and would | 19 | | cease to be a small employer by reason of an increase in the | 20 | | number of its employees shall continue to be treated as a small | 21 | | employer for purposes of this Act as long as it continuously | 22 | | makes enrollment through the SHOP Exchange available to its | 23 | | employees. | 24 | | Section 15. Creation of the Exchange. | 25 | | (a) There is hereby created a political subdivision, body |
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| 1 | | politic, and corporate, that is not a State entity, named the | 2 | | Illinois Health Benefits Exchange. The governing and | 3 | | administrative powers of the Exchange shall be vested in a body | 4 | | known as the Illinois Health Benefits Exchange Board. The Board | 5 | | shall consist of 9 voting members, 7 of whom shall be appointed | 6 | | by the Governor with the advice and consent of the Senate and 2 | 7 | | of whom shall be appointed by the Attorney General with the | 8 | | advice and consent of the Senate. The members appointed by the | 9 | | Governor shall include: | 10 | | (1) one consumer representative who is or has in the | 11 | | preceding 2 years been insured in the individual health | 12 | | insurance market in this State; | 13 | | (2) one small employer representative with experience | 14 | | operating a small business in this State; | 15 | | (3) one employee representative of a small employer in | 16 | | this State; | 17 | | (4) one Illinois-licensed insurance producer with | 18 | | experience facilitating the purchase of health insurance | 19 | | coverage in the individual or small group market in this | 20 | | State; | 21 | | (5) one certified health actuary; and | 22 | | (6) one Illinois-licensed health care provider or | 23 | | other qualified representative with experience serving | 24 | | underserved populations, including but not limited to the | 25 | | uninsured and those receiving coverage through public | 26 | | health care programs such as Medicaid or the Children's |
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| 1 | | Health Insurance Program, in both the community-based | 2 | | health care setting and a hospital-based setting in this | 3 | | State; and | 4 | | (7) one representative of the organized labor | 5 | | community in this State. | 6 | | The members appointed by the Attorney General shall include: | 7 | | (i) one health lawyer with experience in public | 8 | | programs, such as Medicaid or the Children's Health | 9 | | Insurance Program, and private health insurance coverage; | 10 | | and | 11 | | (ii) One health lawyer with experience working in | 12 | | collaboration with the Attorney General's Health Care | 13 | | Bureau. | 14 | | (b) The Director of Insurance, the Director of the | 15 | | Healthcare and Family Services, the Director of Human Services, | 16 | | and the Director of Public Health shall serve as ex officio, | 17 | | non-voting members of the Board. | 18 | | (c) Four members of the General Assembly, one each | 19 | | appointed by the President of the Senate, the Minority Leader | 20 | | of the Senate, the Speaker of the
House of Representatives, and | 21 | | the Minority Leader of the House of Representatives, shall | 22 | | serve as ex officio, nonvoting members of the Board. | 23 | | (d) In making appointments to the Board, the appointing | 24 | | authorities shall take into consideration the cultural, | 25 | | ethnic, and geographic diversity of the State so that the | 26 | | Board's composition reflects the communities of this State. |
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| 1 | | (e) The Board shall appoint one of its members as | 2 | | chairperson of the Board. Members of the Board shall receive no | 3 | | compensation, but shall be reimbursed for reasonable expenses | 4 | | incurred in the necessary performance of their duties, | 5 | | including travel. | 6 | | (f) The Exchange shall procure necessary services and terms | 7 | | using a process with integrity and transparency and that is | 8 | | free of conflicts of interest and serves the best interest of | 9 | | individuals, families, and employers purchasing coverage | 10 | | through the Exchange. | 11 | | (g) The meetings of the Board shall be subject to the Open | 12 | | Meetings Act, except that the Board may hold closed sessions | 13 | | when considering matters related to litigation, personnel, | 14 | | contracting, and rates.
| 15 | | (h) Notwithstanding subsections (8) and (12) of Section | 16 | | 10-15 of the State Officials and Employees Ethics Act, no | 17 | | member of the Board or its employees shall accept food or | 18 | | refreshments or any item or items from any prohibited source. | 19 | | (i) Board members shall have the responsibility and duty to | 20 | | meet the requirements of this Act and all applicable State and | 21 | | federal laws and regulations, to serve the public interest of | 22 | | the individuals and small businesses seeking health insurance | 23 | | coverage through the Exchange, and to ensure the operational | 24 | | well-being and fiscal solvency of the Exchange. | 25 | | (j) No member of the Board nor employees of the Board may | 26 | | be an employee of any licensed carrier authorized to do |
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| 1 | | business in this State. | 2 | | (k) No member of the Board nor employees of the Board shall | 3 | | make, participate in making, or in any way attempt to use his | 4 | | or her official position to influence the making of any | 5 | | decision that he or she knows or has any reason to know will | 6 | | have a reasonably foreseeable material financial effect, | 7 | | distinguishable from its effect on the public generally, on him | 8 | | or her or a member of his or her family or on either of the | 9 | | following: | 10 | | (1) any source of income provided to, received by, or | 11 | | promised to a member within 12 months prior to the time | 12 | | when a decision is made; or | 13 | | (2) any business entity in which the member is a | 14 | | director, officer, partner, trustee, employee, or holds | 15 | | any position of management. | 16 | | (l) The Director, or any person he or she may appoint, may, | 17 | | in the same manner as authorized for examination of domestic, | 18 | | foreign, or alien insurance companies, investigate the affairs | 19 | | of the Exchange and examine the properties and records of the | 20 | | Exchange and shall, at least annually, require the Exchange to | 21 | | provide periodic reporting to the Governor and the General | 22 | | Assembly in relation to the activities undertaken by the | 23 | | Exchange under this Act. | 24 | | (m) The Office of the Executive Inspector General shall | 25 | | have jurisdiction over the Exchange and all individuals | 26 | | supervising, directing, contracting, or working for the |
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| 1 | | Exchange. | 2 | | Section 20. Terms of appointments. Within 60 days after the | 3 | | effective date of this Act, the Governor shall appoint 3 voting | 4 | | members of the Board for initial terms expiring June 30, 2015; | 5 | | the Governor shall appoint 2 public members and the Attorney | 6 | | General shall appoint one voting member of the Board for | 7 | | initial terms expiring June 30, 2014; and the Governor shall | 8 | | appoint 2 voting members and the Attorney General shall appoint | 9 | | one voting member of the Board for initial terms expiring June | 10 | | 30, 2013. All successors shall hold office for a term of 3 | 11 | | years from the first day of July in the year of appointment and | 12 | | running through June 30 of the third year, except in case of an | 13 | | appointment to fill a vacancy. A Board member shall hold office | 14 | | until the expiration of that member's term and until that | 15 | | member's successor is appointed and qualified. Board members | 16 | | may be appointed to subsequent terms. Vacancies shall be filled | 17 | | in the same manner as original appointments for the balance of | 18 | | the unexpired term. In case of vacancy when the Senate is not | 19 | | in session, the Governor may make a temporary appointment until | 20 | | the next meeting of the Senate, when the Governor or Attorney | 21 | | General shall nominate such person to fill the open Board | 22 | | position and any
person so nominated who is confirmed by the | 23 | | Senate shall hold his or her office during the remainder of the | 24 | | term and until his or her successor is appointed and qualified. |
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| 1 | | Section 25. Executive Director. The Board shall appoint an | 2 | | Executive Director who shall be the chief executive officer of | 3 | | the Exchange. The Executive Director shall have at least 5 | 4 | | years of experience in health care policy, management, service, | 5 | | delivery, or coverage. In addition to any other duties set | 6 | | forth in this Act, the Executive Director shall: | 7 | | (1) employ such staff as may be necessary to carry out | 8 | | the provisions of this Act; | 9 | | (2) direct and supervise the administrative affairs | 10 | | and activities of the Exchange in accordance with its | 11 | | rules, regulations, and policies; | 12 | | (3) attend meetings of the Board; | 13 | | (4) keep minutes of all proceedings of the Board; | 14 | | (5) approve all accounts for salaries, per diem | 15 | | payments, and allowable expenses of the Exchange and its | 16 | | employees and consultants and approve all expenses | 17 | | incidental to the operation of the Exchange; and | 18 | | (6) perform any other duty that the Board requires for | 19 | | carrying out the provisions of this Act. | 20 | | Section 30. Quorum; voting; meetings. | 21 | | (a) Five members of the Board constitute a quorum for the | 22 | | purpose of conducting business. | 23 | | (b) Actions of the Board must receive the affirmative vote | 24 | | of at least 5 members of the Board. | 25 | | (c) The Board shall meet at least quarterly or more often |
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| 1 | | if necessary. | 2 | | Section 35. Powers and authority of the Board. | 3 | | (a) In addition to powers set forth elsewhere in this Act, | 4 | | the Board may do the following: | 5 | | (1) Adopt bylaws, rules, and regulations to carry out | 6 | | the provisions of this Act. | 7 | | (2) Authorize the Exchange to enter into contracts as | 8 | | are necessary or proper to carry out the provisions and | 9 | | purposes or perform any of the functions described in this | 10 | | Act. | 11 | | (3) Take or defend any legal actions necessary to | 12 | | effectuate the purposes of this Act. | 13 | | (4) Appoint appropriate legal, actuarial, and other | 14 | | committees as necessary to provide technical assistance in | 15 | | the operation of the Exchange, contract design, and any | 16 | | other function described in this Act. | 17 | | (5) Authorize commercial, banking, and financial | 18 | | arrangements as needed to manage the day-to-day operations | 19 | | of the Exchange. | 20 | | (6) Appoint and fix the compensation of an Executive | 21 | | Director. | 22 | | (7) Enter into intergovernmental cooperation | 23 | | agreements with governmental entities for the purpose of | 24 | | sharing the cost of providing access to health care | 25 | | coverage that are otherwise authorized by this Act or to |
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| 1 | | carry out other responsibilities under this Act provided | 2 | | such agreements adequately protect the confidentiality of | 3 | | information to be shared and comply with applicable State | 4 | | and federal laws and regulations. | 5 | | (8) Establish conditions and procedures under which | 6 | | the exchange may, if charitable or other funds are | 7 | | provided, discount or subsidize premium rates and | 8 | | cost-sharing or prescription drug costs that are paid | 9 | | directly by other public or private entities, as defined by | 10 | | the Board. | 11 | | (9) Apply for, accept, and spend as appropriate any | 12 | | federal or State grant money made available through or | 13 | | pursuant to the Affordable Care Act or any other federal or | 14 | | State-related opportunity in order to assist the Board as | 15 | | it implements the provisions of this Act. | 16 | | (10) Create an administration fund under direction of | 17 | | the Board and management by the Executive Director to: | 18 | | (A) fund administrative and any other expenses of | 19 | | the Exchange; and | 20 | | (B) receive and deposit into the administration | 21 | | fund any money collected or received by the Board | 22 | | pursuant to this Act. | 23 | | (b) The Board shall create an Exchange that shall: | 24 | | (1) facilitate the purchase and sale of qualified | 25 | | health plans; | 26 | | (2) assist qualified small employers in this State in |
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| 1 | | facilitating the enrollment of employees in qualified | 2 | | health plans; | 3 | | (3) develop a process to certify plans eligible to | 4 | | participate in the Exchange; and | 5 | | (4) facilitate enrollment in Medicaid or the | 6 | | Children's Health Insurance Program for eligible | 7 | | individuals; | 8 | | (5) inform individuals of the potential for | 9 | | overpayments of advance premium tax credits and of | 10 | | procedures by which individuals can report a change of | 11 | | income that may affect the subsequent level of premium tax | 12 | | credits, including the availability of any safe harbor from | 13 | | recoupment of any overpayment, to the extent permissible | 14 | | under the Federal Act or any federal regulations | 15 | | promulgated thereunder; and | 16 | | (6) meet the requirements of this Act and any | 17 | | regulations implemented under this Act. | 18 | | (c) In addition to powers set forth elsewhere in this Act, | 19 | | the Board shall do all of the following: | 20 | | (1) Make qualified health plans available to qualified | 21 | | individuals and qualified employers beginning with | 22 | | effective dates on or before January 1, 2014. | 23 | | (2) Not make available any health benefit plan that is | 24 | | not a qualified health plan. | 25 | | (3) Allow a health carrier to offer a plan that | 26 | | provides limited scope dental benefits meeting the |
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| 1 | | requirements of Section 9832(c)(2)(A) of the Internal | 2 | | Revenue Code of 1986 through the Exchange, either | 3 | | separately or in conjunction with a qualified health plan, | 4 | | if the plan provides pediatric dental benefits meeting the | 5 | | requirements of Section 1302(b)(1)(J) of the Federal Act. | 6 | | (4) Not charge, or allow a health carrier offering | 7 | | health benefit plans though the Exchange to charge, an | 8 | | individual a fee or penalty for termination of coverage if | 9 | | the individual enrolls in another type of minimum essential | 10 | | coverage because the individual has become newly eligible | 11 | | for that coverage or because the individual's | 12 | | employer-sponsored coverage has become affordable under | 13 | | the standards of Section 36B(c)(2)(C) of the Internal | 14 | | Revenue Code of 1986. | 15 | | (5) Implement procedures for the certification, | 16 | | recertification, and decertification, consistent with | 17 | | guidelines developed by the Secretary under Section | 18 | | 1311(c) of the Federal Act and Section 35 of this Act, of | 19 | | health benefit plans as qualified health plans. | 20 | | (6) Provide for the operation of a toll-free telephone | 21 | | hotline to respond to requests for assistance. | 22 | | (7) Provide for enrollment periods as provided under | 23 | | Section 1311(c)(6) of the Federal Act. | 24 | | (8) Maintain an Internet website through which | 25 | | enrollees and prospective enrollees of qualified health | 26 | | plans may obtain standardized comparative information on |
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| 1 | | such plans. | 2 | | (9) Assign a rating to each qualified health plan | 3 | | offered through the Exchange in accordance with the | 4 | | criteria developed by the Secretary under Section | 5 | | 1311(c)(3) of the Federal Act, and determine each qualified | 6 | | health plan's level of coverage in accordance with | 7 | | regulations issued by the Secretary under Section | 8 | | 1302(d)(2)(A) of the Federal Act. The Exchange shall make | 9 | | this information public in a manner consistent with | 10 | | subparagraph (B) of paragraph (18) of subsection (c) of | 11 | | this Section and paragraph (3) of subsection (c) of Section | 12 | | 50 of this Act. | 13 | | (10) Use a standardized format for presenting health | 14 | | benefit options in the Exchange, including the use of the | 15 | | uniform outline of coverage established under Section 2715 | 16 | | of the Public Health Service Act. | 17 | | (11) In accordance with Section 1413 of the Federal | 18 | | Act, inform individuals of eligibility requirements for | 19 | | the Medicaid program under title XIX of the Social Security | 20 | | Act, the Children's Health Insurance Program under title | 21 | | XXI of the Social Security Act or any applicable State or | 22 | | local public program and if through screening of the | 23 | | application by the Exchange the Exchange determines that | 24 | | any individual is eligible for any such program, then | 25 | | enroll that individual in that program. | 26 | | (12) Establish and make available by electronic means a |
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| 1 | | calculator to determine the actual cost of coverage after | 2 | | application of any premium tax credit under Section 36B of | 3 | | the Internal Revenue Code of 1986 and any cost-sharing | 4 | | reduction under Section 1402 of the Federal Act. | 5 | | (13) Establish a SHOP Exchange, separate from the | 6 | | activities related to the individual market, through which | 7 | | qualified employers may access coverage for their | 8 | | employees. The SHOP Exchange shall enable any qualified | 9 | | employer to specify a level of coverage so that any of its | 10 | | employees may enroll in any qualified health plan offered | 11 | | through the SHOP Exchange at the specified level of | 12 | | coverage. | 13 | |
(14) Subject to Section 1411 of the Federal Act, grant | 14 | | a certification attesting that, for purposes of the | 15 | | individual responsibility penalty under Section 5000A of | 16 | | the Internal Revenue Code of 1986, an individual is exempt | 17 | | from the individual responsibility requirement or from the | 18 | | penalty imposed by that Section because: | 19 | |
(A) there is no affordable qualified health plan | 20 | | available through the Exchange or the individual's | 21 | | employer covering the individual; or | 22 | |
(B) the individual meets the requirements for any | 23 | | other such exemption from the individual | 24 | | responsibility requirement or penalty; | 25 | |
(15) Transfer to the federal Secretary of the Treasury | 26 | | the following: |
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| 1 | | (A) a list of the individuals who are issued a | 2 | | certification under paragraph (14) of this subsection | 3 | | (c), including the name and taxpayer identification | 4 | | number of each individual;
| 5 | | (B) the name and taxpayer identification number of | 6 | | each individual who was an employee of an employer but | 7 | | who was determined to be eligible for the premium tax | 8 | | credit under Section 36B of the Internal Revenue Code | 9 | | of 1986 because: | 10 | | (i) the employer did not provide minimum | 11 | | essential coverage; or | 12 | | (ii) the employer provided the minimum | 13 | | essential coverage, but it was determined under | 14 | | Section 36B(c)(2)(C) of the Internal Revenue Code | 15 | | to either be unaffordable to the employee or not | 16 | | provide the required minimum actuarial value; and | 17 | | (C) the name and taxpayer identification number | 18 | | of: | 19 | | (i) each individual who notifies the Exchange | 20 | | under Section 1411(b)(4) of the Federal Act that he | 21 | | or she has changed employers; and | 22 | | (ii) each individual who ceases coverage under | 23 | | a qualified health plan during a plan year and the | 24 | | effective date of that cessation. | 25 | | (16) Provide to each employer the name of each employee | 26 | | of the employer described in item (ii) of subparagraph (C) |
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| 1 | | of paragraph (15) of this subsection (c) who ceases | 2 | | coverage under a qualified health plan during a plan year | 3 | | and the effective date of the cessation. | 4 | | (17) Perform duties required of the Exchange by the | 5 | | Secretary or the Secretary of the Treasury related to | 6 | | determining eligibility for premium tax credits, reduced | 7 | | cost-sharing or individual responsibility requirement | 8 | | exemptions.
| 9 | | (18) Select entities qualified to serve as Navigators | 10 | | in accordance with Section 1311(i) of the Federal Act, and | 11 | | standards developed by the Secretary, and award grants to | 12 | | enable Navigators to: | 13 | | (A) conduct public education activities to raise | 14 | | awareness of the availability of qualified health | 15 | | plans, premium assistance tax credits, cost sharing | 16 | | reductions, Medicaid and Children's Health Insurance | 17 | | Program eligibility, and related consumer protections; | 18 | | (B) distribute fair and impartial information | 19 | | concerning enrollment in qualified health plans and | 20 | | the availability of premium tax credits under Section | 21 | | 36B of the Internal Revenue Code of 1986 and | 22 | | cost-sharing reductions under Section 1402 of the | 23 | | Federal Act; | 24 | | (C) facilitate enrollment in qualified health | 25 | | plans and public health care programs, such as Medicaid | 26 | | and the Children Health Insurance Program, where |
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| 1 | | permitted by State and federal law; | 2 | | (D) provide referrals to the Office of Consumer | 3 | | Health Insurance in the Department for any enrollee | 4 | | with a grievance, complaint, or question regarding | 5 | | their health benefit plan, coverage, or a | 6 | | determination under that plan or coverage; and | 7 | | (E) provide information in a manner that is | 8 | | culturally and linguistically appropriate to the needs | 9 | | of the population being served by the Exchange. | 10 | | (19) Within 30 days after issuance of federal guidance | 11 | | regarding the Navigator function in the Exchange, the | 12 | | Board, in collaboration with the advisory committees, | 13 | | shall establish an open process to explore the design and | 14 | | operation of the Exchange's Navigator Program and any other | 15 | | appropriate consumer assistance mechanisms. Within 6 | 16 | | months after the effective date of this Act or by February | 17 | | 1, 2012, whichever occurs first, the Board shall provide | 18 | | recommendations related to the functions of the Exchange or | 19 | | the role of navigators to the Governor and the General | 20 | | Assembly for their consideration, including: | 21 | | (A) the infrastructure of the existing private | 22 | | sector health insurance distribution system in this | 23 | | State to determine whether private sector resources | 24 | | may be available and suitable for use by the Exchange; | 25 | | (B) the effect the Exchange may have on private | 26 | | sector employment in the health insurance distribution |
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| 1 | | system in this State; | 2 | | (C) what functions, in addition to those required | 3 | | by the Patient Protection and Affordable Care Act, | 4 | | should be performed by Navigators; | 5 | | (D) what training and expertise should be required | 6 | | of Navigators, and whether different markets and | 7 | | populations require Navigators with different | 8 | | qualifications; | 9 | | (E) how Navigators should be retained and | 10 | | compensated, and how disparities between Navigator | 11 | | compensation and the compensation of insurance | 12 | | producers outside the Exchange can be minimized or | 13 | | avoided; | 14 | | (F) how to ensure that Navigators provide | 15 | | information in a manner culturally, linguistically, | 16 | | and otherwise appropriate to the needs of the diverse | 17 | | populations served by the Exchange, and that | 18 | | Navigators have the capacity to meet these needs; and | 19 | | (G) what other means of consumer assistance may be | 20 | | appropriate and feasible, and how they should be | 21 | | designed and implemented. | 22 | | (20) Review the rate of premium growth within the | 23 | | Exchange and outside the Exchange and consider the | 24 | | information in developing recommendations to the Board | 25 | | about whether to continue limiting qualified employer | 26 | | status to small employers. |
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| 1 | |
(21) Credit the amount of any free choice voucher to | 2 | | the monthly premium of the plan in which a qualified | 3 | | employee is enrolled, in accordance with Section 10108 of | 4 | | the Federal Act, and collect the amount credited from the | 5 | | offering employer. | 6 | |
(22) Consult with stakeholders relevant to carrying | 7 | | out the activities required under this Act, including, but | 8 | | not limited to: | 9 | | (A) health care consumers who are enrollees in | 10 | | qualified health plans; | 11 | | (B) individuals and entities with experience in | 12 | | facilitating enrollment in qualified health plans and | 13 | | public health care programs, such as Medicaid or the | 14 | | Children's Health Insurance Program; | 15 | | (C) representatives of the employer community, | 16 | | including small businesses, self-employed individuals, | 17 | | and large self-insured plans; | 18 | | (D) providers, including physicians, nurses, | 19 | | behavioral health professionals, other allied health | 20 | | professionals, and hospitals; | 21 | | (E) representatives of union-administered health | 22 | | benefit plans; | 23 | | (F) entities or individuals with experience in | 24 | | designing, managing, and purchasing health benefit | 25 | | plans;
| 26 | | (G) the Department of Healthcare and Family |
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| 1 | | Services; | 2 | | (H) the President of the Senate, the Minority | 3 | | Leader of the Senate, the Speaker of the House of | 4 | | Representatives, and the Minority Leader of the House | 5 | | of Representatives; | 6 | | (I) the Department of Human Services; | 7 | | (J) the Department of Public Health; and | 8 | | (K) advocates for enrolling hard to reach | 9 | | populations. | 10 | | (23) The Board, in collaboration with the advisory | 11 | | committees, shall establish an open process to explore | 12 | | several aspects of Exchange policy and provide | 13 | | recommendations to the General Assembly about future | 14 | | legislative action regarding: | 15 | | (A) expanding the definition of small employer to | 16 | | include employers with up to 100 employees, including | 17 | | an analysis of the impact of such a policy on premiums | 18 | | and access to health insurance coverage for | 19 | | individuals and small businesses in this State; | 20 | | (B) permitting employers with more than 100 | 21 | | employees to purchase coverage through the Exchange | 22 | | beginning in 2017, including an analysis of the impact | 23 | | of such a policy on premiums and access to health | 24 | | insurance coverage for individuals and small | 25 | | businesses in this State; and | 26 | | (C) additional mechanisms to minimize the risk of |
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| 1 | | adverse selection in the Exchange. | 2 | | In close cooperation with the Department of Healthcare | 3 | | and Family Services and other impacted agencies and stake | 4 | | holders, the Board shall make a recommendation as to | 5 | | whether Illinois should adopt a Basic Health Plan as | 6 | | allowed under Section 1331 of the ACA. Such a | 7 | | recommendation should take into account, among other | 8 | | things the potential impact on individuals who would be | 9 | | covered under the Basic Health Plan, the potential cost to | 10 | | the State, and the overall impact on the Exchange. Such a | 11 | | recommendation must be made within 6 months after the final | 12 | | rules for states by the Secretary regarding the | 13 | | establishment of Basic Health Plans. | 14 | | (25) Meet the following financial integrity | 15 | | requirements: | 16 | | (A) keep an accurate accounting of all activities, | 17 | | receipts, and expenditures and annually submit to the | 18 | | Secretary, the Governor, the Director, and the General | 19 | | Assembly a report concerning such accountings; | 20 | | (B) fully cooperate with any investigation | 21 | | conducted by the Secretary pursuant to the Secretary's | 22 | | authority under the Federal Act and allow the | 23 | | Secretary, in coordination with the Inspector General | 24 | | of the U.S. Department of Health and Human Services, to | 25 | | do the following: | 26 | | (i) investigate the affairs of the Exchange; |
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| 1 | | (ii) examine the properties and records of the | 2 | | Exchange; and | 3 | | (iii) require periodic reports in relation to | 4 | | the activities undertaken by the Exchange; and | 5 | | (C) in carrying out its activities under this Act, | 6 | | not use any funds intended for the administrative and | 7 | | operational expenses of the Exchange for staff | 8 | | retreats, promotional giveaways, excessive executive | 9 | | compensation, or promotion of federal or State | 10 | | legislative and regulatory modifications.
| 11 | | (d) Unless authorized by law, the Board and any Exchange | 12 | | employee or representative are not authorized to act in any | 13 | | manner that implies or asserts that the Board or the Exchange | 14 | | in and of itself can add to or impose any fiscal liability on | 15 | | the State. | 16 | | (e) The Board shall recognize waivers approved by the | 17 | | Secretary pursuant to the Federal Act, recognizing that these | 18 | | waivers may change over time and be of limited scope or | 19 | | duration. | 20 | | Section 40. Advisory committees. | 21 | | (a) Within 60 days after the effective date of this Act, | 22 | | the Board shall appoint a Technical Advisory Committee composed | 23 | | of no more than 20 individuals responsible for developing the | 24 | | standards and criteria for selecting qualified health plans to | 25 | | be offered through the Exchange. Such standards and criteria |
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| 1 | | shall be developed based upon the tenets of value, quality, and | 2 | | service and in a manner that serves the best interests of | 3 | | qualified individuals and qualified small employers. The | 4 | | Committee shall meet no less than once every 3 months and shall | 5 | | provide recommendations to the Board regarding standards and | 6 | | criteria for qualified health plans no later than 6 months | 7 | | after its establishment. The Technical Advisory Committee | 8 | | shall consult with the Stakeholder Advisory Committee | 9 | | described in this Section regarding its draft recommendations | 10 | | and provide time for substantive comment no less than once | 11 | | prior to issuing any final recommendations for review by the | 12 | | Board. | 13 | | (b) Each person appointed to the Committee shall serve a | 14 | | 2-year term, and have demonstrated and acknowledged expertise | 15 | | in at least 2 of the following areas: | 16 | | (1) Individual health care coverage. | 17 | | (2) Employer health care coverage. | 18 | | (3) Health benefits plan administration, including | 19 | | revenue cycle billing and collections. | 20 | | (4) The health coverage needs of populations with | 21 | | low-income limited health literacy and limited English | 22 | | language proficiency. | 23 | | (5) Health care finance. | 24 | | (6) Administering a public or private health care | 25 | | delivery system. | 26 | | (7) Purchasing health plan coverage. |
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| 1 | | (8) Education and outreach. | 2 | | The Board shall consider the expertise of the other members | 3 | | of the Committee and attempt to make appointments so that the | 4 | | Committee's composition reflects a diversity of expertise. | 5 | | (c) Within 30 days after the Board's establishment, it | 6 | | shall appoint a Stakeholder Advisory Committee composed of no | 7 | | fewer than 5 Illinois health care consumers, 5 Illinois small | 8 | | business owners, 5 Illinois-licensed health care providers | 9 | | from a variety of provider types, including, but not limited | 10 | | to, hospitals, private practice medical groups, community | 11 | | health centers, and safety net providers that have experience | 12 | | providing medical care to underserved populations, and 5 health | 13 | | plans that rank among the 10 largest in this State for premium | 14 | | volume. Committee members shall serve one-year terms. | 15 | | (d) The Board may establish additional advisory committees | 16 | | to assist in carrying out its duties under the Act. | 17 | | (e) Members of committees shall receive no compensation, | 18 | | but shall be reimbursed for reasonable expenses incurred in the | 19 | | necessary performance of their duties, including travel. | 20 | | (f) The meetings of all advisory committees shall be | 21 | | subject to the Open Meetings Act. | 22 | | Section 45. Annual report.
The Board shall report in | 23 | | writing to the Governor, the Clerk of the House of | 24 | | Representatives, and the Clerk of the Senate by the 30th day of | 25 | | June, annually, the details and results of its administration |
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| 1 | | of this Act. The Board's report shall include an audited | 2 | | financial report, and may include any recommendation intended | 3 | | to improve the value of health coverage sold through the | 4 | | Exchange to patients, families, and employers. The Board shall | 5 | | make such report publicly available on the Exchange website. | 6 | | Section 50. Health benefit plan certification. | 7 | | (a) The Exchange may certify a health benefit plan as a | 8 | | qualified health plan if: | 9 | | (1) the plan provides the essential health benefits | 10 | | package described in Section 1302(a) of the Federal Act, | 11 | | except that the plan is not required to provide essential | 12 | | benefits that duplicate the minimum benefits of qualified | 13 | | dental plans, as provided in subsection (e) of this | 14 | | Section, if: | 15 | | (A) the Exchange has determined that at least one | 16 | | qualified dental plan is available to supplement the | 17 | | plan's coverage; and | 18 | | (B) the carrier makes prominent disclosure at the | 19 | | time it offers the plan, in a form approved by the | 20 | | Exchange, that the plan does not provide the full range | 21 | | of essential pediatric benefits, and that qualified | 22 | | dental plans providing those benefits and other dental | 23 | | benefits not covered by the plan are offered through | 24 | | the Exchange; | 25 | | (2) the premium rates and contract language have been |
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| 1 | | approved by the
Director; | 2 | | (3) the plan provides at least a bronze level of | 3 | | coverage, as determined pursuant to paragraph (9) of | 4 | | subsection (c) of Section 35 of this Act, unless the plan | 5 | | is certified as a qualified catastrophic plan, meets the | 6 | | requirements of the Federal Act for catastrophic plans, and | 7 | | will only be offered to individuals eligible for | 8 | | catastrophic coverage; | 9 | | (4) the plan's cost-sharing requirements do not exceed | 10 | | the limits established under Section 1302(c)(1) of the | 11 | | Federal Act and if the plan is offered through the SHOP | 12 | | Exchange, then the plan's deductible does not exceed the | 13 | | limits established under Section 1302(c)(2) of the Federal | 14 | | Act; | 15 | | (5) the health carrier offering the plan:
| 16 | | (A) is licensed and in good standing to offer | 17 | | health insurance coverage in this State; | 18 | | (B) offers at least one qualified health plan in | 19 | | the silver level and at least one plan in the gold | 20 | | level through each component of the Exchange in which | 21 | | the carrier participates, where "component" refers to | 22 | | the SHOP Exchange and the Exchange for individual | 23 | | coverage; | 24 | | (C) charges the same premium rate for each | 25 | | qualified health plan without regard to whether the | 26 | | plan is offered through the Exchange and without regard |
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| 1 | | to whether the plan is offered directly from the | 2 | | carrier or through an insurance producer; | 3 | | (D) does not charge any cancellation fees or | 4 | | penalties in violation of paragraph (4) of subsection | 5 | | (c) of Section 35 of this Act; and | 6 | | (E) complies with the regulations developed by the | 7 | | Secretary under Section 1311(d) of the Federal Act and | 8 | | such other requirements as the Exchange may establish. | 9 | | Should the qualified health plan offer the benefits of | 10 | | qualified dental plans, the health and dental benefits | 11 | | shall be placed separately. | 12 | | (6) the plan meets the requirements of certification as | 13 | | set forth by the Board, in collaboration with the Technical | 14 | | Advisory Committee, and by the Secretary under Section | 15 | | 1311(c) of the Federal Act, which include, but are not | 16 | | limited to, minimum standards in the areas of marketing | 17 | | practices, network adequacy, essential community providers | 18 | | in underserved areas, accreditation, quality improvement, | 19 | | uniform enrollment forms, and descriptions of coverage and | 20 | | information on quality measures for health benefit plan | 21 | | performance; and | 22 | | (7) the Exchange determines that making the plan | 23 | | available through the Exchange is in the interest of | 24 | | qualified individuals and qualified employers in this | 25 | | State. | 26 | | (b) The Exchange shall not exclude a health benefit plan: |
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| 1 | | (1) on the basis that the plan is a fee-for-service | 2 | | plan; | 3 | | (2) through the imposition of premium price controls by | 4 | | the Exchange; or | 5 | | (3) on the basis that the health benefit plan provides | 6 | | treatments necessary to prevent patients' deaths in | 7 | | circumstances the Exchange determines are inappropriate or | 8 | | too costly. | 9 | | (c) The Exchange shall require each health carrier seeking | 10 | | certification of a plan as a qualified health plan to: | 11 | | (1) submit a justification for any premium increase | 12 | | before implementation of that increase; the carrier shall | 13 | | prominently post the information on its Internet website; | 14 | | the Exchange shall take this information, along with the | 15 | | information and the recommendations provided to the | 16 | | Exchange by the Director under Section 2794(b) of the | 17 | | Public Health Service Act, into consideration when | 18 | | determining whether to allow the carrier to make plans | 19 | | available through the Exchange; | 20 | | (2) make available to the public, in the format | 21 | | described in paragraph (3) of subsection (c) of this | 22 | | Section, and submit to the Exchange, the Secretary, and the | 23 | | Director, accurate and timely disclosure of current data | 24 | | relating to the following: | 25 | | (A) claims payment policies and practices; | 26 | | (B) periodic financial disclosures; |
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| 1 | | (C) data on enrollment; | 2 | | (D) data on disenrollment;
| 3 | | (E) data on the number of claims that are denied, | 4 | | including pre-certification denials and limitations on | 5 | | requested services; | 6 | | (F) data on rating practices; | 7 | | (G) information on cost-sharing and payments with | 8 | | respect to any out-of-network coverage; | 9 | | (H) information on enrollee and participant rights | 10 | | under title I of the Federal Act; | 11 | | (I) data on how the plan's quality scores, consumer | 12 | | satisfaction levels, and performance levels compare to | 13 | | national metrics and others in the Exchange; and | 14 | | (J) other information as determined appropriate by | 15 | | the Secretary; and | 16 | | (3) enable individuals to learn, in a timely manner | 17 | | upon the request of the individual, the amount of | 18 | | cost-sharing, including deductibles, copayments, and | 19 | | coinsurance, under the individual's plan or coverage that | 20 | | the individual would be responsible for paying with respect | 21 | | to the furnishing of a specific item or service by a | 22 | | participating provider; at a minimum, this information | 23 | | shall be made available to the individual through an | 24 | | Internet website and through other means for individuals | 25 | | without access to the Internet, and in a manner consistent | 26 | | with subparagraph (E) of paragraph (18) of subsection (c) |
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| 1 | | of Section 35 of this Act and this paragraph (3). | 2 | | The information required in paragraph (2) of this | 3 | | subsection (c) shall be provided in plain language, as that | 4 | | term is defined in Section 1311(e)(3)(B) of the Federal Act. | 5 | | (d) The Exchange shall not exempt any health carrier | 6 | | seeking certification of a qualified health plan, regardless of | 7 | | the type or size of the carrier, from State licensure or | 8 | | solvency requirements and shall apply the criteria of this | 9 | | Section in a manner that assures a level playing field between | 10 | | or among health carriers participating in the Exchange. | 11 | | (e) Application to dental plans shall comport with all of | 12 | | the following provisions: | 13 | | (1) The provisions of this Act that are applicable to | 14 | | qualified health plans shall also apply to the extent | 15 | | relevant to qualified dental plans except as modified in | 16 | | accordance with the provisions of paragraphs (2), (3), and | 17 | | (4) of this subsection (e) or by regulations adopted by the | 18 | | Exchange. | 19 | | (2) The carrier shall be licensed to offer dental | 20 | | coverage, but need not be licensed to offer other health | 21 | | benefits. | 22 | | (3) The plan shall be limited to dental and oral health | 23 | | benefits, without substantially duplicating the benefits | 24 | | typically offered by health benefit plans without dental | 25 | | coverage and shall include, at a minimum, the essential | 26 | | pediatric dental benefits prescribed by the Secretary |
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| 1 | | pursuant to Section 1302(b)(1)(J) of the Federal Act, and | 2 | | such other dental benefits as the Exchange or the Secretary | 3 | | may specify by regulation. | 4 | | (4) Carriers may jointly offer a comprehensive plan | 5 | | through the Exchange in which the dental benefits are | 6 | | provided by a carrier through a qualified dental plan and | 7 | | the other benefits are provided by a carrier through a | 8 | | qualified health plan, provided that the plans are priced | 9 | | separately and are also made available for purchase | 10 | | separately at the same price. | 11 | | Section 55. Funding; publication of costs.
| 12 | | (a) The Exchange shall be financed in a manner independent | 13 | | of general revenue funds, but that shall preclude any | 14 | | allocations of identifiable costs to State entities for | 15 | | specific services. | 16 | | (b) The Exchange shall publish the average costs of | 17 | | licensing, regulatory fees and any other payments required by | 18 | | the Exchange and the administrative costs of the Exchange, on | 19 | | an Internet website to educate consumers on such costs. This | 20 | | information shall include information on money lost to waste, | 21 | | fraud, and abuse. | 22 | | Section 60. Relation to other laws. Nothing in this Act and | 23 | | no action taken by the Exchange pursuant to this Act shall be | 24 | | construed to preempt or supersede the authority of the Director |
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| 1 | | to regulate the business of insurance. Except as expressly | 2 | | provided to the contrary in this Act, all health carriers | 3 | | offering qualified health plans in this State shall comply | 4 | | fully with all applicable health insurance laws of this State | 5 | | and regulations adopted and orders issued by the Director. | 6 | | Section 65. Health insurance coverage survey. The | 7 | | Department of Insurance shall conduct an annual household and | 8 | | employer survey regarding health insurance coverage in this | 9 | | State, the cost of which shall be incorporated into the | 10 | | operation costs of the Exchange. This purpose of this report is | 11 | | to measure the current state of health insurance coverage in | 12 | | this State, and such information shall inform the Exchange in | 13 | | its pursuit to achieve the goals put forth in this Act. The | 14 | | Department of Revenue and other relevant State departments and | 15 | | agencies shall provide the Department with any and all relevant | 16 | | information for the purposes of successfully completing this | 17 | | survey. The Department shall deliver this report to the Board, | 18 | | the Governor, the Clerk of the House of Representatives, and | 19 | | the Clerk of the Senate by November 1, 2012, and the first day | 20 | | of July annually thereafter. The Department of Insurance shall | 21 | | make such report publicly available on its website. At a | 22 | | minimum, the report shall include: | 23 | | (1) primary and secondary sources of health insurance | 24 | | coverage for individuals and families in this State; | 25 | | (2) demographic characteristics of insured and |
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| 1 | | uninsured individuals in this State, including, but not | 2 | | limited to: | 3 | | (A) household income and size; | 4 | | (B) age; | 5 | | (C) gender; | 6 | | (D) race; | 7 | | (E) sexual orientation; | 8 | | (F) geographic location; | 9 | | (G) employment status; and | 10 | | (H) disability status; | 11 | | (3) barriers to health insurance coverage including, | 12 | | but not limited to: | 13 | | (A) financial; | 14 | | (B) physical; | 15 | | (C) religious or other personal restrictions; | 16 | | (D) administrative barriers, including barriers | 17 | | resulting from the operation of the Exchange; and | 18 | | (E) language barriers;
and | 19 | | (4) survey of Employer-based coverage in this State, | 20 | | including, but not limited to: | 21 | | (A) health benefits offer rates; | 22 | | (B) health benefits take-up rates among employees; | 23 | | (C) scope of benefits provided (including, but not | 24 | | limited to, comprehensive, scheduled, high-deductible, | 25 | | catastrophic, or hospital-only coverage), including | 26 | | the types of health plans; |
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| 1 | | (D) exclusions, restrictions, and waiting periods; | 2 | | (E) worker and employer premium contributions in | 3 | | accordance with the following provisions; | 4 | | (i) employer size (under 20; 20-99; 100-499; | 5 | | and over 500); | 6 | | (ii) part-time, full-time, and seasonal | 7 | | employee; | 8 | | (iii) salaried, hourly employees, or exempt | 9 | | and non-exempt employees; and | 10 | | (iv) employee and dependent coverage available | 11 | | and take-up rate;
| 12 | | (F) organizational characteristics of the | 13 | | employer, including, but not limited to: | 14 | | (i) employer size (under 20; 20-99; 100-499; | 15 | | and over 500); | 16 | | (ii) part-time, full-time, and seasonal | 17 | | employee; | 18 | | (iii) salaried, hourly employees, or exempt | 19 | | and non-exempt employees; and | 20 | | (iv) employee and dependent coverage available | 21 | | and take-up rate; and | 22 | | (G) for employers not offering coverage, reasons | 23 | | for not offering. | 24 | | Section 70. Illinois Administrative Procedures Act. The | 25 | | provisions of the Illinois Administrative Procedures Act as now |
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| 1 | | or hereafter amended are hereby expressly adopted and | 2 | | incorporated herein as though a part of this Act and shall | 3 | | apply to all administrative rules and procedures of the | 4 | | Exchange under this Act. | 5 | | Section 900. The Personnel Code is amended by changing | 6 | | Section 4c as follows: | 7 | | (20 ILCS 415/4c) (from Ch. 127, par. 63b104c) | 8 | | Sec. 4c. General exemptions. The following positions in | 9 | | State
service shall be exempt from jurisdictions A, B, and C, | 10 | | unless the
jurisdictions shall be extended as provided in this | 11 | | Act:
| 12 | | (1) All officers elected by the people.
| 13 | | (2) All positions under the Lieutenant Governor, | 14 | | Secretary of State,
State Treasurer, State Comptroller, | 15 | | State Board of Education, Clerk of
the Supreme Court,
| 16 | | Attorney General, and State Board of Elections.
| 17 | | (3) Judges, and officers and employees of the courts, | 18 | | and notaries
public.
| 19 | | (4) All officers and employees of the Illinois General | 20 | | Assembly, all
employees of legislative commissions, all | 21 | | officers and employees of the
Illinois Legislative | 22 | | Reference Bureau, the Legislative
Research Unit, and the | 23 | | Legislative Printing Unit.
| 24 | | (5) All positions in the Illinois National Guard and |
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| 1 | | Illinois State
Guard, paid from federal funds or positions
| 2 | | in the State Military Service filled by enlistment and paid | 3 | | from State
funds.
| 4 | | (6) All employees of the Governor at the executive | 5 | | mansion and on
his immediate personal staff.
| 6 | | (7) Directors of Departments, the Adjutant General, | 7 | | the Assistant
Adjutant General, the Director of the | 8 | | Illinois Emergency
Management Agency, members of boards | 9 | | and commissions, and all other
positions appointed by the | 10 | | Governor by and with the consent of the
Senate.
| 11 | | (8) The presidents, other principal administrative | 12 | | officers, and
teaching, research and extension faculties | 13 | | of
Chicago State University, Eastern Illinois University, | 14 | | Governors State
University, Illinois State University, | 15 | | Northeastern Illinois University,
Northern Illinois | 16 | | University, Western Illinois University, the Illinois
| 17 | | Community College Board, Southern Illinois
University, | 18 | | Illinois Board of Higher Education, University of
| 19 | | Illinois, State Universities Civil Service System, | 20 | | University Retirement
System of Illinois, and the | 21 | | administrative officers and scientific and
technical staff | 22 | | of the Illinois State Museum.
| 23 | | (9) All other employees except the presidents, other | 24 | | principal
administrative officers, and teaching, research | 25 | | and extension faculties
of the universities under the | 26 | | jurisdiction of the Board of Regents and
the colleges and |
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| 1 | | universities under the jurisdiction of the Board of
| 2 | | Governors of State Colleges and Universities, Illinois | 3 | | Community College
Board, Southern Illinois University, | 4 | | Illinois Board of Higher Education,
Board of Governors of | 5 | | State Colleges and Universities, the Board of
Regents, | 6 | | University of Illinois, State Universities Civil Service
| 7 | | System, University Retirement System of Illinois, so long | 8 | | as these are
subject to the provisions of the State | 9 | | Universities Civil Service Act.
| 10 | | (10) The State Police so long as they are subject to | 11 | | the merit
provisions of the State Police Act.
| 12 | | (11) (Blank).
| 13 | | (12) The technical and engineering staffs of the | 14 | | Department of
Transportation, the Department of Nuclear | 15 | | Safety, the Pollution Control
Board, and the Illinois | 16 | | Commerce Commission, and the technical and engineering
| 17 | | staff providing architectural and engineering services in | 18 | | the Department of
Central Management Services.
| 19 | | (13) All employees of the Illinois State Toll Highway | 20 | | Authority.
| 21 | | (14) The Secretary of the Illinois Workers' | 22 | | Compensation Commission.
| 23 | | (15) All persons who are appointed or employed by the | 24 | | Director of
Insurance under authority of Section 202 of the | 25 | | Illinois Insurance Code
to assist the Director of Insurance | 26 | | in discharging his responsibilities
relating to the |
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| 1 | | rehabilitation, liquidation, conservation, and
dissolution | 2 | | of companies that are subject to the jurisdiction of the
| 3 | | Illinois Insurance Code.
| 4 | | (16) All employees of the St. Louis Metropolitan Area | 5 | | Airport
Authority.
| 6 | | (17) All investment officers employed by the Illinois | 7 | | State Board of
Investment.
| 8 | | (18) Employees of the Illinois Young Adult | 9 | | Conservation Corps program,
administered by the Illinois | 10 | | Department of Natural Resources, authorized
grantee under | 11 | | Title VIII of the Comprehensive
Employment and Training Act | 12 | | of 1973, 29 USC 993.
| 13 | | (19) Seasonal employees of the Department of | 14 | | Agriculture for the
operation of the Illinois State Fair | 15 | | and the DuQuoin State Fair, no one
person receiving more | 16 | | than 29 days of such employment in any calendar year.
| 17 | | (20) All "temporary" employees hired under the | 18 | | Department of Natural
Resources' Illinois Conservation | 19 | | Service, a youth
employment program that hires young people | 20 | | to work in State parks for a period
of one year or less.
| 21 | | (21) All hearing officers of the Human Rights | 22 | | Commission.
| 23 | | (22) All employees of the Illinois Mathematics and | 24 | | Science Academy.
| 25 | | (23) All employees of the Kankakee River Valley Area
| 26 | | Airport Authority.
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| 1 | | (24) The commissioners and employees of the Executive | 2 | | Ethics
Commission.
| 3 | | (25) The Executive Inspectors General, including | 4 | | special Executive
Inspectors General, and employees of | 5 | | each Office of an
Executive Inspector General.
| 6 | | (26) The commissioners and employees of the | 7 | | Legislative Ethics
Commission.
| 8 | | (27) The Legislative Inspector General, including | 9 | | special Legislative
Inspectors General, and employees of | 10 | | the Office of
the Legislative Inspector General.
| 11 | | (28) The Auditor General's Inspector General and | 12 | | employees of the Office
of the Auditor General's Inspector | 13 | | General. | 14 | | (29) The Board members and employees of the Illinois | 15 | | Health Benefits Exchange.
| 16 | | (Source: P.A. 95-728, eff. 7-1-08 - See Sec. 999 .)
| 17 | | Section 999. Effective date. This Act takes effect upon | 18 | | becoming law.".
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