Full Text of SB0107 95th General Assembly
SB0107 95TH GENERAL ASSEMBLY
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95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008 SB0107
Introduced 1/31/2007, by Sen. Bill Brady SYNOPSIS AS INTRODUCED: |
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5 ILCS 375/5 |
from Ch. 127, par. 525 |
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Amends the State Employees Group Insurance Act of 1971. Permits an employee to switch to a different health insurance program after the annual benefits choice period if a health care provider with whom the employee has a long-term relationship transfers from one program to another program after the Director of Central Management Services has submitted the final program contracts before the benefits choice period. Effective immediately.
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A BILL FOR
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SB0107 |
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LRB095 04693 JAM 24752 b |
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| AN ACT concerning government.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The State Employees Group Insurance Act of 1971 | 5 |
| is amended by changing Section 5 as follows:
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| (5 ILCS 375/5) (from Ch. 127, par. 525)
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| Sec. 5. Employee benefits; declaration of State policy.
The | 8 |
| General Assembly declares that it is the policy of the State | 9 |
| and in the best interest of the State to assure quality | 10 |
| benefits to members and their dependents under this Act. The | 11 |
| implementation of this policy depends upon, among other things, | 12 |
| stability and continuity of coverage, care, and services under | 13 |
| benefit programs for members and their dependents. | 14 |
| Specifically, but without limitation, members should have | 15 |
| continued access, on substantially similar terms and | 16 |
| conditions, to trusted family health care providers with whom | 17 |
| they have developed long-term relationships through a benefit | 18 |
| program under this Act. Therefore, the Director must administer | 19 |
| this Act consistent with that State policy, but may consider | 20 |
| affordability, cost of coverage and care, and competition among | 21 |
| health insurers and providers. All contracts for provision of | 22 |
| employee benefits, including those portions of any proposed | 23 |
| collective bargaining agreement that would require |
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| implementation through contracts entered into under this Act, | 2 |
| are 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.
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| (ii) Within 30 days after notice of the awarding or |
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| 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.
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| (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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| 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.
If, however, after the Director submits a final | 10 |
| contract for the employee benefits program, an employee's | 11 |
| trusted health care provider, with whom the employee has | 12 |
| developed a long-term relationship, transfers from the | 13 |
| program selected by that employee to another program, that | 14 |
| employee may switch programs.
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| (vi) The Director must provide the reports, | 16 |
| information, and contracts required under items (i), (ii), | 17 |
| (iv), and (v) by electronic or other means satisfactory to | 18 |
| the Commission. Reports, information, and contracts in the | 19 |
| possession of the Commission pursuant to items (i), (ii), | 20 |
| (iv), and (v) are exempt from disclosure by the Commission | 21 |
| and its members and employees under the Freedom of | 22 |
| Information Act. Reports, information, and contracts | 23 |
| received by the Commission pursuant to items (i), (ii), | 24 |
| (iv), and (v) must be kept confidential by and may not be | 25 |
| disclosed or used by the Commission or its members or | 26 |
| employees if such disclosure or use could compromise the |
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| fairness or integrity of the procurement, bidding, or | 2 |
| contract process. Commission meetings, or portions of | 3 |
| Commission meetings, in which reports, information, and | 4 |
| contracts received by the Commission pursuant to items (i), | 5 |
| (ii), (iv), and (v) are discussed must be closed if | 6 |
| disclosure or use of the report or information could | 7 |
| compromise the fairness or integrity of the procurement, | 8 |
| bidding, or contract process.
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| All contracts entered into under this Section are subject | 10 |
| to appropriation and shall comply with Section 20-60(b) of the | 11 |
| Illinois Procurement Code (30 ILCS 500/20-60(b)).
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| The Director shall contract or otherwise make available | 13 |
| group
life insurance, health benefits and other
employee | 14 |
| benefits to eligible members and, where elected,
their eligible | 15 |
| dependents. Any contract or, if
applicable, contracts or other | 16 |
| arrangement for provision of benefits
shall be on terms | 17 |
| consistent with State policy and
based on, but not limited to, | 18 |
| such
criteria as administrative cost, service capabilities of | 19 |
| the carrier
or other contractor and premiums, fees or charges | 20 |
| as related to benefits.
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| The Director may prepare and issue specifications
for group | 22 |
| life insurance, health benefits, other employee benefits
and | 23 |
| administrative services for the purpose of receiving proposals
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| from interested parties.
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| The Director is authorized to execute a contract, or
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| contracts, for the programs of group life insurance, health
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| benefits, other employee benefits and administrative services
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| authorized by this Act (including, without limitation, | 3 |
| prescription drug benefits). All of the benefits provided under | 4 |
| this Act may be
included in one or more contracts, or the | 5 |
| benefits may be classified into
different types with each type | 6 |
| included under one or more similar contracts
with the same or | 7 |
| different companies.
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| The term of any contract may not extend beyond 5 fiscal | 9 |
| years.
Upon recommendation of the Commission, the Director may | 10 |
| exercise renewal
options of the same contract for up to a | 11 |
| period of 5 years. Any
increases in premiums, fees or charges | 12 |
| requested by a contractor whose
contract may be renewed | 13 |
| pursuant to a renewal option contained therein,
must be | 14 |
| justified on the basis of (1) audited experience data, (2)
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| increases in the costs of health care services provided under | 16 |
| the contract,
(3) contractor performance, (4) increases in | 17 |
| contractor responsibilities,
or (5) any combination thereof.
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| Any contractor shall agree to abide by all
requirements of | 19 |
| this Act and Rules and Regulations promulgated and adopted
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| thereto; to submit such information and data as may from time | 21 |
| to time be
deemed necessary by the Director for effective | 22 |
| administration of the
provisions of this Act and the programs | 23 |
| established
hereunder, and to fully cooperate in any audit.
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| (Source: P.A. 93-839, eff. 7-30-04.)
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| Section 99. Effective date. This Act takes effect upon | 26 |
| becoming law.
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