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90_HB1263 New Act Creates the Employee Health Benefit Mandate Note Act. Requires every bill, the purpose and effect of which is to require HMOs, health insurers, and other health providers serving group health plans to provide specific health benefits, reimbursements, or coverages or to follow specified procedures regarding the provision of medical care to have prepared for it before the second reading of the bill a explanatory statement or note that includes a reliable estimate of the anticipated cost impact on typical employers of various sizes that sponsor group health plans. Requires the Department of Insurance to prepare the note. Provides that the provisions of the Act are severable. Effective immediately. LRB9002824DNmb LRB9002824DNmb 1 AN ACT concerning employee health benefit mandates. 2 WHEREAS, It is crucial to the welfare of the State of 3 Illinois that corporations and other business owners be 4 encouraged to operate in Illinois and to employ its citizens; 5 and 6 WHEREAS, The costs of employee health benefits constitute 7 one of the most critical cost factors influencing employment 8 decisions, and legislation that mandates the provision of 9 specific health benefits by health maintenance organizations, 10 health insurers, or other health providers serving group 11 health plans may have a significant economic impact that 12 should be considered before enactment of those mandates; 13 therefore 14 Be it enacted by the People of the State of Illinois, 15 represented in the General Assembly: 16 Section 1. Short Title. This Act may be cited as the 17 Employee Health Benefit Mandate Note Act. 18 Section 5. Note required. Every bill, the purpose and 19 effect of which is to require health maintenance 20 organizations, health insurers, or other health providers 21 serving group health plans to provide specific health 22 benefits, reimbursements, or coverages or to follow specified 23 procedures regarding the provision of medical care, 24 including, but not limited to, standards regarding the 25 extent of or the duration of care, shall have prepared for 26 it, before the second reading of the bill in the house of 27 introduction, a brief introductory explanatory statement or 28 note that includes a reliable estimate of the anticipated 29 cost impact on typical employers of various sizes that 30 sponsor group health plans under its provisions. For this -2- LRB9002824DNmb 1 purpose, the Department of Insurance shall prepare an annual 2 report regarding the characteristics of group health plans 3 sponsored by employers located in Illinois, based upon data 4 that the Department deems reliable. 5 The statements or notes shall be known as "employee 6 health benefit notes." 7 Section 10. Preparation. The sponsor of each bill, 8 referred to in Section 5, shall present a copy of the bill, 9 with his or her request for an employee health benefit note, 10 to the Department of Insurance. The employee health benefit 11 note shall be prepared by the Department of Insurance and 12 furnished to the sponsor of the bill within 5 calendar days 13 after the bill and request was presented. If, because of the 14 complexity of the measure, additional time is required for 15 preparation of the employee health benefit note, the 16 Department of Insurance may so inform the sponsor of the bill 17 and he or she may approve an extension of the time within 18 which the note is to be furnished, not to extend beyond June 19 15, following the date of the request. 20 Section 15. Requests for note. Whenever the sponsor of 21 any measure that would require that health maintenance 22 organizations, health insurers, or other health providers 23 serving group health plans to provide specific health 24 benefits, reimbursements, or coverages or to follow specified 25 procedures regarding the provision of medical care, 26 including, but not limited to, standards regarding the 27 extent of or the duration of care, is of the opinion that no 28 employee health benefit note is necessary, any member of 29 either house may thereafter request that a note be obtained, 30 and in that case, the matter shall be decided by majority 31 vote of those present and voting in the house of which he or 32 she is a member. -3- LRB9002824DNmb 1 Section 20. Contents. The note shall be factual in 2 nature, as brief and concise as possible, and shall provide 3 a reasonable estimate in dollars and, in addition, it shall 4 include both the immediate effect and, if determinable or 5 reasonably foreseeable, the long range effect of the 6 measure. If, after careful investigation, it is determined 7 that no dollar estimate is possible, the note shall contain 8 a statement to that effect, setting forth the reason why no 9 dollar estimate can be given. A brief summary or work sheet 10 of computations used in arriving at employee health benefit 11 note figures shall be included. 12 Section 25. Comment or opinion. No comment or opinion 13 shall be included in the employee health benefit note with 14 regard to the merits of the measure for which the employee 15 health benefit note is prepared; however, technical or 16 mechanical defects may be noted. The work sheet shall 17 include, if practicable, a breakdown of the costs upon which 18 the estimates are based and a breakdown of the cost impact 19 for each of the hypothetical typical employers for which 20 calculations were prepared. The work sheet shall also 21 include any other information that is required by rules that 22 may be promulgated by each house of the General Assembly with 23 respect to the preparation of employee health benefit notes. 24 The employee health benefit note shall be prepared in 25 quintuplicate, shall bear the name of the Department of 26 Insurance and shall be signed by the head of that department. 27 Section 30. Appearance of State officials and employees 28 in support or opposition of the measure. The fact that a 29 employee health benefit note is prepared for any bill shall 30 not preclude or restrict the appearance before any committee 31 of the General Assembly, of any official or authorized 32 employee of any State board, commission, department, agency, -4- LRB9002824DNmb 1 or other entity who desires to be heard in support or 2 opposition of the measure. 3 Section 35. Amendments. Whenever any committee of 4 either house reports any bill with an amendment of such a 5 nature as will substantially affect the cost estimates as 6 stated in the employee health benefit note attached to the 7 measure at the time of its referral to the committee, there 8 shall be included with the report of the committee, a 9 statement of the effect of the change proposed by the 10 amendment reported if desired by a majority of the committee. 11 In a like manner, whenever any measure is amended on the 12 floor of either house in a manner as to substantially affect 13 the cost estimates as stated in the employee health benefit 14 note attached to the measure before the amendment, a 15 majority of the house may propose that no action shall be 16 taken on the amendment until the sponsor of the amendment 17 presents to the members a statement of the anticipated cost 18 impact of the proposed amendment on typical employers of 19 various sizes that sponsor group health plans. 20 Section 40. Confidentiality. The subject matter of 21 bills submitted to the Department of Insurance for the 22 preparation of employee health benefit notes shall be kept in 23 strict confidence and no information relating to the bill or 24 relating to the anticipated cost impact of the bill shall be 25 divulged by any official or employee of the Department before 26 the introduction of the bill in the General Assembly. 27 Section 45. Severability. The provisions of the Act are 28 severable and if any part or provision of this Act is void, 29 the decision of the court so holding shall not affect or 30 impair the remaining parts or provisions of the Act. -5- LRB9002824DNmb 1 Section 99. Effective date. This Act takes effect upon 2 becoming law.
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