State of Illinois
90th General Assembly
Legislation

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90_SB0769

      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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