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92_HB1901eng HB1901 Engrossed LRB9200938JSpc 1 AN ACT concerning health care benefit information cards. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 1. Short title. This Act may be cited as the 5 Uniform Health Care Service Benefits Information Card Act. 6 Section 5. Legislative intent. It is the intent of the 7 legislature to lessen patients' waiting times, decrease 8 administrative burdens for health care professionals and 9 health care institutions, and improve care to patients by 10 minimizing confusion, eliminating unnecessary paperwork, and 11 streamlining the administrative aspects of care paid for by 12 third-party payors. This Act shall be broadly applied and 13 interpreted to effectuate this purpose. 14 Section 10. Definitions. As used in this Act, the 15 following terms have the meanings given in this Section. 16 "Department" means the Department of Insurance. 17 "Director" means the Director of Insurance. 18 "Health benefit plan" means an accident and health 19 insurance policy or certificate subject to the Illinois 20 Insurance Code, a voluntary health services plan subject to 21 the Voluntary Health Services Plans Act, a health maintenance 22 organization subscriber contract subject to the Health 23 Maintenance Organization Act, a plan provided by a multiple 24 employer welfare arrangement, or a plan provided by another 25 benefit arrangement. Without limitation, "health benefit 26 plan" does not mean any of the following types of insurance: 27 (1) accident; 28 (2) credit; 29 (3) disability income; 30 (4) long-term or nursing home care; HB1901 Engrossed -2- LRB9200938JSpc 1 (5) specified disease; 2 (6) dental or vision; 3 (7) coverage issued as a supplement to liability 4 insurance; 5 (8) medical payments under automobile or 6 homeowners; 7 (9) insurance under which benefits are payable with 8 or without regard to fault as statutorily required to be 9 contained in any liability policy or equivalent 10 self-insurance; 11 (10) hospital income or indemnity; and 12 (11) self-insured health benefit plans under the 13 federal Employee Retirement Income Security Act of 1974. 14 Section 15. Uniform health care benefit information 15 cards required. 16 (a) A health benefit plan that issues a card or other 17 technology and provides coverage for health care services 18 including prescription drugs or devices also referred to as 19 health care benefits and an administrator of such a plan 20 including, but not limited to, third-party administrators for 21 self-insured plans and state-administered plans shall issue 22 to its insureds a card or other technology containing uniform 23 health care benefit information. The health care benefit 24 information card or other technology shall specifically 25 identify and display the following mandatory data elements on 26 the card: 27 (1) processor control number, if required for 28 claims adjudication; 29 (2) group number; 30 (3) card issuer identifier; 31 (4) cardholder ID number; and 32 (5) cardholder name. 33 (b) The uniform health care benefit information card or HB1901 Engrossed -3- LRB9200938JSpc 1 other technology shall specifically identify and display the 2 following mandatory data elements on the back of the card: 3 (1) claims submission names and addresses; and 4 (2) help desk telephone numbers and names. 5 (c) A new uniform health care benefit information card 6 or other technology shall be issued by a health benefit plan 7 upon enrollment and reissued upon any change in the insured's 8 coverage that affects mandatory data elements contained on 9 the card. 10 Section 20. Coordination with Uniform Prescription Drug 11 Information Card. A health benefit plan may comply with this 12 Act by including the information required in Section 15 on 13 one card if a card is also required under the Uniform 14 Prescription Drug Information Card Act. 15 Section 25. Applicability and enforcement. 16 (a) This Act applies to health care benefit plans that 17 are amended, delivered, issued, or renewed on and after the 18 effective date of this amendatory Act of the 92nd General 19 Assembly. 20 (b) The Director may adopt rules necessary to implement 21 the Department's responsibilities under this Act. To enforce 22 the provisions of this Act, the Director may issue a cease 23 and desist order or require a health benefit plan to submit a 24 plan of correction for violations of this Act, or both. 25 Subject to the provisions of the Illinois Administrative 26 Procedure Act, the Director may, pursuant to Section 403A of 27 the Illinois Insurance Code, impose upon a health benefit 28 plan an administrative fine not to exceed $250,000 for 29 failure to submit a requested plan of correction, failure to 30 comply with its plan or correction, or repeated violations of 31 this Act. HB1901 Engrossed -4- LRB9200938JSpc 1 Section 99. Effective date. This Act takes effect on 2 January 1, 2002.