92nd General Assembly
Summary of HB1040
   [ Home ]   [ Back ]   [ Legislation ]
Legislation:  
Please enter a bill number.



 Full Text  Bill Status
House Sponsors:
BRUNSVOLD-KLINGLER-PARKE-MCGUIRE.

Senate Sponsors:
JACOBS-MADIGAN,R

Short description: 
HMO OFFER POINT OF SERVICE                                                 

Synopsis of Bill as introduced:
        Amends the Health Maintenance Organization Act. Authorizes health      
   maintenance  organizations   to   offer   point-of-service   benefits.      
   Establishes  reinsurance  and  capital requirements. Authorizes health      
   maintenance  organizations  to  establish   annual   maximum   benefit      
   allowances for point-of-service products.                                   
        HOUSE AMENDMENT NO. 1.                                                 
          Deletes reference to:                                                
          215 ILCS 125/5-3.7 new                                               
          Adds reference to:                                                   
          215 ILCS 125/2-6                from Ch. 111 1/2, par. 1406.2        
          215 ILCS 125/Art. 4.5, heading new                                   
          215 ILCS 125/4.5-1 new                                               
        Replaces everything after the enacting clause. Amends the  Health      
   Maintenance    Organization   Act.   Authorizes   health   maintenance      
   organizations to offer point-of-service benefits.  Provides  that  net      
   worth  must  be  at  least  300%  of the "authorized control level" as      
   determined in the manner provided under Article IIA  of  the  Illinois      
   Insurance  Code or a specified greater amount based upon the projected      
   out-of-plan claims. Requires  health  maintenance  organizations  that      
   offer  point-of-service  products  to  file quarterly reports with the      
   Department of Insurance and to maintain reinsurance  for  catastrophic      
   losses.  Limits  expenditures  for out-of-plan services. Restricts the      
   offer  of  point-of-service  products  when  expenditures  exceed  the      
   statutory limit. Allows a health maintenance organization to treat  as      
   out-of-plan  services  those  services  an  enrollee  obtains  from  a      
   participating  provider,  but  for  which proper authorization was not      
   given by the organization.                                                  
          FISCAL NOTE (Department of Insurance)                                
          HB 1040 would have no fiscal impact on the Department.               
        HOUSE AMENDMENT NO. 2.                                                 
        Makes a technical correction.                                          
 
Last action on Bill: PUBLIC ACT.............................. 92-0135

   Last action date: JUL-24-2001

           Location: House

 Amendments to Bill: AMENDMENTS ADOPTED: HOUSE -   2     SENATE -   0


   END OF INQUIRY 



 Full Text  Bill Status