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Public Act 92-0106
HB1901 Enrolled LRB9200938JSpc
AN ACT concerning health care benefit information cards.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
Uniform Health Care Service Benefits Information Card Act.
Section 5. Legislative intent. It is the intent of the
legislature to lessen patients' waiting times, decrease
administrative burdens for health care professionals and
health care institutions, and improve care to patients by
minimizing confusion, eliminating unnecessary paperwork, and
streamlining the administrative aspects of care paid for by
third-party payors. This Act shall be broadly applied and
interpreted to effectuate this purpose.
Section 10. Definitions. As used in this Act, the
following terms have the meanings given in this Section.
"Department" means the Department of Insurance.
"Director" means the Director of Insurance.
"Health benefit plan" means an accident and health
insurance policy or certificate subject to the Illinois
Insurance Code, a voluntary health services plan subject to
the Voluntary Health Services Plans Act, a health maintenance
organization subscriber contract subject to the Health
Maintenance Organization Act, a plan provided by a multiple
employer welfare arrangement, or a plan provided by another
benefit arrangement. Without limitation, "health benefit
plan" does not mean any of the following types of insurance:
(1) accident;
(2) credit;
(3) disability income;
(4) long-term or nursing home care;
(5) specified disease;
(6) dental or vision;
(7) coverage issued as a supplement to liability
insurance;
(8) medical payments under automobile or
homeowners;
(9) insurance under which benefits are payable with
or without regard to fault as statutorily required to be
contained in any liability policy or equivalent
self-insurance;
(10) hospital income or indemnity; and
(11) self-insured health benefit plans under the
federal Employee Retirement Income Security Act of 1974.
Section 15. Uniform health care benefit information
cards required.
(a) A health benefit plan that issues a card or other
technology and provides coverage for health care services
including prescription drugs or devices also referred to as
health care benefits and an administrator of such a plan
including, but not limited to, third-party administrators for
self-insured plans and state-administered plans shall issue
to its insureds a card or other technology containing uniform
health care benefit information. The health care benefit
information card or other technology shall specifically
identify and display the following mandatory data elements on
the card:
(1) processor control number, if required for
claims adjudication;
(2) group number;
(3) card issuer identifier;
(4) cardholder ID number; and
(5) cardholder name.
(b) The uniform health care benefit information card or
other technology shall specifically identify and display the
following mandatory data elements on the back of the card:
(1) claims submission names and addresses; and
(2) help desk telephone numbers and names.
(c) A new uniform health care benefit information card
or other technology shall be issued by a health benefit plan
upon enrollment and reissued upon any change in the insured's
coverage that affects mandatory data elements contained on
the card.
Section 20. Coordination with Uniform Prescription Drug
Information Card. A health benefit plan may comply with this
Act by including the information required in Section 15 on
one card if a card is also required under the Uniform
Prescription Drug Information Card Act.
Section 25. Applicability and enforcement.
(a) This Act applies to health care benefit plans that
are amended, delivered, issued, or renewed on and after the
effective date of this amendatory Act of the 92nd General
Assembly.
(b) The Director may adopt rules necessary to implement
the Department's responsibilities under this Act. To enforce
the provisions of this Act, the Director may issue a cease
and desist order or require a health benefit plan to submit a
plan of correction for violations of this Act, or both.
Subject to the provisions of the Illinois Administrative
Procedure Act, the Director may, pursuant to Section 403A of
the Illinois Insurance Code, impose upon a health benefit
plan an administrative fine not to exceed $250,000 for
failure to submit a requested plan of correction, failure to
comply with its plan or correction, or repeated violations of
this Act.
Section 99. Effective date. This Act takes effect on
January 1, 2002.
Passed in the General Assembly May 01, 2001.
Approved July 20, 2001.
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