Bill Text: IL HB3441 | 2011-2012 | 97th General Assembly | Chaptered
Bill Title: Amends the Comprehensive Health Insurance Plan Act to provide that the Comprehensive Health Insurance Board at its option may extend the term of a plan administrator contract for a period not to exceed 3 years. Effective immediately.
Sponsorship: Partisan Bill (Democrat 2)
Status: (Passed) 2011-06-14 - Public Act . . . . . . . . . 97-0011 [HB3441 Detail]
Download: Illinois-2011-HB3441-Chaptered.html
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| Public Act 097-0011 | ||||
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AN ACT concerning insurance.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Comprehensive Health Insurance Plan Act is | ||||
amended by changing Section 5 as follows:
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(215 ILCS 105/5) (from Ch. 73, par. 1305)
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Sec. 5. Plan administrator.
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a. The board shall select a plan administrator through a | ||||
competitive bidding
process to administer the plan. The board | ||||
shall evaluate bids submitted under
this Section based on | ||||
criteria established by the board which shall include:
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(1) The plan administrator's proven ability to handle | ||||
other large group
accident and health benefit plans.
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(2) The efficiency and timeliness of the plan | ||||
administrator's claim
processing procedures.
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(3) An estimate of total net cost for administering the | ||||
plan, including
any discounts or income the Plan could | ||||
expect to receive or benefit from.
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(4) The plan administrator's ability to apply | ||||
effective cost containment
programs and procedures and to | ||||
administer the plan in a cost-efficient manner.
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(5) The financial condition and stability of the plan | ||||
administrator.
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b. The plan administrator shall serve for a period of 5 | ||
years subject to
removal for cause and subject to the terms, | ||
conditions and limitations of the
contract between the board | ||
and the plan administrator. At least one year
prior to the | ||
expiration of each 5 year period of service by the current plan
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administrator, the board shall begin to advertise for bids to | ||
serve as the
plan administrator for the succeeding 5 year | ||
period. Selection of the plan
administrator for the succeeding | ||
period shall be made at least 6 months prior
to the end of the | ||
current 5 year period. Notwithstanding any other provision of | ||
this subsection, the Board at its option may extend the term of | ||
a plan administrator contract for a period not to exceed 3 | ||
years.
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c. The plan administrator shall perform such functions | ||
relating to the plan
as may be assigned to it including:
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(1) establishment of a premium billing procedure for | ||
collection of
premiums from plan participants. Billings | ||
shall be made on a periodic basis as
determined by the | ||
board;
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(2) payment and processing of claims and various cost | ||
containment
functions; and
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(3) other functions to assure timely payment of | ||
benefits to participants
under the plan, including:
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(a) making available information relating to the | ||
proper manner of
submitting a claim for benefits under | ||
the plan and distributing forms upon
which submissions | ||
shall be made, and
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(b) evaluating the eligibility of each claim for | ||
payment under the plan.
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The plan administrator shall be governed by the | ||
requirements of
Part 919 of Title 50 of the Illinois | ||
Administrative Code, promulgated by
the Department of | ||
Insurance, regarding the handling of claims under this
Act.
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d. The plan administrator shall submit regular reports to | ||
the board
regarding the operation of the plan. The frequency, | ||
content and form of the
report shall be as determined by the | ||
board.
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e. The plan administrator shall pay or be reimbursed for | ||
claims expenses
from the premium payments received from or on | ||
behalf of plan participants. If
the plan administrator's | ||
payments or reimbursements for claims expenses exceed
the | ||
portion of premiums allocated by the board for payment of | ||
claims expenses,
the board shall provide additional funds to | ||
the plan administrator for payment
or reimbursement of such | ||
claims expenses.
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f. The plan administrator shall be paid as provided in the
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contract between the Board and the plan administrator.
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(Source: P.A. 90-30, eff. 7-1-97; 90-567, eff. 1-23-98; 91-357, | ||
eff.
7-29-99.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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