HB2088 EngrossedLRB103 04781 BMS 49791 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5adding Section 155.49 as follows:
 
6    (215 ILCS 5/155.49 new)
7    Sec. 155.49. Insurance company supplier diversity report.
8    (a) Every company authorized to do business in this State
9or accredited by this State with assets of at least
10$50,000,000 shall submit a 2-page report on its voluntary
11supplier diversity program, or the company's procurement
12program if there is no supplier diversity program, to the
13Department. The report shall set forth all of the following:
14        (1) The name, address, phone number, and email address
15    of the point of contact for the supplier diversity program
16    for vendors to register with the program.
17        (2) Local and State certifications the company accepts
18    or recognizes for minority-owned, women-owned, LGBT-owned,
19    or veteran-owned business status.
20        (3) On the second page, a narrative explaining the
21    results of the program and the tactics to be employed to
22    achieve the goals of its voluntary supplier diversity
23    program.

 

 

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1        (4) The voluntary goals for the calendar year for
2    which the report is made in each category for the entire
3    budget of the company and the commodity codes or a
4    description of particular goods and services for the area
5    of procurement in which the company expects most of those
6    goals to focus on in that year.
7    Each company is required to submit a searchable report, in
8Portable Document Format (PDF), to the Department on or before
9April 1, 2024 and on or before April 1 every year thereafter.
10    (b) For each report submitted under subsection (a), the
11Department shall publish the results on its Internet website
12for 5 years after submission. The Department is not
13responsible for collecting the reports or for the content of
14the reports.
15    (c) The Department shall hold an annual insurance company
16supplier diversity workshop in July of 2024 and every July
17thereafter to discuss the reports with representatives of the
18companies and vendors.
19    (d) The Department shall prepare a one-page template, not
20including the narrative section, for the voluntary supplier
21diversity reports.
22    (e) The Department may adopt such rules as it deems
23necessary to implement this Section.
 
24    Section 10. The Dental Service Plan Act is amended by
25changing Section 25 as follows:
 

 

 

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1    (215 ILCS 110/25)  (from Ch. 32, par. 690.25)
2    Sec. 25. Application of Insurance Code provisions. Dental
3service plan corporations and all persons interested therein
4or dealing therewith shall be subject to the provisions of
5Articles IIA, XI, and XII 1/2 and Sections 3.1, 133, 136, 139,
6140, 143, 143c, 149, 155.49, 355.2, 355.3, 367.2, 401, 401.1,
7402, 403, 403A, 408, 408.2, and 412, and subsection (15) of
8Section 367 of the Illinois Insurance Code.
9(Source: P.A. 99-151, eff. 7-28-15.)
 
10    Section 15. The Health Maintenance Organization Act is
11amended by changing Section 5-3 as follows:
 
12    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
13    Sec. 5-3. Insurance Code provisions.
14    (a) Health Maintenance Organizations shall be subject to
15the provisions of Sections 133, 134, 136, 137, 139, 140,
16141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
17154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 155.49,
18355.2, 355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w,
19356x, 356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
20356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
21356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
22356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
23356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,

 

 

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1356z.50, 356z.51, 256z.53, 356z.54, 356z.56, 356z.57, 356z.59,
2364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c,
3368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408,
4408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection
5(2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2,
6XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois
7Insurance Code.
8    (b) For purposes of the Illinois Insurance Code, except
9for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
10Health Maintenance Organizations in the following categories
11are deemed to be "domestic companies":
12        (1) a corporation authorized under the Dental Service
13    Plan Act or the Voluntary Health Services Plans Act;
14        (2) a corporation organized under the laws of this
15    State; or
16        (3) a corporation organized under the laws of another
17    state, 30% or more of the enrollees of which are residents
18    of this State, except a corporation subject to
19    substantially the same requirements in its state of
20    organization as is a "domestic company" under Article VIII
21    1/2 of the Illinois Insurance Code.
22    (c) In considering the merger, consolidation, or other
23acquisition of control of a Health Maintenance Organization
24pursuant to Article VIII 1/2 of the Illinois Insurance Code,
25        (1) the Director shall give primary consideration to
26    the continuation of benefits to enrollees and the

 

 

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1    financial conditions of the acquired Health Maintenance
2    Organization after the merger, consolidation, or other
3    acquisition of control takes effect;
4        (2)(i) the criteria specified in subsection (1)(b) of
5    Section 131.8 of the Illinois Insurance Code shall not
6    apply and (ii) the Director, in making his determination
7    with respect to the merger, consolidation, or other
8    acquisition of control, need not take into account the
9    effect on competition of the merger, consolidation, or
10    other acquisition of control;
11        (3) the Director shall have the power to require the
12    following information:
13            (A) certification by an independent actuary of the
14        adequacy of the reserves of the Health Maintenance
15        Organization sought to be acquired;
16            (B) pro forma financial statements reflecting the
17        combined balance sheets of the acquiring company and
18        the Health Maintenance Organization sought to be
19        acquired as of the end of the preceding year and as of
20        a date 90 days prior to the acquisition, as well as pro
21        forma financial statements reflecting projected
22        combined operation for a period of 2 years;
23            (C) a pro forma business plan detailing an
24        acquiring party's plans with respect to the operation
25        of the Health Maintenance Organization sought to be
26        acquired for a period of not less than 3 years; and

 

 

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1            (D) such other information as the Director shall
2        require.
3    (d) The provisions of Article VIII 1/2 of the Illinois
4Insurance Code and this Section 5-3 shall apply to the sale by
5any health maintenance organization of greater than 10% of its
6enrollee population (including without limitation the health
7maintenance organization's right, title, and interest in and
8to its health care certificates).
9    (e) In considering any management contract or service
10agreement subject to Section 141.1 of the Illinois Insurance
11Code, the Director (i) shall, in addition to the criteria
12specified in Section 141.2 of the Illinois Insurance Code,
13take into account the effect of the management contract or
14service agreement on the continuation of benefits to enrollees
15and the financial condition of the health maintenance
16organization to be managed or serviced, and (ii) need not take
17into account the effect of the management contract or service
18agreement on competition.
19    (f) Except for small employer groups as defined in the
20Small Employer Rating, Renewability and Portability Health
21Insurance Act and except for medicare supplement policies as
22defined in Section 363 of the Illinois Insurance Code, a
23Health Maintenance Organization may by contract agree with a
24group or other enrollment unit to effect refunds or charge
25additional premiums under the following terms and conditions:
26        (i) the amount of, and other terms and conditions with

 

 

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1    respect to, the refund or additional premium are set forth
2    in the group or enrollment unit contract agreed in advance
3    of the period for which a refund is to be paid or
4    additional premium is to be charged (which period shall
5    not be less than one year); and
6        (ii) the amount of the refund or additional premium
7    shall not exceed 20% of the Health Maintenance
8    Organization's profitable or unprofitable experience with
9    respect to the group or other enrollment unit for the
10    period (and, for purposes of a refund or additional
11    premium, the profitable or unprofitable experience shall
12    be calculated taking into account a pro rata share of the
13    Health Maintenance Organization's administrative and
14    marketing expenses, but shall not include any refund to be
15    made or additional premium to be paid pursuant to this
16    subsection (f)). The Health Maintenance Organization and
17    the group or enrollment unit may agree that the profitable
18    or unprofitable experience may be calculated taking into
19    account the refund period and the immediately preceding 2
20    plan years.
21    The Health Maintenance Organization shall include a
22statement in the evidence of coverage issued to each enrollee
23describing the possibility of a refund or additional premium,
24and upon request of any group or enrollment unit, provide to
25the group or enrollment unit a description of the method used
26to calculate (1) the Health Maintenance Organization's

 

 

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1profitable experience with respect to the group or enrollment
2unit and the resulting refund to the group or enrollment unit
3or (2) the Health Maintenance Organization's unprofitable
4experience with respect to the group or enrollment unit and
5the resulting additional premium to be paid by the group or
6enrollment unit.
7    In no event shall the Illinois Health Maintenance
8Organization Guaranty Association be liable to pay any
9contractual obligation of an insolvent organization to pay any
10refund authorized under this Section.
11    (g) Rulemaking authority to implement Public Act 95-1045,
12if any, is conditioned on the rules being adopted in
13accordance with all provisions of the Illinois Administrative
14Procedure Act and all rules and procedures of the Joint
15Committee on Administrative Rules; any purported rule not so
16adopted, for whatever reason, is unauthorized.
17(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
18101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
191-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
20eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
21102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
221-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
23eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
24102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
251-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
26eff. 1-1-23; revised 12-13-22.)
 

 

 

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1    Section 20. The Limited Health Service Organization Act is
2amended by changing Section 4003 as follows:
 
3    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
4    Sec. 4003. Illinois Insurance Code provisions. Limited
5health service organizations shall be subject to the
6provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
7141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
8154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 355.2,
9355.3, 355b, 356q, 356v, 356z.10, 356z.21, 356z.22, 356z.25,
10356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.41,
11356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57, 356z.59,
12364.3, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412,
13444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
14XIII 1/2, XXV, and XXVI of the Illinois Insurance Code. For
15purposes of the Illinois Insurance Code, except for Sections
16444 and 444.1 and Articles XIII and XIII 1/2, limited health
17service organizations in the following categories are deemed
18to be domestic companies:
19        (1) a corporation under the laws of this State; or
20        (2) a corporation organized under the laws of another
21    state, 30% or more of the enrollees of which are residents
22    of this State, except a corporation subject to
23    substantially the same requirements in its state of
24    organization as is a domestic company under Article VIII

 

 

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1    1/2 of the Illinois Insurance Code.
2(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
3101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
41-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
5eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
6102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
71-1-23; 102-1093, eff. 1-1-23; revised 12-13-22.)