093_HB1648eng

 
HB1648 Engrossed                     LRB093 06981 JLS 07131 b

 1        AN  ACT  concerning  the  Comprehensive  Health Insurance
 2    Plan.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section  5.  The  Comprehensive Health Insurance Plan Act
 6    is amended by changing Section 4 as follows:

 7        (215 ILCS 105/4) (from Ch. 73, par. 1304)
 8        Sec. 4.  Powers and authority of the  board.   The  board
 9    shall have the general powers and authority granted under the
10    laws  of  this  State  to  insurance  companies  licensed  to
11    transact  health  and  accident  insurance  and  in  addition
12    thereto, the specific authority to:
13        a.  Enter  into  contracts  as are necessary or proper to
14    carry out the provisions and purposes of this Act,  including
15    the  authority,  with  the approval of the Director, to enter
16    into contracts with similar plans of  other  states  for  the
17    joint performance of common administrative functions, or with
18    persons   or  other  organizations  for  the  performance  of
19    administrative  functions  including,   without   limitation,
20    utilization  review  and  quality assurance programs, or with
21    health  maintenance  organizations  or   preferred   provider
22    organizations for the provision of health care services.
23        b.  Sue  or  be  sued, including taking any legal actions
24    necessary or proper.
25        c.  Take such legal action as necessary to:
26             (1)  avoid the payment of  improper  claims  against
27        the plan or the coverage provided by or through the plan;
28             (2)  to   recover   any   amounts   erroneously   or
29        improperly paid by the plan;
30             (3)  to  recover  any  amounts paid by the plan as a
31        result of a mistake of fact or law; or
 
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 1             (4)  to  recover  or  collect  any  other   amounts,
 2        including  assessments,  that are due or owed the Plan or
 3        have been billed on its or the Plan's behalf.
 4        d.  Establish appropriate  rates,  rate  schedules,  rate
 5    adjustments, expense allowances, agents' referral fees, claim
 6    reserves,  and  formulas  and  any  other  actuarial function
 7    appropriate to the operation of the plan.    Rates  and  rate
 8    schedules  may  be adjusted for appropriate risk factors such
 9    as age and area variation in claim costs and shall take  into
10    consideration  appropriate  risk  factors  in accordance with
11    established actuarial and underwriting practices.
12        e.  Issue policies of insurance in  accordance  with  the
13    requirements of this Act.
14        f.  Appoint   appropriate   legal,  actuarial  and  other
15    committees as necessary to provide  technical  assistance  in
16    the  operation of the plan, policy and other contract design,
17    and any other function within the authority of the plan.
18        g.  Borrow money to effect the purposes of  the  Illinois
19    Comprehensive  Health  Insurance  Plan.   Any  notes or other
20    evidence of indebtedness of the plan not in default shall  be
21    legal investments for insurers and may be carried as admitted
22    assets.
23        h.  Establish   rules,   conditions  and  procedures  for
24    reinsuring risks under this Act.
25        i.  Employ and fix the compensation  of  employees.  Such
26    employees  may  be  paid  on  a  warrant  issued by the State
27    Treasurer pursuant to a  payroll  voucher  certified  by  the
28    Board  and drawn by the Comptroller against appropriations or
29    trust funds held by the State Treasurer.
30        j.  Enter into intergovernmental  cooperation  agreements
31    with  other  agencies or entities of State government for the
32    purpose of sharing the cost of providing health care services
33    that are otherwise authorized by this Act  for  children  who
34    are   both  plan  participants  and  eligible  for  financial
 
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 1    assistance from the Division of Specialized Care for Children
 2    of the University of Illinois.
 3        k.  Establish conditions and procedures under  which  the
 4    plan  may,  if  funds  permit,  discount or subsidize premium
 5    rates that are paid directly by senior citizens,  as  defined
 6    by the Board, and other plan participants, who are retired or
 7    unemployed and meet other qualifications.
 8        l.  Establish  and  maintain  the Plan Fund authorized in
 9    Section 3 of this Act, which shall be divided  into  separate
10    accounts, as follows:
11             (1)  accounts to fund the administrative, claim, and
12        other  expenses  of  the  Plan  associated  with eligible
13        persons who qualify for Plan coverage under Section 7  of
14        this Act, which shall consist of:
15                  (A)  premiums   paid   on   behalf  of  covered
16             persons;
17                  (B)  appropriated  funds  and  other   revenues
18             collected or received by the Board;
19                  (C)  reserves  for  future losses maintained by
20             the Board; and
21                  (D)  interest earnings from investment  of  the
22             funds  in the Plan Fund or any of its accounts other
23             than the funds in the account established under item
24             2 of this subsection;
25             (2)  an account, to  be  denominated  the  federally
26        eligible individuals account, to fund the administrative,
27        claim,  and  other  expenses  of the Plan associated with
28        federally  eligible  individuals  who  qualify  for  Plan
29        coverage under  Section  15  of  this  Act,  which  shall
30        consist of:
31                  (A)  premiums   paid   on   behalf  of  covered
32             persons;
33                  (B)  assessments and other  revenues  collected
34             or received by the Board;
 
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 1                  (C)  reserves  for  future losses maintained by
 2             the Board; and
 3                  (D)  interest earnings from investment  of  the
 4             federally eligible individuals account funds; and
 5             (3)  such other accounts as may be appropriate.
 6        m.  Charge  and  collect  assessments  paid  by  insurers
 7    pursuant   to   Section  12  of  this  Act  and  recover  any
 8    assessments for, on behalf of, or against those insurers.
 9        n.  Establish conditions and procedures under  which  the
10    Plan  may, if funds permit, provide catastrophic prescription
11    drug insurance, as defined by the Board.
12    (Source: P.A. 90-30, eff. 7-1-97; 91-357, eff. 7-29-99.)

13        Section 99.  Effective date.  This Act takes effect  upon
14    becoming law.