093_HB1648ham001











                                     LRB093 06981 JLS 13442 a

 1                    AMENDMENT TO HOUSE BILL 1648

 2        AMENDMENT NO.     .  Amend House Bill 1648  by  replacing
 3    everything after the enacting clause with the following:

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

 6        (215 ILCS 105/4) (from Ch. 73, par. 1304)
 7        Sec. 4.  Powers and authority of the  board.   The  board
 8    shall have the general powers and authority granted under the
 9    laws  of  this  State  to  insurance  companies  licensed  to
10    transact  health  and  accident  insurance  and  in  addition
11    thereto, the specific authority to:
12        a.  Enter  into  contracts  as are necessary or proper to
13    carry out the provisions and purposes of this Act,  including
14    the  authority,  with  the approval of the Director, to enter
15    into contracts with similar plans of  other  states  for  the
16    joint performance of common administrative functions, or with
17    persons   or  other  organizations  for  the  performance  of
18    administrative  functions  including,   without   limitation,
19    utilization  review  and  quality assurance programs, or with
20    health  maintenance  organizations  or   preferred   provider
21    organizations for the provision of health care services.
22        b.  Sue  or  be  sued, including taking any legal actions
 
                            -2-      LRB093 06981 JLS 13442 a
 1    necessary or proper.
 2        c.  Take such legal action as necessary to:
 3             (1)  avoid the payment of  improper  claims  against
 4        the plan or the coverage provided by or through the plan;
 5             (2)  to   recover   any   amounts   erroneously   or
 6        improperly paid by the plan;
 7             (3)  to  recover  any  amounts paid by the plan as a
 8        result of a mistake of fact or law; or
 9             (4)  to  recover  or  collect  any  other   amounts,
10        including  assessments,  that are due or owed the Plan or
11        have been billed on its or the Plan's behalf.
12        d.  Establish appropriate  rates,  rate  schedules,  rate
13    adjustments, expense allowances, agents' referral fees, claim
14    reserves,  and  formulas  and  any  other  actuarial function
15    appropriate to the operation of the plan.    Rates  and  rate
16    schedules  may  be adjusted for appropriate risk factors such
17    as age and area variation in claim costs and shall take  into
18    consideration  appropriate  risk  factors  in accordance with
19    established actuarial and underwriting practices.
20        e.  Issue policies of insurance in  accordance  with  the
21    requirements of this Act.
22        f.  Appoint   appropriate   legal,  actuarial  and  other
23    committees as necessary to provide  technical  assistance  in
24    the  operation of the plan, policy and other contract design,
25    and any other function within the authority of the plan.
26        g.  Borrow money to effect the purposes of  the  Illinois
27    Comprehensive  Health  Insurance  Plan.   Any  notes or other
28    evidence of indebtedness of the plan not in default shall  be
29    legal investments for insurers and may be carried as admitted
30    assets.
31        h.  Establish   rules,   conditions  and  procedures  for
32    reinsuring risks under this Act.
33        i.  Employ and fix the compensation  of  employees.  Such
34    employees  may  be  paid  on  a  warrant  issued by the State
 
                            -3-      LRB093 06981 JLS 13442 a
 1    Treasurer pursuant to a  payroll  voucher  certified  by  the
 2    Board  and drawn by the Comptroller against appropriations or
 3    trust funds held by the State Treasurer.
 4        j.  Enter into intergovernmental  cooperation  agreements
 5    with  other  agencies or entities of State government for the
 6    purpose of sharing the cost of providing health care services
 7    that are otherwise authorized by this Act  for  children  who
 8    are   both  plan  participants  and  eligible  for  financial
 9    assistance from the Division of Specialized Care for Children
10    of the University of Illinois.
11        k.  Establish conditions and procedures under  which  the
12    plan  may,  if  funds  permit,  discount or subsidize premium
13    rates that are paid directly by senior citizens,  as  defined
14    by the Board, and other plan participants, who are retired or
15    unemployed and meet other qualifications.
16        l.  Establish  and  maintain  the Plan Fund authorized in
17    Section 3 of this Act, which shall be divided  into  separate
18    accounts, as follows:
19             (1)  accounts to fund the administrative, claim, and
20        other  expenses  of  the  Plan  associated  with eligible
21        persons who qualify for Plan coverage under Section 7  of
22        this Act, which shall consist of:
23                  (A)  premiums   paid   on   behalf  of  covered
24             persons;
25                  (B)  appropriated  funds  and  other   revenues
26             collected or received by the Board;
27                  (C)  reserves  for  future losses maintained by
28             the Board; and
29                  (D)  interest earnings from investment  of  the
30             funds  in the Plan Fund or any of its accounts other
31             than the funds in the account established under item
32             2 of this subsection;
33             (2)  an account, to  be  denominated  the  federally
34        eligible individuals account, to fund the administrative,
 
                            -4-      LRB093 06981 JLS 13442 a
 1        claim,  and  other  expenses  of the Plan associated with
 2        federally  eligible  individuals  who  qualify  for  Plan
 3        coverage under  Section  15  of  this  Act,  which  shall
 4        consist of:
 5                  (A)  premiums   paid   on   behalf  of  covered
 6             persons;
 7                  (B)  assessments and other  revenues  collected
 8             or received by the Board;
 9                  (C)  reserves  for  future losses maintained by
10             the Board; and
11                  (D)  interest earnings from investment  of  the
12             federally eligible individuals account funds; and
13             (3)  such other accounts as may be appropriate.
14        m.  Charge  and  collect  assessments  paid  by  insurers
15    pursuant   to   Section  12  of  this  Act  and  recover  any
16    assessments for, on behalf of, or against those insurers.
17        n.  Establish conditions and procedures under  which  the
18    Plan  may, if funds permit, provide catastrophic prescription
19    drug insurance, as defined by the Board.
20    (Source: P.A. 90-30, eff. 7-1-97; 91-357, eff. 7-29-99.)

21        Section 99.  Effective date.  This Act takes effect  upon
22    becoming law.".