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1 | AN ACT concerning health care.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 1. Short title. This Act may be cited as the Health | ||||||||||||||||||||||||
5 | Benefit Purchasing Cooperatives Act. | ||||||||||||||||||||||||
6 | Section 5. Definitions. For the purposes of this Section:
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7 | (a) "Director" means the Director of Insurance. | ||||||||||||||||||||||||
8 | (b) "Eligible employee" includes any individual permitted | ||||||||||||||||||||||||
9 | to work by a small business employer, as defined in this Act, | ||||||||||||||||||||||||
10 | in an occupation, but does not include any individual permitted | ||||||||||||||||||||||||
11 | to work: | ||||||||||||||||||||||||
12 | (1) For an employer employing fewer than 4 employees | ||||||||||||||||||||||||
13 | exclusive of the employer's parent, spouse or child or | ||||||||||||||||||||||||
14 | other members of his immediate family; | ||||||||||||||||||||||||
15 | (2) As an employee employed in agriculture or | ||||||||||||||||||||||||
16 | aquaculture: | ||||||||||||||||||||||||
17 | (A) if such employee is employed by an employer who | ||||||||||||||||||||||||
18 | did not, during any calendar quarter during the | ||||||||||||||||||||||||
19 | preceding calendar year, use more than 500 man days of | ||||||||||||||||||||||||
20 | agricultural or aquacultural labor; | ||||||||||||||||||||||||
21 | (B) if such employee is the parent, spouse or | ||||||||||||||||||||||||
22 | child, or other member of the employer's immediate | ||||||||||||||||||||||||
23 | family; | ||||||||||||||||||||||||
24 | (C) if such employee (i) is employed as a hand | ||||||||||||||||||||||||
25 | harvest laborer and is paid on a piece rate basis in an | ||||||||||||||||||||||||
26 | operation which has been, and is customarily and | ||||||||||||||||||||||||
27 | generally recognized as having been, paid on a piece | ||||||||||||||||||||||||
28 | rate basis in the region of employment, (ii) commutes | ||||||||||||||||||||||||
29 | daily from his permanent residence to the farm on which | ||||||||||||||||||||||||
30 | he is so employed, and (iii) has been employed in | ||||||||||||||||||||||||
31 | agriculture less than 13 weeks during the preceding | ||||||||||||||||||||||||
32 | calendar year; |
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1 | (D) if such employee (other than an employee | ||||||
2 | described in clause (C) of this subparagraph): (i) is | ||||||
3 | 16 years of age or under and is employed as a hand | ||||||
4 | harvest laborer, is paid on a piece rate basis in an | ||||||
5 | operation which has been, and is customarily and | ||||||
6 | generally recognized as having been, paid on a piece | ||||||
7 | rate basis in the region of employment, (ii) is | ||||||
8 | employed on the same farm as his parent or person | ||||||
9 | standing in the place of his parent, and (iii) is paid | ||||||
10 | at the same piece rate as employees over 16 are paid on | ||||||
11 | the same farm. | ||||||
12 | (3) In domestic service in or about a private home. | ||||||
13 | (4) As an outside salesman. | ||||||
14 | (5) As a member of a religious corporation or | ||||||
15 | organization. | ||||||
16 | (6) At an accredited Illinois college or university | ||||||
17 | employed by the college or university at which he is a | ||||||
18 | student who is covered under the provisions of the Fair | ||||||
19 | Labor Standards Act of 1938. | ||||||
20 | (7) For a motor carrier and with respect to whom the | ||||||
21 | U.S. Secretary of Transportation has the power to establish | ||||||
22 | qualifications and maximum hours of service under the | ||||||
23 | provisions of Title 49 U.S.C. or the State of Illinois | ||||||
24 | under Section 18b 105 (Title 92 of the Illinois | ||||||
25 | Administrative Code, Part 395 Hours of Service of Drivers) | ||||||
26 | of the Illinois Vehicle Code. The above exclusions from the | ||||||
27 | term "employee" may be further defined by of the Director | ||||||
28 | of Labor.
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29 | (c) "Farmer" has the meaning ascribed to that term in the | ||||||
30 | Illinois Family Farmer Support Act. | ||||||
31 | (d) "Person" means any corporation, limited liability | ||||||
32 | company, partnership, cooperative, association, trade or labor | ||||||
33 | organization, city, village, town, county, active farmer, | ||||||
34 | small business, or
self-employed individual. | ||||||
35 | (e) "Self-employed" means people who work in their own | ||||||
36 | business, profession, or on their own farm and rely on their |
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1 | self-owned business for their primary source of income. This | ||||||
2 | definition includes those who work in their own business, | ||||||
3 | profession, or on their own farm and excludes those who operate | ||||||
4 | their own incorporated business or farm. | ||||||
5 | (f) "Small business" means a business situated in Illinois | ||||||
6 | having 50 or fewer employees. | ||||||
7 | Section 10. Organization and purpose.
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8 | (a) One health benefit purchasing cooperative may be | ||||||
9 | organized under this Act in each of the geographic areas | ||||||
10 | designated under Section 35.
Each health benefit purchasing | ||||||
11 | cooperative may be formed by one or more persons. | ||||||
12 | (b) The purpose of a health benefit purchasing cooperative | ||||||
13 | is to provide health care benefits for the individuals | ||||||
14 | specified in Section 25 through a contract with an insurer | ||||||
15 | authorized to do business in this State in one or more lines of | ||||||
16 | insurance that includes health insurance. | ||||||
17 | (c) A health benefit purchasing cooperative shall be | ||||||
18 | designed so that all of the following are accomplished:
(1) The | ||||||
19 | members become better informed about health care trends and | ||||||
20 | cost increases;
(2) All members purchase their health care | ||||||
21 | benefits and prescription drug coverage from the same insurer; | ||||||
22 | (3) The members are actively engaged in designing health care | ||||||
23 | benefit options that are offered by the insurer and that meet | ||||||
24 | the needs of their
community; (4) The health insurance risk of | ||||||
25 | all of the members is pooled; (5) The members actively | ||||||
26 | participate in health improvement decisions for their | ||||||
27 | community.
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28 | Section 15. Temporary Board of Directors. The articles of a | ||||||
29 | health benefit purchasing cooperative shall set forth the name | ||||||
30 | and
address of at least one incorporator who shall act as the | ||||||
31 | temporary board.
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32 | Section 20. Cooperative membership.
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33 | (a) Each health
benefit purchasing cooperative shall be |
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1 | organized on a membership basis with no capital stock. | ||||||
2 | (b) Subject to subsection (c), any person that does | ||||||
3 | business in, is located in, has a principal office in, or | ||||||
4 | resides in the geographic area in which a health benefit | ||||||
5 | purchasing cooperative is
organized, that meets the membership | ||||||
6 | criteria established by the health benefit purchasing | ||||||
7 | cooperative in its bylaws, and that pays the membership fee may | ||||||
8 | be a member of the health benefit purchasing cooperative. | ||||||
9 | (c) A health benefit cooperative may limit membership | ||||||
10 | through its membership criteria, but the criteria must be | ||||||
11 | applied in the same manner. Each health benefit purchasing | ||||||
12 | cooperative shall file its membership criteria, as well as any | ||||||
13 | amendments to the criteria, with the Director.
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14 | Section 25. Health Care Benefits.
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15 | (a) The health care benefits offered by a health
benefit | ||||||
16 | purchasing cooperative shall be negotiated between the health | ||||||
17 | benefit purchasing cooperative and the insurer. The insurer | ||||||
18 | must offer coverage to all of the following: | ||||||
19 | (1) An individual who is a member, officer, or eligible | ||||||
20 | employee of a member of the health benefit purchasing | ||||||
21 | cooperative. | ||||||
22 | (2) A self-employed individual, farmer, or small | ||||||
23 | business that is a member of the health benefit purchasing | ||||||
24 | cooperative. | ||||||
25 | (3) A dependent of an individual under (1) or (2) who | ||||||
26 | receives coverage. | ||||||
27 | (b) The contract between the members of a health benefit | ||||||
28 | purchasing cooperative and the insurer shall be for a term of 3 | ||||||
29 | years. Upon enrollment in the insurer's health benefit plan, | ||||||
30 | each member shall pay to the health benefit purchasing | ||||||
31 | cooperative an amount determined by the health benefit | ||||||
32 | purchasing cooperative that is not less than the member's | ||||||
33 | applicable premium for the 36th month of coverage under the | ||||||
34 | contract. If a member withdraws from the health benefit | ||||||
35 | purchasing cooperative before the end of the contract term, the |
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1 | health benefit purchasing cooperative may retain, as a penalty, | ||||||
2 | the premium that the member paid for the 36th month of | ||||||
3 | coverage. | ||||||
4 | Section 30. Additional required benefits.
Each health | ||||||
5 | benefit purchasing cooperative shall submit to the Director all | ||||||
6 | of the following: | ||||||
7 | (a) Annually, no later than September 30, a report on the | ||||||
8 | progress of the health benefit purchasing arrangement | ||||||
9 | described in this Act and, to the extent possible,
any | ||||||
10 | significant findings in the criteria under subsection (b) | ||||||
11 | (1)-(3) of this Section. | ||||||
12 | (b) Within one year after the end of the term of the | ||||||
13 | contract under subsection (b) of Section 25, a final report | ||||||
14 | that details significant findings from the project and that | ||||||
15 | includes, at
a minimum, to the extent available, information on | ||||||
16 | all of the following: | ||||||
17 | (1) The extent to which the health benefit purchasing | ||||||
18 | arrangement had an impact on the number of uninsured in the | ||||||
19 | geographic area in which it operated. | ||||||
20 | (2) The effect on health care coverage premiums for | ||||||
21 | groups in the geographic area in which the health benefit | ||||||
22 | purchasing arrangement operated, including groups other | ||||||
23 | than the health benefit purchasing cooperative. | ||||||
24 | (3) The degree to which health care consumers were | ||||||
25 | involved in the development and implementation of the | ||||||
26 | health benefit purchasing arrangement.
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27 | Section 35. Designation of geographic areas.
The Director | ||||||
28 | shall designate, by rule, the geographic areas of the State in | ||||||
29 | which health benefit purchasing cooperatives may be organized. | ||||||
30 | A geographic area may overlap with one or more other geographic | ||||||
31 | areas.
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32 | Section 40. The Co-operative Act shall not apply to this | ||||||
33 | Act.
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