093_SB0908
LRB093 07205 JLS 07361 b
1 AN ACT concerning health benefit plans.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Insurance Code is amended by
5 adding Section 352b as follows:
6 (215 ILCS 5/352b new)
7 Sec. 352b. Flexible health plans.
8 (a) The Illinois General Assembly finds that a
9 significant proportion of the residents of this State are
10 unable to obtain affordable health insurance coverage. The
11 General Assembly recognizes the need for individuals and
12 employers in this State to have the opportunity to choose
13 health insurance plans that are more affordable and flexible
14 than standard market policies of accident and health
15 insurance and the need to increase the availability of health
16 insurance coverage by authorizing the transaction of this
17 type of plan or policy by accident and health insurers
18 licensed to transact business in this State. Therefore, it is
19 the intent of the Illinois General Assembly to expand the
20 availability of affordable and flexible health insurance
21 options for consumers and employers by allowing individual
22 and group carriers to develop alternative approaches to
23 traditional accident and health insurance policies currently
24 offered in this State. This Section shall in no way prevent
25 insurers from offering any coverages that are offered or
26 mandated under this Article; provided, however, that it is
27 explicitly intended that individuals and employers may choose
28 pursuant to this Section new health insurance plans offered
29 by insurers that may exclude in whole or in part State
30 mandated health benefits.
31 (b) As used in this Section:
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1 "Health Flex Plan" means a health benefits plan offered
2 by an insurer authorized to transact business in this State.
3 "State mandated health benefits" means coverage for
4 specific health care services, benefits, or treatment
5 required by State law or rule, limitations or restrictions on
6 deductibles, coinsurance, copayments, or any annual or
7 lifetime maximum benefit amounts, or inclusion of a specific
8 health care provider to be provided to a person covered under
9 an individual or group policy of accident and health
10 insurance issued in the State of Illinois.
11 (c) On and after January 1, 2004, any insurer authorized
12 to transact business in this State shall be authorized to
13 offer, as an option, one or more health benefit plans that,
14 either in whole or in part, do not provide State mandated
15 health benefits.
16 (d) In each sale of accident and health insurance
17 policies or contracts in which the proposed group or
18 individual policyholder has chosen a health benefits plan
19 that, either in whole or in part, does not provide State
20 mandated health benefits, the insurer shall:
21 (1) provide to the proposed policyholder a written
22 notice with the following language in bold type:
23 "You have the option to choose this Health Flex Plan
24 which, either in whole or in part, does not provide State
25 mandated health benefits normally required in accident
26 and health insurance policies in Illinois. This health
27 benefits plan may provide a more affordable health
28 insurance policy for you, although, at the same time, it
29 may provide you with fewer health benefits than those
30 normally included as State mandated health benefits in
31 policies in Illinois. If you choose this option, please
32 consult with your insurance agent to discover which State
33 mandated health benefits are excluded in this policy.";
34 (2) provide to the proposed policyholder a
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1 statement to be signed acknowledging that the health
2 benefits plan being purchased does not provide the State
3 mandated health benefits listed on the form; and
4 (3) maintain the signed notice to provide
5 information as may be needed by the Director of
6 Insurance.
7 (e) The Director may promulgate rules as necessary to
8 implement the provisions of this Section.
9 Section 99. Effective date. This Act takes effect upon
10 becoming law.