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94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB3153
Introduced 2/22/2005, by Rep. Tom Cross SYNOPSIS AS INTRODUCED:
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215 ILCS 125/2-5 |
from Ch. 111 1/2, par. 1406.1 |
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Amends the Health Maintenance Organization Act. Makes a technical change in
a
Section concerning claims liability.
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A BILL FOR
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HB3153 |
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LRB094 07742 LJB 37920 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois, |
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| represented in the General Assembly:
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| Section 5. The Health Maintenance Organization Act is |
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| amended by changing Section 2-5 as follows:
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| (215 ILCS 125/2-5) (from Ch. 111 1/2, par. 1406.1)
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| Sec. 2-5. Claims Liabilities. Every Health
Maintenance |
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| Organization shall, at all times,
maintain liabilities in an |
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| amount estimated in the
the aggregate to provide for
the |
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| payment of all claims incurred and any due and unpaid provider
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| capitation, whether reported or unreported, which
are unpaid |
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| and for which such organization is or may be liable, and to
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| provide for the expense of adjustment or settlement of such |
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| claims. Such
liabilities shall be computed in accordance with |
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| regulations promulgated by
the Director upon reasonable |
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| consideration of the ascertained experience
and character of |
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| such business for the purpose of adequately protecting
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| enrollees and securing the solvency of such organizations. |
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| Whenever the claim and claim expense experience of any such |
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| organization
shows the liabilities calculated in accordance |
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| with such regulations to be
inadequate, the Director may |
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| require such organization to maintain
additional liabilities.
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| (Source: P.A. 86-620.)
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