|
Health Care Availability and Access Committee
Filed: 5/13/2008
|
|
09500SB2486ham001 |
|
LRB095 17334 RPM 50691 a |
|
|
1 |
| AMENDMENT TO SENATE BILL 2486
|
2 |
| AMENDMENT NO. ______. Amend Senate Bill 2486 as follows:
|
3 |
| on page 2, by replacing lines 15 through 18 with the following: |
4 |
| " participation in a program, or demonstrative compliance with |
5 |
| treatment recommendations as determined by the health insurer |
6 |
| or managed care plan. "; and |
7 |
| on page 3, line 3, by replacing " shall " with " must "; and |
8 |
| on page 3, immediately below line 8, by inserting the |
9 |
| following: |
10 |
| " (e) A plan offering wellness coverage must do the |
11 |
| following: |
12 |
| (i) give participants the opportunity to qualify for |
13 |
| offered incentives at least once a year; |
14 |
| (ii) allow a reasonable alternative to any individual |
15 |
| for whom it is unreasonably difficult, due to a medical |
|
|
|
09500SB2486ham001 |
- 2 - |
LRB095 17334 RPM 50691 a |
|
|
1 |
| condition, to satisfy otherwise applicable wellness |
2 |
| program standards. Plans may seek physician verification |
3 |
| that health factors make it unreasonably difficult or |
4 |
| medically inadvisable for the participant to satisfy the |
5 |
| standards; and |
6 |
| (iii) not provide a total incentive that exceeds 20% of |
7 |
| the cost of employee-only coverage. The cost of |
8 |
| employee-only coverage includes both employer and employee |
9 |
| contributions. For plans offering family coverage, the 20% |
10 |
| limitation applies to cost of family coverage and applies |
11 |
| to the entire family. "; and |
12 |
| on page 3, line 9, by replacing " (e) " with " (f) "; and |
13 |
| on page 3, immediately below line 11, by inserting the |
14 |
| following: |
15 |
| " (g) Notwithstanding any other rulemaking authority that |
16 |
| may exist, neither the Governor nor any agency or agency head |
17 |
| under the jurisdiction of the Governor has any authority to |
18 |
| make or promulgate rules to implement or enforce the provisions |
19 |
| of this amendatory Act of the 95th General Assembly. If, |
20 |
| however, the Governor believes that rules are necessary to |
21 |
| implement or enforce the provisions of this amendatory Act of |
22 |
| the 95th General Assembly, the Governor may suggest rules to |
23 |
| the General Assembly by filing them with the Clerk of the House |
24 |
| and the Secretary of the Senate and by requesting that the |
|
|
|
09500SB2486ham001 |
- 3 - |
LRB095 17334 RPM 50691 a |
|
|
1 |
| General Assembly authorize such rulemaking by law, enact those |
2 |
| suggested rules into law, or take any other appropriate action |
3 |
| in the General Assembly's discretion. Nothing contained in this |
4 |
| amendatory Act of the 95th General Assembly shall be |
5 |
| interpreted to grant rulemaking authority under any other |
6 |
| Illinois statute where such authority is not otherwise |
7 |
| explicitly given. For the purposes of this amendatory Act of |
8 |
| the 95th General Assembly, "rules" is given the meaning |
9 |
| contained in Section 1-70 of the Illinois Administrative |
10 |
| Procedure Act, and "agency" and "agency head" are given the |
11 |
| meanings contained in Sections 1-20 and 1-25 of the Illinois |
12 |
| Administrative Procedure Act to the extent that such |
13 |
| definitions apply to agencies or agency heads under the |
14 |
| jurisdiction of the Governor. ".
|