SB1716 98TH GENERAL ASSEMBLY

LRB098 09527 RPM 39670 b

98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
SB1716

Introduced 2/15/2013, by Sen. William R. Haine

SYNOPSIS AS INTRODUCED:

215 ILCS 122/5-23 new
215 ILCS 105/16 new
215 ILCS 105/17 new

Amends the Illinois Health Benefits Exchange Law. Provides that except as otherwise provided in the provision concerning the dissolution of the Comprehensive Health Insurance Plan, the insurance operations of the Comprehensive Health Insurance Plan (the Plan) authorized by the Comprehensive Health Insurance Plan Act shall cease on January 1, 2014 (and makes conforming changes in the Comprehensive Health Insurance Plan Act). Sets forth provisions concerning service provided after January 1, 2014, grievances, balance billing, the plan of dissolution, actions by or against the Plan Board, and General Revenue Fund funds and insurer assessments in the Plan on the date of final dissolution. Provides for the repeal of the Comprehensive Health Insurance Plan Act on January 1, 2015. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Health Benefits Exchange Law is amended by adding Section 5-23 as follows:

(215 ILCS 122/5-23 new)

Sec. 5-23. Dissolution of Comprehensive Health Insurance Plan.

(a) Except as otherwise provided in this Section, the insurance operations of the Comprehensive Health Insurance Plan (the Plan) authorized by the Comprehensive Health Insurance Plan Act shall cease on January 1, 2014.

(b) Coverage under the Plan does not apply to service provided on or after January 1, 2014.

(c) A claim for payment under the Plan must be submitted within 60 days after January 1, 2014 and paid within 60 days after receipt.

(d) Any grievance shall be resolved by the Plan Board not later than 90 days after January 1, 2014. In this Section, "Plan Board" means the Illinois Comprehensive Health Insurance Board.

(e) Balance billing under this Section by a health care provider that is not a member of the provider network arrangement used by the Plan is prohibited.

(f) The Plan Board shall, not later than June 30, 2013, submit to the Director of Insurance a plan of dissolution, which must provide for, but not be limited to, the following:

(1) Continuity of care for an individual who is covered under the Plan and is an inpatient on January 1, 2014.

(2) A final accounting of assessments.

(3) Resolution of any net asset deficiency.

(4) Cessation of all liability of the Plan.

(5) Final dissolution of the Plan.

(g) The plan of dissolution may provide that, with the approval of the Plan Board and the Director, a power or duty of the association may be delegated to a person that is to perform functions similar to the functions of the Plan.

(h) The Director shall, after notice and hearing, approve a plan of dissolution submitted under subsection (f) of this Section if the Director determines that the plan of dissolution is suitable to ensure the fair, reasonable, and equitable dissolution of the Plan and complies with subsection (f) of this Section.

(i) A plan of dissolution submitted under subsection (f) of this Section is effective upon the written approval of the Director.

(j) An action by or against the Plan must be filed not more than one year after January 1, 2014.

(k) General Revenue Fund funds remaining in the Plan on the date on which final dissolution of the Plan occurs must be transferred back into the General Revenue Fund.

(l) Insurer assessments remaining in the Plan on the date on which dissolution of the Plan occurs must be returned to insurers based on subsection e of Section 12 of the Comprehensive Health Insurance Plan Act.

(m) The Plan, or the person or entity to which the Plan delegates powers under subsection (g) of this Section, may implement this Section in accordance with the plan of dissolution approved by the Director under subsection (h) of this Section.

Section 10. The Comprehensive Health Insurance Plan Act is amended by adding Sections 16 and 17 as follows:

(215 ILCS 105/16 new)

Sec. 16. Cessation of operations. Notwithstanding any other provision of this Act, the insurance operations of the Plan authorized by this Act shall cease on January 1, 2014 in accordance with Section 5-23 of the Illinois Health Benefits Exchange Law. Plan coverage does not apply to service provided on or after January 1, 2014 in accordance with Section 5-23 of the Illinois Health Benefits Exchange Law.

(215 ILCS 105/17 new)

Sec. 17. Repealer. This Act is repealed on January 1, 2015.

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