Sen. William R. Haine

Filed: 11/6/2013





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2    AMENDMENT NO. ______. Amend Senate Bill 214, AS AMENDED, by
3replacing everything after the enacting clause with the
5    "Section 5. The State Employees Group Insurance Act of 1971
6is amended by changing Section 5 as follows:
7    (5 ILCS 375/5)  (from Ch. 127, par. 525)
8    Sec. 5. Employee benefits; declaration of State policy. The
9General Assembly declares that it is the policy of the State
10and in the best interest of the State to assure quality
11benefits to members and their dependents under this Act. The
12implementation of this policy depends upon, among other things,
13stability and continuity of coverage, care, and services under
14benefit programs for members and their dependents.
15Specifically, but without limitation, members should have
16continued access, on substantially similar terms and



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1conditions, to trusted family health care providers with whom
2they have developed long-term relationships through a benefit
3program under this Act. Therefore, the Director must administer
4this Act consistent with that State policy, but may consider
5affordability, cost of coverage and care, and competition among
6health insurers and providers. All contracts for provision of
7employee benefits, including those portions of any proposed
8collective bargaining agreement that would require
9implementation through contracts entered into under this Act,
10are subject to the following requirements:
11        (i) By April 1 of each year, the Director must report
12    and provide information to the Commission concerning the
13    status of the employee benefits program to be offered for
14    the next fiscal year. Information includes, but is not
15    limited to, documents, reports of negotiations, bid
16    invitations, requests for proposals, specifications,
17    copies of proposed and final contracts or agreements, and
18    any other materials concerning contracts or agreements for
19    the employee benefits program. By the first of each month
20    thereafter, the Director must provide updated, and any new,
21    information to the Commission until the employee benefits
22    program for the next fiscal year is determined. In addition
23    to these monthly reporting requirements, at any time the
24    Commission makes a written request, the Director must
25    promptly, but in no event later than 5 business days after
26    receipt of the request, provide to the Commission any



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1    additional requested information in the possession of the
2    Director concerning employee benefits programs. The
3    Commission may waive any of the reporting requirements of
4    this item (i) upon the written request by the Director. Any
5    waiver granted under this item (i) must be in writing.
6    Nothing in this item is intended to abrogate any
7    attorney-client privilege.
8        (ii) Within 30 days after notice of the awarding or
9    letting of a contract has appeared in the Illinois
10    Procurement Bulletin in accordance with subsection (b) of
11    Section 15-25 of the Illinois Procurement Code, the
12    Commission may request in writing from the Director and the
13    Director shall promptly, but in no event later than 5
14    business days after receipt of the request, provide to the
15    Commission information in the possession of the Director
16    concerning the proposed contract. Nothing in this item is
17    intended to waive or abrogate any privilege or right of
18    confidentiality authorized by law.
19        (iii) Except as otherwise provided in this item (iii),
20    no contract subject to this Section may be entered into
21    until the 30-day period described in item (ii) has expired,
22    unless the Director requests in writing that the Commission
23    waive the period and the Commission grants the waiver in
24    writing. This item (iii) does not apply to any contract
25    entered into after the effective date of this amendatory
26    Act of the 98th General Assembly and through January 1,



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1    2014 to provide a program of group health benefits for
2    Medicare-primary members and their Medicare-primary
3    dependents that is comparable in stability and continuity
4    of coverage, care, and services to the program of health
5    benefits offered to other members and their dependents
6    under this Act.
7        (iv) If the Director seeks to make any substantive
8    modification to any provision of a proposed contract after
9    it is submitted to the Commission in accordance with item
10    (ii), the modified contract shall be subject to the
11    requirements of items (ii) and (iii) unless the Commission
12    agrees, in writing, to a waiver of those requirements with
13    respect to the modified contract.
14        (v) By the date of the beginning of the annual benefit
15    choice period, the Director must transmit to the Commission
16    a copy of each final contract or agreement for the employee
17    benefits program to be offered for the next fiscal year.
18    The annual benefit choice period for an employee benefits
19    program must begin on May 1 of the fiscal year preceding
20    the year for which the program is to be offered. If,
21    however, in any such preceding fiscal year collective
22    bargaining over employee benefit programs for the next
23    fiscal year remains pending on April 15, the beginning date
24    of the annual benefit choice period shall be not later than
25    15 days after ratification of the collective bargaining
26    agreement.



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1        (vi) The Director must provide the reports,
2    information, and contracts required under items (i), (ii),
3    (iv), and (v) by electronic or other means satisfactory to
4    the Commission. Reports, information, and contracts in the
5    possession of the Commission pursuant to items (i), (ii),
6    (iv), and (v) are exempt from disclosure by the Commission
7    and its members and employees under the Freedom of
8    Information Act. Reports, information, and contracts
9    received by the Commission pursuant to items (i), (ii),
10    (iv), and (v) must be kept confidential by and may not be
11    disclosed or used by the Commission or its members or
12    employees if such disclosure or use could compromise the
13    fairness or integrity of the procurement, bidding, or
14    contract process. Commission meetings, or portions of
15    Commission meetings, in which reports, information, and
16    contracts received by the Commission pursuant to items (i),
17    (ii), (iv), and (v) are discussed must be closed if
18    disclosure or use of the report or information could
19    compromise the fairness or integrity of the procurement,
20    bidding, or contract process.
21    All contracts entered into under this Section are subject
22to appropriation and shall comply with Section 20-60(b) of the
23Illinois Procurement Code (30 ILCS 500/20-60(b)).
24    The Director shall contract or otherwise make available
25group life insurance, health benefits and other employee
26benefits to eligible members and, where elected, their eligible



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1dependents. Any contract or, if applicable, contracts or other
2arrangement for provision of benefits shall be on terms
3consistent with State policy and based on, but not limited to,
4such criteria as administrative cost, service capabilities of
5the carrier or other contractor and premiums, fees or charges
6as related to benefits.
7    Notwithstanding any other provisions of this Act, by
8January 1, 2014, the Department of Central Management Services,
9in consultation with and subject to the approval of the Chief
10Procurement Officer, shall contract or make otherwise
11available a program of group health benefits for
12Medicare-primary members and their Medicare-primary
13dependents. The Director may procure a single contract or
14multiple contracts that provide a program of group health
15benefits that is comparable in stability and continuity of
16coverage, care, and services to the program of health benefits
17offered to other members and their dependents under this Act.
18The initial procurement of a contract or contracts under this
19paragraph is not subject to the provisions of the Illinois
20Procurement Code, except for Sections 20-60, 20-65, 20-70, and
2120-160 and Article 50 of that Code, provided that the Chief
22Procurement Officer may, in writing with justification, waive
23any certification required under Article 50.
24    At least 2 group health benefits providers must be
25available to Medicare-primary members and their
26Medicare-primary dependents in each county in the State, with



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1at least one of those providers being a managed care option.
2The Department must conduct a supplemental procurement for
3counties that, on the effective date of this amendatory Act of
4the 98th General Assembly, do not offer at least 2 group health
5benefits providers to Medicare-primary members and their
6medicare-primary dependents to ensure that such options are
7available in these counties. The deadline for enrolling in a
8program of group health benefits for Medicare-primary members
9and their Medicare-primary dependents in counties that, on the
10effective date of this amendatory Act of the 98th General
11Assembly, do not offer at least 2 group health benefits
12providers to Medicare-primary members and their
13medicare-primary dependents shall be extended to such a date as
14to ensure that at least 2 options are available as required by
15this Section.
16    The Director may prepare and issue specifications for group
17life insurance, health benefits, other employee benefits and
18administrative services for the purpose of receiving proposals
19from interested parties.
20    The Director is authorized to execute a contract, or
21contracts, for the programs of group life insurance, health
22benefits, other employee benefits and administrative services
23authorized by this Act (including, without limitation,
24prescription drug benefits). All of the benefits provided under
25this Act may be included in one or more contracts, or the
26benefits may be classified into different types with each type



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1included under one or more similar contracts with the same or
2different companies.
3    The term of any contract may not extend beyond 5 fiscal
4years. Upon recommendation of the Commission, the Director may
5exercise renewal options of the same contract for up to a
6period of 5 years. Any increases in premiums, fees or charges
7requested by a contractor whose contract may be renewed
8pursuant to a renewal option contained therein, must be
9justified on the basis of (1) audited experience data, (2)
10increases in the costs of health care services provided under
11the contract, (3) contractor performance, (4) increases in
12contractor responsibilities, or (5) any combination thereof.
13    Any contractor shall agree to abide by all requirements of
14this Act and Rules and Regulations promulgated and adopted
15thereto; to submit such information and data as may from time
16to time be deemed necessary by the Director for effective
17administration of the provisions of this Act and the programs
18established hereunder, and to fully cooperate in any audit.
19(Source: P.A. 98-19, eff. 6-10-13.)
20    Section 99. Effective date. This Act takes effect upon
21becoming law.".