HB6019 96TH GENERAL ASSEMBLY

LRB096 20130 RPM 35666 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB6019

Introduced 2/10/2010, by Rep. Frank J. Mautino

SYNOPSIS AS INTRODUCED:

760 ILCS 55/20 new

Amends the Charitable Trust Act. Sets forth a definition of "Medical Sharing Trust". Provides that an organization complying with the provisions concerning a Medical Sharing Trust is not subject to the provisions of the Illinois Insurance Code, except that a Medical Sharing Trust offering any services other than a Medical Sharing Trust that are regulated under any provision of the Illinois Insurance Code shall be required to comply with the Illinois Insurance Code with respect to the provision of those services. Sets forth registration requirements for a Medical Sharing Trust. Provides that a Medical Sharing Trust may facilitate payments between participants who have present medical needs and participants with the ability to pay for the benefits of those participants in need. Sets forth requirements concerning the operation of a Medical Sharing Trust.

A BILL FOR

AN ACT concerning insurance.

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

Section 5. The Charitable Trust Act is amended by adding Section 20 as follows:

(760 ILCS 55/20 new)

Sec. 20. Medical Sharing Trust Law.

(a) This Section may be referred to as the Medical Sharing Trust Law.

(b) For the purposes of this Section "Medical Sharing Trust" means an organization that facilitates payment of the medical expenses of its participants as provided in this Section and complies with all provisions of this Act and the Solicitation for Charity Act.

(c) An organization complying with this Section as a Medical Sharing Trust is not subject to the provisions of the Illinois Insurance Code, except that a Medical Sharing Trust offering any services other than a Medical Sharing Trust that are regulated under any provision of the Illinois Insurance Code shall be required to comply with the Illinois Insurance Code with respect to the provision of those services.

(d) No Medical Sharing Trust shall be offered, issued, sold, or solicited to participants in this State as exempt under subsection (c) of this Section unless the Medical Sharing Trust has complied with all requirements set forth in subsections (b) and (e) of this Section.

(e) The following provisions shall apply concerning the operation of a Medical Sharing Trust:

(1) A Medical Sharing Trust may facilitate payments between participants who have present medical needs and participants with the ability to pay for the benefit of those participants in need. A Medical Sharing Trust is prohibited from assuming liability for or guaranteeing payment of any medical expenses.

(2) All participants shall execute a release stating that no other participants or the Medical Sharing Trust shall be legally obligated in any way to pay for a medical need.

(3) A Medical Sharing Trust may facilitate the payments provided for in paragraph (1) of this subsection (e) through payments made directly from one participant to another.

(4) A Medical Sharing Trust may cancel the membership of a participant when that participant indicates their unwillingness to participate by failing to make a payment to another participant for a period in excess of 60 days.

(5) A Medical Sharing Trust may establish qualifications of participation relating to the health of the prospective participant.

(6) A Medical Sharing Trust may establish qualifications as to the participants' physical or medical needs necessary for eligibility for payment among the participants.

(7) A Medical Sharing Trust shall provide the following verbatim written disclaimer on all applications for membership or participation:

"WARNING: This organization is not insurance or an insurance policy nor is it offered through an insurance company. Whether anyone chooses to assist you with your medical bills will be totally voluntary, as no other member will be compelled by law to contribute toward your medical bills. As such, this organization should never be considered to be providing insurance. Whether you receive any payments for medical expenses and whether or not this organization continues to operate, you are always personally responsible for the payment of your own medical bills. This organization is not subject to the regulatory requirements of the Illinois Insurance Code.".

(8) A Medical Sharing Trust shall provide to its participants, within 30 days after enrollment, a complete set of its rules for the sharing of needs, appeals of decisions made by the Medical Sharing Trust and the filing of complaints in the participant's native language if requested by the participant.

(9) A Medical Sharing Trust shall have a Certificate of Authority to do business in Illinois.

(10) A Medical Sharing Trust shall be controlled by a board of directors, the majority of which is elected by its members.