Illinois General Assembly - Full Text of SB0214
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Full Text of SB0214  98th General Assembly


Sen. Michael W. Frerichs

Filed: 11/5/2013





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



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



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1    Director concerning employee benefits programs. The
2    Commission may waive any of the reporting requirements of
3    this item (i) upon the written request by the Director. Any
4    waiver granted under this item (i) must be in writing.
5    Nothing in this item is intended to abrogate any
6    attorney-client privilege.
7        (ii) Within 30 days after notice of the awarding or
8    letting of a contract has appeared in the Illinois
9    Procurement Bulletin in accordance with subsection (b) of
10    Section 15-25 of the Illinois Procurement Code, the
11    Commission may request in writing from the Director and the
12    Director shall promptly, but in no event later than 5
13    business days after receipt of the request, provide to the
14    Commission information in the possession of the Director
15    concerning the proposed contract. Nothing in this item is
16    intended to waive or abrogate any privilege or right of
17    confidentiality authorized by law.
18        (iii) Except as otherwise provided in this item (iii),
19    no contract subject to this Section may be entered into
20    until the 30-day period described in item (ii) has expired,
21    unless the Director requests in writing that the Commission
22    waive the period and the Commission grants the waiver in
23    writing. This item (iii) does not apply to any contract
24    entered into after the effective date of this amendatory
25    Act of the 98th General Assembly and through January 1,
26    2014 to provide a program of group health benefits for



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



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



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1arrangement for provision of benefits shall be on terms
2consistent with State policy and based on, but not limited to,
3such criteria as administrative cost, service capabilities of
4the carrier or other contractor and premiums, fees or charges
5as related to benefits.
6    Notwithstanding any other provisions of this Act, by
7January 1, 2014, the Department of Central Management Services,
8in consultation with and subject to the approval of the Chief
9Procurement Officer, shall contract or make otherwise
10available a program of group health benefits for
11Medicare-primary members and their Medicare-primary
12dependents. The Director may procure a single contract or
13multiple contracts that provide a program of group health
14benefits that is comparable in stability and continuity of
15coverage, care, and services to the program of health benefits
16offered to other members and their dependents under this Act.
17The initial procurement of a contract or contracts under this
18paragraph is not subject to the provisions of the Illinois
19Procurement Code, except for Sections 20-60, 20-65, 20-70, and
2020-160 and Article 50 of that Code, provided that the Chief
21Procurement Officer may, in writing with justification, waive
22any certification required under Article 50.
23    The Department failed to provide the program of group
24health benefits for Medicare-primary members and their
25Medicare-primary dependents by January 1, 2014. Furthermore,
26the Department failed to procure for Medicare-primary members



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1and their Medicare-primary dependents a program comparable in
2stability and continuity of coverage, care, and services to the
3program of health benefits offered to other members and their
4dependents under this Act. The General Assembly requires the
5Department to procure a supplemental Medicare Advantage Health
6Maintenance Organization Request for Proposal (RFP) to meet the
7legislative intent of the General Assembly. If an offeror
8responds to the Supplement RFP and is currently an approved
9Medicare Advantage plan, with 5 years of experience, by Centers
10for Medicare and Medicaid Services, the offeror shall be
11qualified to be selected for an award.
12    The Director may prepare and issue specifications for group
13life insurance, health benefits, other employee benefits and
14administrative services for the purpose of receiving proposals
15from interested parties.
16    The Director is authorized to execute a contract, or
17contracts, for the programs of group life insurance, health
18benefits, other employee benefits and administrative services
19authorized by this Act (including, without limitation,
20prescription drug benefits). All of the benefits provided under
21this Act may be included in one or more contracts, or the
22benefits may be classified into different types with each type
23included under one or more similar contracts with the same or
24different companies.
25    The term of any contract may not extend beyond 5 fiscal
26years. Upon recommendation of the Commission, the Director may



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1exercise renewal options of the same contract for up to a
2period of 5 years. Any increases in premiums, fees or charges
3requested by a contractor whose contract may be renewed
4pursuant to a renewal option contained therein, must be
5justified on the basis of (1) audited experience data, (2)
6increases in the costs of health care services provided under
7the contract, (3) contractor performance, (4) increases in
8contractor responsibilities, or (5) any combination thereof.
9    Any contractor shall agree to abide by all requirements of
10this Act and Rules and Regulations promulgated and adopted
11thereto; to submit such information and data as may from time
12to time be deemed necessary by the Director for effective
13administration of the provisions of this Act and the programs
14established hereunder, and to fully cooperate in any audit.
15(Source: P.A. 98-19, eff. 6-10-13.)
16    Section 99. Effective date. This Act takes effect upon
17becoming law.".