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90_HB0008
New Act
215 ILCS 5/356t new
215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003 from Ch. 73, par. 1504-3
215 ILCS 165/10 from Ch. 32, par. 604
Creates the Genetic Information Privacy Act. Provides
that information derived from genetic testing is
confidential. Limits the use of genetic information by
insurers and employers. Provides an exception to the
confidentiality of genetic information with respect to
criminal proceedings. Amends the Illinois Insurance Code,
the Health Maintenance Organization Act, the Limited Health
Service Organization Act, and the Voluntary Health Services
Plans Act to provide that entities regulated under those Acts
are subject to the Genetic Information Privacy Act.
LRB9000863JSgc
LRB9000863JSgc
1 AN ACT concerning genetic information, amending named
2 Acts.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 1. Short title. This Act may be cited as the
6 Genetic Information Privacy Act.
7 Section 5. Genetic testing. "Genetic testing" means a
8 test of a person's genes, gene products, or chromosomes for
9 abnormalities or deficiencies, including carrier status, that
10 (i) are linked to physical or mental disorders or
11 impairments, (ii) indicate a susceptibility to illness,
12 disease, impairment, or other disorders, whether physical or
13 mental, or (iii) demonstrate genetic or chromosomal damage
14 due to environmental factors.
15 Section 10. Confidentiality of genetic information.
16 (a) Except as otherwise provided in this Act, genetic
17 testing and information derived from genetic testing is
18 confidential and privileged and may be released only to the
19 individual tested and to persons specifically authorized by
20 that individual to receive the information.
21 (b) Information derived from genetic testing regarding
22 the identity of any individual who is the subject of a
23 criminal investigation or a criminal prosecution may be
24 disclosed to appropriate legal authorities conducting the
25 investigation or prosecution. The information may be used
26 during the course of the investigation or prosecution with
27 respect to the individual tested without the consent of the
28 individual.
29 Section 10. Use of genetic testing information by
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1 insurers.
2 (a) An insurer may not seek information derived from
3 genetic testing for use in connection with a policy of
4 accident and health insurance. Except as provided in
5 subsection (b), an insurer that receives information derived
6 from genetic testing may not use the information for a
7 nontherapeutic purpose as it relates to a policy of accident
8 and health insurance.
9 (b) An insurer may consider the results of genetic
10 testing in connection with a policy of accident and health
11 insurance if the individual voluntarily submits the results
12 and the results are favorable to the individual.
13 (c) An insurer that possesses information derived from
14 genetic testing may not release the information to a third
15 party without the explicit written consent of the individual
16 tested.
17 Section 15. Use of genetic testing information by
18 employers.
19 (a) An employer may not fail to hire, refuse to hire,
20 discharge, or otherwise discriminate against an individual
21 with respect to compensation or the terms, conditions, or
22 privileges of employment because of the results of, or the
23 refusal of the individual to submit to, genetic testing.
24 (b) This Section does not prohibit the genetic testing
25 of an employee who requests to undergo genetic testing and
26 who provides written and informed consent to genetic testing
27 to determine the employee's susceptibility or level of
28 exposure to potentially toxic chemicals or potentially toxic
29 substances in the workplace, if the employer does not
30 terminate the employee or take any other action that
31 adversely affects any term, condition, or privilege of the
32 employee's employment as a result of genetic testing.
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1 Section 91. The Illinois Insurance Code is amended by
2 changing Section 356t as follows:
3 (215 ILCS 5/356t new)
4 Sec. 356t. Use of information derived from genetic
5 testing. After the effective date of this amendatory Act of
6 1997, an insurer must comply with the provisions of the
7 Genetic Information Privacy Act in connection with the
8 amendment, delivery, issuance, or renewal of, or coverage
9 under, an individual or group policy of accident and health
10 insurance.
11 Section 93. The Health Maintenance Organization Act is
12 amended by changing Section 5-3 as follows:
13 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
14 Sec. 5-3. Insurance Code provisions.
15 (a) Health Maintenance Organizations shall be subject to
16 the provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
17 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
18 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356t, 367i, 401,
19 401.1, 402, 403, 403A, 408, 408.2, and 412, paragraph (c) of
20 subsection (2) of Section 367, and Articles VIII 1/2, XII,
21 XII 1/2, XIII, XIII 1/2, and XXVI of the Illinois Insurance
22 Code.
23 (b) For purposes of the Illinois Insurance Code, except
24 for Articles XIII and XIII 1/2, Health Maintenance
25 Organizations in the following categories are deemed to be
26 "domestic companies":
27 (1) a corporation authorized under the Medical
28 Service Plan Act, the Dental Service Plan Act, the Vision
29 Service Plan Act, the Pharmaceutical Service Plan Act,
30 the Voluntary Health Services Plan Act, or the Nonprofit
31 Health Care Service Plan Act;
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1 (2) a corporation organized under the laws of this
2 State; or
3 (3) a corporation organized under the laws of
4 another state, 30% or more of the enrollees of which are
5 residents of this State, except a corporation subject to
6 substantially the same requirements in its state of
7 organization as is a "domestic company" under Article
8 VIII 1/2 of the Illinois Insurance Code.
9 (c) In considering the merger, consolidation, or other
10 acquisition of control of a Health Maintenance Organization
11 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
12 (1) the Director shall give primary consideration
13 to the continuation of benefits to enrollees and the
14 financial conditions of the acquired Health Maintenance
15 Organization after the merger, consolidation, or other
16 acquisition of control takes effect;
17 (2)(i) the criteria specified in subsection (1)(b)
18 of Section 131.8 of the Illinois Insurance Code shall not
19 apply and (ii) the Director, in making his determination
20 with respect to the merger, consolidation, or other
21 acquisition of control, need not take into account the
22 effect on competition of the merger, consolidation, or
23 other acquisition of control;
24 (3) the Director shall have the power to require
25 the following information:
26 (A) certification by an independent actuary of
27 the adequacy of the reserves of the Health
28 Maintenance Organization sought to be acquired;
29 (B) pro forma financial statements reflecting
30 the combined balance sheets of the acquiring company
31 and the Health Maintenance Organization sought to be
32 acquired as of the end of the preceding year and as
33 of a date 90 days prior to the acquisition, as well
34 as pro forma financial statements reflecting
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1 projected combined operation for a period of 2
2 years;
3 (C) a pro forma business plan detailing an
4 acquiring party's plans with respect to the
5 operation of the Health Maintenance Organization
6 sought to be acquired for a period of not less than
7 3 years; and
8 (D) such other information as the Director
9 shall require.
10 (d) The provisions of Article VIII 1/2 of the Illinois
11 Insurance Code and this Section 5-3 shall apply to the sale
12 by any health maintenance organization of greater than 10% of
13 its enrollee population (including without limitation the
14 health maintenance organization's right, title, and interest
15 in and to its health care certificates).
16 (e) In considering any management contract or service
17 agreement subject to Section 141.1 of the Illinois Insurance
18 Code, the Director (i) shall, in addition to the criteria
19 specified in Section 141.2 of the Illinois Insurance Code,
20 take into account the effect of the management contract or
21 service agreement on the continuation of benefits to
22 enrollees and the financial condition of the health
23 maintenance organization to be managed or serviced, and (ii)
24 need not take into account the effect of the management
25 contract or service agreement on competition.
26 (f) Except for small employer groups as defined in the
27 Small Employer Rating, Renewability and Portability Health
28 Insurance Act and except for medicare supplement policies as
29 defined in Section 363 of the Illinois Insurance Code, a
30 Health Maintenance Organization may by contract agree with a
31 group or other enrollment unit to effect refunds or charge
32 additional premiums under the following terms and conditions:
33 (i) the amount of, and other terms and conditions
34 with respect to, the refund or additional premium are set
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1 forth in the group or enrollment unit contract agreed in
2 advance of the period for which a refund is to be paid or
3 additional premium is to be charged (which period shall
4 not be less than one year); and
5 (ii) the amount of the refund or additional premium
6 shall not exceed 20% of the Health Maintenance
7 Organization's profitable or unprofitable experience with
8 respect to the group or other enrollment unit for the
9 period (and, for purposes of a refund or additional
10 premium, the profitable or unprofitable experience shall
11 be calculated taking into account a pro rata share of the
12 Health Maintenance Organization's administrative and
13 marketing expenses, but shall not include any refund to
14 be made or additional premium to be paid pursuant to this
15 subsection (f)). The Health Maintenance Organization and
16 the group or enrollment unit may agree that the
17 profitable or unprofitable experience may be calculated
18 taking into account the refund period and the immediately
19 preceding 2 plan years.
20 The Health Maintenance Organization shall include a
21 statement in the evidence of coverage issued to each enrollee
22 describing the possibility of a refund or additional premium,
23 and upon request of any group or enrollment unit, provide to
24 the group or enrollment unit a description of the method used
25 to calculate (1) the Health Maintenance Organization's
26 profitable experience with respect to the group or enrollment
27 unit and the resulting refund to the group or enrollment unit
28 or (2) the Health Maintenance Organization's unprofitable
29 experience with respect to the group or enrollment unit and
30 the resulting additional premium to be paid by the group or
31 enrollment unit.
32 In no event shall the Illinois Health Maintenance
33 Organization Guaranty Association be liable to pay any
34 contractual obligation of an insolvent organization to pay
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1 any refund authorized under this Section.
2 (Source: P.A. 88-313; 89-90, eff. 6-30-95.)
3 Section 95. The Limited Health Service Organization Act
4 is amended by changing Section 4003 as follows:
5 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
6 Sec. 4003. Illinois Insurance Code provisions. Limited
7 health service organizations shall be subject to the
8 provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
9 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
10 154.6, 154.7, 154.8, 155.04, 355.2, 356t, 401, 401.1, 402,
11 403, 403A, 408, 408.2, and 412, and Articles VIII 1/2, XII,
12 XII 1/2, XIII, XIII 1/2, and XXVI of the Illinois Insurance
13 Code. For purposes of the Illinois Insurance Code, except
14 for Articles XIII and XIII 1/2, limited health service
15 organizations in the following categories are deemed to be
16 domestic companies:
17 (1) a corporation under the laws of this State; or
18 (2) a corporation organized under the laws of
19 another state, 30% of more of the enrollees of which are
20 residents of this State, except a corporation subject to
21 substantially the same requirements in its state of
22 organization as is a domestic company under Article VIII
23 1/2 of the Illinois Insurance Code.
24 (Source: P.A. 86-600; 87-587; 87-1090.)
25 Section 97. The Voluntary Services Plans Act is amended
26 by changing Section 10 as follows:
27 (215 ILCS 165/10) (from Ch. 32, par. 604)
28 Sec. 10. Application of Insurance Code provisions.
29 Health services plan corporations and all persons interested
30 therein or dealing therewith shall be subject to the
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1 provisions of Article XII 1/2 and Sections 3.1, 133, 140,
2 143, 143c, 149, 354, 355.2, 356r, 356t, 367.2, 401, 401.1,
3 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7) and
4 (15) of Section 367 of the Illinois Insurance Code.
5 (Source: P.A. 89-514, eff. 7-17-96.)