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90_SB0672
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.
LRB9002410JScc
LRB9002410JScc
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 15. 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 (d) An insurer may not cancel or refuse to renew
18 accident and health insurance coverage based on the results
19 of genetic testing.
20 Section 20. Use of genetic testing information by
21 employers.
22 (a) An employer may not fail to hire, refuse to hire,
23 discharge, or otherwise discriminate against an individual
24 with respect to compensation or the terms, conditions, or
25 privileges of employment because of the results of, or the
26 refusal of the individual to submit to, genetic testing.
27 (b) This Section does not prohibit the genetic testing
28 of an employee who requests to undergo genetic testing and
29 who provides written and informed consent to genetic testing
30 to determine the employee's susceptibility or level of
31 exposure to potentially toxic chemicals or potentially toxic
32 substances in the workplace, if the employer does not
33 terminate the employee or take any other action that
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1 adversely affects any term, condition, or privilege of the
2 employee's employment as a result of genetic testing.
3 Section 91. The Illinois Insurance Code is amended by
4 changing Section 356t as follows:
5 (215 ILCS 5/356t new)
6 Sec. 356t. Use of information derived from genetic
7 testing. After the effective date of this amendatory Act of
8 1997, an insurer must comply with the provisions of the
9 Genetic Information Privacy Act in connection with the
10 amendment, delivery, issuance, or renewal of, or coverage
11 under, an individual or group policy of accident and health
12 insurance.
13 Section 93. The Health Maintenance Organization Act is
14 amended by changing Section 5-3 as follows:
15 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
16 Sec. 5-3. Insurance Code provisions.
17 (a) Health Maintenance Organizations shall be subject to
18 the provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
19 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
20 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356t, 367i, 401,
21 401.1, 402, 403, 403A, 408, 408.2, and 412, paragraph (c) of
22 subsection (2) of Section 367, and Articles VIII 1/2, XII,
23 XII 1/2, XIII, XIII 1/2, and XXVI of the Illinois Insurance
24 Code.
25 (b) For purposes of the Illinois Insurance Code, except
26 for Articles XIII and XIII 1/2, Health Maintenance
27 Organizations in the following categories are deemed to be
28 "domestic companies":
29 (1) a corporation authorized under the Medical
30 Service Plan Act, the Dental Service Plan Act, the Vision
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1 Service Plan Act, the Pharmaceutical Service Plan Act,
2 the Voluntary Health Services Plan Act, or the Nonprofit
3 Health Care Service Plan Act;
4 (2) a corporation organized under the laws of this
5 State; or
6 (3) a corporation organized under the laws of
7 another state, 30% or more of the enrollees of which are
8 residents of this State, except a corporation subject to
9 substantially the same requirements in its state of
10 organization as is a "domestic company" under Article
11 VIII 1/2 of the Illinois Insurance Code.
12 (c) In considering the merger, consolidation, or other
13 acquisition of control of a Health Maintenance Organization
14 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
15 (1) the Director shall give primary consideration
16 to the continuation of benefits to enrollees and the
17 financial conditions of the acquired Health Maintenance
18 Organization after the merger, consolidation, or other
19 acquisition of control takes effect;
20 (2)(i) the criteria specified in subsection (1)(b)
21 of Section 131.8 of the Illinois Insurance Code shall not
22 apply and (ii) the Director, in making his determination
23 with respect to the merger, consolidation, or other
24 acquisition of control, need not take into account the
25 effect on competition of the merger, consolidation, or
26 other acquisition of control;
27 (3) the Director shall have the power to require
28 the following information:
29 (A) certification by an independent actuary of
30 the adequacy of the reserves of the Health
31 Maintenance Organization sought to be acquired;
32 (B) pro forma financial statements reflecting
33 the combined balance sheets of the acquiring company
34 and the Health Maintenance Organization sought to be
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1 acquired as of the end of the preceding year and as
2 of a date 90 days prior to the acquisition, as well
3 as pro forma financial statements reflecting
4 projected combined operation for a period of 2
5 years;
6 (C) a pro forma business plan detailing an
7 acquiring party's plans with respect to the
8 operation of the Health Maintenance Organization
9 sought to be acquired for a period of not less than
10 3 years; and
11 (D) such other information as the Director
12 shall require.
13 (d) The provisions of Article VIII 1/2 of the Illinois
14 Insurance Code and this Section 5-3 shall apply to the sale
15 by any health maintenance organization of greater than 10% of
16 its enrollee population (including without limitation the
17 health maintenance organization's right, title, and interest
18 in and to its health care certificates).
19 (e) In considering any management contract or service
20 agreement subject to Section 141.1 of the Illinois Insurance
21 Code, the Director (i) shall, in addition to the criteria
22 specified in Section 141.2 of the Illinois Insurance Code,
23 take into account the effect of the management contract or
24 service agreement on the continuation of benefits to
25 enrollees and the financial condition of the health
26 maintenance organization to be managed or serviced, and (ii)
27 need not take into account the effect of the management
28 contract or service agreement on competition.
29 (f) Except for small employer groups as defined in the
30 Small Employer Rating, Renewability and Portability Health
31 Insurance Act and except for medicare supplement policies as
32 defined in Section 363 of the Illinois Insurance Code, a
33 Health Maintenance Organization may by contract agree with a
34 group or other enrollment unit to effect refunds or charge
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1 additional premiums under the following terms and conditions:
2 (i) the amount of, and other terms and conditions
3 with respect to, the refund or additional premium are set
4 forth in the group or enrollment unit contract agreed in
5 advance of the period for which a refund is to be paid or
6 additional premium is to be charged (which period shall
7 not be less than one year); and
8 (ii) the amount of the refund or additional premium
9 shall not exceed 20% of the Health Maintenance
10 Organization's profitable or unprofitable experience with
11 respect to the group or other enrollment unit for the
12 period (and, for purposes of a refund or additional
13 premium, the profitable or unprofitable experience shall
14 be calculated taking into account a pro rata share of the
15 Health Maintenance Organization's administrative and
16 marketing expenses, but shall not include any refund to
17 be made or additional premium to be paid pursuant to this
18 subsection (f)). The Health Maintenance Organization and
19 the group or enrollment unit may agree that the
20 profitable or unprofitable experience may be calculated
21 taking into account the refund period and the immediately
22 preceding 2 plan years.
23 The Health Maintenance Organization shall include a
24 statement in the evidence of coverage issued to each enrollee
25 describing the possibility of a refund or additional premium,
26 and upon request of any group or enrollment unit, provide to
27 the group or enrollment unit a description of the method used
28 to calculate (1) the Health Maintenance Organization's
29 profitable experience with respect to the group or enrollment
30 unit and the resulting refund to the group or enrollment unit
31 or (2) the Health Maintenance Organization's unprofitable
32 experience with respect to the group or enrollment unit and
33 the resulting additional premium to be paid by the group or
34 enrollment unit.
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1 In no event shall the Illinois Health Maintenance
2 Organization Guaranty Association be liable to pay any
3 contractual obligation of an insolvent organization to pay
4 any refund authorized under this Section.
5 (Source: P.A. 88-313; 89-90, eff. 6-30-95.)
6 Section 95. The Limited Health Service Organization Act
7 is amended by changing Section 4003 as follows:
8 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
9 Sec. 4003. Illinois Insurance Code provisions. Limited
10 health service organizations shall be subject to the
11 provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
12 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
13 154.6, 154.7, 154.8, 155.04, 355.2, 356t, 401, 401.1, 402,
14 403, 403A, 408, 408.2, and 412, and Articles VIII 1/2, XII,
15 XII 1/2, XIII, XIII 1/2, and XXVI of the Illinois Insurance
16 Code. For purposes of the Illinois Insurance Code, except
17 for Articles XIII and XIII 1/2, limited health service
18 organizations in the following categories are deemed to be
19 domestic companies:
20 (1) a corporation under the laws of this State; or
21 (2) a corporation organized under the laws of
22 another state, 30% of more of the enrollees of which are
23 residents of this State, except a corporation subject to
24 substantially the same requirements in its state of
25 organization as is a domestic company under Article VIII
26 1/2 of the Illinois Insurance Code.
27 (Source: P.A. 86-600; 87-587; 87-1090.)
28 Section 97. The Voluntary Health Services Plans Act is
29 amended by changing Section 10 as follows:
30 (215 ILCS 165/10) (from Ch. 32, par. 604)
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1 Sec. 10. Application of Insurance Code provisions.
2 Health services plan corporations and all persons interested
3 therein or dealing therewith shall be subject to the
4 provisions of Article XII 1/2 and Sections 3.1, 133, 140,
5 143, 143c, 149, 354, 355.2, 356r, 356t, 367.2, 401, 401.1,
6 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7) and
7 (15) of Section 367 of the Illinois Insurance Code.
8 (Source: P.A. 89-514, eff. 7-17-96.)