House Sponsors: BRUNSVOLD-KLINGLER-PARKE-MCGUIRE. Senate Sponsors: JACOBS-MADIGAN,R Short description: HMO OFFER POINT OF SERVICE Synopsis of Bill as introduced: Amends the Health Maintenance Organization Act. Authorizes health maintenance organizations to offer point-of-service benefits. Establishes reinsurance and capital requirements. Authorizes health maintenance organizations to establish annual maximum benefit allowances for point-of-service products. HOUSE AMENDMENT NO. 1. Deletes reference to: 215 ILCS 125/5-3.7 new Adds reference to: 215 ILCS 125/2-6 from Ch. 111 1/2, par. 1406.2 215 ILCS 125/Art. 4.5, heading new 215 ILCS 125/4.5-1 new Replaces everything after the enacting clause. Amends the Health Maintenance Organization Act. Authorizes health maintenance organizations to offer point-of-service benefits. Provides that net worth must be at least 300% of the "authorized control level" as determined in the manner provided under Article IIA of the Illinois Insurance Code or a specified greater amount based upon the projected out-of-plan claims. Requires health maintenance organizations that offer point-of-service products to file quarterly reports with the Department of Insurance and to maintain reinsurance for catastrophic losses. Limits expenditures for out-of-plan services. Restricts the offer of point-of-service products when expenditures exceed the statutory limit. Allows a health maintenance organization to treat as out-of-plan services those services an enrollee obtains from a participating provider, but for which proper authorization was not given by the organization. FISCAL NOTE (Department of Insurance) HB 1040 would have no fiscal impact on the Department. HOUSE AMENDMENT NO. 2. Makes a technical correction. Last action on Bill: PUBLIC ACT.............................. 92-0135 Last action date: JUL-24-2001 Location: House Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 2 SENATE - 0 END OF INQUIRY Full Text Bill Status