Senate Sponsors: JACOBS-MADIGAN,R-SIEBEN. House Sponsors: BRUNSVOLD-PARKE 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. SENATE AMENDMENT NO. 1. Deletes reference to: 215 ILCS 125/5-3.7 new Adds reference to: 215 ILCS 125/2-3 from Ch. 111 1/2, par. 1405 215 ILCS 125/2-4 from Ch. 111 1/2, par. 1406 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. SENATE AMENDMENT NO. 2. Changes "$500,0000" to "$500,000". Last action on Bill: SESSION SINE DIE Last action date: JAN-07-2003 Location: Senate Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 0 SENATE - 2 END OF INQUIRY Full Text Bill Status