Public Act 102-0159
 
SB1087 EnrolledLRB102 04910 CPF 14929 b



    AN ACT concerning regulation.

 
    Be it enacted by the People of the State of Illinois, 
represented in the General Assembly: 




 
 
    Section 5. The Department of Insurance Law of the
Civil 
Administrative Code of Illinois is amended  by adding Section 
1405-40 as follows:
 
    (20 ILCS 1405/1405-40 new)
    Sec. 1405-40. Transfer of the Illinois Comprehensive 
Health Insurance Plan. Upon entry of an Order of 
Rehabilitation or Liquidation against the Comprehensive Health 
Insurance Plan in accordance with Article XIII of the Illinois 
Insurance Code, all powers, duties, rights, and 
responsibilities of the Illinois Comprehensive Health 
Insurance Plan and the Illinois Comprehensive Health Insurance 
Board under the Comprehensive Health Insurance Plan Act shall 
be transferred to and vested in the Director of Insurance as 
rehabilitator or liquidator as provided in the provisions of 
this amendatory Act of the 102nd General Assembly.
 
    Section 10. The Comprehensive Health Insurance Plan Act is 
amended  by changing Sections 1.1, 3, and 15 and  by adding 
Sections 16 and 17 as follows:
 



    (215 ILCS 105/1.1)  (from Ch. 73, par. 1301.1)



    Sec. 1.1. 
The General Assembly hereby makes the following 
findings and
declarations:

        (a) The Comprehensive Health Insurance Plan is 
    established as a State
program that is intended to provide

    an alternate market for health insurance for certain 
    uninsurable Illinois
residents, and further is intended to 
    provide an
acceptable alternative mechanism as described 
    in the federal Health Insurance
Portability and 
    Accountability Act of 1996 for providing portable and

    accessible individual health insurance coverage for 
    federally eligible
individuals as defined in this Act.

        (b) The State of Illinois may subsidize the cost of 
    health insurance
coverage offered by the Plan.  However, 
    since the State
has only a limited amount of
resources, 
    the General Assembly declares that it intends for this 
    program to
provide portable and accessible individual 
    health insurance coverage for every
federally eligible 
    individual who qualifies for coverage in accordance with

    Section 15 of this Act, but does not intend for every

    eligible person who qualifies for Plan coverage in 
    accordance with Section 7
of this Act to be guaranteed a 
    right to be issued a policy under
this
Plan as a matter of 
    entitlement.

        (c) The Comprehensive Health Insurance Plan Board 
    shall operate the Plan
in a manner so that the estimated 
    cost of the program during
any fiscal year will not exceed 
    the total income it expects to receive from
policy 
    premiums, investment income, assessments, or fees 
    collected or
received
by the Board and other funds which 
    are made available from
appropriations for the Plan by
the 
    General Assembly for that fiscal year. 

    With the implementation of the federal Patient Protection 
and Affordable Care Act, the Plan shall discontinue as the 
alternative market for health insurance for certain Illinois 
residents and discontinue as the alternative mechanism, as 
described in the federal Health Insurance Portability and 
Accountability Act of 1996, effective no later than January 1, 
2022. 
(Source: P.A. 90-30, eff. 7-1-97.)

 
    (215 ILCS 105/3)  (from Ch. 73, par. 1303)

    Sec. 3. Operation of the Plan.

    a. There is hereby created an Illinois Comprehensive 
Health Insurance Plan.


    b. The Plan shall operate subject to the supervision and 
control of
the Board.  The Board is created as a political 
subdivision and body
politic and corporate and, as such, is 
not a State agency.  The Board shall
consist of 10 public 
members, appointed by the Governor with the
advice and consent 
of the Senate.


    Initial members shall be appointed to the Board by the 
Governor as
follows: 2 members to serve until July 1, 1988, and 
until their successors
are appointed and qualified; 2 members 
to serve until July 1, 1989, and
until their successors are 
appointed and qualified; 3 members to serve
until July 1, 
1990, and until their successors are appointed and qualified;

and 3 members to serve until July 1, 1991, and until their 
successors are
appointed and qualified. As terms of initial 
members expire, their
successors shall be appointed for terms 
to expire the first day in July 3
years thereafter, and until 
their successors are appointed and qualified.


    Any vacancy in the Board occurring for any reason other 
than the
expiration of a term shall be filled for the unexpired 
term in the same
manner as the original appointment.


    Any member of the Board may be removed by the Governor for 
neglect of
duty, misfeasance, malfeasance, or nonfeasance in 
office.


    In addition, a representative of the
Governor's Office of 
Management and Budget, a representative of the Office
of the 
Attorney General and the Director or the Director's designated

representative shall be members of the Board.  Four members of 
the General
Assembly, one each appointed by the President and 
Minority Leader of the
Senate and by the Speaker and Minority 
Leader of the House of
Representatives, shall serve as 
nonvoting members of the Board.  At least
2 of the public 
members shall be individuals reasonably expected to qualify

for coverage under the Plan, the parent or spouse of such an

individual, or a surviving family member of an individual who 
could have
qualified for the Plan during his lifetime. The 
Director or Director's
representative shall be the chairperson 
of the Board.  Members of the Board
shall receive no 
compensation, but shall be reimbursed for reasonable
expenses 
incurred in the necessary performance of their duties.


    c. The Board shall make an annual report in September and

shall file the report with the Secretary of the Senate and the 
Clerk of
the House of Representatives.  The report shall 
summarize the activities of
the Plan in the preceding calendar 
year, including net written and earned
premiums, the expense 
of administration, the paid and incurred
losses for the year 
and other information as may be requested by the
General 
Assembly. The report shall also include analysis and

recommendations regarding utilization review, quality 
assurance and access
to cost effective quality health care.


    d. In its plan of operation the Board shall:


        (1) Establish procedures for selecting a Plan 
    administrator in
accordance with Section 5 of this Act.


        (2) Establish procedures for the operation of the 
    Board.


        (3) Create a Plan fund, under management of the Board, 
    to fund
administrative, claim, and other expenses of the 
    Plan.


        (4) Establish procedures for the handling and 
    accounting of assets and
monies of the Plan.


        (5) Develop and implement a program to publicize the 
    existence of the
Plan, the eligibility requirements and 
    procedures for enrollment and to
maintain public awareness 
    of the Plan.


        (6) Establish procedures under which applicants and 
    participants may have
grievances reviewed by a grievance 
    committee appointed by the Board.  The
grievances shall be 
    reported to the Board immediately after completion of
the 
    review.  The Department and the Board shall retain all 
    written
complaints regarding the Plan for at least 3 
    years.  Oral complaints
shall be reduced to written form 
    and maintained for at least 3 years.


        (7) Provide for other matters as may be necessary and 
    proper for
the execution of its powers, duties and 
    obligations under the Plan.


    e. No later than 5 years after the Plan is operative the 
Board and
the Department shall conduct cooperatively a study 
of the Plan and the
persons insured by the Plan to determine: 
(1) claims experience including a
breakdown of medical 
conditions for which claims were paid; (2) whether

availability of the Plan affected employment opportunities for

participants; (3) whether availability of the Plan affected 
the receipt of
medical assistance benefits by Plan 
participants; (4) whether a change
occurred in the number of 
personal bankruptcies due to medical or other
health related 
costs; (5) data regarding all complaints received about the

Plan including its operation and services; (6) and any other 
significant
observations regarding utilization of the Plan.  
The study shall culminate
in a written report to be presented 
to the Governor, the President of the
Senate, the Speaker of 
the House and the chairpersons of the House and
Senate 
Insurance Committees.  The report shall be filed with the

Secretary of the Senate and the Clerk of the House of 
Representatives.  The
report shall also be available to members 
of the general public upon request.


    (e-5) The Board shall conduct a feasibility study of 
establishing a small employer health insurance pool in which 
employers may provide affordable health insurance coverage to 
their employees. The Board may contract with a private entity 
or enter into intergovernmental agreements with State agencies 
for the completion of all or part of the study. The study 
shall:
        (i) Analyze other states' experience in establishing 
    small employer health
insurance pools;
        (ii) Assess the need for a small employer health 
    insurance pool, including the number of individuals who 
    might benefit from it;
        (iii) Recommend means of establishing a small employer 
    health insurance pool; and
        (iv) Estimate the cost of providing a small employer 
    health insurance pool through the Illinois Comprehensive 
    Health Insurance Plan or another, public or private 
    entity.
    The Board may accept donations, in trust, from any legal 
source, public or private, for deposit into a trust account 
specifically created for expenditure, without the necessity of 
being appropriated, solely for the purpose of conducting all 
or part of the study.
The Board shall issue a report with 
recommendations to the Governor and the General Assembly by 
January 1, 2005.
As used in this subsection e-5, "small 
employer" means an employer having between one and 50 
employees.

    f. The Board may:


        (1) Prepare and distribute certificate of eligibility 
    forms and
enrollment instruction forms to insurance 
    producers and to the general
public in this State.


        (2) Provide for reinsurance of risks incurred by the 
    Plan and enter into
reinsurance agreements with insurers 
    to establish a reinsurance plan for
risks of coverage 
    described in the Plan, or obtain commercial reinsurance
to 
    reduce the risk of loss through the Plan.


        (3) Issue additional types of health insurance 
    policies to provide
optional coverages as are otherwise 
    permitted by this Act including a
Medicare supplement 
    policy designed to supplement Medicare.


        (4) Provide for and employ cost containment measures 
    and requirements
including, but not limited to, 
    preadmission certification, second surgical
opinion, 
    concurrent utilization review programs, and individual 
    case
management for the purpose of making the pool more 
    cost effective.


        (5) Design, utilize, contract, or otherwise arrange 
    for the
delivery of cost effective health care services, 
    including establishing or
contracting with preferred 
    provider organizations, health maintenance organizations, 
    and other limited network
provider
arrangements.


        (6) Adopt bylaws, rules, regulations, policies and 
    procedures as
may be necessary or convenient for the 
    implementation of the Act and the
operation of the Plan.


        (7) Administer separate pools, separate accounts, or 
    other plans or
arrangements as required by this Act to 
    separate federally eligible
individuals or groups of 
    federally eligible individuals who qualify for Plan

    coverage under Section 15 of this Act from eligible 
    persons or groups of
eligible persons who qualify for Plan 
    coverage under Section 7 of this Act and
apportion the 
    costs of the
administration among such separate pools, 
    separate accounts, or other plans or
arrangements.


    g. The Director may, by rule, establish additional powers 
and duties of
the Board and may adopt rules for any other 
purposes, including the
operation of the Plan, as are 
necessary or proper to implement this Act.


    h. The Board is not liable for any obligation of the Plan.  
There is no
liability on the part of any member or employee of 
the Board, or the
Department, or the Director, both as 
regulator and as rehabilitator or liquidator, and no cause of 
action of any nature may arise against them,
for any action 
taken or omission made by them in the performance of their

powers and duties under this Act, unless the action or 
omission
constitutes willful or wanton misconduct. The Board 
may provide in its
bylaws or rules for indemnification of, and 
legal representation for, its
members and employees.


    i. There is no liability on the part of any insurance 
producer for the
failure of any applicant to be accepted by the 
Plan unless the failure of
the applicant to be accepted by the 
Plan is due to an act or omission by
the insurance producer 
which constitutes willful or wanton misconduct.


    j.    Not later than 60 days after the effective date of this 
amendatory Act of the 102nd General Assembly, the Board shall 
develop a plan of rehabilitation or liquidation and 
dissolution, including the consent of a majority of the Board 
to the entry of an order of rehabilitation or liquidation, to 
wind down the affairs of the Plan, including details for the 
transition to other health plans of any persons currently 
enrolled in the Plan, for presentation to and approval by the 
Director. Upon the Director's approval of the plan of 
rehabilitation or liquidation and dissolution, the Director 
shall thereafter report to the Attorney General of this State, 
whose duty it shall be to file a complaint for rehabilitation 
or liquidation of the Plan pursuant to the provisions of 
Article XIII of the Illinois Insurance Code. Upon entry of a 
final Order of Rehabilitation or Liquidation and the 
Director's appointment as statutory rehabilitator or 
liquidator, the Director shall begin to administer and oversee 
the wind-down and dissolution of the Plan in accordance with 
the provisions of Article XIII. 
(Source: P.A. 92-597, eff. 6-28-02; 93-622, eff. 12-18-03; 
93-824, eff. 7-28-04.)

 
    (215 ILCS 105/15)

    Sec. 15. Alternative portable coverage for federally 
eligible individuals.

    (a) Notwithstanding the requirements of subsection a of 
Section 7 and
except as otherwise provided in this Section, 
any
federally eligible individual for whom a Plan
application, 
and such enclosures and supporting documentation as the Board 
may
require, is received by the Board within 90 days after the

termination of prior
creditable coverage shall qualify to 
enroll in the Plan under the
portability provisions of this 
Section.


    A federally eligible person who has
been certified as 
eligible pursuant to the federal Trade
Act of 2002

and whose 
Plan application and enclosures and supporting
documentation 
as the Board may require is received by the Board within 63 
days
after the termination of previous creditable coverage 
shall qualify to enroll
in the Plan under the portability 
provisions of this Section.


    (b) Any federally eligible individual seeking Plan 
coverage under this
Section must submit with his or her 
application evidence, including acceptable
written 
certification of previous creditable coverage, that will 
establish to
the Board's satisfaction, that he or she meets 
all of the requirements to be a
federally eligible individual 
and is currently and
permanently residing in this State (as of 
the date his or her application was
received by the Board).


    (c) Except as otherwise provided in this Section, a period 
of creditable
coverage shall not be counted, with respect to

qualifying an applicant for Plan coverage as a federally 
eligible individual
under this Section, if after such period 
and before the application for Plan
coverage was received by 
the Board, there was at least a 90-day
period during
all of 
which the individual was not covered under any creditable 
coverage.


    For a federally eligible person who has
 been certified as 
eligible
pursuant to the federal Trade Act of 2002, a period of 
creditable
coverage shall not be counted, with respect to 
qualifying an applicant for Plan
coverage as a federally 
eligible individual under this Section, if after such
period 
and before the application for Plan coverage was received by 
the Board,
there was at
least a 63-day period during all of 
which the individual was not covered under
any creditable 
coverage.


    (d) Any federally eligible individual who the Board 
determines qualifies for
Plan coverage under this Section 
shall be offered his or her choice of
enrolling in one of 
alternative portability health benefit plans which the
Board

is authorized under this Section to establish for these 
federally eligible
individuals
and their dependents.


    (e) The Board shall offer a choice of health care 
coverages consistent with
major medical coverage under the 
alternative health benefit plans authorized by
this Section to 
every federally eligible individual.
The coverages to be 
offered under the plans, the schedule of
benefits, 
deductibles, co-payments, exclusions, and other limitations 
shall be
approved by the Board.  One optional form of coverage 
shall be comparable to
comprehensive health insurance coverage 
offered in the individual market in
this State or a standard 
option of coverage available under the group or
individual 
health insurance laws of the State.  The standard benefit plan 
that
is
authorized by Section 8 of this Act may be used for 
this purpose.  The Board
may also offer a preferred provider 
option and such other options as the Board
determines may be 
appropriate for these federally eligible individuals who

qualify for Plan coverage pursuant to this Section.


    (f) Notwithstanding the requirements of subsection f of 
Section 8, any
Plan coverage
that is issued to federally 
eligible individuals who qualify for the Plan
pursuant
to the 
portability provisions of this Section shall not be subject to 
any
preexisting conditions exclusion, waiting period, or other 
similar limitation
on coverage.


    (g) Federally eligible individuals who qualify and enroll 
in the Plan
pursuant
to this Section shall be required to pay 
such premium rates as the Board shall
establish and approve in 
accordance with the requirements of Section 7.1 of
this Act.


    (h) A federally eligible individual who qualifies and 
enrolls in the Plan
pursuant to this Section must satisfy on an 
ongoing basis all of the other
eligibility requirements of 
this Act to the extent not inconsistent with the
federal 
Health Insurance Portability and Accountability Act of 1996 in 
order to
maintain continued eligibility
for coverage under the 
Plan.


    (i)      New enrollment and policy renewals are discontinued on 
December 31, 2021. 
(Source: P.A. 100-201, eff. 8-18-17.)

 
    (215 ILCS 105/16 new)
    Sec. 16. Cessation of operations.
    (a)   Except as otherwise provided in this Section, the 
insurance operations of the Plan authorized by this Act shall 
cease on December 31, 2021.
    (b)    Coverage under the Plan does not apply to services 
provided on or after January 1, 2022.
    (c)    The Plan shall cease providing coverage for 
participants enrolled prior to January 1, 2022 at 11:59 p.m. 
on December 31, 2021.
    (d)    A claim for payment under the Plan must be submitted 
within 180 days after January 1, 2022 and paid in accordance 
with the provisions of Article XIII of the Illinois Insurance 
Code.
    (e)   Any claim or grievance shall be resolved by the court 
supervising the Plan's Article XIII rehabilitation or 
liquidation proceedings.
    (f)   Balance billing by a health care provider that is not a 
member of the provider network used by the Plan is prohibited.
    (g)   The Board shall, not later than 60 days after the 
effective date of this amendatory Act of the 102nd General 
Assembly, submit to the Director a plan of rehabilitation or 
liquidation and dissolution, which must provide for, but shall 
not be limited to, the following:
        (1)   continuity of care for an individual who is 
    covered under the Plan and is an inpatient on January 1, 
    2022;
        (2)    a final accounting of assessments;
        (3)   resolution of any net asset deficiency;
        (4)   cessation of all liability of the Plan; and
        (5)    final dissolution of the Plan.
    (h)    The plan of rehabilitation or liquidation and 
dissolution may provide that, with the approval of the 
Director, a power or duty of the Plan may be delegated to a 
person that is to perform functions similar to the functions 
of the Plan.
    (i)   Upon entry of an Order of Rehabilitation or 
Liquidation against the Plan, the court supervising the 
rehabilitation or liquidation proceedings shall have the 
jurisdiction to issue injunctions as set forth in Section 189 
of the Illinois Insurance Code, including, but not limited to, 
the restraining of all persons, companies, and entities from 
bringing or further prosecuting all actions and proceedings at 
law or in equity or otherwise, whether in this State or 
elsewhere, against the Plan or its assets or property or the 
Director except insofar as those actions or proceedings arise 
in or are brought in the rehabilitation or liquidation 
proceedings.
    (j)    Upon the entry of an order of rehabilitation or 
liquidation, the rights and liabilities of the Plan and of its 
policyholders and all other persons interested in its assets 
shall be fixed as of the date of entry of the order directing 
rehabilitation or liquidation, or such later date as may be 
provided by order of the court supervising the rehabilitation 
or liquidation proceedings.
    (k)      Upon the satisfaction of all claims allowed in the 
rehabilitation or liquidation proceedings, including the costs 
and expenses of administering the rehabilitation or 
liquidation, any remaining funds shall be distributed as 
follows:
        (1)   for the accounts described in paragraph (2) of 
    subsection (l) of Section 4, all funds shall be refunded 
    on a pro rata basis to the insurers that were assessed 
    based on the most recent deficit projections of the Plan's 
    operation pursuant to Section 12 and to covered persons 
    where appropriate; and
        (2)   for all other accounts, all remaining funds shall 
    be released and deposited into the Insurance Producer 
    Administration Fund for use by the Department for 
    initiatives to support the Illinois Health Benefits 
    Exchange.
    (l)   Upon the entry of an Order of Rehabilitation or 
Liquidation against the Plan, if the Director determines the 
Plan is holding any surplus funds in a segregated account 
associated with persons who qualified for coverage under 
Section 7 that are no longer required for the purposes for 
which they were acquired and are restricted from any other 
use, the Director may petition the court for such funds to be 
released and placed as follows:
        (1)   the first $10,000,000 shall be deposited into the 
    Insurance Producer Administration Fund for use by the 
    Department for initiatives to support the Illinois Health 
    Benefits Exchange; and
        (2)   the remainder shall be deposited into the Parity 
    Advancement Fund. 
 
    (215 ILCS 105/17 new)
    Sec. 17. Transfer of the Illinois Comprehensive Health 
Insurance Plan.
    (a)     Upon entry of an Order of Rehabilitation or 
Liquidation against the Plan all powers, duties, rights, and 
responsibilities of the Plan and the Board shall be 
transferred to and vested in the Director, as rehabilitator or 
liquidator, who is authorized to wind down the affairs of the 
Plan in accordance with Article XIII of the Illinois Insurance 
Code.
    (b)     The Director, as rehabilitator or liquidator, shall 
act on behalf of the Plan and the Board and shall have the 
power and duty to receive and answer correspondence, and shall 
evaluate all claims that are timely filed in the 
rehabilitation or liquidation proceedings and is authorized to 
make distribution from any unencumbered funds of the Plan's 
rehabilitation or liquidation estate upon all such claims as 
are allowed in the proceedings consistent with subsection (1) 
of Section 205 of the Illinois Insurance Code. Timely filed 
claims of vendors allowed in the rehabilitation or liquidation 
proceedings that are not capable of being discharged, in full, 
from the assets of the rehabilitation or liquidation estate 
may be presented to the Court of Claims.
    (c)     All books, records, papers, documents, property (real 
and personal), contracts, causes of action, and pending 
business pertaining to the powers, duties, rights, and 
responsibilities transferred by this amendatory Act of the 
102nd General Assembly from the Plan and the Board to the 
Director, as rehabilitator or liquidator, including, but not 
limited to, material in electronic or magnetic format and 
necessary computer hardware and software, shall be transferred 
to the Director, as rehabilitator or liquidator. Records shall 
be maintained as required by the federal Health Insurance 
Portability and Accountability Act of 1996, as now or 
hereafter amended, unless otherwise ordered by the court 
supervising the rehabilitation or liquidation proceedings.
    (d)     The rights of the employees in the State of Illinois 
and its agencies under the Personnel Code and applicable 
collective bargaining agreements or under any pension, 
retirement, or annuity plan shall not be affected by this 
amendatory Act of the 102nd General Assembly.
    (e)    Upon entry of an Order of Rehabilitation or 
Liquidation against the Plan, all unexpended appropriations 
and balances and other funds available for use by the Plan and 
the Board shall be transferred to and vested in the Director, 
as rehabilitator or liquidator. Except as provided in 
subsection (l) of Section 16, unexpended balances so 
transferred shall be distributed in accordance with Article 
XIII of the Illinois Insurance Code for paying the Director's 
administrative expenses incurred in connection with winding 
down the affairs of the Plan.
    (f)    Whenever reports or notices are, on the effective date 
of this amendatory Act of the 102nd General Assembly, required 
to be made or given or papers or documents furnished or served 
by any person to or upon the Plan or the Board in connection 
with any of the powers, duties, rights, and responsibilities 
transferred by this amendatory Act of the 102nd General 
Assembly, the same shall be made, given, furnished, or served 
in the same manner to or upon the Director, as rehabilitator or 
liquidator.
    (g)    This amendatory Act of the 102nd General Assembly does 
not affect any act done, ratified, or canceled or any right 
occurring or established or any action or proceeding had or 
commenced in the administrative, civil, or criminal cause by 
the Plan or the Board prior to the entry of an Order of 
Rehabilitation or Liquidation against the Plan; such actions 
or proceedings may be prosecuted and continued by the 
Director, as rehabilitator or liquidator.
 
 
    Section 99. Effective date. This Act takes effect upon 
becoming law. 
  

Effective Date:  7/23/2021