Bill Text: IL HB0471 | 2019-2020 | 101st General Assembly | Engrossed


Bill Title: Amends the Foreign Banking Office Act. Makes a technical change in a Section concerning the short title.

Spectrum: Partisan Bill (Democrat 63-0)

Status: (Engrossed) 2019-05-24 - Rule 3-9(a) / Re-referred to Assignments [HB0471 Detail]

Download: Illinois-2019-HB0471-Engrossed.html



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1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Illinois Insurance Code is amended by
5changing Section 355 as follows:
6 (215 ILCS 5/355) (from Ch. 73, par. 967)
7 Sec. 355. Accident and health policies; provisions.
8policies-Provisions.)
9 (a) As used in this Section, "unreasonable rate increase"
10means a rate increase that the Director determines to be
11excessive, unjustified, or unfairly discriminatory in
12accordance with 45 CFR 154.205.
13 (b) No policy of insurance against loss or damage from the
14sickness, or from the bodily injury or death of the insured by
15accident shall be issued or delivered to any person in this
16State until a copy of the form thereof and of the
17classification of risks and the premium rates pertaining
18thereto have been filed with the Director; nor shall it be so
19issued or delivered until the Director shall have approved such
20policy pursuant to the provisions of Section 143. If the
21Director disapproves the policy form he shall make a written
22decision stating the respects in which such form does not
23comply with the requirements of law and shall deliver a copy

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1thereof to the company and it shall be unlawful thereafter for
2any such company to issue any policy in such form.
3 (c) All individual and small group accident and health
4policies written in compliance with the Patient Protection and
5Affordable Care Act must file rates with the Department for
6approval. Rate increases found to be unreasonable rate
7increases in relation to benefits under the policy provided
8shall be disapproved. The Department shall provide a report to
9the General Assembly on or after January 1, 2021, regarding
10both on and off exchange individual and small group rates in
11the Illinois market.
12 (d) A rate increase filed under this Section must be
13approved or denied within 60 calendar days after the date the
14rate increase is filed with the Department. Any rate increase
15that is not approved or denied by the Department shall
16automatically be approved on the 61st calendar day.
17 (e) No less than 30 days after the federal Centers for
18Medicare and Medicaid Services has certified the policies
19described in this Section for the upcoming plan year, the
20Department shall publish on its website a report explaining the
21rates for the subsequent calendar year's certified policies.
22(Source: P.A. 79-777.)
23 Section 10. The Health Maintenance Organization Act is
24amended by changing Section 4-12 as follows:

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1 (215 ILCS 125/4-12) (from Ch. 111 1/2, par. 1409.5)
2 Sec. 4-12. Changes in Rate Methodology and Benefits,
3Material Modifications. A health maintenance organization
4shall file with the Director, prior to use, a notice of any
5change in rate methodology, or benefits and of any material
6modification of any matter or document furnished pursuant to
7Section 2-1, together with such supporting documents as are
8necessary to fully explain the change or modification.
9 (a) Contract modifications described in subsections
10(c)(5), (c)(6) and (c)(7) of Section 2-1 shall include all form
11agreements between the organization and enrollees, providers,
12administrators of services and insurers of health maintenance
13organizations.
14 (b) Material transactions or series of transactions other
15than those described in subsection (a) of this Section, the
16total annual value of which exceeds the greater of $100,000 or
175% of net earned subscription revenue for the most current
18twelve month period as determined from filed financial
19statements.
20 (c) Any agreement between the organization and an insurer
21shall be subject to the provisions of the laws of this State
22regarding reinsurance as provided in Article XI of the Illinois
23Insurance Code. All reinsurance agreements must be filed.
24Approval of the Director is required for all agreements except
25the following: individual stop loss, aggregate excess,
26hospitalization benefits or out-of-area of the participating

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1providers unless 20% or more of the organization's total risk
2is reinsured, in which case all reinsurance agreements require
3approval.
4 (d) All individual and small group accident and health
5policies written in compliance with the Patient Protection and
6Affordable Care Act must file rates with the Department for
7approval. Rate increases found to be unreasonable rate
8increases in relation to benefits under the policy provided
9shall be disapproved. The Department shall provide a report to
10the General Assembly on or after January 1, 2021, regarding
11both on and off exchange individual and small group rates in
12the Illinois market.
13 (e) A rate increase filed under this Section must be
14approved or denied within 60 calendar days after the date the
15rate increase is filed with the Department. Any rate increase
16that is not approved or denied by the Department shall
17automatically be approved on the 61st calendar day.
18 (f) No less than 30 days after the federal Centers for
19Medicare and Medicaid Services has certified the policies
20described in this Section for the upcoming plan year, the
21Department shall publish on its website a report explaining the
22rates for the subsequent calendar year's certified policies.
23 (g) As used in this Section, "unreasonable rate increase"
24means a rate increase that the Director determines to be
25excessive, unjustified, or unfairly discriminatory in
26accordance with 45 CFR 154.205.

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1(Source: P.A. 86-620.)
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