97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB3236

 

Introduced 2/24/2011, by Rep. Karen May

 

SYNOPSIS AS INTRODUCED:
 
805 ILCS 310/30 new

    Amends the Co-operative Act. Provides that health benefit purchasing cooperatives may be organized by one or more persons in geographic areas designated by the Director of the Department of Insurance. Provides guidance for the design of a health benefit purchasing cooperative. Provides guidance for establishing member criteria and requires a cooperative to file the criteria and other reports with the Director of the Department of Insurance. Provides that each health benefit purchasing cooperative shall be organized on a membership basis with no capital stock. Provides that the contract between the health benefit purchasing cooperative and an insurer shall be for a term of 3 years. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning business.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Co-operative Act is amended by adding
5Section 30 as follows:
 
6    (805 ILCS 310/30 new)
7    Sec. 30. Health benefit purchasing cooperative.
8    (a) Notwithstanding any other provisions of this Act,
9health benefit purchasing cooperatives may be organized by one
10or more persons under this Section in each of the geographic
11areas identified in subsection (l) of this Section.
12    (b) The purpose of a health benefit purchasing cooperative
13is to provide health care benefits for the individuals
14specified in subsection (i) of this Section, under a single
15group health care policy or plan through a contract between the
16health benefit purchasing cooperative and an insurer
17authorized to do business in this State in one or more lines of
18insurance that includes health insurance.
19    (c) A health benefit purchasing cooperative shall be
20designed so that all of the following are accomplished:
21        (1) The members become better informed about health
22    care trends and cost increases.
23        (2) All members receive their health care benefits

 

 

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1    under the group health care policy or plan negotiated under
2    subsection (i) of this Section.
3        (3) The members are actively engaged in designing
4    health care benefit options that are offered by the insurer
5    and that meet the needs of their community.
6        (4) The health insurance risk of all of the members is
7    pooled.
8        (5) The members actively participate in health
9    improvement decisions for their community.
10    (d) The articles of a health benefit purchasing cooperative
11shall set forth the name and address of at least one
12incorporator who will act as the temporary board.
13    (e) Each health benefit purchasing cooperative shall be
14organized on a membership basis with no capital stock.
15    (f) Subject to subsection (g) of this Section, any person
16that does business in, is located in, has a principal office
17in, or resides in the geographic area in which a health benefit
18purchasing cooperative is organized, that meets the membership
19criteria established by the health benefit purchasing
20cooperative in its bylaws, and that pays the membership fee may
21be a member of the health benefit purchasing cooperative.
22    (g) A health benefit cooperative may limit membership of
23self-employed individuals through its membership criteria, but
24such criteria must be applied in the same manner to all
25self-employed individuals.
26    (h) Each health benefit purchasing cooperative shall file

 

 

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1its membership criteria, as well as any amendments to the
2criteria, with the Director.
3    (i) The health care benefits offered by a health benefit
4purchasing cooperative shall be negotiated between the health
5benefit purchasing cooperative and the insurer and shall be
6offered in a single group health care policy or plan. The
7insurer must offer coverage under the group health care policy
8or plan to all of the following:
9        (1) An individual who is a member, officer, or eligible
10    employee of a member of the health benefit purchasing
11    cooperative.
12        (2) A self-employed individual who is a member of the
13    health benefit purchasing cooperative.
14        (3) A dependent of an individual under subdivisions
15    (i)(1) and (2) who receives coverage.
16    (j) The contract between the health benefit purchasing
17cooperative and an insurer shall be for a term of 3 years. Upon
18enrollment in the insurer's group health care policy or plan,
19each member shall pay to the health benefit purchasing
20cooperative an amount determined by the health benefit
21purchasing cooperative that is not less than the member's
22applicable premium for the 36th month of coverage under the
23contract. If a member withdraws from the health benefit
24purchasing cooperative before the end of the contract term, the
25health benefit purchasing cooperative may retain, as a penalty,
26an amount specified by the health benefit purchasing

 

 

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1cooperative that is not less than the premium that the member
2paid for the 36th month of coverage.
3    (k) Each health benefit purchasing cooperative shall
4submit to the Director all of the following:
5        (1) Annually, no later than September 30, a report on
6    the progress of the health benefit purchasing arrangement
7    described in this Section and, to the extent possible, any
8    significant findings in the criteria under subdivision
9    (k)(2) of this Section.
10        (2) Within one year after the end of the term of the
11    contract under subsection (j) of this Section, a final
12    report that details significant findings from the project
13    and that includes, at a minimum, to the extent available,
14    information on all of the following:
15            (A) The extent to which the health benefit
16        purchasing arrangement had an impact on the number of
17        uninsured in the geographic area in which it operated.
18            (B) The effect on health care coverage premiums for
19        groups in the geographic area in which the health
20        benefit purchasing arrangement operated, including
21        groups other than the health benefit purchasing
22        cooperative.
23            (C) The degree to which health care consumers were
24        involved in the development and implementation of the
25        health benefit purchasing arrangement.
26    (l) The Director shall designate, by order, the geographic

 

 

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1areas of the State in which health benefit purchasing
2cooperatives may be organized. A geographic area may overlap
3with one or more other geographic areas.
4    (m) As used in this Section, "Director" means the Director
5of the Department of Insurance.
 
6    Section 99. Effective date. This Act takes effect upon
7becoming law.