HB4728 98TH GENERAL ASSEMBLY

LRB098 17340 RPM 52436 b

98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB4728

Introduced , by Rep. Robyn Gabel

SYNOPSIS AS INTRODUCED:

215 ILCS 5/351A-11.1 new
215 ILCS 5/355	from Ch. 73, par. 967

Amends the Illinois Insurance Code. Provides that, with respect to long-term care insurance coverage, no policy or certificate, or modification thereof, shall be issued or delivered to any person in this State until the classification of risks and the premium rates pertaining thereto have been approved by the Director of Insurance and that any subsequent addition to or change in premium rates shall also be subject to the Director's approval. Sets forth provisions concerning the standards for approval, determinations by the Director, and public hearings. Provides that, with respect to long-term care insurance, a filing of premium rates shall not be considered complete unless it contains all information necessary to justify the premium rate and such other information as the Director may require to determine the rate's compliance with the provision concerning long-term care insurance rates and prior approval. Sets forth additional requirements for rate filings. Effective immediately.

A BILL FOR

AN ACT concerning regulation.

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

Section 5. The Illinois Insurance Code is amended by changing Section 355 and by adding Section 351A-11.1 as follows:

(215 ILCS 5/351A-11.1 new)

Sec. 351A-11.1. Long-term care insurance rates; prior approval.

(a) With respect to long-term care insurance coverage, no policy or certificate, or modification thereof, shall be issued or delivered to any person in this State until the classification of risks and the premium rates pertaining thereto have been approved by the Director under this Section. Any subsequent addition to or change in premium rates shall also be subject to the Director's approval under this Section.

(b) The Director shall disapprove a premium rate under this Section if:

(1) the benefits provided are not reasonable in relation to the premium charged;

(2) the proposed premium rate is excessive, unjustified, or unfairly discriminatory; or

(3) for a given policy form, the premium rate applicable to any particular policy issued on that policy form is increased by an amount exceeding an annual rate cap of 15%.

The company proposing the rate has the burden of proving by clear and convincing evidence that the rate does not violate this Section.

(c) The Director may request actuarial reasons and data, as well as other information, needed to determine if a previously-approved rate continues to satisfy the requirements of this Section. The Director may withdraw approval of any rate that has previously been approved on any of the grounds set forth in subsection (b) of this Section.

(d) The Director, at his or her discretion, may conduct a public hearing on any proposed change in premium rates referenced in subsection (a) of this Section.

(215 ILCS 5/355) (from Ch. 73, par. 967)

Sec. 355. Accident and health policies-Provisions.)

(a) No policy of insurance against loss or damage from the sickness, or from the bodily injury or death of the insured by accident shall be issued or delivered to any person in this State until a copy of the form thereof and of the classification of risks and the premium rates pertaining thereto have been filed with the Director; nor shall it be so issued or delivered until the Director shall have approved such policy pursuant to the provisions of Section 143. If the Director disapproves the policy form he shall make a written decision stating the respects in which such form does not comply with the requirements of law and shall deliver a copy thereof to the company and it shall be unlawful thereafter for any such company to issue any policy in such form.

(b) With respect to long-term care insurance, a filing of premium rates pursuant to subsection (a) of this Section shall not be considered complete unless it contains all information necessary to justify the premium rate and such other information as the Director may require to determine the rate's compliance with Section 351A-11.1 of this Code. Each rate filing must also include a certification by a qualified actuary that to the best of the actuary's knowledge and judgment the rate filing is in compliance with applicable laws and regulations and that the premiums are reasonable in relation to the benefits and consistent with company experience. Each rate filing shall also include a certification from an office of the company that the requested increase has been reviewed and authorized by company management. For the purpose of this Section, "long-term care insurance" has the meaning given to it in subsection (a) of Section 351A-1 of this Code.

(Source: P.A. 79-777.)

Section 99. Effective date. This Act takes effect upon becoming law.