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91_HB1573
LRB9103901JSmg
1 AN ACT to amend the Health Maintenance Organization Act
2 by changing Section 2-5.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Health Maintenance Organization Act is
6 amended by changing Section 2-5 as follows:
7 (215 ILCS 125/2-5) (from Ch. 111 1/2, par. 1406.1)
8 Sec. 2-5. Claims Liabilities. A Every Health
9 Maintenance Organization shall, at all times, maintain
10 liabilities in an amount estimated in the aggregate to
11 provide for the payment of all claims incurred and any due
12 and unpaid provider capitation, whether reported or
13 unreported, which are unpaid and for which such organization
14 is or may be liable, and to provide for the expense of
15 adjustment or settlement of such claims. Such liabilities
16 shall be computed in accordance with regulations promulgated
17 by the Director upon reasonable consideration of the
18 ascertained experience and character of such business for the
19 purpose of adequately protecting enrollees and securing the
20 solvency of such organizations.
21 Whenever the claim and claim expense experience of any
22 such organization shows the liabilities calculated in
23 accordance with such regulations to be inadequate, the
24 Director may require such organization to maintain additional
25 liabilities.
26 (Source: P.A. 86-620.)