SB3448 - 104th General Assembly
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| 1 | AN ACT concerning regulation. | |||||||||||||||||||
| 2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||
| 3 | represented in the General Assembly: | |||||||||||||||||||
| 4 | Section 1. Short title. This Act may be cited as the | |||||||||||||||||||
| 5 | Not-for-Profit Health Insurance Reserve Cap Act. | |||||||||||||||||||
| 6 | Section 5. Purpose. The purpose of this Act is to limit | |||||||||||||||||||
| 7 | excessive accumulation of reserves by not-for-profit health | |||||||||||||||||||
| 8 | insurance companies in order to ensure that surplus funds are | |||||||||||||||||||
| 9 | used to improve health care services in Illinois, fairly | |||||||||||||||||||
| 10 | compensate Illinois medical providers, and benefit | |||||||||||||||||||
| 11 | policyholders and the policyholders' employees, retirees, and | |||||||||||||||||||
| 12 | dependents. | |||||||||||||||||||
| 13 | Section 10. Definitions. In this Act: | |||||||||||||||||||
| 14 | "Department" means the Department of Insurance. | |||||||||||||||||||
| 15 | "Excess reserves" means any amount of reserves maintained | |||||||||||||||||||
| 16 | by a not-for-profit health insurance company that exceeds 125% | |||||||||||||||||||
| 17 | of the regulatory minimum solvency requirement established by | |||||||||||||||||||
| 18 | the Department. | |||||||||||||||||||
| 19 | "Health insurance issuer" has the meaning given to that | |||||||||||||||||||
| 20 | term in Section 5 of the Illinois Health Insurance Portability | |||||||||||||||||||
| 21 | and Accountability Act. | |||||||||||||||||||
| 22 | "Not-for-profit health insurance company" means any health | |||||||||||||||||||
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| 1 | insurance issuer organized and operated as a not-for-profit | ||||||
| 2 | under applicable State and federal laws. | ||||||
| 3 | "Reserves" means any surplus funds or financial assets | ||||||
| 4 | held by a not-for-profit health insurance company that exceed | ||||||
| 5 | the minimum amount required by the Department to endure | ||||||
| 6 | solvency and operational stability. | ||||||
| 7 | Section 15. Limitations on reserves. By the end of each | ||||||
| 8 | calendar year, no not-for-profit health insurance company | ||||||
| 9 | shall maintain reserves in excess of 125% of the minimum | ||||||
| 10 | solvency reserve standards required by the Department. Each | ||||||
| 11 | not-for-profit health insurance company shall submit an annual | ||||||
| 12 | financial report to the Department detailing the company's | ||||||
| 13 | reserve levels, including any reserves held in excess of the | ||||||
| 14 | prescribed cap. | ||||||
| 15 | Section 20. Use of excess reserves. Any excess reserves | ||||||
| 16 | shall be utilized for all the following purposes during the | ||||||
| 17 | applicable calendar year: | ||||||
| 18 | (1) market level compensation for health care | ||||||
| 19 | providers currently in the insurer's network; | ||||||
| 20 | (2) expansion of access to health care for underserved | ||||||
| 21 | populations; and | ||||||
| 22 | (3) reduction in premiums for current policyholders. | ||||||
| 23 | Section 25. Enforcement and penalties. The Department | ||||||
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| 1 | shall monitor compliance with this Act. This monitoring shall | ||||||
| 2 | include, but not be limited to, conducting audits, reviewing | ||||||
| 3 | financial disclosures required by this Act, issuing subpoenas, | ||||||
| 4 | and other judicial processes. Any not-for-profit health | ||||||
| 5 | insurance company in violation of this Act shall be subject to | ||||||
| 6 | fines, penalties, and other corrective action, including, but | ||||||
| 7 | not limited to: | ||||||
| 8 | (1) imposition of a monetary fine not exceeding 50% of | ||||||
| 9 | the excess reserve held; and | ||||||
| 10 | (2) suspension or revocation of its license to operate | ||||||
| 11 | in Illinois. | ||||||
