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Rep. John E. Bradley
Filed: 6/3/2015
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1 | | AMENDMENT TO HOUSE BILL 1287
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2 | | AMENDMENT NO. ______. Amend House Bill 1287, AS AMENDED, by |
3 | | inserting the following in its proper numeric sequence in the |
4 | | bill:
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5 | | "Section 8. The Workers' Compensation Act is amended by |
6 | | changing Section 29.2 and by adding Section 29.3 as follows: |
7 | | (820 ILCS 305/29.2) |
8 | | Sec. 29.2. Insurance and self-insurance oversight. |
9 | | (a) The Department of Insurance shall annually submit to |
10 | | the Governor, the Chairman of the Commission, the President of |
11 | | the Senate, the Speaker of the House of Representatives, the |
12 | | Minority Leader of the Senate, and the Minority Leader of the |
13 | | House of Representatives a written report that details the |
14 | | state of the workers' compensation insurance market in |
15 | | Illinois. The report shall be completed by April 1 of each |
16 | | year, beginning in 2012, or later if necessary data or analyses |
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1 | | are only available to the Department at a later date. The |
2 | | report shall be posted on the Department of Insurance's |
3 | | Internet website. Information to be included in the report |
4 | | shall be for the preceding calendar year. The report shall |
5 | | include, at a minimum, the following: |
6 | | (1) Gross premiums collected by workers' compensation |
7 | | carriers in Illinois and the national rank of Illinois |
8 | | based on premium volume. |
9 | | (2) The number of insurance companies actively engaged |
10 | | in Illinois in the workers' compensation insurance market, |
11 | | including both holding companies and subsidiaries or |
12 | | affiliates, and the national rank of Illinois based on |
13 | | number of competing insurers. |
14 | | (3) The total number of insured participants in the |
15 | | Illinois workers' compensation assigned risk insurance |
16 | | pool, and the size of the assigned risk pool as a |
17 | | proportion of the total Illinois workers' compensation |
18 | | insurance market. |
19 | | (4) The advisory organization premium rate for |
20 | | workers' compensation insurance in Illinois for the |
21 | | previous year. |
22 | | (5) The advisory organization prescribed assigned risk |
23 | | pool premium rate. |
24 | | (6) The total amount of indemnity payments made by |
25 | | workers' compensation insurers in Illinois. |
26 | | (7) The total amount of medical payments made by |
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1 | | workers' compensation insurers in Illinois, and the |
2 | | national rank of Illinois based on average cost of medical |
3 | | claims per injured worker. |
4 | | (8) The gross profitability of workers' compensation |
5 | | insurers in Illinois, and the national rank of Illinois |
6 | | based on profitability of workers' compensation insurers. |
7 | | (9) The loss ratio of workers' compensation insurers in |
8 | | Illinois and the national rank of Illinois based on the |
9 | | loss ratio of workers' compensation insurers. For purposes |
10 | | of this loss ratio calculation, the denominator shall |
11 | | include all premiums and other fees collected by workers' |
12 | | compensation insurers and the numerator shall include the |
13 | | total amount paid by the insurer for care or compensation |
14 | | to injured workers. |
15 | | (10) The growth of total paid indemnity benefits by |
16 | | temporary total disability, scheduled and non-scheduled |
17 | | permanent partial disability, and total disability. |
18 | | (11) The number of injured workers receiving wage loss |
19 | | differential awards and the average wage loss differential |
20 | | award payout. |
21 | | (12) Illinois' rank, relative to other states, for: |
22 | | (i) the maximum and minimum temporary total |
23 | | disability benefit level; |
24 | | (ii) the maximum and minimum scheduled and |
25 | | non-scheduled permanent partial disability benefit |
26 | | level; |
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1 | | (iii) the maximum and minimum total disability |
2 | | benefit level; and |
3 | | (iv) the maximum and minimum death benefit level. |
4 | | (13) The aggregate growth of medical benefit payout by |
5 | | non-hospital providers and hospitals. |
6 | | (14) The aggregate growth of medical utilization for |
7 | | the top 10 most common injuries to specific body parts by |
8 | | non-hospital providers and hospitals. |
9 | | (15) The percentage of injured workers filing claims at |
10 | | the Commission that are represented by an attorney. |
11 | | (16) The total amount paid by injured workers for |
12 | | attorney representation. |
13 | | (a-5) The Department of Insurance shall annually submit to |
14 | | the Governor, the Chairman of the Commission, and the General |
15 | | Assembly a written report that details the state of |
16 | | self-insurance for workers' compensation in Illinois. The |
17 | | report shall be completed by October 1, 2015 and April 1 of |
18 | | each year thereafter or later if necessary data or analyses are |
19 | | only available to the Department at a later date. The report |
20 | | shall be posted on the Department of Insurance's Internet |
21 | | website. Information to be included in the report shall be for |
22 | | the preceding calendar year. The report shall include, at a |
23 | | minimum, the following: |
24 | | (1) The number of employers that self-insure for |
25 | | workers' compensation. |
26 | | (2) The total number of employers belonging to a group |
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1 | | workers' compensation pool. |
2 | | (3) The total amount of indemnity payments made by |
3 | | self-insureds and by group workers' compensation pools in |
4 | | Illinois. |
5 | | (4) The total amount of medical payments made by |
6 | | self-insureds and by group workers' compensation pools in |
7 | | Illinois, and the national rank of Illinois based on |
8 | | average cost of medical claims per injured worker. |
9 | | (5) The growth of total paid indemnity benefits by |
10 | | temporary total disability, scheduled and non-scheduled |
11 | | permanent partial disability, and total disability. |
12 | | (6) The number of injured workers receiving wage loss |
13 | | differential awards and the average wage loss differential |
14 | | award payout. |
15 | | (7) Illinois' rank, relative to other states, for: |
16 | | (i) the maximum and minimum temporary total |
17 | | disability benefit levels; |
18 | | (ii) the maximum and minimum scheduled and |
19 | | non-scheduled permanent partial disability benefit |
20 | | levels; |
21 | | (iii) the maximum and minimum total disability |
22 | | benefit levels; and |
23 | | (iv) the maximum and minimum death benefit levels. |
24 | | (8) The aggregate growth of medical benefit payouts by |
25 | | non-hospital providers and hospitals. |
26 | | (9) The aggregate growth of medical utilization for the |
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1 | | top 10 most common injuries to specific body parts by |
2 | | non-hospital providers and hospitals. |
3 | | (b) The Director of Insurance shall promulgate rules |
4 | | requiring each insurer licensed to write workers' compensation |
5 | | coverage in the State self-insured employer, and group workers' |
6 | | compensation pool to record and report the following |
7 | | information on an aggregate basis to the Department of |
8 | | Insurance before March 1 of each year, relating to claims in |
9 | | the State opened within the prior calendar year: |
10 | | (1) The number of claims opened. |
11 | | (2) The number of reported medical only claims. |
12 | | (3) The number of contested claims. |
13 | | (4) The number of claims for which the employee has |
14 | | attorney representation. |
15 | | (5) The number of claims with lost time and the number |
16 | | of claims for which temporary total disability was paid. |
17 | | (6) The number of claim adjusters employed to adjust |
18 | | workers' compensation claims. |
19 | | (7) The number of claims for which temporary total |
20 | | disability was not paid within 14 days from the first full |
21 | | day off, regardless of reason. |
22 | | (8) The number of medical bills paid 60 days or later |
23 | | from date of service and the average days paid on those |
24 | | paid after 60 days for the previous calendar year. |
25 | | (9) The number of claims in which in-house defense |
26 | | counsel participated, and the total amount spent on |
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1 | | in-house legal services. |
2 | | (10) The number of claims in which outside defense |
3 | | counsel participated, and the total amount paid to outside |
4 | | defense counsel. |
5 | | (11) The total amount billed to employers for bill |
6 | | review. |
7 | | (12) The total amount billed to employers for fee |
8 | | schedule savings. |
9 | | (13) The total amount charged to employers for any and |
10 | | all managed care fees. |
11 | | (14) The number of claims involving in-house medical |
12 | | nurse case management, and the total amount spent on |
13 | | in-house medical nurse case management. |
14 | | (15) The number of claims involving outside medical |
15 | | nurse case management, and the total amount paid for |
16 | | outside medical nurse case management. |
17 | | (16) The total amount paid for Independent Medical |
18 | | exams. |
19 | | (17) The total amount spent on in-house Utilization |
20 | | Review for the previous calendar year. |
21 | | (18) The total amount paid for outside Utilization |
22 | | Review for the previous calendar year. |
23 | | The Department shall make the submitted information |
24 | | publicly available on the Department's Internet website or such |
25 | | other media as appropriate in a form useful for consumers.
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26 | | (Source: P.A. 97-18, eff. 6-28-11.) |
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1 | | (820 ILCS 305/29.3 new) |
2 | | Sec. 29.3. Workers' Compensation Premium Rates Task Force. |
3 | | (a) There is created the Workers' Compensation Premium |
4 | | Rates Task Force consisting of 12 members appointed as follows: |
5 | | 2 legislative members appointed by the Speaker of the House of |
6 | | Representatives; 2 legislative members appointed by the |
7 | | Minority Leader of the House of Representatives; 2 legislative |
8 | | members appointed by the President of the Senate; 2 legislative |
9 | | members appointed by the Minority Leader of the Senate; and one |
10 | | member appointed by the Governor from each of the following |
11 | | organizations: (i) a statewide association representing |
12 | | retailers; (ii) a statewide association representing |
13 | | manufacturers; (ii) a statewide association representing labor |
14 | | interests; and (iii) a statewide association representing |
15 | | injured workers. The members of the Task Force shall be |
16 | | appointed by August 1, 2015. Two co-chairpersons, representing |
17 | | different political parties, shall be selected by the members |
18 | | of the Task Force. Members of the Task Force shall receive no |
19 | | compensation for their service on the Task Force. |
20 | | (b) The Task Force shall study the National Council on |
21 | | Compensation Insurance's recommendations for workers' |
22 | | compensation premium rates and the extent to which Illinois |
23 | | employers' actual premiums reflect these recommended rates. |
24 | | The Department of Insurance shall provide administrative |
25 | | support to the Task Force. |