HB5954 96TH GENERAL ASSEMBLY

LRB096 20199 RPM 35762 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB5954

Introduced 2/10/2010, by Rep. Mary E. Flowers

SYNOPSIS AS INTRODUCED:

New Act

Creates the Consumer Health Insurance Counsel Act. Creates the independent Office of Consumer Health Insurance Counsel for the purpose of representing the interests of health insurance consumers. Sets forth provisions concerning the appointment and qualifications of and prohibited activities regarding the position of Consumer Health Insurance Counsel. Provides that the Consumer Health Insurance Counsel may assess the impact of insurance rates, rules, and forms on consumers and shall advocate positions determined to be most advantageous to a substantial number of insurance consumers. Sets forth additional provisions.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning insurance.

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

Section 1. Short title. This Act may be cited as the Consumer Health Insurance Counsel Act.

Section 5. Definitions. For the purposes of this Act:

"Department" means the Department of Insurance.

"Director" means the Director of Insurance.

"Office" means the Office of Consumer Health Insurance Counsel.

Section 10. Office of Consumer Health Insurance Counsel. The independent Office of Consumer Health Insurance Counsel is created for the purpose of representing the interests of health insurance consumers in Illinois.

Section 15. Appointment; term. The Governor, with the advice and consent of the Senate, shall appoint a Consumer Health Insurance Counsel to serve as director of the Office. The term of the Consumer Health Insurance Counsel shall be 4 years.

Section 20. Qualifications. To be eligible to serve as Consumer Health Insurance Counsel, a person must:

(1) be an attorney licensed to practice in Illinois;

(2) have demonstrated a strong commitment to and involvement in efforts to safeguard the rights of the public; and

(3) possess the knowledge and experience necessary to practice effectively in insurance proceedings.

Section 25. Business interest prohibitions. A person is not eligible for appointment as Consumer Health Insurance Counsel or for employment as an Assistant Consumer Health Insurance Counsel with the Office if the person or the person's spouse:

(1) is employed by or participates in the management of a business entity or other organization regulated by or receiving funds from the Department;

(2) owns or controls, directly or indirectly, an interest in a business entity or other organization regulated by or receiving funds from the Department; or

(3) uses or receives a substantial amount of tangible goods, services, or funds from the Department or the Office, other than compensation or reimbursement authorized by law for Department or Office membership, attendance, or expenses.

Section 30. Lobbying activities. A person may not serve as Consumer Health Insurance Counsel or act as Assistant Consumer Health Insurance Counsel if the person is required to register as a lobbyist under the Lobbyist Registration Act because of the person's activities for compensation related to the operation of the Department or the Office.

Section 35. Grounds for removal. The Consumer Health Insurance Counsel shall be removed from the position by the appointing officer if he or she:

(1) does not have at the time of appointment or maintain during service as Consumer Health Insurance Counsel the qualifications required by Section 20 of this Act;

(2) violates a prohibition established by Section 25 of this Act;

(3) cannot, because of illness or disability, discharge the Consumer Health Insurance Counsel's duties for a substantial part of the Consumer Health Insurance Counsel's term.

Section 40. Revolving door prohibition. No former Consumer Health Insurance Counsel or Assistant Consumer Health Insurance Counsel or spouse or immediate family member living with such person, shall, within a year after the date the person ceases to serve as Consumer Health Insurance Counsel or Assistant Consumer Health Insurance Counsel, represent any person or receive compensation for services rendered on behalf of any party involved in a matter in which the Consumer Health Insurance Counsel or Assistant Consumer Health Insurance Counsel participated personally and substantially before the Director, the Department, or any State health insurance rate review board in the year immediately preceding the date the person ceases to serve as Consumer Health Insurance Counsel or Assistant Consumer Health Insurance Counsel.

Section 45. Prohibitions against political activities.

(a) No Consumer Health Insurance Counsel or employee of the Office may, during his or her term of appointment or employment:

(1) become a candidate for any elective office;

(2) hold any other elected or appointed public office, except for appointments on governmental advisory boards or study commissions or as otherwise expressly authorized by law;

(3) be actively involved in the affairs of any political party or political organization; or

(4) advocate for the appointment of another person to an appointed or elected office or position or actively participate in any campaign for any elective office.

(b) In this Section, "appointed public office" means a position authorized by law that is filled by an appointing authority as provided by law and does not include employment by hiring in the ordinary course of business.

(c) No Consumer Health Insurance Counsel or employee of the Office may, for one year after the termination of his or her employment:

(1) become a candidate for any elective office;

(2) hold any elected public office; or

(3) hold any appointed State, county, or local judicial office.

(d) The requirements of item (3) of subsection (a) of this Section may be waived by the Executive Ethics Commission.

Section 50. Office personnel. The Office shall be comprised of the Consumer Health Insurance Counsel and such Assistant Consumer Health Insurance Counsels and other staff as are deemed necessary to implement this Act.

Section 55. Powers and duties. The Office:

(1) may assess the impact of insurance rates, rules, and forms on health insurance consumers in this State; and

(2) shall advocate in the Office's own name positions determined by the Consumer Health Insurance Counsel to be most advantageous to a substantial number of insurance consumers.

Section 60. Authority to appear, intervene, or initiate. The Consumer Health Insurance Counsel:

(1) may appear or intervene, as a party or otherwise, as a matter of right before the Director, the Department, or any State health insurance rate review board on behalf of insurance consumers, as a class, in matters involving rates, rules, and forms affecting accident and health insurance policies, managed care plans, and health plans offered by health maintenance organizations;

(2) may initiate or intervene as a matter of right or otherwise appear in a judicial proceeding involving or arising from an action taken by an administrative agency in a proceeding in which the Consumer Health Insurance Counsel previously appeared under the authority granted by this Section; and

(3) may appear or intervene, as a party or otherwise, as a matter of right on behalf of insurance consumers as a class in any proceeding in which the Consumer Health Insurance Counsel determines that insurance consumers are in need of representation, except that he or she may not intervene in an enforcement or parens patriae proceeding brought by the Attorney General.

Section 65. Intervention. The Consumer Health Insurance Counsel may not intervene or appear in:

(1) any proceeding or hearing before the Director or Department, or any other proceeding, that relates to approval or consideration of an individual charter, license, certificate of authority, acquisition, merger, or examination; or

(2) any proceeding concerning the solvency of an individual insurer, a financial issue, a policy form, advertising, or another regulatory issue affecting an individual insurer or agent.

Section 70. Recommendation of legislation. The Consumer Health Insurance Counsel may recommend legislation to the legislature that the Consumer Health Insurance Counsel determines would positively affect the interests of insurance consumers.