Full Text of HB3783 97th General Assembly
HB3783 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 HB3783 Introduced 5/20/2011, by Rep. Frank J. Mautino - Chapin Rose - Naomi D. Jakobsson - Chad Hays, Dwight Kay, et al. SYNOPSIS AS INTRODUCED: |
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5 ILCS 375/5 | from Ch. 127, par. 525 |
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Amends the State Employees Group Insurance Act of 1971. Requires the Director of Central Management Services and the Director of Healthcare and Family Services to renew, through June 30, 2013, Health Maintenance Organization (HMO) and Open Access Plan (OAP) health benefit contracts that were in place on April 1, 2011. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| 1 | | AN ACT concerning State government.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The State Employees Group Insurance Act of 1971 | 5 | | is amended by changing Section 5 as follows:
| 6 | | (5 ILCS 375/5) (from Ch. 127, par. 525)
| 7 | | Sec. 5. Employee benefits; declaration of State policy.
The | 8 | | General Assembly declares that it is the policy of the State | 9 | | and in the best interest of the State to assure quality | 10 | | benefits to members and their dependents under this Act. The | 11 | | implementation of this policy depends upon, among other things, | 12 | | stability and continuity of coverage, care, and services under | 13 | | benefit programs for members and their dependents. | 14 | | Specifically, but without limitation, members should have | 15 | | continued access, on substantially similar terms and | 16 | | conditions, to trusted family health care providers with whom | 17 | | they have developed long-term relationships through a benefit | 18 | | program under this Act. Therefore, the Director must administer | 19 | | this Act consistent with that State policy, but may consider | 20 | | affordability, cost of coverage and care, and competition among | 21 | | health insurers and providers. All contracts for provision of | 22 | | employee benefits, including those portions of any proposed | 23 | | collective bargaining agreement that would require |
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| 1 | | implementation through contracts entered into under this Act, | 2 | | are subject to the following requirements: | 3 | | (i) By April 1 of each year, the Director must report | 4 | | and provide information to the Commission concerning the | 5 | | status of the employee benefits program to be offered for | 6 | | the next fiscal year. Information includes, but is not | 7 | | limited to, documents, reports of negotiations, bid | 8 | | invitations, requests for proposals, specifications, | 9 | | copies of proposed and final contracts or agreements, and | 10 | | any other materials concerning contracts or agreements for | 11 | | the employee benefits program. By the first of each month | 12 | | thereafter, the Director must provide updated, and any new, | 13 | | information to the Commission until the employee benefits | 14 | | program for the next fiscal year is determined. In addition | 15 | | to these monthly reporting requirements, at any time the | 16 | | Commission makes a written request, the Director must | 17 | | promptly, but in no event later than 5 business days after | 18 | | receipt of the request, provide to the Commission any | 19 | | additional requested information in the possession of the | 20 | | Director concerning employee benefits programs. The | 21 | | Commission may waive any of the reporting requirements of | 22 | | this item (i) upon the written request by the Director. Any | 23 | | waiver granted under this item (i) must be in writing. | 24 | | Nothing in this item is intended to abrogate any | 25 | | attorney-client privilege.
| 26 | | (ii) Within 30 days after notice of the awarding or |
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| 1 | | letting of a contract has appeared in the Illinois | 2 | | Procurement Bulletin in accordance with subsection (b) of | 3 | | Section 15-25 of the Illinois Procurement Code, the | 4 | | Commission may request in writing from the Director and the | 5 | | Director shall promptly, but in no event later than 5 | 6 | | business days after receipt of the request, provide to the | 7 | | Commission information in the possession of the Director | 8 | | concerning the proposed contract. Nothing in this item is | 9 | | intended to waive or abrogate any privilege or right of | 10 | | confidentiality authorized by law. | 11 | | (iii) No contract subject to this Section may be | 12 | | entered into until the 30-day period described in item (ii) | 13 | | has expired, unless the Director requests in writing that | 14 | | the Commission waive the period and the Commission grants | 15 | | the waiver in writing. | 16 | | (iv) If the Director seeks to make any substantive | 17 | | modification to any provision of a proposed contract after | 18 | | it is submitted to the Commission in accordance with item | 19 | | (ii), the modified contract shall be subject to the | 20 | | requirements of items (ii) and (iii) unless the Commission | 21 | | agrees, in writing, to a waiver of those requirements with | 22 | | respect to the modified contract.
| 23 | | (v) By the date of the beginning of the annual benefit | 24 | | choice period, the Director must transmit to the Commission | 25 | | a copy of each final contract or agreement for the employee | 26 | | benefits program to be offered for the next fiscal year. |
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| 1 | | The annual benefit choice period for an employee benefits | 2 | | program must begin on May 1 of the fiscal year preceding | 3 | | the year for which the program is to be offered. If, | 4 | | however, in any such preceding fiscal year collective | 5 | | bargaining over employee benefit programs for the next | 6 | | fiscal year remains pending on April 15, the beginning date | 7 | | of the annual benefit choice period shall be not later than | 8 | | 15 days after ratification of the collective bargaining | 9 | | agreement.
| 10 | | (vi) The Director must provide the reports, | 11 | | information, and contracts required under items (i), (ii), | 12 | | (iv), and (v) by electronic or other means satisfactory to | 13 | | the Commission. Reports, information, and contracts in the | 14 | | possession of the Commission pursuant to items (i), (ii), | 15 | | (iv), and (v) are exempt from disclosure by the Commission | 16 | | and its members and employees under the Freedom of | 17 | | Information Act. Reports, information, and contracts | 18 | | received by the Commission pursuant to items (i), (ii), | 19 | | (iv), and (v) must be kept confidential by and may not be | 20 | | disclosed or used by the Commission or its members or | 21 | | employees if such disclosure or use could compromise the | 22 | | fairness or integrity of the procurement, bidding, or | 23 | | contract process. Commission meetings, or portions of | 24 | | Commission meetings, in which reports, information, and | 25 | | contracts received by the Commission pursuant to items (i), | 26 | | (ii), (iv), and (v) are discussed must be closed if |
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| 1 | | disclosure or use of the report or information could | 2 | | compromise the fairness or integrity of the procurement, | 3 | | bidding, or contract process.
| 4 | | All contracts entered into under this Section are subject | 5 | | to appropriation and shall comply with Section 20-60(b) of the | 6 | | Illinois Procurement Code (30 ILCS 500/20-60(b)).
| 7 | | The Director shall contract or otherwise make available | 8 | | group
life insurance, health benefits and other
employee | 9 | | benefits to eligible members and, where elected,
their eligible | 10 | | dependents. Any contract or, if
applicable, contracts or other | 11 | | arrangement for provision of benefits
shall be on terms | 12 | | consistent with State policy and
based on, but not limited to, | 13 | | such
criteria as administrative cost, service capabilities of | 14 | | the carrier
or other contractor and premiums, fees or charges | 15 | | as related to benefits.
| 16 | | The Director may prepare and issue specifications
for group | 17 | | life insurance, health benefits, other employee benefits
and | 18 | | administrative services for the purpose of receiving proposals
| 19 | | from interested parties.
| 20 | | The Director is authorized to execute a contract, or
| 21 | | contracts, for the programs of group life insurance, health
| 22 | | benefits, other employee benefits and administrative services
| 23 | | authorized by this Act (including, without limitation, | 24 | | prescription drug benefits). All of the benefits provided under | 25 | | this Act may be
included in one or more contracts, or the | 26 | | benefits may be classified into
different types with each type |
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| 1 | | included under one or more similar contracts
with the same or | 2 | | different companies.
| 3 | | The term of any contract may not extend beyond 5 fiscal | 4 | | years.
Upon recommendation of the Commission, the Director may | 5 | | exercise renewal
options of the same contract for up to a | 6 | | period of 5 years. Notwithstanding the contract duration | 7 | | limitations contained in this Section, or in the Illinois | 8 | | Procurement Code, or any other statutory provision or | 9 | | administrative rule, the Director of Central Management | 10 | | Services and the Director of Healthcare and Family Services | 11 | | shall renew, through June 30, 2013, Health Maintenance | 12 | | Organization (HMO) and Open Access Plan (OAP) health benefit | 13 | | contracts that were in place on April 1, 2011. Any
increases in | 14 | | premiums, fees or charges requested by a contractor whose
| 15 | | contract may be renewed pursuant to a renewal option contained | 16 | | therein,
must be justified on the basis of (1) audited | 17 | | experience data, (2)
increases in the costs of health care | 18 | | services provided under the contract,
(3) contractor | 19 | | performance, (4) increases in contractor responsibilities,
or | 20 | | (5) any combination thereof.
| 21 | | Any contractor shall agree to abide by all
requirements of | 22 | | this Act and Rules and Regulations promulgated and adopted
| 23 | | thereto; to submit such information and data as may from time | 24 | | to time be
deemed necessary by the Director for effective | 25 | | administration of the
provisions of this Act and the programs | 26 | | established
hereunder, and to fully cooperate in any audit.
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| 1 | | (Source: P.A. 93-839, eff. 7-30-04.)
| 2 | | Section 99. Effective date. This Act takes effect upon | 3 | | becoming law.
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