Full Text of HB1287 99th General Assembly
HB1287eng 99TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning employment.
| 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly:
| 4 | | Section 2. The Illinois Insurance Code is amended by | 5 | | changing Sections 456, 457, and 458 and by adding Section 462a | 6 | | as follows:
| 7 | | (215 ILCS 5/456) (from Ch. 73, par. 1065.3)
| 8 | | Sec. 456. Making of rates. (1) All rates shall be made in | 9 | | accordance with the following provisions:
| 10 | | (a) Due consideration shall be given to past and | 11 | | prospective loss
experience within and outside this state, to | 12 | | catastrophe hazards, if
any, to a reasonable margin for profit | 13 | | and contingencies,
to dividends, savings or unabsorbed premium | 14 | | deposits allowed or returned
by companies to their | 15 | | policyholders, members or subscribers, to past and
prospective | 16 | | expenses both countrywide and those specially applicable to
| 17 | | this state, to underwriting practice and judgment and to all | 18 | | other
relevant factors within and outside this state;
| 19 | | (b) The systems of expense provisions included in the rates | 20 | | for use
by any company or group of companies may differ from | 21 | | those of other
companies or groups of companies to reflect the | 22 | | requirements of the
operating methods of any such company or | 23 | | group with respect to any kind
of insurance, or with respect to |
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| 1 | | any subdivision or combination thereof
for which subdivision or | 2 | | combination separate expense provisions are
applicable;
| 3 | | (c) Risks may be grouped by classifications for the | 4 | | establishment of
rates and minimum premiums. Classification | 5 | | rates may be modified to
produce rates for individual risks in | 6 | | accordance with rating plans which
measure variation in hazards | 7 | | or expense provisions, or both. Such rating
plans may measure | 8 | | any differences among risks that have a probable
effect upon | 9 | | losses or expenses;
| 10 | | (d) Rates shall not be excessive, inadequate or unfairly
| 11 | | discriminatory.
| 12 | | A rate in a competitive market is not excessive. A rate in | 13 | | a noncompetitive
market is excessive if it is likely to produce | 14 | | a long run profit that is
unreasonably high for the insurance | 15 | | provided or if expenses are unreasonably
high in relation to | 16 | | the services rendered.
| 17 | | A rate is not inadequate unless such rate is clearly | 18 | | insufficient to sustain
projected losses and expenses in the | 19 | | class of business to which it applies
and the use of such rate | 20 | | has or, if continued, will have the effect of substantially
| 21 | | lessening competition or the tendency to create monopoly in any | 22 | | market.
| 23 | | Unfair discrimination exists if, after allowing for | 24 | | practical limitations,
price differentials fail to reflect | 25 | | equitably the differences in expected
losses and expenses. A | 26 | | rate is not unfairly discriminatory because different
premiums |
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| 1 | | result for policyholders with like exposures but different | 2 | | expenses,
or like expenses but different loss exposures, so | 3 | | long as the rate reflects
the differences with reasonable | 4 | | accuracy.
| 5 | | (e) The rating plan shall contain a mandatory offer of a | 6 | | deductible applicable
only to the medical benefit under the | 7 | | Workers' Compensation Act.
Such deductible offer shall be in a | 8 | | minimum amount of at least $1,000 per accident.
| 9 | | (f) Any rating plan or program shall include a rule | 10 | | permitting 2 or more
employers with similar risk | 11 | | characteristics, who participate in a loss prevention
program | 12 | | or safety group, to pool their premium and loss experience in | 13 | | determining
their rate or premium for such participation in the | 14 | | program.
| 15 | | (2) Except to the extent necessary to meet the provisions | 16 | | of
subdivision (d) of subsection (1) of this Section, | 17 | | uniformity among
companies in any matters within the scope of | 18 | | this Section is neither
required nor prohibited.
| 19 | | (Source: P.A. 82-939.)
| 20 | | (215 ILCS 5/457) (from Ch. 73, par. 1065.4)
| 21 | | Sec. 457. Rate filings. (1) Every Beginning January 1, | 22 | | 1983, every company
shall prefile file with the Director every | 23 | | manual of classifications, every manual
of rules and rates, | 24 | | every rating plan and every modification of the foregoing
which | 25 | | it intends to use. Such filings shall be made at least not |
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| 1 | | later than 30 days before
after they become effective.
A | 2 | | company may satisfy its obligation to make such filings by | 3 | | adopting the
filing of a licensed rating organization of which | 4 | | it is a member or subscriber,
filed pursuant to subsection (2) | 5 | | of this Section, in total or , with the approval of the | 6 | | Director, by notifying
the Director in what respects it intends | 7 | | to deviate from such filing. If a company intends to deviate | 8 | | from the filing of a licensed rating organization of which it | 9 | | is a member, the company shall provide the Director with | 10 | | supporting information that specifies the basis for the | 11 | | requested deviation and provides justification for the | 12 | | deviation. Any
company adopting a pure premium filed by a | 13 | | rating organization pursuant to subsection
(2) must file with | 14 | | the Director the modification factor it is using for
expenses | 15 | | and profit so that the final rates in use by such company can | 16 | | be determined.
| 17 | | (2) Each Beginning January 1, 1983, each licensed rating | 18 | | organization must prefile
file with the Director every manual | 19 | | of classification, every manual of rules
and advisory rates, | 20 | | every pure premium which has been fully adjusted and
fully | 21 | | developed, every rating plan and every modification of any of | 22 | | the
foregoing which it intends to recommend for use to its | 23 | | members and subscribers,
at least not later than 30 days before | 24 | | after such manual, premium, plan or modification
thereof takes | 25 | | effect. Every licensed rating organization shall also file
with | 26 | | the Director the rate classification system, all rating rules, |
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| 1 | | rating
plans, policy forms, underwriting rules or similar | 2 | | materials, and each modification
of any of the foregoing which | 3 | | it requires its members and subscribers to
adhere to not later | 4 | | than 30 days before such filings or modifications thereof
are | 5 | | to take effect. Every such filing shall state the proposed | 6 | | effective
date thereof and shall indicate the character and | 7 | | extent of the coverage contemplated.
| 8 | | (3) A filing and any supporting information made pursuant | 9 | | to this Section
shall be open to public inspection as soon as | 10 | | filed after the filing becomes effective .
| 11 | | (4) A filing shall not be effective nor used until approved | 12 | | by the Director. A filing shall be deemed approved if the | 13 | | Director fails to disapprove within 30 days after the filing. | 14 | | (Source: P.A. 82-939.)
| 15 | | (215 ILCS 5/458) (from Ch. 73, par. 1065.5)
| 16 | | Sec. 458. Disapproval of filings. (1) If within 30 thirty | 17 | | days of any filing the Director
finds that such filing does not | 18 | | meet the requirements of this Article, he
shall send to the | 19 | | company or rating organization which made such filing a
written | 20 | | notice of disapproval of such filing, specifying therein in | 21 | | what
respects he finds that such filing fails to meet the | 22 | | requirements of this
Article and stating when, within a | 23 | | reasonable period thereafter, such
filing shall be deemed no | 24 | | longer effective . A company or rating organization whose filing | 25 | | has been disapproved shall be given a hearing upon a written |
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| 1 | | request made within 30 days after the disapproval order. If the | 2 | | company or rating
organization making the filing shall, prior | 3 | | to the expiration of the period
prescribed in the notice, | 4 | | request a hearing, such filings shall be
effective until the | 5 | | expiration of a reasonable period specified in any
order | 6 | | entered thereon. If the rate resulting from such filing be | 7 | | unfairly
discriminatory or materially inadequate, and the | 8 | | difference
between such rate and the approved rate equals or | 9 | | exceeds the cost of
making an adjustment, the Director shall in | 10 | | such notice or order direct an
adjustment of the premium to be | 11 | | made with the policyholder either by refund
or collection of | 12 | | additional premium. If the policyholder does not accept
the | 13 | | increased rate, cancellation shall be made on a pro rata basis. | 14 | | Any
policy issued pursuant to this subsection shall contain a | 15 | | provision that
the premium thereon shall be subject to | 16 | | adjustment upon the basis of the
filing finally approved.
| 17 | | (2) If at any time subsequent to the applicable review | 18 | | period provided
for in subsection (1) of this Section, the | 19 | | Director finds that a
filing does not meet the requirements of | 20 | | this Article, he shall, after a
hearing held upon not less than | 21 | | ten days written notice, specifying the
matters to be | 22 | | considered at such hearing, to every company and rating
| 23 | | organization which made such filing, issue an order specifying | 24 | | in what
respects he finds that such filing fails to meet the | 25 | | requirements of this
Article, and stating when, within a | 26 | | reasonable period thereafter, such
filings shall be deemed no |
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| 1 | | longer effective. Copies of said order shall be
sent to every | 2 | | such company and rating organization. Said order shall not
| 3 | | affect any contract or policy made or issued prior to the | 4 | | expiration of the
period set forth in said order.
| 5 | | (3) Any person or organization aggrieved with respect to | 6 | | any filing
which is in effect may make written application to | 7 | | the Director for a
hearing thereon, provided, however, that the | 8 | | company or rating organization
that made the filing shall not | 9 | | be authorized to proceed under this
subsection. Such | 10 | | application shall specify the grounds to be relied upon by
the | 11 | | applicant. If the Director shall find that the application is | 12 | | made in
good faith, that the applicant would be so aggrieved if | 13 | | his grounds are
established, and that such grounds otherwise | 14 | | justify holding such a
hearing, he shall, within thirty days | 15 | | after receipt of such application,
hold a hearing upon not less | 16 | | than ten days written notice to the applicant
and to every | 17 | | company and rating organization which made such filing.
| 18 | | If, after such hearing, the Director finds that the filing | 19 | | does not meet
the requirements of this Article, he shall issue | 20 | | an order specifying in
what respects he finds that such filing | 21 | | fails to meet the requirements of
this Article, and stating | 22 | | when, within a reasonable period thereafter, such
filing shall | 23 | | be deemed no longer effective. Copies of said order shall be
| 24 | | sent to the applicant and to every such company and rating | 25 | | organization.
Said order shall not affect any contract or | 26 | | policy made or issued prior to
the expiration of the period set |
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| 1 | | forth in said order.
| 2 | | (4) Whenever an insurer has no legally effective rates as a | 3 | | result of the Director's disapproval of rates or other act, the | 4 | | Director shall on request of the insurer specify interim rates | 5 | | for the insurer that are high enough to protect the interests | 6 | | of all parties and may order that a specified portion of the | 7 | | premiums be placed in an escrow account approved by him or her. | 8 | | When new rates become legally effective, the Director shall | 9 | | order the escrowed funds or any overcharge in the interim rates | 10 | | to be distributed appropriately, except that refunds to | 11 | | policyholders that are de minimus shall not be required. | 12 | | (Source: P.A. 82-939.)
| 13 | | (215 ILCS 5/462a new) | 14 | | Sec. 462a. Premiums; review. | 15 | | (a) Premiums shall not be excessive. A premium is excessive | 16 | | if it is likely to produce a long run profit that is | 17 | | unreasonably high for the insurance provided or if expenses are | 18 | | unreasonably high in relation to the coverage or services | 19 | | rendered. | 20 | | (b) At any time, an insured may file a request for review | 21 | | of a premium with the Director. The request shall be in such | 22 | | form as the Director prescribes and shall specify the grounds | 23 | | on which the premium is excessive. | 24 | | If within 30 days of any proper request for review under | 25 | | this Section, the Director finds that the premium does not meet |
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| 1 | | the requirements of this Section, he or she shall send to the | 2 | | insurer a written notice of disapproval of premium, specifying | 3 | | therein in what respects he or she finds that the premium fails | 4 | | to meet the requirements of this Section, stating when, within | 5 | | a reasonable period thereafter, the premium shall be deemed no | 6 | | longer effective, and ordering an adjustment of the premium. An | 7 | | insurer whose premium has been disapproved shall be given a | 8 | | hearing upon a written request made within 30 days after the | 9 | | disapproval order. If the insurer requests a hearing, the | 10 | | premium shall be effective until the expiration of a reasonable | 11 | | period specified in any order entered thereon. If, after a | 12 | | hearing, the premium is found to be excessive, the Director | 13 | | shall order an adjustment of the premium. The insurer shall | 14 | | refund to the insured any amount found to be excessive under | 15 | | this Section. | 16 | | If the Director finds that a review is not warranted or a | 17 | | premium is not excessive, he or she shall provide notice of | 18 | | that decision to the insured and the insurer. | 19 | | (c) An insurer shall provide all information requested by | 20 | | the Director as he or she determines necessary to assist in | 21 | | review of premiums under this Section.
| 22 | | (215 ILCS 5/460 rep.)
| 23 | | Section 3. The Illinois Insurance Code is amended by | 24 | | repealing Section 460.
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| 1 | | Section 4. The Workers' Compensation Act is amended by | 2 | | adding Section 4e as follows: | 3 | | (820 ILCS 305/4e new) | 4 | | Sec. 4e. Safety programs and return to work programs; | 5 | | recalculation of premiums and waiver of self-insurers fee. | 6 | | (a) An employer may file with the Commission a workers' | 7 | | compensation safety program or a workers' compensation return | 8 | | to work program implemented by the employer. The Commission may | 9 | | certify any such safety program as a bona fide safety program | 10 | | after reviewing the program for the following minimum | 11 | | requirements: adequate safety training for employees; | 12 | | establishment of joint employer-employee safety committees; | 13 | | use of safety devices; and consultation with safety | 14 | | organizations. The Commission may certify any such return to | 15 | | work program as a bona fide return to work program after | 16 | | reviewing the program for the following minimum requirements: | 17 | | light duty or restricted duty work; leave of absence policy; | 18 | | and full duty return to work policy. The Commission shall | 19 | | notify the Department of Insurance of the certification. | 20 | | (b) Upon receipt of a certification notice from the | 21 | | Commission under this Section related to an employer that | 22 | | provides workers' compensation through an insurer, the | 23 | | Director of Insurance shall immediately direct in writing the | 24 | | employer's workers' compensation insurer to recalculate the | 25 | | workers' compensation premium rates for the employer so that |
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| 1 | | those premium rates incorporate and take into account the | 2 | | certified program. | 3 | | (c) If any workers' compensation safety program or a | 4 | | workers' compensation return to work program implemented by a | 5 | | self-insured employer is certified under this Section, the | 6 | | annual fee under Section 4d of this Act is waived for the | 7 | | self-insured employer as long as the workers' compensation | 8 | | safety program or a workers' compensation return to work | 9 | | program continues. The self-insured employer shall certify the | 10 | | continuation of the program by each July 1 after the waiver is | 11 | | obtained. | 12 | | Section 5. The Prevailing Wage Act is amended by changing | 13 | | Section 6 as follows:
| 14 | | (820 ILCS 130/6) (from Ch. 48, par. 39s-6)
| 15 | | Sec. 6. Any officer, agent or representative of any public | 16 | | body who
wilfully violates, or willfully fails to comply with, | 17 | | any of the
the provisions of
this Act, and any contractor or | 18 | | subcontractor, and any officer, employee, or agent thereof, who | 19 | | as such officer, employee, or agent, has a duty to create, | 20 | | keep, maintain, or produce any record or document required by | 21 | | this Act to be created, kept, maintained, or produced who | 22 | | willfully fails to create, keep, maintain, or produce such | 23 | | record or document as or when required by this Act, is guilty | 24 | | of a Class A misdemeanor. |
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| 1 | | The Department of Labor shall inquire diligently as to any | 2 | | violation
of this Act, shall institute actions for penalties | 3 | | herein prescribed,
and shall enforce generally the provisions | 4 | | of this Act. The Attorney
General shall prosecute such cases | 5 | | upon complaint by the Department or
any interested person.
| 6 | | (Source: P.A. 97-571, eff. 1-1-12.)
| 7 | | Section 6. The Workers' Compensation Act is amended by | 8 | | changing Section 1 as follows:
| 9 | | (820 ILCS 305/1) (from Ch. 48, par. 138.1)
| 10 | | Sec. 1. This Act may be cited as the Workers' Compensation | 11 | | Act.
| 12 | | (a) The term "employer" as used in this Act means:
| 13 | | 1. The State and each county, city, town, township, | 14 | | incorporated
village, school district, body politic, or | 15 | | municipal corporation
therein.
| 16 | | 2. Every person, firm, public or private corporation, | 17 | | including
hospitals, public service, eleemosynary, religious | 18 | | or charitable
corporations or associations who has any person | 19 | | in service or under any
contract for hire, express or implied, | 20 | | oral or written, and who is
engaged in any of the enterprises | 21 | | or businesses enumerated in Section 3
of this Act, or who at or | 22 | | prior to the time of the accident to the
employee for which | 23 | | compensation under this Act may be claimed, has in
the manner | 24 | | provided in this Act elected to become subject to the
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| 1 | | provisions of this Act, and who has not, prior to such | 2 | | accident,
effected a withdrawal of such election in the manner | 3 | | provided in this Act.
| 4 | | 3. Any one engaging in any business or enterprise referred | 5 | | to in
subsections 1 and 2 of Section 3 of this Act who | 6 | | undertakes to do any
work enumerated therein, is liable to pay | 7 | | compensation to his own
immediate employees in accordance with | 8 | | the provisions of this Act, and
in addition thereto if he | 9 | | directly or indirectly engages any contractor
whether | 10 | | principal or sub-contractor to do any such work, he is liable | 11 | | to
pay compensation to the employees of any such contractor or
| 12 | | sub-contractor unless such contractor or sub-contractor has | 13 | | insured, in
any company or association authorized under the | 14 | | laws of this State to
insure the liability to pay compensation | 15 | | under this Act, or guaranteed
his liability to pay such | 16 | | compensation. With respect to any time
limitation on the filing | 17 | | of claims provided by this Act, the timely
filing of a claim | 18 | | against a contractor or subcontractor, as the case may
be, | 19 | | shall be deemed to be a timely filing with respect to all | 20 | | persons
upon whom liability is imposed by this paragraph.
| 21 | | In the event any such person pays compensation under this | 22 | | subsection
he may recover the amount thereof from the | 23 | | contractor or sub-contractor,
if any, and in the event the | 24 | | contractor pays compensation under this
subsection he may | 25 | | recover the amount thereof from the sub-contractor, if any.
| 26 | | This subsection does not apply in any case where the |
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| 1 | | accident occurs
elsewhere than on, in or about the immediate | 2 | | premises on which the
principal has contracted that the work be | 3 | | done.
| 4 | | 4. Where an employer operating under and subject to the | 5 | | provisions
of this Act loans an employee to another such | 6 | | employer and such loaned
employee sustains a compensable | 7 | | accidental injury in the employment of
such borrowing employer | 8 | | and where such borrowing employer does not
provide or pay the | 9 | | benefits or payments due such injured employee, such
loaning | 10 | | employer is liable to provide or pay all benefits or payments
| 11 | | due such employee under this Act and as to such employee the | 12 | | liability
of such loaning and borrowing employers is joint and | 13 | | several, provided
that such loaning employer is in the absence | 14 | | of agreement to the
contrary entitled to receive from such | 15 | | borrowing employer full
reimbursement for all sums paid or | 16 | | incurred pursuant to this paragraph
together with reasonable | 17 | | attorneys' fees and expenses in any hearings
before the | 18 | | Illinois Workers' Compensation Commission or in any action to | 19 | | secure such
reimbursement. Where any benefit is provided or | 20 | | paid by such loaning
employer the employee has the duty of | 21 | | rendering reasonable cooperation
in any hearings, trials or | 22 | | proceedings in the case, including such
proceedings for | 23 | | reimbursement.
| 24 | | Where an employee files an Application for Adjustment of | 25 | | Claim with
the Illinois Workers' Compensation
Commission | 26 | | alleging that his claim is covered by the
provisions of the |
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| 1 | | preceding paragraph, and joining both the alleged
loaning and | 2 | | borrowing employers, they and each of them, upon written
demand | 3 | | by the employee and within 7 days after receipt of such demand,
| 4 | | shall have the duty of filing with the Illinois Workers' | 5 | | Compensation Commission a written
admission or denial of the | 6 | | allegation that the claim is covered by the
provisions of the | 7 | | preceding paragraph and in default of such filing or
if any | 8 | | such denial be ultimately determined not to have been bona fide
| 9 | | then the provisions of Paragraph K of Section 19 of this Act | 10 | | shall apply.
| 11 | | An employer whose business or enterprise or a substantial | 12 | | part
thereof consists of hiring, procuring or furnishing | 13 | | employees to or for
other employers operating under and subject | 14 | | to the provisions of this
Act for the performance of the work | 15 | | of such other employers and who pays
such employees their | 16 | | salary or wages notwithstanding that they are doing
the work of | 17 | | such other employers shall be deemed a loaning employer
within | 18 | | the meaning and provisions of this Section.
| 19 | | (b) The term "employee" as used in this Act means:
| 20 | | 1. Every person in the service of the State, including | 21 | | members of
the General Assembly, members of the Commerce | 22 | | Commission, members of the
Illinois Workers' Compensation | 23 | | Commission, and all persons in the service of the University
of | 24 | | Illinois, county, including deputy sheriffs and assistant | 25 | | state's
attorneys, city, town, township, incorporated village | 26 | | or school
district, body politic, or municipal corporation |
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| 1 | | therein, whether by
election, under appointment or contract of | 2 | | hire, express or implied,
oral or written, including all | 3 | | members of the Illinois National Guard
while on active duty in | 4 | | the service of the State, and all probation
personnel of the | 5 | | Juvenile Court appointed pursuant to Article VI
of the Juvenile | 6 | | Court Act of 1987, and including any official of the
State, any | 7 | | county, city, town, township, incorporated village, school
| 8 | | district, body politic or municipal corporation therein except | 9 | | any duly
appointed member of a police department in any city | 10 | | whose
population exceeds 500,000 according to the last Federal | 11 | | or State
census, and except any member of a fire insurance | 12 | | patrol maintained by a
board of underwriters in this State. A | 13 | | duly appointed member of a fire
department in any city, the | 14 | | population of which exceeds 500,000 according
to the last | 15 | | federal or State census, is an employee under this Act only
| 16 | | with respect to claims brought under paragraph (c) of Section | 17 | | 8.
| 18 | | One employed by a contractor who has contracted with the | 19 | | State, or a
county, city, town, township, incorporated village, | 20 | | school district,
body politic or municipal corporation | 21 | | therein, through its
representatives, is not considered as an | 22 | | employee of the State, county,
city, town, township, | 23 | | incorporated village, school district, body
politic or | 24 | | municipal corporation which made the contract.
| 25 | | 2. Every person in the service of another under any | 26 | | contract of
hire, express or implied, oral or written, |
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| 1 | | including persons whose
employment is outside of the State of | 2 | | Illinois where the contract of
hire is made within the State of | 3 | | Illinois, persons whose employment
results in fatal or | 4 | | non-fatal injuries within the State of Illinois
where the | 5 | | contract of hire is made outside of the State of Illinois, and
| 6 | | persons whose employment is principally localized within the | 7 | | State of
Illinois, regardless of the place of the accident or | 8 | | the place where the
contract of hire was made, and including | 9 | | aliens, and minors who, for the
purpose of this Act are | 10 | | considered the same and have the same power to
contract, | 11 | | receive payments and give quittances therefor, as adult | 12 | | employees.
| 13 | | 3. Every sole proprietor and every partner of a business | 14 | | may elect to
be covered by this Act.
| 15 | | An employee or his dependents under this Act who shall have | 16 | | a cause
of action by reason of any injury, disablement or death | 17 | | arising out of
and in the course of his employment may elect to | 18 | | pursue his remedy in
the State where injured or disabled, or in | 19 | | the State where the contract
of hire is made, or in the State | 20 | | where the employment is principally
localized.
| 21 | | However, any employer may elect to provide and pay | 22 | | compensation to
any employee other than those engaged in the | 23 | | usual course of the trade,
business, profession or occupation | 24 | | of the employer by complying with
Sections 2 and 4 of this Act. | 25 | | Employees are not included within the
provisions of this Act | 26 | | when excluded by the laws of the United States
relating to |
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| 1 | | liability of employers to their employees for personal
injuries | 2 | | where such laws are held to be exclusive.
| 3 | | The term "employee" does not include persons performing | 4 | | services as real
estate broker, broker-salesman, or salesman | 5 | | when such persons are paid by
commission only.
| 6 | | (c) "Commission" means the Industrial Commission created | 7 | | by Section
5 of "The Civil Administrative Code of Illinois", | 8 | | approved March 7,
1917, as amended, or the Illinois Workers' | 9 | | Compensation Commission created by Section 13 of
this Act.
| 10 | | (d) To obtain compensation under this Act, an employee | 11 | | bears the burden of showing, by a preponderance of the | 12 | | evidence, that he or she has sustained accidental injuries | 13 | | arising out of and in the course of the employment. Except as | 14 | | provided in subsection (e) of this Section, accidental injuries | 15 | | sustained while traveling to or from work do not arise out of | 16 | | and in the course of employment. | 17 | | For the purposes of this subsection (d): | 18 | | "In the course of employment" refers to the time, place, | 19 | | and circumstances surrounding the accidental injuries. | 20 | | "Arising out of the employment" refers to causal | 21 | | connection. It must be shown that the injury had its origin in | 22 | | some risk connected with, or incidental to, the employment so | 23 | | as to create a causal connection between the employment and the | 24 | | accidental injuries. An injury arises out of the employment if, | 25 | | at the time of the occurrence, the employee was performing acts | 26 | | he or she was instructed to perform by his or her employer, |
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| 1 | | acts which he or she had a common law or statutory duty to | 2 | | perform, or acts which the employee might reasonably be | 3 | | expected to perform incident to his or her assigned duties. A | 4 | | risk is incidental to the employment where it belongs to or is | 5 | | connected with what an employee has to do in fulfilling his or | 6 | | her duties. | 7 | | (e) Where an employee is required to travel away from his | 8 | | or her employer's premises in order to perform his or her job, | 9 | | the traveling employee's accidental injuries arise out of his | 10 | | or her employment, and are in the course of his or her | 11 | | employment, when the conduct in which he or she was engaged at | 12 | | the time of the injury is reasonable and when that conduct | 13 | | might have been anticipated or foreseen by the employer. | 14 | | Accidental injuries while traveling do not occur in the course | 15 | | of employment if the accident occurs during a purely personal | 16 | | deviation or personal errand unless such deviation or errand is | 17 | | insubstantial. | 18 | | (Source: P.A. 97-18, eff. 6-28-11; 97-268, eff. 8-8-11; 97-813, | 19 | | eff. 7-13-12.)
| 20 | | Section 7. The Workers' Compensation Act is amended by | 21 | | adding Section 35 as follows: | 22 | | (820 ILCS 305/35 new) | 23 | | Sec. 35. Repetitive and cumulative injuries; right of | 24 | | contribution. |
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| 1 | | (a) Any accidental injury which results from repetitive or | 2 | | cumulative trauma and occurs within 3 months after the employee | 3 | | begins his or her employment shall not be considered by a | 4 | | workers' compensation insurer in setting the premium rate for | 5 | | the employer. | 6 | | (b) If an award is made for benefits in connection with | 7 | | repetitive or cumulative injury resulting from employment with | 8 | | more than one employer, the employer liable for award or its | 9 | | insurer is entitled to contributions or reimbursement from each | 10 | | of the employee's prior employers which are subject to this Act | 11 | | or their insurers for the prior employer's pro rata share of | 12 | | responsibility as determined by the Commission. The right to | 13 | | contribution or reimbursement under this Section shall not | 14 | | delay, diminish, restrict, or alter in any way the benefits to | 15 | | which the employee or his or her dependents are entitled under | 16 | | this Act.
At any time within one year after the Commission or | 17 | | the Arbitrator has made an award for benefits in connection | 18 | | with repetitive or cumulative injury, the employer liable under | 19 | | the award or its insurer may institute proceedings before the | 20 | | Commission for the purpose of determining the right of | 21 | | contribution or reimbursement. The proceeding shall not delay, | 22 | | diminish, restrict, or alter in any way the benefits to which | 23 | | the employee or his or her dependents are entitled under this | 24 | | Act, but shall be limited to a determination of the respective | 25 | | contribution or reimbursement rights and the responsibilities | 26 | | of all the employers joined in the proceeding. The employee has |
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| 1 | | the duty of rendering reasonable cooperation in any such | 2 | | proceeding. | 3 | | (c) No contribution or reimbursement may be sought for any | 4 | | payment of benefits more than 2 years after the employer | 5 | | seeking contribution or reimbursement has made the payment. | 6 | | (d) This Section shall apply only to injuries occurring on | 7 | | or after the effective date of this amendatory Act of the 99th | 8 | | General Assembly. | 9 | | (e) The Commission shall adopt emergency rules under | 10 | | Section 5-45 of the Illinois Administrative Procedure Act to | 11 | | implement the provisions of this Section to implement this | 12 | | Section. | 13 | | Section 8. The Workers' Compensation Act is amended by | 14 | | changing Section 29.2 and by adding Section 29.3 as follows: | 15 | | (820 ILCS 305/29.2) | 16 | | Sec. 29.2. Insurance and self-insurance oversight. | 17 | | (a) The Department of Insurance shall annually submit to | 18 | | the Governor, the Chairman of the Commission, the President of | 19 | | the Senate, the Speaker of the House of Representatives, the | 20 | | Minority Leader of the Senate, and the Minority Leader of the | 21 | | House of Representatives a written report that details the | 22 | | state of the workers' compensation insurance market in | 23 | | Illinois. The report shall be completed by April 1 of each | 24 | | 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.
| 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; (iii) a statewide association representing | 14 | | labor interests; and (iv) 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. |
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| 1 | | (c) The Task Force shall report its findings and | 2 | | recommendations to the General Assembly no later than December | 3 | | 31, 2015. | 4 | | (d) This Section is repealed on December 31, 2016. |
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