Illinois Compiled Statutes
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5 ILCS 375/13.1
(5 ILCS 375/13.1)
(from Ch. 127, par. 533.1)
(a) All contributions, appropriations, interest, and dividend
payments to fund the program of health benefits and other employee benefits, and all other revenues arising from the administration of any employee health benefits program,
shall be deposited in a trust fund outside the State Treasury, with the State
Treasurer as ex-officio custodian, to be known as the Health Insurance Reserve
(b) Upon the adoption of a self-insurance health plan, any monies
attributable to the group health insurance program shall be deposited in or
transferred to the Health Insurance Reserve Fund for use by the Department.
As of the effective date of this amendatory Act of 1986, the Department
shall certify to the Comptroller the amount of money in the Group Insurance
Premium Fund attributable to the State group health insurance program and the
Comptroller shall transfer such money from the Group Insurance Premium Fund
to the Health Insurance Reserve Fund. Contributions by the State to the
Health Insurance Reserve Fund to meet the requirements of this Act, as
established by the Director, from the General Revenue Fund and the Road
Fund to the Health Insurance Reserve Fund shall be by annual
appropriations, and all other contributions to meet the requirements of the
programs of health benefits or other employee benefits shall be deposited
in the Health Insurance Reserve Fund. The Department shall draw the
appropriation from the General Revenue Fund and the Road Fund from time to
time as necessary to make expenditures authorized under this Act.
The Director may employ such assistance and services and may purchase
such goods as may be necessary for the proper development and
administration of any of the benefit programs authorized by this Act. The
Director may promulgate rules and regulations in regard to the
administration of these programs.
All monies received by the Department for deposit in or transfer to the
Health Insurance Reserve Fund, through appropriation or otherwise, shall be
used to provide for the making of payments to claimants and providers and
to reimburse the Department for all expenses directly incurred relating to
Department development and administration of the program of health benefits
and other employee benefits.
Any administrative service organization administering any self-insurance
health plan and paying claims and benefits under authority of this Act may
receive, pursuant to written authorization and direction of the Director,
an initial transfer and periodic transfers of funds from the Health
Insurance Reserve Fund in amounts determined by the Director who may
consider the amount recommended by the administrative service organization.
Notwithstanding any other statute, such transferred funds shall be
retained by the administrative service organization in a separate
account provided by any bank as defined by the Illinois Banking
Act. The Department may promulgate regulations further defining the banks
authorized to accept such funds and all methodology for transfer of such
funds. Any interest earned by monies in such
account shall inure to the Health Insurance Reserve Fund, shall remain
in such account and shall be used exclusively to pay claims and benefits
under this Act. Such transferred funds shall be used exclusively for
administrative service organization payment of claims to claimants and
providers under the self-insurance health plan by the drawing of checks
against such account. The administrative service organization may not use
such transferred funds, or interest accrued thereon, for any other purpose
including, but not limited to, reimbursement of administrative expenses or
payments of administration fees due the organization pursuant to its
contract or contracts with the Department of Central Management Services.
The account of the administrative service organization established under
this Section, any transfers from the Health Insurance Reserve Fund to
such account and the use of such account and funds shall be subject
to (1) audit by the Department or private contractor authorized by the
Department to conduct audits, and (2) post audit pursuant to the
Illinois State Auditing Act.
The Department of Central Management Services, or any successor agency designated to procure healthcare contracts pursuant to this Act, is authorized to establish funds, separate accounts provided by any bank or banks as defined by the Illinois Banking Act, or separate accounts provided by any savings and loan association or associations as defined by the Illinois Savings and Loan Act of 1985 to be held by the Director, outside the State treasury, for the purpose of receiving the transfer of moneys from the Health Insurance Reserve Fund. The Department may promulgate rules further defining the methodology for the transfers. Any interest earned by monies in the funds or accounts shall inure to the Health Insurance Reserve Fund. The transferred moneys, and interest accrued thereon, shall be used exclusively for transfers to administrative service organizations or their financial institutions for payments of claims to claimants and providers under the self-insurance health plan. The transferred moneys, and interest accrued thereon, shall not be used for any other purpose including, but not limited to, reimbursement of administration fees due the administrative service organization pursuant to its contract or contracts with the Department.
(c) The Director, with the advice and consent of the Commission, shall
establish premiums for optional coverage for dependents of eligible members
for the health plans. The eligible members
shall be responsible for their portion of such optional
premium. The State shall
contribute an amount per month for each eligible member who has
enrolled one or more dependents under the health plans. Such contribution
shall be made directly to the Health Insurance
Reserve Fund. Those employees described in subsection (b) of Section 9 of this
Act shall be allowed to continue in the health plan by
making personal payments with the premiums to be deposited
in the Health Insurance Reserve Fund.
(d) The Health Insurance Reserve Fund shall be a continuing fund not subject
to fiscal year limitations. All expenditures from that fund shall be at
the direction of the Director and shall be only for the purpose of:
(1) the payment of administrative expenses incurred
by the Department for the program of health benefits or other employee benefit programs, including but not limited to the costs of audits or actuarial consultations, professional and contractual services, electronic data processing systems and services, and expenses in connection with the development and administration of such programs;
(2) the payment of administrative expenses incurred
by an Administrative Service Organization;
(3) the payment of health benefits;
(3.5) the payment of medical expenses incurred by the
Department for the treatment of employees who suffer accidental injury or death within the scope of their employment;
(4) refunds to employees for erroneous payments of
their selected health insurance coverage;
(5) payment of premium for stop-loss or re-insurance;
(6) payment of premium to health maintenance
organizations pursuant to Section 6.1 of this Act;
(7) payment of adoption program benefits; and
(8) payment of other benefits offered to members and
dependents under this Act.
(Source: P.A. 102-19, eff. 7-1-21.)