State of Illinois
92nd General Assembly

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SB849 Engrossed                               LRB9200768JSpcA

 1        AN ACT  concerning  the  Comprehensive  Health  Insurance
 2    Plan.

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

 5        Section 5.  The Comprehensive Health Insurance  Plan  Act
 6    is amended by changing Section 5 as follows:

 7        (215 ILCS 105/5) (from Ch. 73, par. 1305)
 8        Sec. 5.  Plan administrator.
 9        a.  The board shall select a plan administrator through a
10    competitive  bidding  process  to  administer  the plan.  The
11    board shall evaluate bids submitted under this Section  based
12    on criteria established by the board which shall include:
13             (1)  The  plan  administrator's  proven  ability  to
14        administer   handle   other  large  group  or  individual
15        accident and health benefit plans.
16             (2)  The  efficiency  and  timeliness  of  the  plan
17        administrator's claim processing procedures.
18             (3)  An estimate of total net cost for administering
19        the plan, including any  discounts  or  income  the  Plan
20        could expect to receive or benefit from.
21             (4)  The   plan  administrator's  ability  to  apply
22        effective cost containment programs and procedures and to
23        administer the plan in a cost-efficient manner.
24             (5)  The financial condition and  stability  of  the
25        plan administrator.
26        b.  The  plan administrator shall serve for a period of 5
27    years subject to removal for cause and subject to the  terms,
28    conditions  and limitations of the contract between the board
29    and the plan administrator.  At least one year prior  to  the
30    expiration  of  each  5 year period of service by the current
31    plan administrator, the board shall begin  to  advertise  for
SB849 Engrossed             -2-               LRB9200768JSpcA
 1    bids  to serve as the plan administrator for the succeeding 5
 2    year period.  Selection of the  plan  administrator  for  the
 3    succeeding  period  shall  be made at least 6 months prior to
 4    the end of the current 5 year period.
 5        c.  The plan administrator shall perform  such  functions
 6    relating to the plan as may be assigned to it including:
 7             (1)  establishment  of  a  premium billing procedure
 8        for  collection  of  premiums  from  plan   participants.
 9        Billings  shall be made on a periodic basis as determined
10        by the board;
11             (2)  payment and processing of  claims  and  various
12        cost containment functions; and
13             (3)  other  functions  to  assure  timely payment of
14        benefits to participants under the plan, including:
15                  (a)  making available information  relating  to
16             the proper manner of submitting a claim for benefits
17             under  the  plan  and  distributing forms upon which
18             submissions shall be made, and
19                  (b)  evaluating the eligibility of  each  claim
20             for payment under the plan.
21          The   plan  administrator  shall  be  governed  by  the
22    requirements  of  Part  919  of  Title  50  of  the  Illinois
23    Administrative  Code,  promulgated  by  the   Department   of
24    Insurance, regarding the handling of claims under this Act.
25        d.  The  plan  administrator shall submit regular reports
26    to the board  regarding  the  operation  of  the  plan.   The
27    frequency,  content  and  form  of  the  report  shall  be as
28    determined by the board.
29        e.  The plan administrator shall pay or be reimbursed for
30    claims expenses from the premium payments received from or on
31    behalf of plan participants.   If  the  plan  administrator's
32    payments  or  reimbursements  for  claims expenses exceed the
33    portion of premiums allocated by the  board  for  payment  of
34    claims  expenses, the board shall provide additional funds to
SB849 Engrossed             -3-               LRB9200768JSpcA
 1    the plan administrator for payment or reimbursement  of  such
 2    claims expenses.
 3        f.  The  plan  administrator shall be paid as provided in
 4    the contract between the Board and the plan administrator.
 5    (Source: P.A.  90-30,  eff.  7-1-97;  90-567,  eff.  1-23-98;
 6    91-357, eff. 7-29-99.)

 7        Section  99.  Effective date.  This Act takes effect upon
 8    becoming law.

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