215 ILCS 123/1
(215 ILCS 123/1) Sec. 1. Short title. This Act may be cited as the Health Care Purchasing Group Act. (Source: P.A. 90-337, eff. 1-1-98.)
215 ILCS 123
215 ILCS 123
in effect215 ILCS 123/5 Purpose; applicability of Illinois Health Insurance Portability and Accountability Act
(215 ILCS 123/5) Sec. 5. Purpose; applicability of Illinois Health Insurance Portability and Accountability Act. (a) The purpose and intent of this Act is to authorize the formation, operation, and regulation of health care purchasing groups (referred to in this Act as "HPGs") as described by this Act, to authorize the sale and regulation of health insurance products for employers that are sold to HPGs, and to encourage the development of financially secure and cost effective markets for the basic health care needs of employers, employees, and their dependents in this State. Nothing in this Act authorizes an employer to join with other employers to self-insure through risk pooling. (b) All health insurance contracts issued under this Act are subject to the Illinois Health Insurance Portability and Accountability Act. (Source: P.A. 90-337, eff. 1-1-98; 90-567, eff. 1-23-98.)
215 ILCS 123/10 Definitions
(215 ILCS 123/10) Sec. 10. Definitions. Words and phrases used in this Act, unless defined in this Section, have the meanings attributed to them in Section 5 of the Illinois Health Insurance Portability and Accountability Act. "Director" means the Director of Insurance. "Employer" means an individual, sole proprietorship, partnership, firm, corporation, association, or any other legal entity that has one or more employees and is legally doing business in this State. "Employer" includes employers as defined in the Illinois Health Insurance Portability and Accountability Act. "Health insurance contract", "group or master health insurance contract" and "insurance" refer to the forms of insurance obligations which a "risk-bearer" as defined in this Section has been authorized to issue. "Risk-bearer" means an insurance company licensed in this State and authorized to transact the kinds of business described in clause (b) of Class 1 and clause (a) of Class 2 of Section 4 of the Illinois Insurance Code and entities authorized under the Health Maintenance Organization Act. (Source: P.A. 97-715, eff. 1-1-13.)
215 ILCS 123/25
(215 ILCS 123/25) Sec. 25. Risk-bearer. (a) A risk-bearer may issue for delivery in this State any health insurance contracts as provided by this Act. A risk-bearer may also be a sponsor of an HPG. (b) A risk-bearer must also file an annual report in the form and at the time prescribed by the Director in rules that shall require, at minimum, (i) the number of employer members then enrolled in each HPG; (ii) the date on which each HPG was issued a group or master health insurance contract, if any; and (iii) the date on which each such contract, if any, was terminated, together with any other information that may be necessary to carry out the purposes of this Act. A fee of $25 shall be paid to the Director at the time the annual report is filed. (Source: P.A. 90-337, eff. 1-1-98.)
215 ILCS 123/30
(215 ILCS 123/30) Sec. 30. Insurance policy requirements. (a) No health insurance contract may be issued or delivered pursuant to this Act unless a copy of the form of the contract has been filed with the Director and approved in accordance with Section 355 of the Illinois Insurance Code. It must also contain, in substance, those provisions contained in Sections 357.1 through 357.30 of the Illinois Insurance Code as may be applicable and contain all other provisions applicable to group accident and health insurance policies as provided in Article XX of the Illinois Insurance Code, except as provided in Section 50 of this Act. This subsection (a) does not apply to health maintenance organizations. (b) No health maintenance organization contract may be issued or delivered under this Act unless a copy of the form of the contract has been filed with the Director and approved in accordance with Section 4-13 of the Health Maintenance Organization Act. It must also provide or arrange for and pay for or reimburse the cost of basic health care services as defined in Section 1-2 of the Health Maintenance Organization Act and provide the benefits specified in the Health Maintenance Organization Act for group contracts. (c) In the event that the enrollee has moved outside of the service area of the health maintenance organization, the HMO must make available conversion coverage through a contract with a licensed insurance carrier. The conversion coverage must be similar to that which is provided through the HMO. Coverage shall be considered "similar" if it provides a comprehensive medical benefit plan for at least 18 months and is provided without imposing any preexisting condition limitation or exclusion, other than those remaining unexpired under the contract from which conversion is exercised. (d) Nothing in this Act shall preclude a risk-bearer and an HPG or employer from entering into a contract that contains provisions whereby each party agrees to continue the contract in force for a prescribed period of time. (e) Nothing in this Act shall preclude a risk-bearer from offering health insurance contracts that contain benefits in addition to those required in subsection (a). (f) No HPG may purchase insurance providing for a deductible or an aggregate limit unless the deductible or aggregate limit applies separately to each individual insured person of the purchasing group. (Source: P.A. 90-337, eff. 1-1-98.)
215 ILCS 123/35
(215 ILCS 123/35) Sec. 35. Underwriting provisions. All health insurance contracts issued under this Act shall be subject to the portability and preexisting condition provisions of the Illinois Health Insurance Portability and Accountability Act. (Source: P.A. 90-337, eff. 1-1-98; 90-567, eff. 1-23-98.)
215 ILCS 123/40 Renewability
(215 ILCS 123/40) Sec. 40. Renewability. All health insurance contracts issued under this Act are subject to the renewability provisions of the Illinois Health Insurance Portability and Accountability Act. (Source: P.A. 90-337, eff. 1-1-98; 90-567, eff. 1-23-98.)
215 ILCS 123/45
(215 ILCS 123/45) Sec. 45. Disclosure requirements. In connection with the offering for sale of any health insurance contract or certificate under the contract to an HPG sponsor, HPG, employer, and employee, a risk-bearer shall make a reasonable disclosure, as part of its solicitation and sales materials of all of the following: (1) the provisions of the health insurance contracts concerning the risk-bearer's right to change premium rates and the factors, other than claim experience, that affect changes in premium rates; (2) the provisions relating to renewability of policies and contracts; (3) the provisions relating to any preexisting condition provision; and (4) the provisions relating to portability provisions. (Source: P.A. 90-337, eff. 1-1-98; 90-567, eff. 1-23-98.)
215 ILCS 123/50 (Repealed)
(215 ILCS 123/50) Sec. 50. (Repealed). (Source: P.A. 90-337, eff. 1-1-98. Repealed by P.A. 90-567, eff. 1-23-98.)
215 ILCS 123/60
(215 ILCS 123/60) Sec. 60. Administrative and procedural authority regarding HPGs and HPG sponsors. The Director is authorized to make use of any of the powers established under the Illinois Insurance Code to enforce the laws of this State. This includes but is not limited to, the Director's administrative authority to investigate, issue subpoenas, conduct depositions and hearings, issue orders (including without limitation orders pursuant to Article XII 1/2 and Section 401.1 of the Illinois Insurance Code), and impose penalties. With regard to any investigation, administrative proceedings, or litigation, the Director shall rely on the procedural law and regulations of this State. (Source: P.A. 90-337, eff. 1-1-98.)
215 ILCS 123/65 Fees
(215 ILCS 123/65) Sec. 65. Fees. (a) The Director shall charge, collect, and give proper acquittance for the payment all fees provided for by this Act, except that any Illinois corporations licensed by the Department of Insurance pursuant to the provisions of the Illinois Insurance Code, the Dental Service Plan Act, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Vision Service Plan Act and the Voluntary Health Services Plans Act or licensed as a third party administrator or as a managing general agent is exempt from the registration fee imposed under this Act. (b) Any funds collected under provisions of this Act shall be deposited in the Insurance Producer Administration Fund. (Source: P.A. 90-337, eff. 1-1-98; 90-567, eff. 1-23-98.)
215 ILCS 123/70 Rules
(215 ILCS 123/70) Sec. 70. Rules. The Director shall promulgate rules as may be necessary or desirable to carry out the provisions of this Act. (Source: P.A. 90-337, eff. 1-1-98.)
215 ILCS 123/75 Severability
(215 ILCS 123/75) Sec. 75. Severability. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes. (Source: P.A. 90-337, eff. 1-1-98.)
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