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| | 98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB2031 Introduced , by Rep. Tom Cross SYNOPSIS AS INTRODUCED:
| | 215 ILCS 125/2-5 | from Ch. 111 1/2, par. 1406.1 |
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Amends the Health Maintenance Organization Act. Makes a technical change in
a
Section concerning claims liability.
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| | A BILL FOR |
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| | HB2031 | | LRB098 06300 RPM 36341 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois, |
| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Health Maintenance Organization Act is |
| 5 | | amended by changing Section 2-5 as follows:
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| 6 | | (215 ILCS 125/2-5) (from Ch. 111 1/2, par. 1406.1)
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| 7 | | Sec. 2-5. Claims Liabilities. Every Health
Maintenance |
| 8 | | Organization shall, at all times,
maintain liabilities in an |
| 9 | | amount estimated in the
the aggregate to provide for
the |
| 10 | | payment of all claims incurred and any due and unpaid provider
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| 11 | | capitation, whether reported or unreported, which
are unpaid |
| 12 | | and for which such organization is or may be liable, and to
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| 13 | | provide for the expense of adjustment or settlement of such |
| 14 | | claims. Such
liabilities shall be computed in accordance with |
| 15 | | regulations promulgated by
the Director upon reasonable |
| 16 | | consideration of the ascertained experience
and character of |
| 17 | | such business for the purpose of adequately protecting
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| 18 | | enrollees and securing the solvency of such organizations. |
| 19 | | Whenever the claim and claim expense experience of any such |
| 20 | | organization
shows the liabilities calculated in accordance |
| 21 | | with such regulations to be
inadequate, the Director may |
| 22 | | require such organization to maintain
additional liabilities.
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| 23 | | (Source: P.A. 86-620.)
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