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[ Introduced ] | [ House Amendment 001 ] |
91_HB2777eng HB2777 Engrossed LRB9101905JSpc 1 AN ACT concerning financial reports of certain insurers, 2 amending named Acts. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Illinois Insurance Code is amended by 6 changing Section 3.1 as follows: 7 (215 ILCS 5/3.1) (from Ch. 73, par. 615.1) 8 Sec. 3.1. Definitions of admitted assets. "Admitted 9 Assets" includes the investments authorized or permitted by 10 this Code, the credit for reinsurance allowed by this Code, 11 and in addition thereto, only the following: 12(a) Petty cash and other cash funds in the company's13principal or any official branch office and under the control14of the company.15(b) Immediately withdrawable funds on deposit in demand16accounts, in a bank or trust company as defined in Section17126.2MMM(1) or like funds actually in the principal or any18official branch office at statement date, and, in transit to19such bank or trust company with authentic deposit credit20given prior to the close of business on the fifth bank21working day following the statement date.22(c) The amount fairly estimated as recoverable on cash23deposited in a closed bank or trust company, if qualifying24under the provisions of this Section prior to the suspension25of such bank or trust company.26(d) Bills and accounts receivable collateralized by27securities of the kind in which the company is authorized to28invest.29(e) Bills receivable not past due covering uncollected30premiums taken by a company in the transaction of business31described in Class 3 of Section 4, in an amount not to exceedHB2777 Engrossed -2- LRB9101905JSpc 1the unearned premium reserve liability calculated on each2respective policy.3(f) For in force insurance coverages written by fire,4casualty, and reciprocal companies, excluding group accident5and health business, premium deposits, gross premiums, and6agents' balances (net of related commissions) not more than790 days past due; installments booked but deferred and not8yet due (net of related commissions), provided that all9amounts having become due from the insured are not more than1090 days past due; and audit and retrospective premium to the11extent permitted to be admitted pursuant to the Annual12Statement Instructions and the Accounting Practices and13Procedures Manual for Property and Casualty Insurers14published by the National Association of Insurance15Commissioners, unless the Director prescribes otherwise.16However, audit and retrospective premiums that represent17anticipated additional premiums on policies for which the18policy period has not yet expired may not be admitted.19(g) Net amount of uncollected premiums on group life and20group accident and health policies, not more than 90 days21past due.22(h) Due and uncollected accident and health premiums on23in force individual policies, on insurance written by Class241, Section 4 companies, less commissions due thereon to25agents; not exceeding in the aggregate the premium reserve26liability computed on such business.27(i) Premium notes, policy loans and liens, and the net28amount of uncollected and deferred premiums on individual29life insurance policies, not in excess of the liability for30the legal reserves specified in Section 223 or 281 of this31Code on such individual life insurance policies.32(j) Premium and assessment notes, certificate loans and33liens, and the gross amount less loading, of premiums or34assessments actually collected by subordinate lodges not yetHB2777 Engrossed -3- LRB9101905JSpc 1turned over to the Supreme Lodge on individual life insurance2certificates not in excess of the liability for the legal3reserves specified in Section 297.1 or 305.1 on such4individual life insurance certificates.5(k) Mortuary assessments due and unpaid on last call6made within 60 days, on insurance in force and for which7notices have been issued, not in excess of the liability for8the unpaid claims which are to be paid by the proceeds.9(l) Amounts fairly estimated as recoverable from10advances made on contracts under surety bonds.11(m) Amounts receivable from insurance companies12authorized to do business in this State and from associations13or bureaus owned or controlled by 5 or more separate and14nonaffiliated, by ownership or management, insurance15companies of which a majority thereof are authorized to16transact business in this State. The amount of those17receivables allowed as admitted assets may not exceed the18lesser of 5% of the company's total admitted assets or 10% of19the company's surplus as regards policyholders. Amounts20receivable from insurance companies or associations or21bureaus not meeting the preceding standards of this Section22if collateralized in the manner prescribed by Section 173.1.23(n) Tax refunds due from the United States or any state,24the Government of Canada or any province, or the Commonwealth25of Puerto Rico or amounts due to a subsidiary from a parent26under a tax allocation agreement that conforms with rules27adopted by the Director.28(o) The interest accrued on mortgage loans conforming to29this Code, not exceeding an aggregate amount on an individual30loan of one year's total due and accrued interest.31(p) The rents accrued and owing to the company on real32and personal property, directly or beneficially owned, not33exceeding on each individual property the amount of one34year's total due and accrued rent.HB2777 Engrossed -4- LRB9101905JSpc 1(q) Interest or rents accrued on conditional sales2agreements, security interests, chattel mortgages and real or3personal property under lease to other corporations, all4conforming to this Code, and not exceeding on any individual5investment, the amount of one year's total due and accrued6interest or rent.7(r) The fixed and required interest due and accrued on8bonds and other like evidences of indebtedness, conforming to9this Code, and not in default.10(s) Dividends receivable on shares of stock conforming11to this Code; provided that the market price taken for12valuation purposes does not include the value of the13dividend.14(t) The interest or dividends due and payable, but not15credited, on deposits in banks and trust companies or on16accounts with savings and loan associations.17(u) Interest accrued on secured loans conforming to this18Code, not exceeding the amount of one year's interest on any19loan.20(v) Interest accrued on tax anticipation warrants.21(w) The value of electronic computer or data processing22machines or systems purchased for use in connection with the23business of the company, if such machines or systems whenever24purchased have an aggregate original cost to the company of25at least $75,000. The amortized value of such machines or26systems at the end of any calendar year shall not be greater27than the original purchase price less 10% for each completed28year, or pro rata portion for any fraction thereof, after29such purchase, with the total admissible value at any30statement date to be limited to an amount not exceeding 2% of31the company's admitted assets at such statement date.32 (1)(x)Amounts, other than premium, receivable from 33 affiliates, not outstanding for more than 3 months, and 34 arising under, management contracts or service agreements HB2777 Engrossed -5- LRB9101905JSpc 1 which meet the requirements of Section 141.1 of the Illinois 2 Insurance Code to the extent that the affiliate has liquid 3 assets sufficient to pay the balance. The amount of those 4 receivables included in admitted assets may not exceed the 5 lesser of 5% of the company's admitted assets or 10% of the 6 company's surplus as regards policyholders. For purposes of 7 this subsection, "affiliate" has the meaning given that term 8 in Article VIII 1/2 of the Illinois Insurance Code. 9 (2) Amounts permitted under Section 136. 10(y) Property and liability guaranty fund or guaranty11association assessments paid in any state, but only to the12extent it is probable the company will be able to offset13those assessments against present or future premium taxes or14income taxes payable in the state in which the assessments15were paid. The amount of those assessments allowed as16admitted assets may not exceed the lesser of 5% of the17company's total admitted assets or 10% of the company's18surplus as regards policyholders. The Director may disallow19any such assessment as an admitted asset to the extent he20determines a company is unlikely to realize a present or21future premium tax or income tax offset as a result of the22assessment.23 (Source: P.A. 89-97, eff. 7-7-95; 89-669, eff. 1-1-97; 24 90-418, eff. 8-15-97.) 25 Section 10. The Health Maintenance Organization Act is 26 amended by changing Sections 1-3 and 2-7 as follows: 27 (215 ILCS 125/1-3) (from Ch. 111 1/2, par. 1402.1) 28 Sec. 1-3. Definitions of admitted assets. "Admitted 29 Assets" includes the investments authorized or permitted by 30 Section 3-1 of this Act and, in addition thereto, only the 31 following: 32(a) Petty cash and other cash funds in theHB2777 Engrossed -6- LRB9101905JSpc 1organization's principal or any official branch office and2under the control of the organization.3(b) Immediately withdrawable funds on deposit in demand4accounts, in a bank or trust company as defined in paragraph5(3) of subsection (g) of Section 3-1 or like funds actually6in the principal or any official branch office at statement7date, and, in transit to such bank or trust company with8authentic deposit credit given prior to the close of business9on the fifth bank working day following the statement date.10(c) The amount fairly estimated as recoverable on cash11deposited in a closed bank or trust company, if qualifying12under the provisions of this Sec. prior to the suspension of13such bank or trust company.14(d) Bills and accounts receivable collateralized by15securities of the kind in which the organization is16authorized to invest.17(e) Premiums receivable from groups or individuals which18are not more than 60 days past due. Premiums receivable from19the United States, any state thereof or any political20subdivision of either which is not more than 90 days past21due.22(f) Amounts due under insurance policies or reinsurance23arrangements from insurance companies authorized to do24business in this State.25(g) Tax refunds due from the United States, any state or26any political subdivision thereof.27(h) The interest accrued on mortgage loans conforming to28Section 3-1 of this Act, not exceeding in aggregate amount on29an individual loan of one year's total due and accrued30interest.31(i) The rents accrued and owing to the organization on32real and personal property, directly or beneficially owned,33not exceeding on each individual property the amount of one34year's total due and accrued rent.HB2777 Engrossed -7- LRB9101905JSpc 1(j) Interest or rents accrued on conditional sales2agreements, security interests, chattel mortgages and real or3personal property under lease to other corporations, all4conforming to Section 3-1 of this Act, and not exceeding on5any individual investment, the amount of one year's total due6and accrued interest or rent.7(k) The fixed and required interest due and accrued on8bonds and other like evidences of indebtedness, conforming to9Section 3-1 of this Act, and not in default.10(l) Dividends receivable on shares of stock conforming11to Section 3-1 of this Act; provided that the market price12taken for valuation purposes does not include the value of13the dividend.14(m) The interest or dividends due and payable, but not15credited, on deposits in banks and trust companies or on16accounts with savings and loan associations.17(n) Interest accrued on secured loans conforming to this18Act, not exceeding the amount of one year's interest on any19loan.20(o) Interest accrued on tax anticipation warrants.21(p) The amortized value of electronic computer or data22processing machines or systems purchased for use in23connection with the business of the organization, including24software purchased and developed specifically for the25organization's use and purposes.26(q) The cost of furniture, equipment and medical27equipment, less accumulated depreciation thereon, and28medical and pharmaceutical supplies that are used in the29delivery of health care and under the control of the30organization, provided such assets do not exceed 30% of31admitted assets.32 (1)(r)Amounts due from affiliates pursuant to 33 management contracts or service agreements which meet the 34 requirements of Section 141.1 of the Illinois Insurance Code HB2777 Engrossed -8- LRB9101905JSpc 1 to the extent that the affiliate has liquid assets with which 2 to pay the balance and maintain its accounts on a current 3 basis; provided that the aggregate amount due from affiliates 4 may not exceed the lesser of 10% of the organization's 5 admitted assets or 25% of the organization's net worth as 6 defined in Section 3-1. Any amount outstanding more than 3 7 months shall be deemed not current. For purpose of this 8 subsection "affiliates" are as defined in Article VIII 1/2 of 9 the Illinois Insurance Code. 10(s) Intangible assets, including, but not limited to,11organization goodwill and purchased goodwill, to the extent12reported in the most recent annual or quarterly financial13statement filed with the Director preceding the effective14date of this Amendatory Act of 1987. However, such assets15shall be amortized, by the straight-line method, to a value16of zero no later than December 31, 1990; provided, however,17that no organization shall be required pursuant to the18foregoing provision to amortize such assets in an amount19greater than $300,000 in any one year, and in cases where20amortization of such assets by December 31, 1990 would21otherwise require amortization of an annual amount in excess22of $300,000, the organization shall be required only to23amortize such assets at a rate of $300,000 per year until all24such assets have been amortized to a value of zero, unless25the continuation of the current amortization schedule would26result in an earlier zero value, in which case the current27amortization schedule shall be applied.28(t) Amounts due from patients or enrollees for health29care services rendered which are not more than 60 days past30due.31 (2)(u)Amounts advanced to providers under contract to 32 the organization for services to be rendered to enrollees 33 pursuant to the contract. Amounts advanced must be for 34 period of not more than 3 months and must be based on HB2777 Engrossed -9- LRB9101905JSpc 1 historical or estimated utilization patterns with the 2 provider and must be reconciled against actual incurred 3 claims at least semi-annually. Amounts due in the aggregate 4 may not exceed 50% of the organization's net worth as defined 5 in Section 3-1. Amounts due from a single provider may not 6 exceed the lesser of 5% of the organization's admitted assets 7 or 10% of the organization's net worth. 8 (3) Amounts permitted under Section 2-7. 9(v) Cost reimbursement due from the Health Care10Financing Administration for furnishing covered medicare11services to medicare enrollees which are not more than twelve12months past due.13(w) Prepaid rent or lease payments no greater than 314months in advance, on real property used for the15administration of the organizations business or for the16delivery of medical care.17 (Source: P.A. 88-364; revised 10-31-98.) 18 (215 ILCS 125/2-7) (from Ch. 111 1/2, par. 1407) 19 Sec. 2-7. Annual statement; audited financial reports 20enrollment projections and budget filings. 21 (a) A health maintenance organization shall file with 22 the Director by March 1st in each year 2 copies of its 23 financial statement for the year ending December 31st 24 immediately preceding on forms prescribed by the Director, 25 which shall conform substantially to the form of statement 26 adopted by the National Association of Insurance 27 Commissioners. Unless the Director provides otherwise, the 28 annual statement is to be prepared in accordance with the 29 annual statement instructions and the Accounting Practices 30 and Procedures Manual adopted by the National Association of 31 Insurance Commissioners. The Director shall have power to 32 make such modifications and additions in this form as he may 33 deem desirable or necessary to ascertain the condition and HB2777 Engrossed -10- LRB9101905JSpc 1 affairs of the organization. The Director shall have 2 authority to extend the time for filing any statement by any 3 organization for reasons which he considers good and 4 sufficient. The statement shall be verified by oaths of the 5 president and secretary of the organization or, in their 6 absence, by 2 other principal officers. In addition, any 7 organization may be required by the Director, when he 8 considers that action to be necessary and appropriate for the 9 protection of enrollees, creditors, shareholders, 10 subscribers, or claimants, to file, within 60 days after 11 mailing to the organization a notice that such is required, a 12 supplemental summary statement as of the last day of any 13 calendar month occurring during the 100 days next preceding 14 the mailing of such notice designated by him on forms 15 prescribed and furnished by the Director. The Director may 16 require supplemental summary statements to be certified by an 17 independent actuary deemed competent by the Director or by an 18 independent certified public accountant.Every Health19Maintenance Organization shall annually, on or before the20first day of March, file 2 original copies of its annual21statement with the Director verified by at least two22principal officers, covering the two preceding calendar23years. Such annual statement shall be on forms prescribed by24the Director and shall include: (1) financial statements of25the organization; (2) the number of persons enrolled during26the year, the number of enrollees at the end of the year and27the number of enrollments terminated during the year; and (3)28such other information relating to the performance of the29Health Maintenance Organization as is necessary to enable the30Director to carry out his duties under this Act.31Any organization failing, without just cause, to file its32annual statement as required in this Act shall be required,33after notice and hearing, to pay a penalty of $100 for each34day's delay, to be recovered by the Director of Insurance ofHB2777 Engrossed -11- LRB9101905JSpc 1the State of Illinois and the penalty so recovered shall be2paid into the General Revenue Fund of the State of Illinois.3The Director may reduce the penalty if the company4demonstrates to the Director that the imposition of the5penalty would constitute a financial hardship to the6organization.7An annual statement which is not materially complete when8filed shall not be considered to have been properly filed9until those deficiencies which make the filing incomplete10have been corrected and file. 11 (b) Audited financial reports shall be filed on or 12 before June 1 of each year for the two calendar years 13 immediately preceding and shall provide an opinion expressed 14 by an independent certified public accountant on the 15 accompanying financial statement of the Health Maintenance 16 Organization and a detailed reconciliation for any 17 differences between the accompanying financial statements and 18 each of the related financial statements filed in accordance 19 with subsection (a) of this Section. Any organization 20 failing, without just cause, to file the annual audited 21 financial statement as required in this Act shall be 22 required, after the notice and hearing, to pay a penalty of 23 $100 for each day's delay, to be recovered by the Director of 24 Insurance of the State of Illinois and the penalty so 25 recovered shall be paid into the General Revenue Fund of the 26 State of Illinois. The Director may reduce the penalty if 27 the organization demonstrates to the Director that the 28 imposition of the penalty would constitute a financial 29 hardship to the organization. 30 (c) The Director may require that additional summary 31 financial information be filed no more often than 3 times per 32 year on reporting forms provided by him. However, he may 33 request certain key information on a more frequent basis if 34 necessary for a determination of the financial viability of HB2777 Engrossed -12- LRB9101905JSpc 1 the organization. 2 (d) The Director shall have the authority to extend the 3 time for filing any statement by any organization for reasons 4 which the Director considers good and sufficient. 5 (Source: P.A. 85-20; revised 10-31-98.) 6 Section 15. The Limited Health Service Organization Act 7 is amended by changing Section 2007 as follows: 8 (215 ILCS 130/2007) (from Ch. 73, par. 1502-7) 9 Sec. 2007. Annual statement; audited financial reports;10enrollment projections and budget; filings. 11 (a) A limited health service organization shall file 12 with the Director by March 1st in each year 2 copies of its 13 financial statement for the year ending December 31st 14 immediately preceding on forms prescribed by the Director, 15 which shall conform substantially to the form of statement 16 adopted by the National Association of Insurance 17 Commissioners. Unless the Director provides otherwise, the 18 annual statement is to be prepared in accordance with the 19 annual statement instructions and the Accounting Practices 20 and Procedures Manual adopted by the National Association of 21 Insurance Commissioners. The Director shall have power to 22 make such modifications and additions in this form as he may 23 deem desirable or necessary to ascertain the condition and 24 affairs of the organization. The Director shall have 25 authority to extend the time for filing any statement by any 26 organization for reasons which he considers good and 27 sufficient. The statement shall be verified by oaths of the 28 president and secretary of the organization or, in their 29 absence, by 2 other principal officers. In addition, any 30 organization may be required by the Director, when he 31 considers that action to be necessary and appropriate for the 32 protection of enrollees, creditors, shareholders, HB2777 Engrossed -13- LRB9101905JSpc 1 subscribers, or claimants, to file, within 60 days after 2 mailing to the organization a notice that such is required, a 3 supplemental summary statement as of the last day of any 4 calendar month occurring during the 100 days next preceding 5 the mailing of such notice designated by him on forms 6 prescribed and furnished by the Director. The Director may 7 require supplemental summary statements to be certified by an 8 independent actuary deemed competent by the Director or by an 9 independent certified public accountant.Every limited health10service organization shall annually, on or before the first11day of March, file 2 original copies of its annual statement12with the Director verified by at least 2 principal officers,13covering the 2 preceding calendar years. Such annual14statement shall be on forms prescribed by the Director and15shall include:16(1) the financial statements of the organization;17(2) the number of persons enrolled during the year,18the number of enrollees at the end of the year and the19number of enrollments terminated during the year; and20(3) such other information relating to the21performance of the limited health service organization as22the Director deems necessary to enable the Director to23carry out his duties under this Act.24Any organization failing, without just cause, to file its25annual statement as required in this Act shall be required,26after notice and opportunity for hearing, to pay a penalty of27$100 for each day's delay, to be recovered by the Director of28Insurance. The penalty so recovered shall be paid into the29General Revenue Fund of the State of Illinois. The Director30may reduce the penalty if the organization demonstrates to31the Director that the imposition of the penalty would32constitute a financial hardship to the organization.33An annual statement which is not materially complete when34filed shall not be considered to have been properly filedHB2777 Engrossed -14- LRB9101905JSpc 1until those deficiencies which make the filing incomplete2have been corrected and filed.3 (b) Audited financial reports shall be filed on or 4 before June 1 of each year for the 2 calendar years 5 immediately preceding and shall provide an opinion expressed 6 by an independent certified public accountant on the 7 accompanying financial statement of the limited health 8 service organization and detailed reconciliation for any 9 differences between the accompanying financial statements and 10 each of the related financial statements filed in accordance 11 with subsection (a) of this Section. Any organization 12 failing, without just cause, to file the annual audited 13 financial statement as required in this Act shall be 14 required, after the notice and opportunity for hearing, to 15 pay a penalty of $100 for each day's delay, to be recovered 16 by the Director of Insurance. The penalty so recovered shall 17 be paid into the General Revenue Fund of the State of 18 Illinois. The Director may reduce the penalty if the 19 organization demonstrates to the Director that the imposition 20 of the penalty would constitute a financial hardship to the 21 organization. 22 (c) The Director may require that additional summary 23 financial information be filed no more often than 3 times per 24 year on reporting forms provided by him. However, he may 25 request certain key information on a more frequent basis if 26 necessary for a determination of the financial viability of 27 the organization. 28 (d) The Director shall have the authority to extend the 29 time for filing any statements by an organization for reasons 30 which the Director considers good and sufficient. 31 (Source: P.A. 86-600.) 32 Section 99. Effective date. This Act takes effect on 33 January 1, 2001.