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92_SB0849eng 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 administerhandle otherlarge 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.