Bill Text: IL SB2266 | 2015-2016 | 99th General Assembly | Introduced

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Bill Title: Amends the Illinois Insurance Code. Provides that a health insurer that covers dental services file a report known as the Dental MLR Annual Report every year. Provides that the Director of Insurance may conduct examinations of information included in an insurer's MLR annual report upon giving the insurer 30 days' notice. Provides that the insurer shall have 30 days from the day of notification to comply with record requests, unless the Director finds good cause shown for an extension. Provides that the Department shall make available to the public all the data given to the Department pursuant to this Section. Excludes policies covering dental services under the State of Illinois Medicaid program.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2016-04-22 - Rule 3-9(a) / Re-referred to Assignments [SB2266 Detail]

Download: Illinois-2015-SB2266-Introduced.html

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99TH GENERAL ASSEMBLY State of Illinois 2015 and 2016 SB2266 Introduced 1/27/2016, by Sen. John G. Mulroe SYNOPSIS AS INTRODUCED:
215 ILCS 5/355.4 new
Amends the Insurance Code. Provides that a health insurer that covers dental services file a report known as the Dental MLR Annual Report every year. Provides that the Director of Insurance may conduct examinations of information included in an insurer's MLR annual report upon giving the insurer 30 days' notice. Provides that the insurer shall have 30 days from the day of notification to comply with record requests, unless the Director finds good cause shown for an extension. Provides that the Department shall make available to the public all the data given to the Department pursuant to this Section. Excludes policies covering dental services under the State of Illinois Medicaid program.
LRB099 16014 EGJ 40331 b
A BILL FOR
SB2266 LRB099 16014 EGJ 40331 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Insurance Code is amended by adding
Section 355.4 as follows:
(215 ILCS 5/355.4 new)
Sec. 355.4. Minimum loss ratio reports for dental plans.
(a) A health insurer that issues, sells, renews, or offers
a specialized health insurance policy covering dental services
shall, no later than September 30, 2017 and each year
thereafter, file a Dental MLR Annual Report with the Department
that is organized by market and product type and contains the
same information required in the 2013 federal Medical Loss
Ratio (MLR) Annual Reporting Form (CMS-10418).
(b) The reporting year for the Dental MLR Annual Report is
the calendar year during which dental coverage is provided by
the plan. All terms used in the Dental MLR Annual Report shall
have the same meaning as used in the federal Public Health
Service Act (42 U.S.C. Sec. 300gg-18) and Part 158 (commencing
with 158.101) of Title 45 of the Code of Federal Regulations.
(c) If the Director decides to conduct an examination
because the Director finds it necessary to verify the health
insurer's representations in the Dental MLR Annual Report, the

SB2266 - 2 - LRB099 16014 EGJ 40331 b
Department shall provide the health insurer with a notification
30 days before the commencement of the examination.
(d) The health insurer shall have 30 days after the date of
notification to electronically submit to the Department all
requested records specified by the Department. The Director may
extend the time for a health insurer to comply with this
subsection (d) upon a finding of good cause.
(e) The Department shall make available to the public all
of the data provided to the Department pursuant to this
Section.
(f) This Section does not apply to an insurance policy
issued, sold, renewed, or offered for health care services or
coverage provided as a function of the State of Illinois
Medicaid coverage for children or adults or disability
insurance for covered benefits in the single specialized area
of dental-only health care that pays benefits on a fixed
benefit, cash payment-only basis.