Bill Text: IL SB2799 | 2013-2014 | 98th General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Illinois Act on the Aging and the Department of Insurance Law of the Civil Administrative Code of Illinois. Implements Executive Order 2013-1. Transfers the Senior Health Insurance Program from the Department of Insurance to the Department on Aging. Contains a severability provision. Effective immediately.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Failed) 2015-01-13 - Session Sine Die [SB2799 Detail]

Download: Illinois-2013-SB2799-Amended.html

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Rep. Robyn Gabel

Filed: 5/23/2014

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AMENDMENT TO SENATE BILL 2799
AMENDMENT NO. ______. Amend Senate Bill 2799 by replacing
everything after the enacting clause with the following:
"Section 5. The Personnel Code is amended by changing
Section 4c as follows:
(20 ILCS 415/4c) (from Ch. 127, par. 63b104c)
Sec. 4c. General exemptions. The following positions in
State service shall be exempt from jurisdictions A, B, and C,
unless the jurisdictions shall be extended as provided in this
Act:
(1) All officers elected by the people.
(2) All positions under the Lieutenant Governor,
Secretary of State, State Treasurer, State Comptroller,
State Board of Education, Clerk of the Supreme Court,
Attorney General, and State Board of Elections.
(3) Judges, and officers and employees of the courts,

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and notaries public.
(4) All officers and employees of the Illinois General
Assembly, all employees of legislative commissions, all
officers and employees of the Illinois Legislative
Reference Bureau, the Legislative Research Unit, and the
Legislative Printing Unit.
(5) All positions in the Illinois National Guard and
Illinois State Guard, paid from federal funds or positions
in the State Military Service filled by enlistment and paid
from State funds.
(6) All employees of the Governor at the executive
mansion and on his immediate personal staff.
(7) Directors of Departments, the Adjutant General,
the Assistant Adjutant General, the Director of the
Illinois Emergency Management Agency, members of boards
and commissions, and all other positions appointed by the
Governor by and with the consent of the Senate.
(8) The presidents, other principal administrative
officers, and teaching, research and extension faculties
of Chicago State University, Eastern Illinois University,
Governors State University, Illinois State University,
Northeastern Illinois University, Northern Illinois
University, Western Illinois University, the Illinois
Community College Board, Southern Illinois University,
Illinois Board of Higher Education, University of
Illinois, State Universities Civil Service System,

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University Retirement System of Illinois, and the
administrative officers and scientific and technical staff
of the Illinois State Museum.
(9) All other employees except the presidents, other
principal administrative officers, and teaching, research
and extension faculties of the universities under the
jurisdiction of the Board of Regents and the colleges and
universities under the jurisdiction of the Board of
Governors of State Colleges and Universities, Illinois
Community College Board, Southern Illinois University,
Illinois Board of Higher Education, Board of Governors of
State Colleges and Universities, the Board of Regents,
University of Illinois, State Universities Civil Service
System, University Retirement System of Illinois, so long
as these are subject to the provisions of the State
Universities Civil Service Act.
(10) The State Police so long as they are subject to
the merit provisions of the State Police Act.
(11) (Blank).
(12) The technical and engineering staffs of the
Department of Transportation, the Department of Nuclear
Safety, the Pollution Control Board, and the Illinois
Commerce Commission, and the technical and engineering
staff providing architectural and engineering services in
the Department of Central Management Services.
(13) All employees of the Illinois State Toll Highway

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Authority.
(14) The Secretary of the Illinois Workers'
Compensation Commission.
(15) All persons who are appointed or employed by the
Director of Insurance under authority of Section 202 of the
Illinois Insurance Code to assist the Director of Insurance
in discharging his responsibilities relating to the
rehabilitation, liquidation, conservation, and dissolution
of companies that are subject to the jurisdiction of the
Illinois Insurance Code.
(16) All employees of the St. Louis Metropolitan Area
Airport Authority.
(17) All investment officers employed by the Illinois
State Board of Investment.
(18) Employees of the Illinois Young Adult
Conservation Corps program, administered by the Illinois
Department of Natural Resources, authorized grantee under
Title VIII of the Comprehensive Employment and Training Act
of 1973, 29 USC 993.
(19) Seasonal employees of the Department of
Agriculture for the operation of the Illinois State Fair
and the DuQuoin State Fair, no one person receiving more
than 29 days of such employment in any calendar year.
(20) All "temporary" employees hired under the
Department of Natural Resources' Illinois Conservation
Service, a youth employment program that hires young people

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to work in State parks for a period of one year or less.
(21) All hearing officers of the Human Rights
Commission.
(22) All employees of the Illinois Mathematics and
Science Academy.
(23) All employees of the Kankakee River Valley Area
Airport Authority.
(24) The commissioners and employees of the Executive
Ethics Commission.
(25) The Executive Inspectors General, including
special Executive Inspectors General, and employees of
each Office of an Executive Inspector General.
(26) The commissioners and employees of the
Legislative Ethics Commission.
(27) The Legislative Inspector General, including
special Legislative Inspectors General, and employees of
the Office of the Legislative Inspector General.
(28) The Auditor General's Inspector General and
employees of the Office of the Auditor General's Inspector
General.
(29) All employees of the Illinois Power Agency.
(30) Employees having demonstrable, defined advanced
skills in accounting, financial reporting, or technical
expertise who are employed within executive branch
agencies and whose duties are directly related to the
submission to the Office of the Comptroller of financial

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information for the publication of the Comprehensive
Annual Financial Report (CAFR).
(31) All employees of the Illinois Sentencing Policy
Advisory Council.
(32) The employees of the Illinois Health Benefits
Exchange.
(Source: P.A. 97-618, eff. 10-26-11; 97-1055, eff. 8-23-12;
98-65, eff. 7-15-13.)
Section 10. The Department of Insurance Law of the Civil
Administrative Code of Illinois is amended by adding Section
1405-40 as follows:
(20 ILCS 1405/1405-40 new)
Sec. 1405-40. Transfer of the Comprehensive Health
Insurance Plan.
(a) On January 1, 2015, all powers, duties, rights, and
responsibilities of the Comprehensive Health Insurance Plan
and the Illinois Comprehensive Health Insurance Board shall be
transferred to the Department of Insurance.
(b) The Department of Insurance shall act on behalf of the
Comprehensive Health Insurance Plan and the Illinois
Comprehensive Health Insurance Board and shall have the power
and duty to receive and answer correspondence, pay claims due
and owing to the Department of Central Management Services
revolving fund from any unencumbered funds, refer unpaid

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vendors to the court of claims, and arrange for the orderly
termination of any affairs of the Comprehensive Health
Insurance Plan and the Illinois Comprehensive Health Insurance
Board that remain unresolved on or after January 1, 2015.
(c) All books, records, papers, documents, property (real
and personal), contracts, causes of action, and pending
business pertaining to the powers, duties, rights, and
responsibilities transferred by this amendatory Act of the 98th
General Assembly from the Comprehensive Health Insurance Plan
and the Illinois Comprehensive Health Insurance Board to the
Department of Insurance, including, but not limited to,
material in electronic or magnetic format and necessary
computer hardware and software, shall be transferred to the
Department of Insurance. Records shall remain intact as
regulated by the federal Health Insurance Portability and
Accountability Act of 1996.
(d) The personnel of the Comprehensive Health Insurance
Plan and the Illinois Comprehensive Health Insurance Board
shall be transferred to the Department of Insurance. The status
and rights of those employees under the Personnel Code shall
not be affected by the transfer. The rights of the employees
and the State of Illinois and its agencies under the Personnel
Code and applicable collective bargaining agreements or under
any pension, retirement, or annuity plan shall not be affected
by this amendatory Act of the 98th General Assembly.
(e) All unexpended appropriations and balances and other

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funds available for use by the Comprehensive Health Insurance
Plan and the Illinois Comprehensive Health Insurance Board
shall be transferred for use by the Department of Insurance.
Unexpended balances so transferred shall be expended only for
the purpose for which the appropriations were originally made.
(f) The powers, duties, rights, and responsibilities
transferred from the Comprehensive Health Insurance Plan and
the Illinois Comprehensive Health Insurance Board shall be
vested in and shall be exercised by the Department of
Insurance.
(g) Whenever reports or notices are now required to be made
or given or papers or documents furnished or served by any
person to or upon the Comprehensive Health Insurance Plan or
the Illinois Comprehensive Health Insurance Board in
connection with any of the powers, duties, rights, and
responsibilities transferred by this amendatory Act of the 98th
General Assembly, the same shall be made, given, furnished, or
served in the same manner to or upon the Department of
Insurance.
(h) This amendatory Act of the 98th General Assembly does
not affect any act done, ratified, or canceled or any right
occurring or established or any action or proceeding had or
commenced in an administrative, civil, or criminal cause by the
Comprehensive Health Insurance Plan or the Illinois
Comprehensive Health Insurance Board prior to January 1, 2015;
such actions or proceedings may be prosecuted and continued by

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the Department of Insurance.
Section 15. The Illinois State Auditing Act is amended by
changing Section 3-1 as follows:
(30 ILCS 5/3-1) (from Ch. 15, par. 303-1)
Sec. 3-1. Jurisdiction of Auditor General. The Auditor
General has jurisdiction over all State agencies to make post
audits and investigations authorized by or under this Act or
the Constitution.
The Auditor General has jurisdiction over local government
agencies and private agencies only:
(a) to make such post audits authorized by or under
this Act as are necessary and incidental to a post audit of
a State agency or of a program administered by a State
agency involving public funds of the State, but this
jurisdiction does not include any authority to review local
governmental agencies in the obligation, receipt,
expenditure or use of public funds of the State that are
granted without limitation or condition imposed by law,
other than the general limitation that such funds be used
for public purposes;
(b) to make investigations authorized by or under this
Act or the Constitution; and
(c) to make audits of the records of local government
agencies to verify actual costs of state-mandated programs

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when directed to do so by the Legislative Audit Commission
at the request of the State Board of Appeals under the
State Mandates Act.
In addition to the foregoing, the Auditor General may
conduct an audit of the Metropolitan Pier and Exposition
Authority, the Regional Transportation Authority, the Suburban
Bus Division, the Commuter Rail Division and the Chicago
Transit Authority and any other subsidized carrier when
authorized by the Legislative Audit Commission. Such audit may
be a financial, management or program audit, or any combination
thereof.
The audit shall determine whether they are operating in
accordance with all applicable laws and regulations. Subject to
the limitations of this Act, the Legislative Audit Commission
may by resolution specify additional determinations to be
included in the scope of the audit.
In addition to the foregoing, the Auditor General must also
conduct a financial audit of the Illinois Sports Facilities
Authority's expenditures of public funds in connection with the
reconstruction, renovation, remodeling, extension, or
improvement of all or substantially all of any existing
"facility", as that term is defined in the Illinois Sports
Facilities Authority Act.
The Auditor General may also conduct an audit, when
authorized by the Legislative Audit Commission, of any hospital
which receives 10% or more of its gross revenues from payments

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from the State of Illinois, Department of Healthcare and Family
Services (formerly Department of Public Aid), Medical
Assistance Program.
The Auditor General is authorized to conduct financial and
compliance audits of the Illinois Distance Learning Foundation
and the Illinois Conservation Foundation.
As soon as practical after the effective date of this
amendatory Act of 1995, the Auditor General shall conduct a
compliance and management audit of the City of Chicago and any
other entity with regard to the operation of Chicago O'Hare
International Airport, Chicago Midway Airport and Merrill C.
Meigs Field. The audit shall include, but not be limited to, an
examination of revenues, expenses, and transfers of funds;
purchasing and contracting policies and practices; staffing
levels; and hiring practices and procedures. When completed,
the audit required by this paragraph shall be distributed in
accordance with Section 3-14.
The Auditor General shall conduct a financial and
compliance and program audit of distributions from the
Municipal Economic Development Fund during the immediately
preceding calendar year pursuant to Section 8-403.1 of the
Public Utilities Act at no cost to the city, village, or
incorporated town that received the distributions.
The Auditor General must conduct an audit of the Health
Facilities and Services Review Board pursuant to Section 19.5
of the Illinois Health Facilities Planning Act.

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The Auditor General of the State of Illinois shall annually
conduct or cause to be conducted a financial and compliance
audit of the books and records of any county water commission
organized pursuant to the Water Commission Act of 1985 and
shall file a copy of the report of that audit with the Governor
and the Legislative Audit Commission. The filed audit shall be
open to the public for inspection. The cost of the audit shall
be charged to the county water commission in accordance with
Section 6z-27 of the State Finance Act. The county water
commission shall make available to the Auditor General its
books and records and any other documentation, whether in the
possession of its trustees or other parties, necessary to
conduct the audit required. These audit requirements apply only
through July 1, 2007.
The Auditor General must conduct audits of the Rend Lake
Conservancy District as provided in Section 25.5 of the River
Conservancy Districts Act.
The Auditor General must conduct financial audits of the
Southeastern Illinois Economic Development Authority as
provided in Section 70 of the Southeastern Illinois Economic
Development Authority Act.
The Auditor General shall conduct a compliance audit in
accordance with subsections (d) and (f) of Section 30 of the
Innovation Development and Economy Act.
The Auditor General shall have the authority to conduct an
audit of the Illinois Health Benefits Exchange. The audit may

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be a financial audit, a management audit, a program audit, or
any combination thereof.
(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09;
96-939, eff. 6-24-10.)
Section 20. The Comprehensive Health Insurance Plan Act is
amended by adding Sections 16 and 17 as follows:
(215 ILCS 105/16 new)
Sec. 16. Cessation of operations.
(a) Except as otherwise provided in this Section, the
insurance operations of the Plan authorized by this Act shall
cease on January 1, 2015.
(b) Coverage under the Plan does not apply to service
provided on or after January 1, 2015.
(c) The Plan shall cease enrolling new participants on
December 31, 2014.
(d) The Plan shall cease providing coverage for
participants enrolled prior to January 1, 2015 at 11:59 p.m. on
December 31, 2014. Except as otherwise provided in this
subsection (d), the Board shall provide at least 90 days
written notice to all Plan participants of the cessation of
coverage under this Section. For participants enrolled less
than 90 days before January 1, 2015, notice of the cessation of
coverage under this Section shall be provided to all applicants
and to all participants upon enrollment.

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(e) Any claim for payment under the Plan must be submitted
no later than 90 days after January 1, 2015, and any valid
claim submitted on or after January 1, 2015 must be paid within
90 days after receipt.
(f) Any grievance shall be resolved by the Board not later
than October 31, 2015.
(g) Balance billing under this Section by a health care
provider that is not a member of the provider network
arrangement used by the Plan is prohibited.
(h) The Board shall, not later than June 30, 2014, submit
to the Director a plan of dissolution, which must provide for,
but not be limited to, the following:
(1) Continuity of care for an individual who is covered
under the Plan and is an inpatient on at the time the Plan
ceases.
(2) A final accounting of assessments.
(3) Resolution of any net asset deficiency.
(4) Cessation of all liability of the Plan.
(5) Final dissolution of the Plan.
(i) No legal action by or against the Plan may be filed on
or after January 1, 2016.
(j) General Revenue Fund funds remaining in the Plan after
satisfaction of all of the Plan's liabilities shall be
transferred back into the General Revenue Fund.
(k) The Board shall cease charging insurer assessments on
January 1, 2015; however, the Board may charge and collect

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insurer assessments pursuant to Section 12 of this Act as
necessary to satisfy any remaining liabilities of the Plan.
Insurer assessments remaining in the Plan after satisfaction of
all of the Plan's liabilities shall be returned to insurers
based on subsection (e) of Section 12 of this Act.
(215 ILCS 105/17 new)
Sec. 17. Repealer. This Act is repealed on July 1, 2016.
Section 25. The Illinois Health Benefits Exchange Law is
amended by changing Sections 5-3, 5-5, 5-10, and 5-15 and by
adding Sections 5-4, 5-11, 5-16, 5-17, 5-18, 5-21, 5-23, and
5-30 as follows:
(215 ILCS 122/5-3)
Sec. 5-3. Legislative intent. The General Assembly finds
the health benefits exchanges authorized by the federal Patient
Protection and Affordable Care Act represent one of a number of
ways in which the State can address coverage gaps and provide
individual consumers and small employers access to greater
coverage options. The General Assembly also finds that the
State is best positioned to implement an exchange that is
sensitive to the coverage gaps and market landscape unique to
this State.
The purpose of this Law is to provide for the establishment
of an Illinois Health Benefits Exchange (the Exchange) to

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facilitate the purchase and sale of qualified health plans and
qualified dental plans in the individual market in this State
and to provide for the establishment of a Small Business Health
Options Program (SHOP Exchange) to assist qualified small
employers in this State in facilitating the enrollment of their
employees in qualified health plans and qualified dental plans
offered in the small group market. The intent of the Exchange
is to supplement the existing health insurance market to
simplify shopping for individual and small employers by
increasing access to benefit options, encouraging a
competitive market both inside and outside the Exchange,
reducing the number of uninsured, and providing a transparent
marketplace and effective consumer education and programmatic
assistance tools. The purpose of this Law is to ensure that the
State is making sufficient progress towards establishing an
exchange within the guidelines outlined by the federal law and
to protect Illinoisans from undue federal regulation. Although
the federal law imposes a number of core requirements on
state-level exchanges, the State has significant flexibility
in the design and operation of a State exchange that make it
prudent for the State to carefully analyze, plan, and prepare
for the exchange. The General Assembly finds that in order for
the State to craft a tenable exchange that meets the
fundamental goals outlined by the Patient Protection and
Affordable Care Act of expanding access to affordable coverage
and improving the quality of care, the implementation process

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should (1) provide for broad stakeholder representation; (2)
foster a robust and competitive marketplace, both inside and
outside of the exchange; and (3) provide for a broad-based
approach to the fiscal solvency of the exchange.
(Source: P.A. 97-142, eff. 7-14-11.)
(215 ILCS 122/5-4 new)
Sec. 5-4. Definitions. In this Law:
"Board" means the Illinois Health Benefits Exchange Board
established pursuant to this Law.
"Department" means the Department of Insurance.
"Director" means the Director of Insurance.
"Educated health care consumer" means an individual who is
knowledgeable about the health care system, and has background
or experience in making informed decisions regarding health,
medical, and public health matters.
"Essential health benefits" has the meaning provided under
Section 1302(b) of the Federal Act.
"Exchange" means the Illinois Health Benefits Exchange
established by this Law and includes the Individual Exchange
and the SHOP Exchange, unless otherwise specified.
"Executive Director" means the Executive Director of the
Illinois Health Benefits Exchange.
"Federal Act" means the federal Patient Protection and
Affordable Care Act (Public Law 111-148), as amended by the
federal Health Care and Education Reconciliation Act of 2010

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(Public Law 111-152), and any amendments thereto, or
regulations or guidance issued under, those Acts.
"Health benefit plan" means a policy, contract,
certificate, or agreement offered or issued by a health carrier
to provide, deliver, arrange for, pay for, or reimburse any of
the costs of health care services. "Health benefit plan" does
not include:
(1) coverage for accident only or disability income
insurance or any combination thereof;
(2) coverage issued as a supplement to liability
insurance;
(3) liability insurance, including general liability
insurance and automobile liability insurance;
(4) workers' compensation or similar insurance;
(5) automobile medical payment insurance;
(6) credit-only insurance;
(7) coverage for on-site medical clinics; or
(8) other similar insurance coverage, specified in
federal regulations issued pursuant to the federal Health
Information Portability and Accountability Act of 1996,
Public Law 104-191, under which benefits for health care
services are secondary or incidental to other insurance
benefits.
"Health benefit plan" does not include the following
benefits if they are provided under a separate policy,
certificate, or contract of insurance or are otherwise not an

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integral part of the plan:
(a) limited scope dental or vision benefits;
(b) benefits for long-term care, nursing home care,
home health care, community-based care, or any combination
thereof; or
(c) other similar, limited benefits specified in
federal regulations issued pursuant to Public Law 104-191.
"Health benefit plan" does not include the following
benefits if the benefits are provided under a separate policy,
certificate, or contract of insurance, there is no coordination
between the provision of the benefits and any exclusion of
benefits under any group health plan maintained by the same
plan sponsor, and the benefits are paid with respect to an
event without regard to whether benefits are provided with
respect to such an event under any group health plan maintained
by the same plan sponsor:
(i) coverage only for a specified disease or illness;
or
(ii) hospital indemnity or other fixed indemnity
insurance.
"Health benefit plan" does not include the following if
offered as a separate policy, certificate, or contract of
insurance:
(A) Medicare supplemental health insurance as defined
under Section 1882(g)(1) of the federal Social Security
Act;

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(B) coverage supplemental to the coverage provided
under Chapter 55 of Title 10, United States Code (Civilian
Health and Medical Program of the Uniformed Services
(CHAMPUS)); or
(C) similar supplemental coverage provided to coverage
under a group health plan.
"Health benefit plan" does not include a group health plan
or multiple employer welfare arrangement to the extent the plan
or arrangement is not subject to State insurance regulation
under Section 514 of the federal Employee Retirement Income
Security Act of 1974.
"Health insurance carrier" or "carrier" means an entity
subject to the insurance laws and regulations of this State, or
subject to the jurisdiction of the Director, that contracts or
offers to contract to provide, deliver, arrange for, pay for,
or reimburse any of the costs of health care services,
including a sickness and accident insurance company, a health
maintenance organization, or any other entity providing a plan
of health insurance, or health benefits. "Health insurance
carrier" does not include short term, accident only, disability
income, hospital confinement or fixed indemnity, vision only,
limited benefit, or credit insurance, coverage issued as a
supplement to liability insurance, insurance arising out of a
workers' compensation or similar law, automobile
medical-payment insurance, insurance under which benefits are
payable with or without regard to fault and which is

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statutorily required to be contained in any liability insurance
policy or equivalent self-insurance, or a Consumer Operated and
Oriented Plan.
"Illinois Health Benefits Exchange Fund" means the fund
created outside of the State treasury to be used exclusively to
provide funding for the operation and administration of the
Exchange in carrying out the purposes authorized by this Law.
"Individual Exchange" means the exchange marketplace
established by this Law through which qualified individuals may
obtain coverage through an individual market qualified health
plan.
"Principal place of business" means the location in a state
where an employer has its headquarters or significant place of
business and where the persons with direction and control
authority over the business are employed.
"Qualified dental plan" means a limited scope dental plan
that has been certified in accordance with this Law.
"Qualified employee" means an eligible individual employed
by a qualified employer who has been offered health insurance
coverage by that qualified employer through the SHOP on the
Exchange.
"Qualified employer" means a small employer that elects to
make its full-time employees eligible for one or more qualified
health plans or qualified dental plans offered through the SHOP
Exchange, and at the option of the employer, some or all of its
part-time employees, provided that the employer has its

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principal place of business in this State and elects to provide
coverage through the SHOP Exchange to all of its eligible
employees, wherever employed.
"Qualified health plan" or "QHP" means a health benefit
plan that has in effect a certification that the plan meets the
criteria for certification described in Section 1311(c) of the
Federal Act.
"Qualified health plan issuer" or "QHP issuer" means a
health insurance issuer that offers a health plan that the
Exchange has certified as a qualified health plan.
"Qualified individual" means an individual, including a
minor, who:
(1) is seeking to enroll in a qualified health plan or
qualified dental plan offered to individuals through the
Exchange;
(2) resides in this State;
(3) at the time of enrollment, is not incarcerated,
other than incarceration pending the disposition of
charges; and
(4) is, and is reasonably expected to be, for the
entire period for which enrollment is sought, a citizen or
national of the United States or an alien lawfully present
in the United States.
"Secretary" means the Secretary of the federal Department
of Health and Human Services.
"SHOP Exchange" means the Small Business Health Options

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Program established under this Law through which a qualified
employer can provide small group qualified health plans to its
qualified employees through various options available to the
employer, including, but not limited to: (a) offering one
qualified health plan to employees, (b) offering multiple
qualified health plans to employees, or (c) offering an
employee-directed choice of a qualified health plan within an
employer-selected coverage tier.
"Small employer" means, in connection with a group health
plan with respect to a calendar year and a plan year, an
employer who employed an average of at least 2 but not more
than 50 employees before January 1, 2016 and no more than 100
employees on and after January 1, 2016 on business days during
the preceding calendar year and who employs at least one
employee on the first day of the plan year. For purposes of
this definition:
(a) all persons treated as a single employer under
subsection (b), (c), (m) or (o) of Section 414 of the
federal Internal Revenue Code of 1986 shall be treated as a
single employer;
(b) an employer and any predecessor employer shall be
treated as a single employer;
(c) employees shall be counted in accordance with
federal law and regulations and State law and regulations;
provided however, that in the event of a conflict between
the federal law and regulations and the State law and

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regulations, the federal law and regulations shall
prevail;
(d) if an employer was not in existence throughout the
preceding calendar year, then the determination of whether
that employer is a small employer shall be based on the
average number of employees that is reasonably expected
that employer will employ on business days in the current
calendar year; and
(e) an employer that makes enrollment in qualified
health plans or qualified dental plans available to its
employees through the SHOP Exchange, and would cease to be
a small employer by reason of an increase in the number of
its employees, shall continue to be treated as a small
employer for purposes of this Law as long as it
continuously makes enrollment through the SHOP Exchange
available to its employees.
(215 ILCS 122/5-5)
Sec. 5-5. Establishment of the Exchange State health
benefits exchange.
(a) It is declared that this State, beginning on the
effective date of this amendatory Act of the 98th General
Assembly October 1, 2013, in accordance with Section 1311 of
the federal Patient Protection and Affordable Care Act, shall
establish a State health benefits exchange to be known as the
Illinois Health Benefits Exchange in order to help individuals

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and small employers with no more than 50 employees shop for,
select, and enroll in qualified, affordable private health
plans that fit their needs at competitive prices. The Exchange
shall separate coverage pools for individuals and small
employers and shall supplement and not supplant any existing
private health insurance market for individuals and small
employers. These health plans shall be available to individuals
and small employers for enrollment by October 1, 2015.
(b) There is hereby created a political subdivision, body
politic and corporate, named the Illinois Health Benefits
Exchange. The Exchange shall be a public entity, but shall not
be considered a department, institution, or agency of the
State.
(c) The Exchange shall be comprised of an individual and a
small business health options (SHOP) exchange. Pursuant to
Section 1311(b)(2) of the Federal Act, the Exchange shall
provide individual exchange services to qualified individuals
and SHOP Exchange services to qualified employers under a
single governance and administrative structure. The Board
shall produce an assessment, which must include a premium
impact study, by July 1, 2017 to determine the viability of
merging the SHOP Exchange and Individual Exchange functions
into a single exchange by January 1, 2018. Any recommended
merger of the SHOP Exchange and Individual Exchange functions
shall be subject to legislative approval.
(d) The Exchange shall promote a competitive marketplace

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for consumer access to affordable health coverage options. The
Department shall review and recommend that the Board certify
health benefit plans on the individual and SHOP Exchange, as
applicable, provided that any such health benefit plan meets
the requirements set forth in Section 1311(c) of the Federal
Act and any other requirements of the Illinois Insurance Code.
The Board shall certify health benefit plans that the
Department recommends for certification.
(e) The Exchange shall not supersede the provisions of the
Illinois Insurance Code, nor the functions of the Department of
Insurance, the Department of Healthcare and Family Services, or
the Department of Public Health.
(Source: P.A. 97-142, eff. 7-14-11.)
(215 ILCS 122/5-10)
Sec. 5-10. Exchange functions.
(a) On or before January 1, 2016, in compliance with
paragraph (4) of subdivision (d) of Section 1311 of the federal
Patient Protection and Affordable Care Act, the Exchange shall,
at a minimum, do all of the following to implement Section 1311
of the federal Patient Protection and Affordable Care Act:
(1) Make qualified health plans available to qualified
individuals and qualified employers.
(2) Implement procedures for the certification,
recertification, and decertification, consistent with
Section 5-11 of this Act and the guidelines established by

09800SB2799ham001 - 27 - LRB098 12336 RPM 60081 a
the U.S. Secretary of Health and Human Services, of health
plans as qualified health plans.
(3) Provide for the operation of a toll-free telephone
hotline and call center to respond to requests for
assistance.
(4) Maintain an Internet website through which
enrollees and prospective enrollees of qualified health
plans may obtain standardized comparative information on
those plans.
(5) With respect to each qualified health plan offered
through the Exchange, do both of the following:
(A) assign a rating to each qualified health plan
offered through the Exchange in accordance with the
criteria developed by the U.S. Secretary of Health and
Human Services; and
(B) determine each qualified health plan's level
of coverage in accordance with regulations adopted by
the U.S. Secretary of Health and Human Services under
paragraph (A) of subdivision (2) of Section 1302(d) of
the federal Patient Protection and Affordable Care Act
and any additional regulations adopted by the Exchange
under this Law.
(6) Utilize a standardized format for presenting
health benefits plan options in the Exchange, including the
use of the uniform outline of coverage established under
Section 2715 of the federal Public Health Service Act.

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(7) Inform individuals of eligibility requirements for
the Medicaid program, the Covering ALL KIDS Health
Insurance Program, or any applicable State or local public
program and, if through screening of the application by the
Exchange the Exchange determines that an individual is
eligible for any such program, enroll that individual in
the program.
(8) Establish and make available by electronic means a
calculator to determine the actual cost of coverage after
the application of any premium tax credit under Section 36B
of the Internal Revenue Code of 1986 and any cost sharing
reduction under Section 1402 of the federal Patient
Protection and Affordable Care Act.
(9) Coordinate with other State and county agencies.
(10) Grant a certification attesting that, for
purposes of the individual responsibility penalty under
Section 5000A of the Internal Revenue Code of 1986, an
individual is exempt from the individual requirement or
from the penalty imposed by that Section because of either
of the following:
(A) There is no affordable qualified health plan
available through the Exchange or the individual's
employer covering the individual.
(B) The individual meets the requirements for any
other exemption from the individual responsibility
requirement or penalty.

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(11) Transfer to the Secretary of the Treasury of the
United States all of the following:
(A) a list of the individuals who are issued a
certification, including the name and taxpayer
identification number of each individual;
(B) the name and taxpayer identification number of
each individual who was an employee of an employer, but
who was determined to be eligible for the premium tax
credit under Section 36B of the Internal Revenue Code
of 1986 because:
(i) the employer did not provide the minimum
essential coverage or the employer provided the
minimum essential coverage but it was determined
under item (C) of paragraph (2) of subdivision (c)
of Section 36B of the Internal Revenue Code to
either be unaffordable to the employee or not
provide the required minimum actuarial value; and
(ii) the name and taxpayer identification
number of each individual who notifies the
Exchange under paragraph (4) of subdivision (b) of
Section 1411 of the federal Patient Protection and
Affordable Care Act that they have changed
employers and of each individual who ceases
coverage under a qualified health plan during a
plan year, and the effective date of such
cessation.

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(12) Provide to each employer the name of each employee
of the employer described in subdivision (i) of Section
1311 of the federal Patient Protection and Affordable Care
Act who ceases coverage under a qualified health plan
during a plan year and the effective date of that
cessation.
(13) Perform duties required of, or delegated to, the
Exchange by the U.S. Secretary of Health and Human Services
or the Secretary of the Treasury of the United States
related to the following:
(A) Determining eligibility for premium tax
credits, reduced cost sharing, or individual
responsibility exemptions.
(B) Establishing procedures necessary for the
operation of the program, including, but not limited
to, procedures for application, enrollment, risk
assessment, risk adjustment, plan administration,
performance monitoring, and consumer education.
(C) Arranging for collection of contributions from
participating employers and individuals.
(D) Arranging for payment of premiums and other
appropriate disbursements based on the selections of
products and services by the individual participants.
(E) Establishing criteria for disenrollment of
participating individuals based on failure to pay the
individual's share of any contribution required to

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maintain enrollment in selected products.
(F) Establishing criteria for exclusion of
vendors.
(G) Developing and implementing a plan for
promoting public awareness of and participation in the
program.
(H) Evaluating options for employer participation
which may conform with common insurance practices.
(14) Providing for initial, annual, and special
enrollment periods, in accordance with guidelines adopted
by the U.S. Secretary of Health and Human Services under
paragraph (6) of subdivision (c) of Section 1311 of the
federal Patient Protection and Affordable Care Act.
(15) Establish the Navigator Program in accordance
with subdivision (i) of Section 1311 of the federal Patient
Protection and Affordable Care Act. The Exchange shall
award grants to certain entities to do the following:
(A) Conduct public education activities to raise
awareness of the availability of qualified health
plans.
(B) Distribute fair and impartial information
concerning enrollment in qualified health plans and
the availability of premium tax credits under Section
36B of the Internal Revenue Code of 1986 and
cost-sharing reductions under Section 1402 of the
federal Patient Protection and Affordable Care Act.

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(C) Facilitate enrollment in qualified health
plans.
(D) Provide referrals to any applicable office of
health insurance consumer assistance or health
insurance ombudsman established under Section 2793 of
the federal Public Health Service Act, or any other
appropriate State agency or agencies, for any enrollee
with a grievance, complaint, or question regarding his
or her health plan, coverage, or a determination under
that plan or coverage.
(E) Refer individuals with a grievance, complaint,
or question regarding a plan, a plan's coverage, or a
determination under a plan's coverage to a customer
relations unit established by the Exchange.
(F) Provide information in a manner that is
culturally and linguistically appropriate to the needs
of the population being served by the Exchange.
(16) Establish the Small Business Health Options
Program, separate from the activities of the Board related
to the individual market, to assist qualified small
employers in facilitating the enrollment of their
employees in qualified health plans offered through the
Exchange in the small employer market in a manner
consistent with paragraph (2) of subdivision (a) of Section
1312 of the Federal Act. The Illinois Health Benefits
Exchange shall meet the core functions identified by

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Section 1311 of the Patient Protection and Affordable Care
Act and subsequent federal guidance and regulations.
(b) The In order to meet the deadline of October 1, 2013
established by federal law to have operational a State
exchange, the Department of Insurance and the Commission on
Government Governmental Forecasting and Accountability is
authorized to apply for, accept, receive, and use as
appropriate for and on behalf of the State any grant money
provided by the federal government and to share federal grant
funding with, give support to, and coordinate with other
agencies of the State and federal government or third parties
as determined by the Governor, until the Board has the ability
to do so, at which time the Board is authorized to apply for,
accept, receive, and use as appropriate for and on behalf of
the State any grant money provided by the federal government
and to share federal grant funding with, give support to, and
coordinate with other agencies of the State and federal
government or third parties pursuant to Section 5-11 of this
Law.
(Source: P.A. 97-142, eff. 7-14-11; revised 9-11-13.)
(215 ILCS 122/5-11 new)
Sec. 5-11. Health benefit plan certification.
(a) To be certified as a qualified health plan, a health
benefit plan shall, at a minimum:
(1) provide the essential health benefits package

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described in Section 1302(a) of the Federal Act; except
that the plan is not required to provide essential benefits
that duplicate the minimum benefits of qualified dental
plans, as provided in subsection (e) of this Section if:
(A) the Board, in cooperation with the Department,
has determined that at least one qualified dental plan
is available to supplement the plan's coverage; and
(B) the health carrier makes prominent disclosure
at the time it offers the plan, in a form approved by
the Board, that the plan does not provide the full
range of essential pediatric dental benefits and that
qualified dental plans providing those benefits and
other dental benefits not covered by the plan are
offered through the Exchange;
(2) fulfill all premium rate and contract filing
requirements and ensure that no contract language has been
disapproved by the Director;
(3) provide at least the minimum level of coverage
prescribed by the Federal Act;
(4) ensure that the cost-sharing requirements of the
plan do not exceed the limits established under Section
1302(c)(l) of the Federal Act, and if the plan is offered
through the SHOP Exchange, the plan's deductible does not
exceed the limits established under Section 1302(c)(2) of
the Federal Act;
(5) be offered by a health carrier that:

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(A) is authorized and in good standing to offer
health insurance coverage;
(B) offers at least one qualified health plan at
the silver level and at least one plan at the gold
level, as described in the Federal Act, through each
component of the Board in which the health carrier
participates; for the purposes of this subparagraph
(B), "component" means the SHOP Exchange and the
exchange for individual coverage within the American
Health Benefit Exchange;
(C) charges the same premium rate for each
qualified health plan without regard to whether the
plan is offered through the Exchange and without regard
to whether the plan is offered directly from the health
carrier or through an insurance producer;
(D) does not charge any cancellation fees or
penalties; and
(E) complies with the regulations established by
the Secretary under Section 1311 (d) of the Federal Act
and any other requirements of the Illinois Insurance
Code and the Department;
(6) meet the requirements of certification pursuant to
the requirements of the Department and the Illinois
Insurance Code provided in this Law and the requirements
issued by the Secretary under Section 1311(c) of the
Federal Act and rules promulgated or adopted pursuant to

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this Law or the Federal Act, which shall include:
(A) minimum standards in the areas of marketing
practices;
(B) network adequacy;
(C) essential community providers in underserved
areas;
(D) accreditation;
(E) quality improvement;
(F) uniform enrollment forms and descriptions of
coverage; and
(G) information on quality measures for health
benefit plan performance;
(7) include outpatient clinics in the health plan's
region that are controlled by an entity that also controls
a 340B eligible provider as defined by Section 340B(a)(4)
of the federal Public Health Service Act such that the
outpatient clinics are subject to the same mission,
policies, and medical standards related to the provision of
health care services as the 340B eligible provider; and
(8) submit a justification for any premium increase
prior to the implementation of the increase; the plans
shall prominently post that information on their Internet
websites; the Board shall take this information, and the
information and the recommendations provided to the Board
by the Department of Insurance or the Department of Managed
Health Care under paragraph (1) of subdivision (b) of

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Section 2794 of the federal Public Health Service Act, into
consideration when determining whether to make the health
plan available through the Exchange; the Board shall take
into account any excess of premium growth outside the
Exchange as compared to the rate of that growth inside the
Exchange, including information reported by the Department
of Insurance and the Department of Managed Health Care.
(b) The Department shall require each health carrier
seeking certification of a plan as a qualified health plan to:
(1) make available to the public, in plain language as
defined in Section 1311(e)(3)(B) of the Federal Act, and
submit to the Board, the Secretary, and the Department
accurate and timely disclosure of the following:
(i) claims payment policies and practices;
(ii) periodic financial disclosures;
(iii) data on enrollment;
(iv) data on disenrollment;
(v) data on the number of claims that are
denied;
(vi) data on rating practices;
(vii) information on cost-sharing and payments
with respect to any out-of-network coverage;
(viii) information on enrollee and participant
rights under Title I of the Federal Act; and
(ix) other information as determined
appropriate by the Secretary, including, but not

09800SB2799ham001 - 38 - LRB098 12336 RPM 60081 a
limited to, accredited clinical quality measures;
and
(2) permit individuals to learn, in a timely manner
upon the request of the individual, the comparative quality
standards of the plans along established clinical
data-based standards and the amount of cost-sharing,
including deductibles, copayments, and coinsurance, under
the individual's plan or coverage that the individual would
be responsible for paying with respect to the furnishing of
a specific item or service by a participating provider and
make this information available to the individual through
an Internet website that is publicly accessible and through
other means for individuals without access to the Internet.
(c) The Department shall not exempt any health carrier
seeking certification as a qualified health plan, regardless of
the type or size of the health carrier, from licensure or
solvency requirements and shall apply the criteria of this
Section in a manner that ensures a level playing field between
or among health carriers participating in the Exchange.
(d) The provisions of this Law that are applicable to
qualified health plans shall also apply, to the extent
relevant, to qualified dental plans, except as modified in
accordance with the provisions of paragraphs (1), (2), and (3)
of this subsection (d) or by rules adopted by the Board.
(1) The health carrier shall be licensed to offer
dental coverage, but need not be licensed to offer other

09800SB2799ham001 - 39 - LRB098 12336 RPM 60081 a
health benefits.
(2) The plan shall be limited to dental and oral health
benefits, without substantially duplicating the benefits
typically offered by health benefit plans without dental
coverage and shall include, at a minimum, the essential
pediatric dental benefits prescribed by the Secretary
pursuant to Section 1302(b)(l)(J) of the Federal Act and
such other dental benefits as the Board or the Secretary
may specify by rule.
(3) Health carriers may jointly offer a comprehensive
plan through the Exchange in which the dental benefits are
provided by a health carrier through a qualified dental
plan and the other benefits are provided by a health
carrier through a qualified health plan, provided that the
plans are priced separately and are also made available for
purchase separately at the same price.
(215 ILCS 122/5-15)
Sec. 5-15. Illinois Health Benefits Exchange Legislative
Oversight Study Committee.
(a) There is created an Illinois Health Benefits Exchange
Legislative Oversight Study Committee within the Commission on
Government Forecasting and Accountability to provide
accountability for conduct a study regarding State
implementation and establishment of the Illinois Health
Benefits Exchange and to ensure Exchange operations and

09800SB2799ham001 - 40 - LRB098 12336 RPM 60081 a
functions align with the goals and duties outlined by this Law.
The Committee shall also be responsible for providing policy
recommendations to ensure the Exchange aligns with the Federal
Act, amendments to the Federal Act, and regulations promulgated
pursuant to the Federal Act.
(b) Members of the Legislative Oversight Study Committee
shall be appointed as follows: 3 members of the Senate shall be
appointed by the President of the Senate; 3 members of the
Senate shall be appointed by the Minority Leader of the Senate;
3 members of the House of Representatives shall be appointed by
the Speaker of the House of Representatives; and 3 members of
the House of Representatives shall be appointed by the Minority
Leader of the House of Representatives. Each legislative leader
shall select one member to serve as co-chair of the committee.
(c) Members of the Legislative Oversight Study Committee
shall be appointed no later than September 1, 2014 within 30
days after the effective date of this Law. The co-chairs shall
convene the first meeting of the committee no later than 45
days after the effective date of this Law.
(Source: P.A. 97-142, eff. 7-14-11.)
(215 ILCS 122/5-16 new)
Sec. 5-16. Exchange governance. The governing and
administrative powers of the Exchange shall be vested in a body
known as the Illinois Health Benefits Exchange Board. The
following provisions shall apply:

09800SB2799ham001 - 41 - LRB098 12336 RPM 60081 a
(1) The Board shall consist of 11 voting members
appointed by the Governor with the advice and consent of a
majority of the members elected to the Senate. In addition,
the Director of Healthcare and Family Services, and the
Executive Director of the Exchange shall serve as
non-voting, ex-officio members of the Board. The Governor
shall also appoint as non-voting, ex-officio members one
economist with experience in the health care markets and
one educated health care consumer advocate. All Board
members shall be appointed no later than September 1, 2014.
(2) The Governor shall make the appointments so as to
reflect no less than proportional representation of the
geographic, gender, cultural, racial, and ethnic
composition of this State and in accordance with
subparagraphs (A), (B), and (C) of this paragraph, as
follows:
(A) No more than 4 voting members may represent the
following interests, of which no more than 2 may
represent any one interest:
(1) the insurance industry;
(2) health care administrators; and
(3) licensed health care professionals.
(B) At least 7 voting members shall represent the
following interest groups, with each interest group
represented by at least one voting member:
(1) a labor interest group;

09800SB2799ham001 - 42 - LRB098 12336 RPM 60081 a
(2) a women's interest group;
(3) a minorities' interest group;
(4) a disabled persons' interest group;
(5) a small business interest group; and
(6) a public health interest group.
(C) Each person appointed to the Board should have
demonstrated experience in at least one of the
following areas:
(1) individual health insurance coverage;
(2) small employer health insurance;
(3) health benefits administration;
(4) health care finance;
(5) administration of a public or private
health care delivery system;
(6) the provision of health care services;
(7) the purchase of health insurance coverage;
(8) health care consumer navigation or
assistance;
(9) health care economics or health care
actuarial sciences;
(10) information technology; or
(11) starting a small business with 50 or fewer
employees.
(3) The Board shall elect one voting member of the
Board to serve as chairperson and one voting member to
serve as vice-chairperson, upon approval of a majority of

09800SB2799ham001 - 43 - LRB098 12336 RPM 60081 a
the Board.
(4) The Exchange shall be administered by an Executive
Director, who shall be appointed, and may be removed, by a
majority of the Board. The Board shall have the power to
determine compensation for the Executive Director.
(5) The terms of the non-voting, ex-officio members of
the Board shall run concurrent with their terms of
appointment to office, or in the case of the Executive
Director, his or her term of appointment to that position,
subject to the determination of the Board. The terms of the
members, including those non-voting, ex-officio members
appointed by the Governor, shall be 4 years. Upon
conclusion of the initial term, the next term and every
term subsequent to it shall run for 3 years. Voting members
shall serve no more than 3 consecutive terms.
A person appointed to fill a vacancy and complete the
unexpired term of a member of the Board shall only be
appointed to serve out the unexpired term by the individual
who made the original appointment within 45 days after the
initial vacancy. A person appointed to fill a vacancy and
complete the unexpired term of a member of the Board may be
re-appointed to the Board for another term, but shall not
serve than more than 2 consecutive terms following their
completion of the unexpired term of a member of the Board.
If a voting Board member's qualifications change due to
a change in employment during the term of their

09800SB2799ham001 - 44 - LRB098 12336 RPM 60081 a
appointment, then the Board member shall resign their
position, subject to reappointment by the individual who
made the original appointment.
(6) The Board shall, as necessary, create and appoint
qualified persons with requisite expertise to Exchange
technical advisory groups. These Exchange technical
advisory groups shall meet in a manner and frequency
determined by the Board to discuss exchange-related issues
and to provide exchange-related guidance, advice, and
recommendations to the Board and the Exchange. There shall
be at a minimum, 6 technical advisory groups, including the
following:
(1) an insurer advisory group;
(2) a business advisory group;
(3) a consumer advisory group;
(4) a provider advisory group;
(5) an insurance producer advisory group; and
(6) a dentist advisory group.
(7) The Board shall meet no less than quarterly on a
schedule established by the chairperson. Meetings shall be
public and public records shall be maintained, subject to
the Open Meetings Act. A majority of the Board shall
constitute a quorum and the affirmative vote of a majority
is necessary for any action of the Board. No vacancy shall
impair the ability of the Board to act provided a quorum is
reached. Members shall serve without pay, but shall be

09800SB2799ham001 - 45 - LRB098 12336 RPM 60081 a
reimbursed for their actual and reasonable expenses
incurred in the performance of their duties. The
chairperson of the Board shall file a written report
regarding the activities of the Board and the Exchange to
the Governor and General Assembly annually, and the
Legislative Oversight Committee established in Section
5-15 quarterly, beginning on January 1, 2015 through
December 31, 2016.
(8) The Board shall adopt conflict of interest rules
and recusal procedures. Such rules and procedures shall (i)
prohibit a member of the Board from performing an official
act that may have a direct economic benefit on a business
or other endeavor in which that member has a direct or
substantial financial interest and (ii) require a member of
the Board to recuse himself or herself from an official
matter, whether direct or indirect. All recusals must be in
writing and specify the reason and date of the recusal. All
recusals shall be maintained by the Executive Director and
shall be disclosed to any person upon written request.
(9) The Board shall develop a budget, to be submitted
to the General Assembly along with the Governor's annual
budget proposal and approved by the General Assembly, for
the implementation and operation of the Exchange for
operating expenses, including, but not limited to:
(A) proposed compensation levels for the Executive
Director and shall identify personnel and staffing

09800SB2799ham001 - 46 - LRB098 12336 RPM 60081 a
needs for the implementation and operation of the
Exchange;
(B) disclosure of funds received or expected to be
received from the federal government for the
infrastructure and systems of the Exchange and those
funds received or expected to be received for program
administration and operations;
(C) delineation of those functions of the Exchange
that are to be paid by State and federal programs that
are allocable to the State's General Revenue Fund; and
(D) beginning January 1, 2016, insurer assessments
contingent upon the use of federal funds for the first
year of operation of the Exchange and upon the review
and recommendations of the Commission on Government
Forecasting and Accountability.
(10) The Board shall, in consultation with the Health
Benefits Exchange Legislative Oversight Committee, produce
a cost-benefit analysis of the State's essential health
benefits no later than August 1, 2015 for the purposes of
informing the U.S. Department of Health and Human Services
in their re-evaluation of the essential health benefits for
plan years 2016 and beyond.
(11) The purpose of the Board shall be to implement the
Exchange in accordance with this Section and shall be
authorized to establish procedures for the operation of the
Exchange, subject to legislative approval.

09800SB2799ham001 - 47 - LRB098 12336 RPM 60081 a
(215 ILCS 122/5-17 new)
Sec. 5-17. Insurer's assessment. Every carrier licensed to
issue, and that issues for delivery, policies of accident and
health insurance in this State shall be assessed. An insurer's
assessment shall be determined by multiplying the total
assessment, as determined in this Section, by a fraction, the
numerator of which equals that insurer's direct Illinois
premiums, excluding those premiums from limited lines policies
and supplemental insurance policies, during the preceding
calendar year and the denominator of which equals the total of
all insurers' direct Illinois premiums, excluding those
premiums from limited lines policies and supplemental
insurance policies. The Board may exempt those insurers whose
share as determined under this Section would be so minimal as
to not exceed the estimated cost of levying the assessment. The
Board shall charge and collect from each insurer the amounts
determined to be due under this Section. The assessment shall
be billed by Board invoice based upon the insurer's direct
Illinois premium income, excluding premium income from limited
lines policies and supplemental insurance policies, as shown in
its annual statement for the preceding calendar year as filed
with the Director. The invoice shall be due upon receipt and
must be paid no later than 30 days after receipt by the
insurer.
When a carrier fails to pay the full amount of any

09800SB2799ham001 - 48 - LRB098 12336 RPM 60081 a
assessment of $100 or more due under this Section there shall
be added to the amount due as a penalty the greater of $50 or an
amount equal to 5% of the deficiency for each month or part of
a month that the deficiency remains unpaid. All moneys
collected by the Board shall be placed in the Illinois Health
Benefits Exchange Fund.
Insurers shall be assessed only an amount not exceeding the
General Assembly's approved Board budget. No assessment shall
be made on insurers while assessments are being made pursuant
to Section 12 of the Comprehensive Health Insurance Plan Act.
The assessment shall also take into consideration any unspent
federal funds remaining and shall be reduced accordingly.
The Board shall prepare annually a complete and detailed
written report accounting for all funds received and dispensed
during the preceding fiscal year.
(215 ILCS 122/5-18 new)
Sec. 5-18. Illinois Health Benefits Exchange Fund. There
is hereby created as a fund outside of the State treasury the
Illinois Health Benefits Exchange Fund to be used, subject to
appropriation, exclusively by the Exchange to provide funding
for the operation and administration of the Exchange in
carrying out the purposes authorized in this Law.
(215 ILCS 122/5-23 new)
Sec. 5-23. Examination or investigation of the Exchange.

09800SB2799ham001 - 49 - LRB098 12336 RPM 60081 a
The Director shall have the ability to examine or investigate
the Exchange pursuant to his or her authority under Article
XXIV of the Illinois Insurance Code.
Section 99. Effective date. This Act takes effect upon
becoming law.".