Sen. John M. Sullivan
Filed: 11/5/2013
 
 


 




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1
AMENDMENT TO HOUSE BILL 2494




2 AMENDMENT NO. ______. Amend House Bill 2494 by replacing 
3everything after the enacting clause with the following:


4 "Section 5. The State Employees Group Insurance Act of 1971 
5is amended by changing Section 5 as follows: 




6 (5 ILCS 375/5) (from Ch. 127, par. 525)



7 Sec. 5. Employee benefits; declaration of State policy.
The 
8General Assembly declares that it is the policy of the State 
9and in the best interest of the State to assure quality 
10benefits to members and their dependents under this Act. The 
11implementation of this policy depends upon, among other things, 
12stability and continuity of coverage, care, and services under 
13benefit programs for members and their dependents. 
14Specifically, but without limitation, members should have 
15continued access, on substantially similar terms and 
16conditions, to trusted family health care providers with whom 
 
 
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1they have developed long-term relationships through a benefit 
2program under this Act. Therefore, the Director must administer 
3this Act consistent with that State policy, but may consider 
4affordability, cost of coverage and care, and competition among 
5health insurers and providers. All contracts for provision of 
6employee benefits, including those portions of any proposed 
7collective bargaining agreement that would require 
8implementation through contracts entered into under this Act, 
9are subject to the following requirements:
10  (i) By April 1 of each year, the Director must report 
11 and provide information to the Commission concerning the 
12 status of the employee benefits program to be offered for 
13 the next fiscal year. Information includes, but is not 
14 limited to, documents, reports of negotiations, bid 
15 invitations, requests for proposals, specifications, 
16 copies of proposed and final contracts or agreements, and 
17 any other materials concerning contracts or agreements for 
18 the employee benefits program. By the first of each month 
19 thereafter, the Director must provide updated, and any new, 
20 information to the Commission until the employee benefits 
21 program for the next fiscal year is determined. In addition 
22 to these monthly reporting requirements, at any time the 
23 Commission makes a written request, the Director must 
24 promptly, but in no event later than 5 business days after 
25 receipt of the request, provide to the Commission any 
26 additional requested information in the possession of the 
 
 
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1 Director concerning employee benefits programs. The 
2 Commission may waive any of the reporting requirements of 
3 this item (i) upon the written request by the Director. Any 
4 waiver granted under this item (i) must be in writing. 
5 Nothing in this item is intended to abrogate any 
6 attorney-client privilege.

7  (ii) Within 30 days after notice of the awarding or 
8 letting of a contract has appeared in the Illinois 
9 Procurement Bulletin in accordance with subsection (b) of 
10 Section 15-25 of the Illinois Procurement Code, the 
11 Commission may request in writing from the Director and the 
12 Director shall promptly, but in no event later than 5 
13 business days after receipt of the request, provide to the 
14 Commission information in the possession of the Director 
15 concerning the proposed contract. Nothing in this item is 
16 intended to waive or abrogate any privilege or right of 
17 confidentiality authorized by law.
18  (iii) Except as otherwise provided in this item (iii), 
19 no contract subject to this Section may be entered into 
20 until the 30-day period described in item (ii) has expired, 
21 unless the Director requests in writing that the Commission 
22 waive the period and the Commission grants the waiver in 
23 writing. This item (iii) does not apply to any contract 
24 entered into after the effective date of this amendatory 
25 Act of the 98th General Assembly and through January 1, 
26 2014 to provide a program of group health benefits for 
 
 
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1 Medicare-primary members and their Medicare-primary 
2 dependents that is comparable in stability and continuity 
3 of coverage, care, and services to the program of health 
4 benefits offered to other members and their dependents 
5 under this Act. 
6  (iv) If the Director seeks to make any substantive 
7 modification to any provision of a proposed contract after 
8 it is submitted to the Commission in accordance with item 
9 (ii), the modified contract shall be subject to the 
10 requirements of items (ii) and (iii) unless the Commission 
11 agrees, in writing, to a waiver of those requirements with 
12 respect to the modified contract.

13  (v) By the date of the beginning of the annual benefit 
14 choice period, the Director must transmit to the Commission 
15 a copy of each final contract or agreement for the employee 
16 benefits program to be offered for the next fiscal year. 
17 The annual benefit choice period for an employee benefits 
18 program must begin on May 1 of the fiscal year preceding 
19 the year for which the program is to be offered. If, 
20 however, in any such preceding fiscal year collective 
21 bargaining over employee benefit programs for the next 
22 fiscal year remains pending on April 15, the beginning date 
23 of the annual benefit choice period shall be not later than 
24 15 days after ratification of the collective bargaining 
25 agreement.

26  (vi) The Director must provide the reports, 
 
 
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1 information, and contracts required under items (i), (ii), 
2 (iv), and (v) by electronic or other means satisfactory to 
3 the Commission. Reports, information, and contracts in the 
4 possession of the Commission pursuant to items (i), (ii), 
5 (iv), and (v) are exempt from disclosure by the Commission 
6 and its members and employees under the Freedom of 
7 Information Act. Reports, information, and contracts 
8 received by the Commission pursuant to items (i), (ii), 
9 (iv), and (v) must be kept confidential by and may not be 
10 disclosed or used by the Commission or its members or 
11 employees if such disclosure or use could compromise the 
12 fairness or integrity of the procurement, bidding, or 
13 contract process. Commission meetings, or portions of 
14 Commission meetings, in which reports, information, and 
15 contracts received by the Commission pursuant to items (i), 
16 (ii), (iv), and (v) are discussed must be closed if 
17 disclosure or use of the report or information could 
18 compromise the fairness or integrity of the procurement, 
19 bidding, or contract process.

20 All contracts entered into under this Section are subject 
21to appropriation and shall comply with Section 20-60(b) of the 
22Illinois Procurement Code (30 ILCS 500/20-60(b)).

23 The Director shall contract or otherwise make available 
24group
life insurance, health benefits and other
employee 
25benefits to eligible members and, where elected,
their eligible 
26dependents. Any contract or, if
applicable, contracts or other 
 
 
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1arrangement for provision of benefits
shall be on terms 
2consistent with State policy and
based on, but not limited to, 
3such
criteria as administrative cost, service capabilities of 
4the carrier
or other contractor and premiums, fees or charges 
5as related to benefits.

6 Notwithstanding any other provisions of this Act, by 
7January 1, 2014, the Department of Central Management Services, 
8in consultation with and subject to the approval of the Chief 
9Procurement Officer, shall contract or make otherwise 
10available a program of group health benefits for 
11Medicare-primary members and their Medicare-primary 
12dependents. The Director may procure a single contract or 
13multiple contracts that provide a program of group health 
14benefits that is comparable in stability and continuity of 
15coverage, care, and services to the program of health benefits 
16offered to other members and their dependents under this Act. 
17The initial procurement of a contract or contracts under this 
18paragraph is not subject to the provisions of the Illinois 
19Procurement Code, except for Sections 20-60, 20-65, 20-70, and 
2020-160 and Article 50 of that Code, provided that the Chief 
21Procurement Officer may, in writing with justification, waive 
22any certification required under Article 50. 
23 At least 2 group health benefits providers must be 
24available to Medicare-primary members and their 
25Medicare-primary dependents in each county in the State, with 
26at least one of those providers being a managed care option. 
 
 
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1The Department must conduct a supplemental procurement to 
2ensure that such options are available. The deadline for 
3enrolling in a program of group health benefits for 
4Medicare-primary members and their Medicare-primary dependents 
5shall be extended to such a date as to ensure that at least 2 
6options are available as required by this Section. 
7 The Director may prepare and issue specifications
for group 
8life insurance, health benefits, other employee benefits
and 
9administrative services for the purpose of receiving proposals

10from interested parties. 

11 The Director is authorized to execute a contract, or

12contracts, for the programs of group life insurance, health

13benefits, other employee benefits and administrative services

14authorized by this Act (including, without limitation, 
15prescription drug benefits). All of the benefits provided under 
16this Act may be
included in one or more contracts, or the 
17benefits may be classified into
different types with each type 
18included under one or more similar contracts
with the same or 
19different companies.

20 The term of any contract may not extend beyond 5 fiscal 
21years.
Upon recommendation of the Commission, the Director may 
22exercise renewal
options of the same contract for up to a 
23period of 5 years. Any
increases in premiums, fees or charges 
24requested by a contractor whose
contract may be renewed 
25pursuant to a renewal option contained therein,
must be 
26justified on the basis of (1) audited experience data, (2)

 
 
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1increases in the costs of health care services provided under 
2the contract,
(3) contractor performance, (4) increases in 
3contractor responsibilities,
or (5) any combination thereof.

4 Any contractor shall agree to abide by all
requirements of 
5this Act and Rules and Regulations promulgated and adopted

6thereto; to submit such information and data as may from time 
7to time be
deemed necessary by the Director for effective 
8administration of the
provisions of this Act and the programs 
9established
hereunder, and to fully cooperate in any audit.

10(Source: P.A. 98-19, eff. 6-10-13.)



11 Section 99. Effective date. This Act takes effect upon 
12becoming law.".