SB 1273 Illinois Senate · 98th Regular Session

EXCLUSIVE PROVIDER BNFT PLANS

Summary
Creates the Exclusive Provider Benefit Plan Act. Provides that an exclusive provider benefit plan that meets the requirements of the Act shall be permitted. Provides that to the extent of any conflict between the provision permitting exclusive provider benefit plans and any other statutory provision, the provision permitting exclusive provider benefit plans prevails over the conflicting provision. Provides that an insurer duly licensed under the laws of this State may offer exclusive provider benefit plans to individuals and group health plans in conformity with the terms set forth in the provision concerning the applicability of the Act. Provides that an insurer shall not be required to be licensed as an HMO under the Health Maintenance Organization Act in order to offer exclusive provider benefit plans under the provision concerning the applicability of the Act. Sets forth provisions concerning the applicability of the Health Carrier External Review Act; the construction of the Exclusive Provider Benefit Plan Act; providing information to enrollees and prospective enrollees; the availability of exclusive providers; notice of nonrenewal or termination; transitions of service and continuity of care; prohibitions; exclusive provider benefit plan's access to specialists; health care services appeals, complaints, and external independent reviews; emergency services prior to stabilization; post-stabilization medical services; quality assessment programs; utilization review; and qualifying examinations of insurers and fees. Amends the Freedom of Information Act to establish an exemption for all identified or deidentified health information due to the Department of Insurance's administration of the Exclusive Provider Benefit Plan Act. Effective immediately.
Bill status failed 1 of 4 stages cleared
Introduction
Jan 2013
Committee Review
Floor Vote
Governor
Introduced Jan 31, 2013 Last action Jan 13, 2015
Floor votes

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Full legislative history

Actions timeline

Total actions
6
Key actions
0
Committee
3
Mar 22, 2013
Committee
Rule 3-9(a) / Re-referred to Assignments
upper
Feb 14, 2013
Committee
Assigned to Insurance
upper
Jan 31, 2013
Committee
Referred to Assignments
upper
0 primary · 1 co-sponsor

Sponsors

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