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Legislative Reports The situation at the Capitol has gone from bad to worse and Speaker Madigan finally stated publicly what all legislators and lobbyists have known for over a year when he stated that Democrats are engaged in a “civil war” and that “no prisoners are being taken” in the democratic family feud. While the Senate continues to bottle up House-passed measures, like a constitutional amendment providing a recall mechanism for constitutional officers and members of the General Assembly, Speaker Madigan and House Democrats have been busy moving legislation to the floor reenacting Illinois’ old Structural Work Act and a single payer universal coverage health insurance plan. As the shots are fired back and forth across the rotunda, Governor Blagojevich remains mired in historically low ratings with one poll recently measuring his approval rating at an astonishing 13%. The Governor continues to suffer legal and political setbacks as the Tony Rezko trial unveils a massive “pay to play” fundraising scheme and a Cook County judge ordered the administration to stop enrollment in his unilateral move to expand the state’s Medicaid program, Family Care. Although today was supposed to be the 3rd reading deadline for bills in their original chamber, both the House and Senate have extended the deadline for several weeks. The General Assembly takes next week off and then returns for five straight weeks to attempt to meet the scheduled May 31st adjournment date. Unless something major, very major, develops between now and then, it looks like legislators are in for a very long summer. With the exception of HB 2094, the Construction Safety Act of 2008, almost all of the legislation activity this session has been focused on the life and health side of the insurance industry. Producers
Life & Benefits The 3rd reading deadline for both HB 4941 – Mautino, the NAIC Viatical Settlements Act and SB 2358 – Haine, the NCOIL model, have been extended to give all the parties additional time to work out a compromise. While several life agencies have been working to try and develop language to carve out their particular nice markets, others such as Coventry and premium finance companies are opposed to any efforts to outlaw the practice. HB 4866 Graham (Wilhelmi) & SB 2098 Wilhelmi (Graham) Amends the State Treasurer Act. Authorizes the State Treasurer to create the State Treasurer Financial Education and Savings Not-For-Profit Corporation for the purposes of promoting financial literacy and savings among the residents of the State of Illinois and to issue grants and scholarships. Sets forth requirements for the creation and operation of the corporation. Effective immediately. Health Insurance HB 311 would create a state run single payer health plan and would prohibit private insurers from selling plans that duplicate coverage of the program. While it stretches the imagination to take the legislation seriously when the state is billions in debt and can’t pay its current bills, it is significant that almost 30 House Democrats, including Speaker Madigan, have joined as cosponsors of the legislation. Most in the health care industry believe that the House Democrats want something they can point to as an alternative to the Governor’s health care plans. Meanwhile, several expensive health insurance mandates continue to advance out of both chambers. HB 953 Lang Amends the Illinois Insurance Code. Requires coverage of treatment for mental, emotional, or nervous disorders or conditions by a licensed marriage and family therapist when the insurance covers mental, emotional, or nervous disorders or conditions. Effective immediately. HB 1432 Crespo (Cullerton) - Amends the Illinois Insurance Code. Changes the definition of "serious mental illness" to include eating disorders, including anorexia nervosa, bulimia nervosa, and Eating Disorders Not Otherwise Specified (EDNOS), as recognized by the most current edition of the Diagnostic and Statistical Manual. HB 4223 Flowers (Collins) - Mandatory External Appeals - Provides that a policy of accident or health insurance or managed care plan shall establish and maintain an appeals procedure related to the denial of health care benefits. Sets forth guidelines for maintaining an appeals procedure, including an expedited process for an enrollee with an ongoing course of treatment ordered by a health care provider, the denial of which could significantly increase the risk to an enrollee's health, or a treatment referral, service, procedure, or other health care service, the denial of which could significantly increase the risk to an enrollee's health. Provides that if an initial appeal is denied by the policy or plan, an enrollee is entitled to seek external independent review of the decision made by the policy or plan. Sets forth guidelines and requirements for the external independent review process. Provides that the Office of Consumer Health Insurance of the Division of Insurance shall adopt rules for the enforcement of the provision. HB 4620 Smith - Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, the Voluntary Health Services Plans Act, and the Public Aid Code to provide coverage for heart disease prevention tests for women. Effective immediately HB 4824 Coulson - Amends the Illinois Insurance Code, the Health Maintenance Organization Act, and the Voluntary Health Services Plans Act to require coverage for an operation to implant cochlear implants and post-treatment services for children identified within one year of birth as being deaf or hearing impaired. HB 4940 Mautino - Amends the Illinois Insurance Code. Provides that a policy or plan that provides coverage for hospital or medical treatment on an expense incurred basis, may offer wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan. HB 5192 Harris (Collins) - Amends the Illinois Public Aid Code, the Illinois Insurance Code, and other Acts. Provides that on and after July 1, 2008, screening and diagnostic mammography shall be reimbursed under the medical assistance program at the same rate as the Medicare program's rates, including the increased reimbursement for digital mammography. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after the effective date of this amendatory Act must provide coverage for all medically necessary pain medication and pain therapy related to the treatment of breast cancer on the same terms and conditions that are generally applicable to coverage for other conditions. Provides that mandatory insurance coverage relating to mammography shall be provided at no cost to the insured and shall not be subject to an annual or lifetime maximum benefit. HB 5285 Jefferson (Hendon) - Amends the Illinois Insurance Code to require the continuation of coverage for a dependent college student who takes a medical leave of absence or reduces his or her course load to part-time status because of an illness or injury. HB 5865 Flowers (Crotty) Creates the Premium and Loss Data Reporting Act. Provides that all insurers subject to the Act shall report to the Director of the Division of Insurance accurate and complete information for each accident and health coverage type requested. Sets forth the specific types of accident and health coverage requested for reporting. SB 1900 DeLeo (Saviano) -Amends the Illinois Insurance Code to provide coverage for autism spectrum disorders to the extent that the diagnosis and treatment of autism spectrum disorders are not already covered by the policy or plan. Provides that this coverage shall be subject to a maximum benefit of $36,000 per year, but shall not be subject to any limits on the number of visits to an autism service provider. Makes other changes. Effective immediately. SB 2002 Haine (Mautino) Amends the State Employees Group Insurance Act of 1971. With respect to the participation of units of local government, school districts, rehabilitation facilities, and child advocacy centers in the group health insurance plan, permits participation with fewer than all employees enrolled as long as (i) those not enrolled are covered spouses or dependents in this or another plan or (ii) at least 50% of employees are enrolled (now, for units, districts, and facilities, at least 85% of employees must be enrolled and for child advocacy centers, all employees must be enrolled without exception). Effective immediately. SB 2486 Kotowski (Mathias) - Amends the Illinois Insurance Code. Provides that a policy or plan that provides coverage for hospital or medical treatment on an expense incurred basis, may offer wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan. Provides that "wellness coverage" means health care coverage with the primary purpose to engage and motivate the insured or enrollee through: incentives; provision of health education, counseling, and self-management skills; identification of modifiable health risks; and other activities to influence health behavior changes. Makes other changes. Effective January 1, 2009. SB 2499 Crotty (Coulson) Provides for coverage for habilitative services for children under 19 years of age with a congenital, genetic, or early acquired disorder (was congenital or genetic defect existing at or from birth or a defect acquired at a young age); provides conditions for the coverage; makes changes in the definition of "habilitative services"; sets forth general exclusions and limitations of the coverage; and provides that upon request of the reimbursing insurer, the provider under whose supervision the habilitative services are being provided shall furnish medical records, clinical notes, or other necessary data to allow the insurer to substantiate that initial or continued medical treatment is medically necessary and that the patient's condition is clinically improving. Competing Tax Proposals HB 750 Increases the income tax rates for individuals, trusts and estates from 3% to 5% and increases the rate of income tax for corporations from 4.8% to 8% of the taxpayer's net income. HB 750 expands the sales tax to include services and provides that the increased revenue go to schools and for property tax relief. SB 2288 is a modified version of HB 750 (a significant difference is that SB 2288 does not expand the sales tax to include services) that will fund education, a property tax swap ($2.9 billion in property tax relief), debt payment, and a capital program. The individual income tax rate would increase from 3% to 5% while the corporate rate would increase from 4.2% to 8%. The total estimated new revenue would be $7.2 billion. HB 4636 Amends the Illinois Income Tax Act. Increases the rate of tax on individuals and on trusts and estates from 3% to 4% on January 1, 2009. HB 5104 Illinois Income Tax Act and the Property Tax Code. In the Property Tax Code, it creates the standard homestead exemption in an amount equal to $150,000 and repeals sections concerning various other homestead exemptions. In the Illinois Income Tax Act, increases the rate of tax on individuals and on trusts and estates from 3% to 5.7% and requires that the additional revenue generated from the increased rate must be deposited into the Homestead Property Tax Replacement Fund. Property & Casualty
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Current (below)