HB 4059

Abstract

Amends the Illinois Insurance Code, the Health Care Purchasing Group Act, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. Provides that upon the written request of a sponsor of a group health plan, the health insurance issuer providing health insurance coverage under the plan must report to the sponsor information from the 12 months preceding the date of the report regarding: (1) the total amount of charges submitted to the health insurance issuer for persons covered under the plan; (2) the total amount of payments made by the health insurance issuer to health care providers for persons covered under the plan; (3) to the extent available, information on claims paid by type of health care provider; and (4) the diagnosis codes for payment of claims that exceed $25,000. Provides that the plan sponsor may use the information only for purposes relating to obtaining and maintaining health insurance coverage for the sponsor's employees (if the sponsor is an employer) or members (if the sponsor is an employee organization).