Sec. 4. Powers and authority of the board.
781 words·~4 min read·
/il/chapter-215/act-105/4A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Sec. 4. Powers and authority of the board. The board shall have the general powers and authority granted under the laws of this State to insurance companies licensed to transact health and accident insurance and in addition thereto, the specific authority to:
a. Enter into contracts as are necessary or proper to carry out the provisions and
purposes of this Act, including the authority, with the approval of the Director, to enter into contracts with similar plans of other states for the joint performance of common administrative functions, or with persons or other organizations for the performance of administrative functions including, without limitation, utilization review and quality assurance programs, or with health maintenance organizations or preferred provider organizations for the provision of health care services.
b. Sue or be sued, including taking any legal actions necessary or proper.
c. Take such legal action as necessary to:
(1)avoid the payment of improper claims against the plan or the coverage provided
by or through the plan;
(2)to recover any amounts erroneously or improperly paid by the plan;
(3)to recover any amounts paid by the plan as a result of a mistake of fact or law;
or
(4)to recover or collect any other amounts, including assessments, that are due or
owed the Plan or have been billed on its or the Plan's behalf.
d. Establish appropriate rates, rate schedules, rate adjustments, expense allowances,
agents' referral fees, claim reserves, and formulas and any other actuarial function appropriate to the operation of the plan. Rates and rate schedules may be adjusted for appropriate risk factors such as age and area variation in claim costs and shall take into consideration appropriate risk factors in accordance with established actuarial and underwriting practices.
e. Issue policies of insurance in accordance with the requirements of this Act.
f. Appoint appropriate legal, actuarial and other committees as necessary to provide
technical assistance in the operation of the plan, policy and other contract design, and any other function within the authority of the plan.
g. Borrow money to effect the purposes of the Illinois Comprehensive Health Insurance
Plan. Any notes or other evidence of indebtedness of the plan not in default shall be legal investments for insurers and may be carried as admitted assets.
h. Establish rules, conditions and procedures for reinsuring risks under this Act.
i. Employ and fix the compensation of employees. Such employees may be paid on a warrant
issued by the State Treasurer pursuant to a payroll voucher certified by the Board and drawn by the Comptroller against appropriations or trust funds held by the State Treasurer.
j. Enter into intergovernmental cooperation agreements with other agencies or entities
of State government for the purpose of sharing the cost of providing health care services that are otherwise authorized by this Act for children who are both plan participants and eligible for financial assistance from the Division of Specialized Care for Children of the University of Illinois.
k. Establish conditions and procedures under which the plan may, if funds permit,
discount or subsidize premium rates that are paid directly by senior citizens, as defined by the Board, and other plan participants, who are retired or unemployed and meet other qualifications.
l. Establish and maintain the Plan Fund authorized in Section 3 of this Act, which shall
be divided into separate accounts, as follows:
(1)accounts to fund the administrative, claim, and other expenses of the Plan
associated with eligible persons who qualify for Plan coverage under Section 7 of this Act, which shall consist of:
(A)premiums paid on behalf of covered persons;
(B)appropriated funds and other revenues collected or received by the Board;
(C)reserves for future losses maintained by the Board; and
(D)interest earnings from investment of the funds in the Plan Fund or any of
its accounts other than the funds in the account established under item
(2)of this subsection;
(2)an account, to be denominated the federally eligible individuals account, to
fund the administrative, claim, and other expenses of the Plan associated with federally eligible individuals who qualify for Plan coverage under Section 15 of this Act, which shall consist of:
(A)premiums paid on behalf of covered persons;
(B)assessments and other revenues collected or received by the Board;
(C)reserves for future losses maintained by the Board;
(D)interest earnings from investment of the federally eligible individuals
account funds; and
(E)grants provided pursuant to the federal Trade Act of 2002; and
(3)such other accounts as may be appropriate.
m. Charge and collect assessments paid by insurers pursuant to Section 12 of this Act
and recover any assessments for, on behalf of, or against those insurers.