The State Employees Group Insurance Act of 1971 is amended. The Illinois Insurance Code is amended by adding Section 356y and changing Sections 357.9 and 370a. Interest penalties accrue on the day after payment required until the date late payment made. Interest payments due within 30 days from date late payment made. Payor to provide written notice of requirement to all Enrollees.
Nothing requires payor to select a health care professional or facility for an Enrollee.
Payor provides notice to professional or facility within 60 calendar days of selection. The same 60-day timeframe to begin payments applies to PHOs and IPAs. Independent practice associations and physician-hospital organizations shall notify the insured, insured's assignee, health care professional, or health care facility of any failure to provide sufficient documentation for a due proof of loss within 30 days after receipt of the claim for health services. All insurers, HMOs, managed care plans, health care plans, PPOs, and TPAs pay all claims other than periodic payments within 30 days after receipt of due written proof of loss. Notification required of any known failure to provide sufficient documentation for a due proof of loss within 30 days after receipt of the claim for health care services.