Illinois Administrative Code
Title 80 - PUBLIC OFFICIALS AND EMPLOYEES
Part 2160 - LOCAL GOVERNMENT HEALTH PLAN
Subpart F - FUNDING
Section 2160.620 - Premium Rate Structure
Universal Citation: 80 IL Admin Code ยง 2160.620
Current through Register Vol. 48, No. 38, September 20, 2024
The Director shall annually determine monthly rates of payment subject to the following constraints.
a) A tiered rate methodology shall be employed.
b) Units shall be assigned a rate tier based on the projected costs for each Unit according to the following guidelines:
1) In the first
Fiscal Year of coverage the rates shall be based on the cost of administration
and the cost of medical services adjusted for age, sex, geographic or
demographic characteristics, or other factors that may affect the costs of the
Plan. A margin to cover fluctuation in the amount of claims shall also be added
to the premium.
2) In subsequent
years, premium rates shall be based on prior years' claims experience, the cost
of administration and the cost of medical services adjusted for age, sex,
geographic or demographic characteristics, or other factors that may affect the
costs of the Plan. A margin to cover fluctuations in the amount of claims shall
also be added to the premium.
3)
Premium rates shall remain unchanged throughout the Fiscal Year. A Unit shall
experience a one-tier rate increase or decrease if the projected costs, based
on employee demographics and actual prior years' claims experience of Members
and Dependents, warrant such an increase or decrease for the following Fiscal
Year.
c) Beginning with the first year, Units that enroll more than 250 Members may be individually experience rated to determine the monthly premium rates.
Disclaimer: These regulations may not be the most recent version. Illinois may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
