Ill. Admin. Code tit. 80 § 2160.250

Current through Register Vol. 48, No. 52, December 27, 2024

Section 2160.250 - Other Administrative Responsibilities

a) The Department shall offer an annual Benefits Choice Period for Units to:

1) add or drop coverage for Annuitants as a group;

2) allow Members to add or drop Dependent coverage;

3) allow Members to change health plans.

b) The Department shall provide information to the Units about the benefits and requirements of the Program in the Local Government Health Plan Benefits Handbook and the annual Benefit Choice Options booklet.

c) The Department shall prepare and distribute an administrative procedures manual with periodic updates for the Health Plan Representatives designated by the Units.

d) The Department will provide training seminars for Health Plan Representatives designated by the Units.

e) The Department shall establish an Advisory Board. The responsibilities of the Board are described in Section 2160.520.

f) The Department shall establish formal appeal procedures to be followed when the Member is dissatisfied with the benefit determination made by the Administrative Service Organization or self-funded managed care plan as described in Section 2160.420.

g) The Department shall notify the designated Health Plan Representatives of the Administrative Service Organizations being used and the address and forms needed to submit claims to the Administrative Service Organizations.

h) The Department shall audit records of participating Units, such as payroll information, to verify enrollment and enforce eligibility rules under the Plan.

Ill. Admin. Code tit. 80, § 2160.250

Amended at 32 Ill. Reg. 15994, effective September 11, 2008