1997 Annual Report - Illinois Comprehensive Health Insurance Plan

Transcription

ICHIP 01/09/08
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State of Illinois
Comprehensive Health Insurance Plan
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Jim Edgar
Governor
Jim Ryan
Attorney General
Arnold L. Dutcher
Chairman, Board of
Directors
Richard W. Carlson
Executive Director
1997 Annual Report and
Financial Summaries
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~ CHIP At a Glance
-Y
CHIP is a state insurance program for eligible persons who are unable to obtain private
health insurance and qualify under Section 7 of the CHIP Act and federally eligible
individuals who qualify under Section 15.
-Y
Since May 1989, CHIP has provided coverage to more than 15,000 Illinois
residents from every county in the state.
-Y
Through the same period, CHIP has paid over $285 million in benefits on behalf of
these CHIP participants.
-Y
The average CHIP participant pays annual premiums of approximately $3,800.
-v An optional Hospital PPO plan (Plan 3), introduced in 1995, offers a more affordable
alternative with premiums 19% less than the Standard Plan (Plan 1).
-v Since July 1, 1997, CHIP has also offered a choice of alternative portability
health benefit plans to federally eligible individuals. Benefits and premiums for
these Plans 4 and 5 are similar to Plans 1 and 3 except that there is no exclusion for
preexisting conditions in either of these new HIPAA-CHIP plans.
-v There will never be a waiting list for Plans 4 and 5, and there has been no waiting
list for Plans 1-3 since January 1995.
-Y
The lifetime maximum in benefits for each individual covered by CHIP was
increased from $500,000 to $1 million as of July 1, 1997.
-v Heart disease and cancer are the two costliest conditions for which CHIP
participants receive benefits.
-v
Forty-five percent of CHIP participants believe that having CHIP improved their
employment opportunities.
_,r/"'--
-v CHIP has helped Illinois residents avoid having to access
Public Aid's Medical Assistance program.
-Y
One-third of CHIP participants believe that having CHIP
kept them from filing for bankruptcy.
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-Y
For fiscal year 1999, CHIP received an appropriation of
$15.3 million to help fund the anticipated deficit for Plans 1-3. Anticipated
deficits for federally eligible individuals in Plans 4 and 5 are funded by an
assessment of all health insurers and HMO's doing business in Illinois.
-Y
The efficiency demonstrated by this program shows that state government can
provide health insurance in a manner that is not disruptive of the private
insurance market or unduly restrictive of patient choice.
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STATE OF ILLINOIS
DEPARTMENT OF INSURANCE
320 WEST WASHINGTON STREET
SPRINGFIELD, ILLINOIS 62767-0001
ARNOLD L. DUTCHER
JIM EDGAR
ACTING DIRECTOR
GOVERNOR
September 28, 1998
To the Honorable Members
of the 90th General Assembly
On behalf of the Board of Directors of the Comprehensive Health Insurance Plan, I am pleased to
present its Annual Report and Financial Summaries for Calendar Year 1997.
This report is completed in accordance with the requirements of the Comprehensive Health Insurance
Plan Act (215 ILCS 105/1 et seq.) and contains significant information concerning CHIP participants,
benefits, operations and cost containment activities.
Of special significance was the General Assembly's overwhelming approval of Senate Bill 802, which
Governor Jim Edgar signed into law on June 26, 1997. This legislation made the necessary changes
in state law to implement the federal Health Insurance Portability and Accountability Act of 1996
(HIPAA). It also amended the CHIP Act to qualify CHIP as an "acceptable alternative mechanism" for
ensuring that "federally eligible individuals" can obtain individual health insurance coverage through
CHIP with no exclusions for preexisting conditions. This legislation also provided that this new HIPAACHIP program is to be funded by an assessment of all health insurers, health maintenance
organizations and voluntary health service plans, and that there can be no limitation on enrollment or
exclusion for preexisting conditions for these federally eligible individuals.
A total assessment of $7.5 million for fiscal year 1998 was billed and collected from 352 health
insurers and health maintenance organizations with total direct Illinois premiums of approximately $9.7
billion. As a result, this assessment of the insurance industry for the first year of the new HIPAA-CHIP
program amounted to approximately 8/1 OOths of 1% of their total direct Illinois premiums as reported
to the Department of Insurance on their annual statements for calendar year 1996.
The CHIP Board and its staff worked diligently to have this important new program operational by
July 1, 1997, a full six months in advance of the federal requirement. The early results of this new
program, while still preliminary, clearly indicate that the Governor and General Assembly made the
right decision in approving its implementation last year.
Respectfully submitted,
4
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Arnold~tu~
Acting Director of Insurance and
Chairman of the Board of Directors
http://www.state.iJ.us/ins
Ptinted on recycled paper
State of Illinois
Office of the Board of Directors
I CHIP
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Comprehensive Health Insurance Plan
400 West Monroe Street, Suite 202 Springfield, Illinois 62704-1823
Telephone: 217/782-6333 (Voice) 217/782-6410 (TOO)
217/782-6468 (Fax) 1-800-962-8384 (Consumer Information)
http://www.state.il.us/ins/chip.htm
September 28, 1998
The Honorable Jim Edgar
Governor
State of Illinois
Room 207, State House
Springfield, IL 62706
Dear Governor Edgar:
On behalf of our Board of Directors, I am pleased to present its ninth Annual Report summarizing
major activities of the Comprehensive Health Insurance Plan for calendar year 1997.
CHIP is a state health benefits risk pool which has been established and maintained by the State of
Illinois since 1989 to provide health insurance coverage to eligible Illinois residents who, due to the
existence or history of a high risk medical condition, are unable to obtain private health insurance.
The original CHIP program is now nine years old and continues to be funded in part by an annual
appropriation which the CHIP Board receives from the State's General Revenue Fund. Since its
inception, CHIP has served more than 15,000 Illinois residents from all102 counties who qualified for
this coverage. It has paid more than $285 million benefits on behalf of these CHIP participants.
Of major significance for CHIP and its now more than 6,000 participants was the approval and
implementation in 1997 of a major new program for us in response to the enactment of the federal
Health Insurance Portability and Accountability Act of 1996 (HIPAA). Among the many important
provisions of this major legislation was that it gave the individual states, like Illinois, the choice of
requiring insurance companies in the individual market to guarantee issue its own policies or of
selecting an alternative mechanism, such as CHIP, to satisfy this new federal requirement.
After months of study and debate concerning the implications for CHIP and its participants, the CHIP
Board unanimously voted to recommend that the existing CHIP program be expanded for this
purpose. Acting on this recommendation, you then submitted a formal request to the Secretary of the
U.S. Department of Health and Human Services to use CHIP as an alternative mechanism for
meeting this new federal requirement in March of 1997. At your request, Senate Bill802 was also
introduced to bring the CHIP Act into compliance with HIPAA and allow CHIP to qualify as this type of
alternative mechanism, and you signed this legislation into law on June 26, 1997.
With the hard work and diligent planning of the existing CHIP Board, its staff and Administrator, we
then were able to begin enrolling federally eligible individuals on July 1, 1997. By the end of the
calendar year 1997, more than 400 eligible individuals had taken advantage of this new program and
enrolled in either of the new plans 4 or 5 pursuant to a new Section 15 which was added to the CHIP
Act by Senate Bill 802. In addition an assessment of $7.5 million was collected from all of the health
insurers and health maintenance organizations doing business in Illinois to fund the anticipated deficit
for this new pool of federally eligible individuals in fiscal year 1998.
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In a report to Congress earlier this year on HIPAA, the General Accounting office reported that
premiums for individual policies had increased from 140% to 600% in a number of the "federal fallback" states that had chosen to implement and enforce the guarantee issue requirements in this
federal legislation. We are pleased that problems of this nature have not been reported in Illinois, and
that the use of CHIP to meet this new federal mandate appears to have been the right choice for
Illinois. Illinois continues to enjoy a stable individual health insurance market because the additional
costs of providing this type of guaranteed coverage for high-risk individuals is being spread over the
entire health insurance industry in Illinois with annual premiums of almost $10 billion rather than
having to be absorbed by the individual market with a premium base of approximately $800 million.
This is not only important for those citizens of our state who continue to be able to purchase
affordable private individual health insurance policies but is also equally important for the 6,000 plus
participants of both the original and new CHIP programs since the premiums they have to pay for this
coverage are based on the premiums being charged to these other private individual policyholders by
the largest individual carriers in Illinois. There was no need for the CHIP Board to implement any
increases in the premiums which CHIP participants are required to pay for this coverage during
calendar year 1997.
The traditional CHIP program, for which eligible persons can continue to qualify for coverage under
Section 7 of the CHIP Act that is funded in part by the State's General Revenue Fund, again had no
waiting list for the entire year. There was no need for the CHIP Board to implement any increases in
the premiums which CHIP participants are required to pay for this coverage during calendar year
1997, and its enrollment continued to grow and reached another all-time high of 5,062 as of
December 31, 1997. Through continued good management of the Plan, our Board was again able in
1997 to authorize increasing our cap on enrollment for Plans 1-3 by another 250 individuals to its
current total of 5,500, and the lifetime maximum benefit for all CHIP participants was able to be
increased from $500,000 to $1 million by Senate Bill 802.
The CHIP Board has not needed to seek an increase in the amount of the General Revenue
appropriation which it receives each year to support this original or Section 7 pool. For each of fiscal
years 1994-1998, we were able to accomplish all of the above with a level appropriation of $17.3
million which we received in each of these years. Our actual deficit for fiscal year 1998 is expected to
be approximately $17 million, and we will therefore use almost all of the appropriation we received for
this past year. We recently received an appropriation for Fiscal Year 1999 of $15.3 million and our
actuaries are projecting a deficit in excess of $21 million for this period.
We very much appreciate the confidence you have shown in CHIP in deciding to use our program as
the alternative mechanism for satisfying the individual availability requirements of HIPAA. As you and
Senator Howard Carroll of Chicago, who has served on the CHIP Board since its inception, prepare to
leave office in January of next year, I want to take this opportunity to thank both of you for everything
you have done for us and this very important state health program. We appreciate and will long
remember the leadership and support which each of you have provided for CHIP.
Executive Director
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Introduction
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Section 7- Traditional CHIP
Since its inception in 1989, the Illinois
Comprehensive Health Insurance Plan (CHIP)
has provided much-needed health insurance
coverage for more than 15,000 eligible residents
from every county in Illinois who qualified for
such coverage under Section 7 of the
Comprehensive Health Insurance Plan Act.
Total benefits paid on behalf of these CHIP
participants over that time now exceed $285
million.
The original CHIP legislation resulted in Illinois
becoming the fifteenth state to establish a state
health benefits risk pool for the chronically ill and
thousands of its other citizens who were
currently uninsurable and unable to obtain
coverage elsewhere.
This original or traditional CHIP program, now
nine years old, continues to be very successful
in carrying out its original mission, and continues
to serve well the needs of thousands of eligible
Illinois residents who otherwise would find
themselves without coverage when it is needed
most.
The efficiency demonstrated by this
program demonstrates that state government
can effectively provide financial security for
those citizens who find themselves uninsurable
without being disruptive of the private insurance
markets.
Traditional CHIP continues to
serve well the needs of
thousands of eligible Illinois
residents who otherwise find
themselves without coverage
when it is needed most.
Enrollment was originally limited to 4,000 and
then 4,500. When this number was not adequate
to address demand in the early years, a waiting
list had to be used. This enrollment cap was
subsequently increased in small increments
several times over the next five years. The need
for a waiting list was eliminated in 1994 and has
not been used since that time. The Board again
raised the enrollment cap in 1997 to 5,500,
which should prevent a waiting list from
reoccurring in the foreseeable future.
Applications during 1997 for the regular CHIP
program totaled 1,756. While this was down
from the total number of applications for 1996 of
2,057, total applications for both pools in 1997
was 2,589. This represented a 25 percent
increase in the total number of applications
received in 1997. Enrollment in the Section 7
pool at the end of 1997 increased to a total of
5,062 compared to 4,986 at the end of calendar
year 1996. New participants added in 1996
numbered 1,037, while new participants added
for 1997 totaled 1,676. This represented a 18
percent increase from 1996 to 1997.
This past year also saw a major change to the
coverage provided by CHIP when the lifetime
maximum benefit for each covered person was
raised to $1,000,000.
Illinois Comprehensive Health Insurance Plan
Page 1
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Section 15- HIPAA-CHIP
A second new program for CHIP was approved
and implemented in 1997 in response to the
enactment of the new federal legislation, the
Health Insurance Portability and Accountability
Act of 1996 (HIPAA).
Among the many important provisions of this
major legislation was that it gave the individual
states, like Illinois, several options for ensuring
that "eligible individuals" have access to
individual health insurance coverage on a
guaranteed-issue basis, with no preexisting
condition exclusions. States had a choice of
requiring companies in the individual market to
guarantee issue or of selecting an alternative
mechanism, such as CHIP, to satisfy this new
federal requirement.
After months of study and debate concerning the
implications for CHIP and its participants, the
CHIP Board voted unanimously to recommend
to the Governor and General Assembly that the
existing CHIP program be expanded for this
purpose. This recommendation was conditioned
on the insurance industry agreeing to pay a
broad-based assessment for funding the
anticipated deficits resulting from CHIP providing
coverage to all of these federally eligible
individuals.
Legislation to bring the CHIP Act in compliance
with HIPAA and allow CHIP to qualify as this
alternative mechanism was
subsequently
introduced at the Governor's request as Senate
Bill 802. It overwhelmingly passed both
chambers of the General Assembly during the
Spring session, and was signed into law by
Governor Edgar on June 26, 1997. All four of
the CHIP Board's legislative members (Senator
Robert Madigan of Lincoln; Senator Howard
Carroll of Chicago; Representative Frank
Mautino of Spring Valley; and Representative
David Leitch of Peoria) were sponsors and
strong proponents of this important legislative
initiative for CHIP.
As a result of diligent efforts by the CHIP Board
and staff everything was in place to begin
enrolling applicants who qualified for CHIP
coverage under a new Section 15 of the CHIP
Act without having to impose any preexisting
condition exclusion as of July 1, 1997.
As the alternative mechanism to guarantee
issue for the individual health insurance market,
CHIP is now able to offer a choice of alternative
health benefit plans to federally eligible
individuals, Plans 4 and 5, in addition to Plans 13 that are still offered under the traditional CHIP
program.
Benefits and premiums for these Plans 4 and 5
are similar to the existing Standard (Plan 1) and
Hospital PPO option (Plan 3) except that neither
of the new plans contains any waiting period or
exclusion for preexisting conditions. There also
will never be a waiting list for Plans 4 and 5.
The early results of this new HIPAACHIP program, while still preliminary,
have been very favorable.
Deficits for coverage afforded to federally
eligible individuals under Section 15 are covered
by an assessment levied against all health
insurers, health maintenance organizations and
voluntary health service corporations. An
assessment of $7.5 million was levied against
these companies for this purpose in 1997 for
fiscal year 1998.
By year end, 842 applications had , been
received for this new HIPAA-CHIP program, and
a total of 448 federally eligible individuals had
enrolled in one of these two new plans. Total inforce enrollment for Plans 4 and 5 on December
31, 1997 was 377. This indicated that a number
of these individuals who had exercised their right
to enroll in HIPAA-CHIP were then apparently
able to later obtain other coverage in the private
market.
The early results of this new HIPAA-CHIP
program, while still preliminary, ha-ve been very
favorable for both our new CHIP participants
and our other citizens who have continued to
have access to a strong and competitive private
individual health insurance market in Illinois.
Unlike other states that have reported significant
increases in premiums for individual policies
sold by private insurers and serious disruptions
in their individual health insurance market,
Illinois has not experienced any such problems
during the first year of this new program. With
one exception, the same insurers continued to
offer individual health insurance policies in
Illinois without significant increases in the
premiums which were being charged for these
policies.
Page2
Program Funding
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Premiums paid by CHIP participants historically
have provided only 45% of the funding
necessary to operate the system. The deficits
are addressed differently for the traditional CHIP
program and the new HIPAA-CHIP program.
Section 7 - Traditional CHIP
The traditional CHIP plan has historically been
funded partly by premiums paid by participants
and, to the extent that premiums do not meet
anticipated expenses, by an appropriation from
the state's General Revenue Fund.
Prior to July 1 , 1997 premiums were set at
135%. Senate Bill 802 amended the CHIP Act to
allow the premiums charged for CHIP coverage
to be between 125 to 150 percent of the average
rates charged individuals for comparable
coverage by five or more of the largest
insurance companies in the individual health
insurance market in Illinois.
ICHIP 01/09/08
As in previous years, an appropriation from
the
12:19
state's General Assembly was once again
needed to fund the plan's anticipated deficit for
CHIP enrollees. That appropriation for fiscal
year 1998 was $17.3 million, and the actual
deficit was approximately $17 million. The
appropriation approved by the Governor and
General Assembly for traditional CHIP for fiscal
year 1999 is $15.3 million, but the Board is
anticipating the deficit for this state funded
program to be more than $21 million.
The average annualized
premium paid by participants in
the CHIP program during 1997
was $3,741 - 6 percent below
the previous year.
The average annualized premium paid by
participants in the CHIP program during 1997
was $3,7 41 - 6 percent below the previous year.
This represents the third year in a row that the
average annual premium cost for CHIP has
actually dropped and reflects the shift in
population in the traditional CHIP plan to the
less costly optional Hospital PPO plan.
The CHIP Board of Directors is sensitive to the
fact that cost continues to be the number one
barrier to individuals obtaining health insurance
today, whether from CHIP or from the private
market. A state high risk pool like CHIP would
do relatively little to increase access to health
insurance for the medically uninsurable if
premiums for this program were priced
according to each individual's actual risk based
on his or her health status. Premiums in that
case would have to be approximately twice their
current level. Premiums must, therefore, be
subsidized by the state.
This state subsidy allows the cost of insuring the
uninsurable in Illinois to be spread across a
broad segment of our population and helps
keep everyone's insurance rates down by
pooling the cost of treating these high risk
individuals.
Page3
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On
July 1, 1997, CHIP began to enroll federally
eligible individuals pursuant to Section 15 of the
(CHIP) Act.
As amended by Senate Bill 802 (Public Act 9030), Section 12 of the CHIP Act now requires
that the CHIP Board during the first quarter of
each fiscal year assess all health insurers,
health maintenance organizations and voluntary
health service plans for the amount of the
anticipated deficit which it expects to be incurred
during that fiscal year for all eligible individuals
who have enrolled in CHIP under Section 15 of
the CHIP Act. The process for determining the
amount of the anticipated deficit begins with a
report and recommendation prepared by the
Board's consulting actuary. It is reviewed by the
Board's Actuarial Advisory Committee which
then makes a report and recommendation to the
Board's Finance Committee.
The Finance
Committee then reviews this report and makes
its own recommendation to the full Board for its
final approval.
An assessment of $7.5 million was levied in
August of 1997 for fiscal year 1998 to cover
projected deficits for this Section 15 pool. This
was spread over an assessment base of
approximately $10 billion, and represented
8/1 OOths of 1% of this direct Illinois premium.
Each year a determination will be made by the
CHIP Board as to what is needed to fund
projected deficits.
Premiums for coverage in the HIPM portability
plans 4 and 5 are coincidentally the same as for
traditional CHIP plans 1 and 3. Since premiums
paid by participants in Section 7 provide only
45% of the necessary funds to operate the
program, it is reasonable to assume that the
experience of the Section 15 pool would, at least
initially be similar. The Board has the authority
to charge different premiums for the traditional
CHIP and HIPM-CHIP plans.
Page4
Administration
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CHIP is governed by a seventeen-member
board of directors, which by statute includes the
Director of Insurance as Chairman, the Attorney
General, the Chairperson of the Health Care
Cost Containment Council, ten public members
appointed by the Governor, and four legislative
members.
Claims processing,
premium billing and
customer services are provided under a contract
with an administrative carrier. Since January 1,
1992, Health Care Service Corporation, which
does business as Blue Cross and Blue Shield of
Illinois (BCBSI), has served in this capacity.
The Board's activities are supported and
managed by a small and experienced staff
based in Springfield, headed by its Executive
Mr. Carlson
Director, Richard W. Carlson.
formerly served as Assistant Director of the
Illinois Department of Insurance (1981-1989)
and as Superintendent of the Illinois State
Lottery (1977-1981). Mr. Carlson is the coauthor of An Introduction to the Illinois General
Assembly and was on the legislative staff for the
Illinois State Senate from 1969 to 1977. He was
named as a Charter Member of the Samuel K.
Gove Legislative Staff Intern Hall of Fame for
outstanding public service by Illinois Issues
magazine.
Ronald M. Wolf serves as the Board's outside
consulting actuary. Mr. Wolf is Principal of
Tillinghast-Towers Perrin, in St. Louis. He is a
Fellow of the Society of Actuaries (F.S.A.), a
Member of the American Academy of Actuaries
(M.A.A.A.), and a Fellow of the Conference of
Consulting Actuaries.
The Board also receives actuarial support from
an Actuarial Advisory Committee comprised of
five prominent life and health actuaries. This
committee meets periodically to review with Mr.
Wolf and members of the Board's Finance
Committee the results of his work and any
recommendations he plans on making on rate
adjustments or other actuarial matters prior to
their submission to the Board. Its contribution
has been very generous and helpful in assuring
the long-term financial stability and success of
CHIP.
The Board receives support from an
Actuarial Committee comprised of
well-respected actuaries from the
insurance industry
KPMG Peat Marwick continues to serve as the
Board's independent auditor and has, since
inception of the program, annually audited the
plan's financial statements.
Robert E. Wagner, an attorney and President of
Robert E. Wagner and Associates, serves as
He was formerly an
outside legal counsel.
Assistant Attorney General, and continues to
serve as Special Assistant Attorney General for
the Department of Insurance and the CHIP
Board of Directors. He is a member of the
Federation of Regulatory Counsel and maintains
an active private practice in insurance regulatory
law.
Page 5
Board of Directors
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Legislative Members
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Statutory Members
Arnold Dutcher, Springfield. Chairman. ActingDirector of Insurance since March 1, 1998.
Appointed Chief Deputy of the Department of
Insurance in August of 1995. Prior to that, he
served in a variety of positions during a career
with the Department of Insurance that has
spanned two and one-half decades. He joined
the Department on January 25, 1973. Before his
appointment as Chief Deputy, he served as
Examiner-in-Charge, Supervisor of the Life,
Accident and Health Financial Analysis Unit,
Assistant Deputy Director of the Life, Accident
and Health Financial Corporate Section, Deputy
Director of the Life, Accident and Health
Division, and Deputy Directory of the FinancialCorporate Regulatory Division. He has been
actively involved in the National Association of
Insurance Commissioners (NAIC), and currently
chairs and participates in numerous committees
of that organization. Mr. Dutcher received his
B.S. in Accounting and Marketing from Southern
Illinois University and is a veteran of the United
States Army. He has an F.L.M.I. designation
from the Life Office Management Association.
Honorable Jim Ryan, Bensenville.
Elected
Attorney General of the State of Illinois in 1994.
Served ten years as DuPage County State's
Attorney. Past President of the Illinois State's
Attorney Association, he has won numerous
county, regional and statewide awards for
prosecutorial excellence. Previously he was a
trial lawyer in the criminal division of DuPage
County State's Attorney's Office; first Assistant
State's Attorney; and in private practice with
Ryan and Darrah. Bachelor's degree in political
science from Illinois Benedictine College; Juris
Doctor from Chicago-Kent College of Law,
Illinois Institute of Technology.
Frank Gramm, Esq., C.L.U., Libertyville. Chair,
Illinois Health Care Cost Containment Council;
Senior Vice President, General Counsel and
Corporate Secretary, Trustmark Insurance
Company. Board Member, Illinois Life and
Health Insurance Guaranty Association, Member
of the Litigation Advisory Group of the American
Council of Life Insurance, Legal Advisory
Committee of the Health Insurance Association
of America and the Legislative Committee of the
Illinois Life Insurance Council. B.A., University of
Illinois; Juris Doctor, Loyola University School of
Law.
Honorable Howard W. Carroll, Chicago. State
Senator, 8th District; Assistant Minority Leader,
Illinois
State
Senate;
Member,
Senate
on
Appropriations;
Financial
Committees
Institutions; Executive Appointments; and State
Government Operations; received "Outstanding
Legislator" award from Coalition of Citizens with
Disabilities in Illinois, 1992; practicing Attorney;
Juris Doctor from De Paul University College of
Law, Chicago.
Honorable David Leitch, Peoria.
State
Representative, 93rd District; Assistant Minority
Leader, Illinois House of Representatives;
Member,
House
Appropriations;
Human
Services; Electric Utility Deregulation; Public
Utilities Committee; and Health Care Availability
& Access Committee. Received the 1998
American Medical Association Dr. Nathan Davis
Award (awarded to the state legislator of the
year in the U.S.). In 1993, he became one of
only two people in the nation to receive the
Government Achievement award from the
National Hemophilia Foundation; Vice-President,
Area Development, First of America/National
City Corp, N.A., B.A. in History, Kalamazoo
College, Kalamazoo, Michigan.
Honorable Robert A. Madigan, Lincoln., State
Senator, 45th District; Chairman of Senate
Insurance & Pensions Committee; Member,
Agriculture & Conservation, Appropriations
Committees,
Pension
Laws
Commission,
General Assembly. Retirement System Board of
Trustees; full-time state legislator; B.S. from
Millikin University, Decatur.
Honorable Frank J. Mautino, Spring Valley.
State Representative, 76th District; Chairman,
House Committee on Insurance; Member,
Appropriations, Public Safety; Elementary and
Secondary Education; Financial Institutions;
Local Government; and Personnel and Pensions
Committees, Economic and Fiscal Commission;
full-time legislator; first appointed in 1991 to
complete term of his late father, Richard A.
Mautino, who was Chair of House Insurance
Committee and also served on the CHIP Board
at the time of his death. B.S. in Marketing from
Illinois State University.
PageS
Public Members
Howard J. Bolnick, F.S.A., Chicago. Chair,
Finance Committee. Chief Executive Officer of
Radix Health Connection, LLC; Adjunct
Professor,
Kellogg
Graduate
School
of
Business; Former President, Celtic Life
Insurance Company; former partner, Coopers &
Lybrand; Fellow of the Society of Actuaries;
President and Member, Board of Governors,
Society of Actuaries; Member of the American
Academy of Actuaries; M.B.A., University of
Chicago.
Sharon K. Heaton, Graymont.
Owner of
Heaton Agency, Inc., in Pontiac; Trustee,
Professional Insurance Agents National Group
Health
Insurance;
member,
National
Professional
Insurance Agents;
member,
National
Independent
Insurance
Agents
Association; member, Professional Independent
Insurance Agents of Illinois; Board Member,
Insurance
Education
Foundation;
Board
Member, American Association of Crop Insurers;
Board Member, Heartland Community College
Foundation Board (Vice President); Board
Member, Agents Mortgage Services (Subsidiary
of PIIAI); Board Member, Education Options
Foundation.
Richard F. Kotz, Esq., Glencoe. Secretary,
Member, Dykema Gossett, Law Firm. Former
Vice President-Law and Deputy General
Counsel of Sears, Roebuck and Co.; Consultant
to National Institute of Mental Health; former
Glencoe Village Trustee; former President of
Midwest Regional Group of the American
Society of Corporate Secretaries and former
National and Regional Board Member of the
Society; Board Member over time of many civic
and charitable organizations. Member of the
American and .Chicago Bar Associations;
graduate of Wharton School of Finance a~d
Commerce of the University of Pennsylvama
and University of Pennsylvania Law School;
M.B.A. from The American University.
Johanna Lund, Rockford. Consumer Member.
Chair Personnel Committee. Former Chair,
lllinoi~ Health Care Cost Containment Council;
Chairman & CEO, Health Care Consultants,
Inc.; President & CEO Employer's Coalit1on on
Health· Chair, Development Committee &
Memb~r Dean's Council, University of Illinois
College of Medicine at Rockford; Public Saf.ety
Commissioner, Winnebago County Shenffs
Department.
ICHIP 01/09/08
12:19
James M. Meyer, Naperville.
Senior VicePresident and Manager of Employee Benefits
Division, Near North Insurance Brokerage, Inc.;
Member of the Board of Directors, Worksite
Wellness
Council
of
Illinois;
Member,
International Foundation of Employee Benefits;
previously served as insurance consultant for
the Teachers' Retirement System; B.S. in
Business and Economics,
University of
Wisconsin.
Saul J. Morse, Esq., Springfield. Treasurer and
Consumer
Member.
Chair,
Grievance
Committee.
Vice President and General
Counsel, Illinois State Medical Society and
Illinois State Medical Insurance Services, Inc.;
former
member,
Illinois
Human
Rights
Commission,
1985-1991;
1985
Disabled
Advocate of the Year, Illinois Department of
Rehabilitation Services; 1990 Susan Suter
Award as outstanding disabled Illinoisan, Illinois
State Easter Seal and United Cerebral Palsy
Association; 1995 Outstanding Board Member,
United Cerebral Palsy Land of Lincoln; Board
Member, United Cerebral Palsy Land of Lincoln;
Board Member, Hope School; President,
Springfield
Professional
Baseball,
L.L.C.;
Member, Sangamon County, Illinois, and
American Bar Associations; Member, American
Society of Medical Association Counsel;
Member, American Health Lawyers Association;
American Corporate Counsel Association; B.A.,
University of Illinois; Juris Doctor, College of
Law, University of Illinois.
Jay R. Naftzger, Esq., Naperville. Vice
President, General Counsel and Secretary of
Rush Prudential Health Plans. Member of the
Board of Directors and Secretary/Treasurer,
Illinois
Health
Maintenance
Organization
Guaranty Association; Past Director and Past
Secretary, Illinois Association of HMOs; PastChair of the Health Insurance Law Committee of
the Tort and Insurance Practice Section of the
American Bar Association. Admitted to practice
in Illinois and Minnesota. Member of both states'
bar associations and the American Bar
Association. B.B.A and Juris Doctor, University
of Iowa; Master of Management, Northwestern
University.
Page7
Janis M. Orlowski, M.D., River Forest.
Physician and Executive Dean, Rush Medical
College; Associate Vice President, Rush
Presbyterian-St.
Luke's
Medical
Center;
practicing nephrologist; certified by the National
Board of Medical Examiners, American Board of
Internal Medicine, and Subspecialty Board,
Nephrology; three-time recipient of Teacher of
the Year Award, Department of Medicine;
Executive
Associate
Editor "Nephrology";
Associate Editor "Disease-a-Month"; member
American College of Physicians, the American
Society Nephrology, and Chicago Society of
Internal Medicine; member, Board of Trustees of
the Illinois State and Chicago Medical Society,
President Chicago Medical Society and the
American Society of Nephrology; B.S. in
Biomedical Engineering, Marquette University;
M.D. from the Medical College of Wisconsin,
Milwaukee, Wisconsin.
Robert E. Schaaf, C.L.U., Ch.F.C., Springfield.
President, Insurance Management Services,
Inc.; Instructor, NAIC Financial Examiners and
Insurance
Department
Staff
Education
programs; past Director of National Association
of Life Companies; past President and Director
of Illinois Association of Life Companies and the
Central Illinois Chapter of Chartered Life
Underwriters Association; past Director of Illinois
Life and Health Guaranty Association; Chartered
Life
Underwriter;
Chartered
Financial
Consultant; Fellow, Life Management Institute;
B.B.A. from the University of Wisconsin.
Bryan W. Swank, C.L.U. Waukegan. Chair,
Communications Committee. President, Swank
Insurance Agency; Board Member, District 15
(Lake & McHenry) counties, Professional
Independent Insurance Agents of Illinois. Board
Member,
Statewide
Insurance
Company,
Waukegan, Illinois.
Actuarial Advisory Committee
Charles J. Sherfey, F.S.A., M.A.A.A., Chair, is
a Senior Consultant for Pricewaterhouse
Coopers and a past-President of the Chicago
Actuarial Association. Mr. Sherfey is a Fellow of
the Society of Actuaries, a Fellow of the
Canadian Institute of Actuaries, a Member of the
American Academy of Actuaries and a
Chartered Life Underwriter. He has a B.A. in
economics from the University of Nebraska and
is a former member of the Board of Pensions of
the Presbyterian Church (USA).
Michael S. Abroe, F.S.A., M.A.A.A., is a
principal in the Chicago office of Milliman &
Robertson, Inc., and is a Fellow of the Society of
Actuaries and a member of the American
Academy of Actuaries. His area of expertise is
ICHIP 01/09/08
health insurance. He has assisted a variety
of
12:19
clients with administration and management,
strategic planning and acquisitions, as well as
marketing and pricing. Mr. Abroe has advised
many types of organizations, such as hospitals,
insurance companies, Blues Plans, HMOs and
PPOs. Before joining Milliman & Robertson, Mr.
Abroe was Vice President and Health Actuary at
Bankers Life and Casualty where he was
responsible for actuarial aspects of their
individual and small group health lines of
business.
Dale C. Griffin, F.S.A., M.A.A.A., is the pricing
actuary for Direct Markets with Blue Cross and
Blue Shield of Illinois. President, Chicago
Actuarial Association (1998-1999).
He is a
Fellow of the Society of Actuaries and Member
of the American Academy of Actuaries. He has
specialized in health insurance since 1982,
including consulting to the Michigan Bureau of
Insurance in its regulation of health maintenance
organizations and Blue Cross and Blue Shield of
Michigan. Mr. Griffin received a Bachelor of
Science degree in Mathematics with high
distinction from the University of Michigan.
Paul W. Janus, F.S.A., M.A.A.A., retired Senior
Vice President and Chief Actuary for Bankers
Life and Casualty Company. He is a Fellow of
the Society of Actuaries and a member of the
American Academy of Actuaries. He has served
as President of the Chicago Actuarial
Association and as Chairman of the Health
Insurance Association of America's Individual
Insurance Committee. He is a graduate of
Knox College, Galesburg, Illinois.
Richard J. Ruppel, A.S.A., M.A.A.A., is Vice
President and Actuary for the Golden Rule
Insurance Company, a position he has held
since 1967. He is a member of the Society of
Actuaries and the American Academy of
Actuaries. He is a graduate of St. Meinrad
College, St. Meinrad, Indiana and holds an M.S.
degree from Butler University, Indianapolis,
Indiana.
Norman J. Zwitter, F.S.A., is an actuary for
Blue Cross and Blue Shield of Wisconsin and
was formerly with CNA Insurance Companies.
He is a Fellow of the Society of Actuaries and
Member, Academy of Actuaries. Mr. Zwitter
received his Bachelor of Arts degree in
Mathematics from the University of Wisconsin Milwaukee in 1970 and is a Chartered Life
Underwriter and a Fellow of the Life
Management Institute.
PageS
Who Qualifies For CHIP?
·'
"'
.... · .·· w.. .. ;?'-t-o/::""'~ .
. ..·:;::,· .• "'.
.;'; .. · :-.:··....... ~ ...
Illinois residents can currently qualify for CHIP,
unless otherwise ineligible, if they meet one of
the following criteria:
o
have applied for health insurance and
have been rejected because of a
preexisting condition; or
o
have
which
costs
CHIP;
a very expensive existing policy
is substantially similar to CHIP and
more than they would pay under
or
have one of the 31 presumptive medical
conditions that do not require a rejection
letter from an insurer (see table). These
conditions are presumed to result in
automatic rejections by all insurance
companies. In these cases, the applicants
may submit a letter from their attending
physician.
o
Persons are not eligible for CHIP who:
o
to
Presumptive Medical Conditions
Acquired Immune Deficiency Syndrome (AIDS)
or AIDS Related Complex (ARC)
Angina Pectoris
Arteriosclerosis Obliterans
Cerebrovascular Accident (Stroke)
Chemical Dependency
Cirrhosis of the Liver
Coronary Insufficiency
Coronary Occlusion
Cystic Fibrosis
Friedreich's Ataxia
Hemophilia (Classical)
have or obtain other health insurance
which is substantially similar to or more
comprehensive than CHIP or would be
eligible for such coverage if they elected
to obtain it (unless the rate they
themselves would be required to pay
exceeds what they would pay for CHIP};
approved
ICHIP 01/09/08
employer has more than ten employees and
has
12:19
discontinued
their
coverage
without
discontinuing coverage for all employees. This
is to prevent employers from removing persons
from their plan who are seriously or chronically ill
- a practice referred to as dumping - merely to
lower the employer's cost of insurance.
o
receive or are
Medicaid;
receive
o
are 65 years of age or older and are
eligible for Parts A and B of Medicare;
Hodgkin's Disease
Huntington's Chorea
Juvenile Diabetes
Kidney Failure Requiring Dialysis
Leukemia
Lupus Erythematosus Disseminate
Metastatic Cancer
Multiple or Disseminated Sclerosis
have voluntarily terminated coverage
under CHIP within the past 12 months;
Muscular Atrophy or Dystrophy
have already received $1,000,000 in
benefits paid under CHIP;
Myotonia
o
are residents of a public institution;
Parkinson's Disease
o
have their premium paid or reimbursed
by a government agency or program or
by a health care provider; or
Poliomyelitis
o
o
o
have received a settlement or award as
the result of an accident or injury
involving third party liability from which
more than $100,000 still remains.
Persons who were previously covered under a
health care policy or plan provided by an
employer are not eligible for CHIP if the
Myasthenia Gravis
Paraplegia or Quadriplegia
Polycystic Kidney
Severe Traumatic Brain Injury
Sickle Cell Anemia
Silicosis Pneumoconiosis (Black Lung)
Syringomyelia
Wilson's Disease
Page9
ICHIP 01/09/08
12:19
Applicants who meet the criteria to be federally
eligible individuals and qualify for CHIP
coverage under Section 15 of the CHIP Act can
enroll in either HIPAA-CHIP Plans 4 or 5 and will
not have to satisfy a preexisting condition
waiting period.
Federally eligible individuals are those individual
residents of Illinois who, at the time they seek
plan coverage, under Section 15 of the CHIP
Act, satisfy all of the following criteria:
o
they must have accrued a total of 18 or
more months of prior creditable coverage;
they have no more than a 62-day break in
between periods of creditable coverage;
o
their most recent creditable coverage must
have been provided under a group health
plan, government plan or church plan;
o
they must not be eligible for group health
coverage, Medicare or Medicaid, and must
not have any other health insurance
coverage;
o
their most recent coverage must not have
been terminated due to nonpayment of
premium or fraud; and,
o
if offered continuation of coverage under
federal COBRA requirements or state
continuation laws, they must have elected
and exhausted such continuation coverage.
Creditable coverage means, with respect to an
individual, coverage of the individual under any
of the following types of plans:
•
•
•
•
•
•
•
•
•
•
a group health plan;
Part A or B of Medicare;
Medicaid;
CHAMPUS;
a medical care program of the Indian Health
Service or tribal organization;
a state health benefits risk pool such as
CHIP;
the federal employees health benefits
program;
a public health plan; (a plan established or
maintained by a state, country, or other
political subdivision of a state that provides
health insurance coverage to individuals)
a health benefit plan under the Peace Corps
Act; or
a church plan.
Page 10
ICHIP 01/09/08
Coverage Options
~
• ,
.
.
ma
,
Since August 1, 1995, traditional CHIP
participants who are not eligible for Medicare
have been given the opportunity to choose
between the standard indemnity plan (Plan 1)
and a hospital only preferred provider (PPO)
option (Plan 3). Persons choosing to enroll in the
PPO could do so at a reduced rate. By year-end
1997, 54 percent of traditional CHIP participants
had enrolled in the PPO option.
DISTRIBUTION BY PLAN TYPE
Non PPO
PPO
54%
Medicare
CHIP also continues to offer an alternate plan
(Plan 2) for persons who are eligible for
Medicare.
The Medicare plan (Plan 2) option is only
available for persons who are under 65 years of
age and who are eligible for Medicare due to a
disabling condition. Such persons frequently find
it difficult to obtain private supplemental
coverage and find CHIP to be valuable
secondary coverage. This alternative CHIP plan
is NOT, however, a standard Medicare
Supplement policy. Persons 65 and older are
not normally eligible for CHIP because of the
adequate availability of insurance supplemental
to Medicare in the private market.
12:19
$500,000. As a result of S.B. 802, this lifetime
maximum was increased for all persons insured
by CHIP. Currently, policies provide coverage
for hospital, physician, prescription drugs and
other specified items up to a lifetime maximum
of $1,000,000.
In any of the CHIP plans, the deductible which
applies must be met in each calendar year.
Once the annual deductible is satisfied, benefits
are payable at a percentage (which can vary by
plan choice, PPO or non-PPO) of usual and
customary eligible charges for covered services.
Once a participant accumulates an out-of-pocket
expense limit (which varies depending on the
type of plan and deductible amount), the plan
begins paying benefits at 100 percent of covered
charges for dates of service prior to the
beginning of the next calendar year. All benefits
are subject to the $1,000,000 lifetime maximum.
Participants may also purchase at the time of
enrollment or marriage an optional indemnity
rider which provides limited maternity coverage.
This is available in $500 increments, up to a
maximum which varies depending upon the
geographic area in which she lives.
TRADITIONAL CHIP DISTRIBUTION BY
DEDUCTIBLE
0$500 Ded
0$1000 Ded
•$1500 Ded
16%
4"/.~D0$2500Ded
.
54%
26%
CHIP premiums for persons on Medicare are
half those charged for the standard (non-PPO)
coverage, since benefits are reduced by benefits
received from Medicare. Plan deductibles and
coinsurance both apply to benefits received.
All plans offer deductible options of $500,
$1,000, $1,500, and $2,500. If two or more
members of a family are insured under a single
policy, a family annual deductible of $1,000,
$2,000, $3,000 or $5,000 is available.
Prior to July 1, 1997, persons insured by CHIP
were insured up to a lifetime maximum of
Page 11
ICHIP 01/09/08
12:19
One of the requirements in the federal HIPAA
was that states provide a choice of portability
plans for federally eligible persons seeking
individual coverage. Senate Bill 802 provides
that the CHIP Board shall offer a choice of
health care
coverage for such eligible
individuals. The Board has therefore authorized
two plans under the HIPAA-CHIP program.
These are Plans 4 and 5.
Plan 4 is a standard plan with a choice of
deductibles of $500, $1000, $1500 and $2500.
After the deductible has been met benefits are
paid on the basis of 80% - 20%. The plan
participant pays 20% and CHIP pays 80% of
usual and customary expenses as specified in
the CHIP policy. This coverage is the same as
in the traditional CHIP Plan 1.
Plan 5 has the same deductible options as Plan
4. Plan 5 differs from Plan 4 with respect to
inpatient hospitalizations.
Under Plan 5 the
participant is required to select a hospital from
the list of PPO hospitals if the 20% co-payment
is going to be applicable. If a non-PPO hospital
is used the co-payment raises to 40%. The
coverage provided in Plan 5 is the same as in
Plan 3 under the traditional Section 7.
HIPAA DISTRIBUTION BY PLAN TYPE
Non PPO
19%
PPO
HIPAA DISTRIBUTION BY DEDUCTIBLE
0$500 Ded
20%
10%
0$1000 Ded
r-1
Cl$1500 Ded
Dll$2500 Ded
{,llllfl/l//ll55%
Maternity coverage in increments of $500 is also
available to be purchased on initial enrollment or
upon marriage.
Page 12
ICHIP 01/09/08
12:19
Section 7 -Traditional CHIP
Persons enrolling in CHIP who are not federally
eligible are still subject to a six-month exclusion
of coverage for preexisting conditions.
In most cases, benefits are not payable by CHIP
for medical care received by a participant during
the first six months of coverage under the
program for any condition or illness which was
either manifest or for which an enrollee received
medical advice or attention during the six month
period prior to the effective date of coverage.
After CHIP coverage has been in force for six
months, benefits for conditions that preexisted
the effective date of that coverage are treated
the same as any other illness.
Since CHIP began operations, a rider waiving
the entire preexisting condition limitation has
been available for purchase in a limited number
of cases.
In order to qualify to purchase a waiver rider,
applicants currently must:
o demonstrate that they had satisfied a
similar waiting period for pre-existing
conditions under previous coverage
which had been involuntarily terminated;
o apply for CHIP coverage no later than 30
days following the date of their
involuntary termination;
o be ineligible for any further continuation
or conversion rights to substantially
similar
coverage
following
such
termination; and
o pay a surcharge of 10 percent for the
lesser of 60 months or the life of the
policy.
Forty-four waivers of the six-month preexisting
condition limitation were granted during 1997. This
represents a marked decrease in waivers granted
from ninety-two in the first six months of 1996.
Waivers had been up significantly in 1996 due to
a rev1s1on of the definition of involuntary
termination adopted by the Board in September,
1995. The definition now includes the exhaustion
of all federal or state continuation rights. This has
allowed eligible persons who apply for CHIP within
30 days of the end of their COBRA to obtain the
waiver at additional cost. The availability of the
new HIPAA-CHIP option since July 1, 1997 under
Section 15, for which there is no preexisting
conditions exclusion, has virtually eliminated the
number of applicants who would qualify for a
waiver under Section 7.
Self-Reported Diagnoses of Enrollees with Waivers
Granted in 1997
Primary Condition
Number
%
Cancer
7
16%
Other Conditions
7
16%
Musculo-Skeletal
5
11%
Diabetes
6
14%
Heart
6
14%
Mental Conditions
7
16%
Brain/Nervous System
3
7%
Diabetes/Heart
1
2%
Digestive, Kidneys, Liver
1
2%
Height/Weight/Hypertension
1
2%
44
100%
Total
The absence of any limitations on preexisting
is
the
primary
distinguishing
conditions
characteristic between traditional CHIP (Plans 1-3)
and HIPAA-CHIP (Plans 4-5). The new plans 4
and 5 for federally eligible individuals who qualify
for CHIP coverage under Section 15 of the CHIP
Act have no exclusions or limitations on
preexisting conditions.
The absence of any preexisting conditions
exclusions in the HIPAA-CHIP plans should have
the effect of reducing the number of applicants
overall who need to apply for a waiver. ·
Page 13
ICHIP 01/09/08
12:19
Premiums
.
.
Prior to the passage of Senate Bill 802 CHIP
premiums were set at 135 percent of applicable
standard rates. Amendments to the CHIP Act in
1997 changed the level at which premiums were
to be set to a range rather that a set percentage.
This was done to bring the Illinois CHIP Act in
compliance with the requirements for coverage
provided to federally eligible individuals under
HIPAA. It set the range at 125 to 150 percent.
In order to develop premiums in accordance with
the 125 to 150 percent statutory requirement,
CHIP's consulting actuaries began by averaging
the premiums charged by the five or more
largest
insurers
offering
individual
comprehensive major medical policies in Illinois,
adjusting for differences in coverage and
effective dates of each company's rates. Their
recommendations were then reviewed by
actuaries from the Illinois Department of
Insurance and the Board's Actuarial Advisory
Committee before being presented to the
Board's Finance Committee and, later, to the
entire Board for final approval.
Based on such reviews, rates for the CHIP
standard Plan 1 and the optional Medicare
secondary Plan 2 remained level during all of
1996, and did not increase during 1997.
Premiums paid by CHIP participants, like
individual
premiums
paid
to
insurance
companies, vary depending upon one's age,
sex, where he or she lives within the state, the
type of policy and the deductible amount.
As a result of legislation sponsored by
Representatives Winters, Leitch and Feigenholtz
and Senators Madigan, Syverson and Carroll,
and approved by Governor Edgar in June of
1996, the CHIP Board in 1997 introduced
optional family coverage and established
separate premium rates for this plan. This
optional coverage would only be available in
cases where family members of the same
household each qualify for CHIP. The oldest
qualified family member pays premiums at 100
percent of the stated rate and all other family
members pay premiums at 80 percent of the
stated rates.
For rating purposes, the state is divided into four
geographic rate areas that reflect the relative
differences in the cost of medical care in those
areas. The basis for area rating is county of
residence, except for the City of Chicago.
Rate Area A
The City of Chicago. This is the area where
health care costs are highest and, consequently,
premiums are the highest.
Rate Area B
Suburban Cook, and all of DuPage, Kane, Lake,
Me Henry and Will Counties.
Rate Area C
All of Boone, Champaign, De Kalb, Grundy,
Kankakee, Kendall, Madison, Peoria, Rock
Island, Sangamon, St. Clair, Tazewell, and
Winnebago counties.
Rate Area D
The remaining 83 counties in downstate Illinois.
This rate area has the lowest premiums and is
predominantly rural in nature.
The premiums for coverage in the HIPAA-CHIP
plans are to be established by the Board within
the 125 to 150 percent range that is applicable
to the regular CHIP programs. Rating factors,
which apply to the regular CHIP program, also
apply to HIPAA-CHIP. Currently the premiums
for Plans 1 and 4 and Plans 3 and 5 are
coincidentally the same.
Annualized Premiums Area B
$500 Deductible Standard
9000 , . . . . . . . . - - - - - - - - - - - - - - - - .
8000
7000
6000
5000
4000 l------.-r--Hr-HIHr.t-t....-+
3000
2000
1000
0 ww--~~~~~~--~L-w.~~
Page 14
I
Enrollment
ICHIP 01/09/08
12:19
Overall Enrollment Activity
January 1- December 31, 1997
CHIP
HIPAA
Total
New Applications
1,756
Entered
842
2,598
Each year, the Board of Directors is required by
law to estimate the number of new policies it
believes it has the financial capacity to issue
during the year. The Board must then take the
necessary steps to ensure that plan enrollment
does not exceed the number of Illinois residents
which it has estimated can be covered at any
one time.
For this reason, enrollment was
initially limited to 4.000 and later raised to 4,500
in late 1989, a limit that was first met in February
of 1990. Subsequently, the Board raised this
limit to 4,750 in 1993 and again in late 1994
when the cap was increased to 5,000. This cap
was again raised in December of 1996 to 5,250
and again in October of 1997 to 5,500.
Since CHIP became operative in May, 1989, the
cumulative enrollment (i.e., the total number of
persons who had been covered by the plan)
through 1997 was more than 15,000.
t
l
Ii
!
I
i'I
!·
I
I
(,
iI
f
Applications during 1997 for the regular CHIP
program totaled 1,756. This is down from the
1996 number of 2,057 applications. However, if
the HIPAA-CHIP applications (842) are added to
the CHIP applications there was actually a 25
percent increase in the total number of
applications received in 1997. Enrollment was
also up in 1997 when the traditional CHIP and
HIPAA-CHIP numbers are combined.
New
participants numbered 1,037 in 1996 and new
participants for 1997 total 1,676 (1,226
traditional CHIP and 448 HIPAA-CHIP). This
represents a 36 percent increase from 1996 to
1997. A total of 1,108 participants terminated or
had their CHIP coverage terminated. The largest
percentage of terminations resulted from
insureds obtaining other coverage. The second
major cause of termination - and 1997 marks
the first year in which it was not at the top of the
list
was non-payment of premium.
Persistency of policies issued by CHIP remains
strong, with 90 percent of policies issued in 1997
still in force at the end of the year. Sixteen
percent of those who enrolled in CHIP when the
program began in 1989 are still insured by the
program.
New Participants
Added
1,226
448
1,674
Applications
Rejected
392
95
487
Applications
Withdrawn
248
86
334
Participants
Terminated
1085
23
1108
25
25
50
5,062
377
5,439
Participants
Enrolled and
Subsequently
Rescinded
Active Enrollment
Year End
The numbers for HIPAA applications and
enrollment are referenced above. It is clear from
the total number of applications and the
increases in new participants from last year to
this year, that the presence of the HIPPA-CHIP
element is having a significant impact on the
In 1998 additional
overall CHIP program.
emphasis will be placed on public awareness of
the traditional CHIP and HIPAA-CHIP programs.
This may again affect the number of new
applications and participants. The numbers for
calendar
year
1998
should
allow
for
development of a better understanding as to
how the presence of the HIPAA-CHIP
participants will impact the program over a
longer period of time.
Total enrollment in CHIP at the end of calendar
year 1997 was 5,439, up 9% over year-end
enrollment for 1996.
Page 15
ICHIP 01/09/08
12:19
Participant Terminations by Reason
Reason for Termination
CHIP HIPAA Total
Other Coverage
Non-Payment - Lapsed
Age 65
Insured's Request
Death
Medicaid
NSF Check
Medicare
Non-Resident
Premium too high
10 Day Free Look
Maximum Age for
Dependent
284
263
193
99
93
41
41
26
24
11
8
2
1,085
15
1
2
2
1
1
1
23 1,108
Active Participants by Rate Area
I CHIP I HIPAA I Total I
574
38
607
A
224
2,460
2,600
B
729
41
770
c
1,299
74
1373
D
Total
377
5,439
5,062
Area
299
264
193
101
95
42
41
27
24
11
9
2
%
11%
49%
14%
26%
100%
In-Force Enrollment by Plan Type as of
December 31, 1997
Number
%
Plan
Deductible
1,020
502
40
184
464
97
7
15
1,277
711
153
592
1A
500
1B
1000
1C
1500
10
2500
2A
500
2B
1000
2C
1500
20
2500
3A
500
3B
1000
3C
1500
30
2500
Subtotal for Section 7
4A
500
4B
1000
4C
1500
40
2500
5A
500
5B
1000
5C
1500
50
2500
Subtotal for Section 15
Grand Total
19%
9%
1%
3%
9%
2%
0%
0%
23%
13%
3%
11%
5,062
38
16
5
1%
0%
0%
0%
3%
1%
1%
1%
14
166
42
34
62
377
5,439 100%
Plan Persistency 1989-1997
Year
Month
Issued
In-Force
%
1989
1990
1991
1992
1993
1994
1995
1996
1997
Subtotal
Subtotal
Subtotal
Subtotal
Subtotal
Subtotal
Subtotal
Subtotal
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
Subtotal
4,512
1,350
1,016
982
1,262
1,079
1,108
1,247
122
129
132
104
138
91
150
141
146
193
134
194
1,674
25
14,255
738
216
279
308
458
438
649
872
107
104
111
88
123
79
142
136
136
176
132
193
1,527
16%
16%
27%
31%
36%
41%
59%
70%
5,439
38%
-
Adjustment
Total
90%
Page 16
ICHIP 01/09/08
12:19
. Section 15- HIPAA-CHIP
Section 7 - Traditional CHIP
Thirty-six percent of CHIP participants at the
end of 1997 were between the ages of 55 and
64. The next largest age groups enrolled in
CHIP are: ages 45 to 54 (24 percent); ages 35
to 44 (19 percent); ages 25 to 34 (11 percent);
and ages 0 to 25 ( 11 percent). Less than 1
percent of CHIP enrollees are age 65 or older.
Many of those in the under age 25 category are
children who have serious medical conditions,
many of whom require constant care, and who
have been unable to obtain insurance coverage
elsewhere.
As for the age 65 and older
category, there are now ample choices in the
private market for supplemental coverage when
persons become eligible for Medicare. CHIP is
only appropriate at this age if a person is
ineligible for Medicare.
Forty-seven percent of HIPAA-CHIP participants
at the end of 1997 were between the ages of 55
and 64. The next largest age groups enrolled in
HIPAA-CHIP are: ages 45 to 54 (17 percent);
ages 35 to 44 ( 17 percent); ages 25 to 34 ( 10
percent)/ and ages 0 to 25 (7 percent). It should
be noted that for the calendar year 1997 the
total number of HIPAA-CHIP enrollees was only
377. This is most likely too. small a number on
which to base any conclusions about age
distribution.
In the HIPAA-CHIP pool there are slightly more
females that males. However, this should also
be qualified by the fact that the number of
participants is small.
CHIP AGE GENDER DISTRIBUTION
60-64=~
45-49
30-34
Thirty-six percent of all
participants were between the
ages of 55 and 64 at year's end
0-19 iiiiiiliiii~===--------__j
0
200
400
600
800
Plan-wide, the split between the sexes remains
nearly even, with 54 percent female and 46
percent male.
,~ '
Participation by females is lower in the younger
years, evens up in the middle-aged category,
and then outstrips males in the older age
groups. Female participation increases by age
group: they comprise 39 percent of the under 25
age category, 53% of the 45-54 age group, and
64% of the 55-64 age category.
HIPAA AGE GENDER DISTRIBUTION
60-64
45-49
;;;~:====-----
30-34
j;;;;;iiiiii...-
0-19 iiiiiiiii...__ _ _ _ _ _ _ _ __j
0
20
40
60
80
!
I
r
j.
l
L
I
!
Page 17
w
~
!*:' · .•
·~V.::$'. ~.v.-·
.
.
. . , ..,..m «~~~w.
.;
Chicago and the suburban or "collar" counties
(areas A and B, respectively) are home to 60
percent of the people enrolled in CHIP. The
next largest group lives in rural downstate,
Illinois (area D). This area accounted for 26
percent of the people enrolled in CHIP at the
CHIP is serving persons
end of 1997.
throughout Illinois and at least one person in all
but two counties in Illinois was enrolled in CHIP
at year-end 1997.
WHERE DO THEY LIVE? TRADITIONAL CHIP
A
11%
D
c
49%
WHERE DO THEY LIVE? HIPAA-CHIP
D
20%
ICHIP 01/09/08
Most Populous Counties at Year-End
i
12:19
HIPAA
CHIP
TOTAL
!couNTY
Cook
154
1,939
1,785
i
Geographical Distribution
A
10%
c
11%
BY RATE AREA
I
Du Page
466
35
501
Lake
399
23
422
Kane
134
11
145
Me Henry
131
14
145
Will
129
8
137
Winnebago
121
8
129
94
8
102
Madison
Sangamon
100
2
102
Peoria
81
7
88
La Salle
81
2
83
Me Lean
77
6
83
Champaign
63
3
66
StClair
59
5
64
Macon
49
4
53
Kankakee
46
3
49
Stephenson
41
2
43
Effingham
36
3
39
Tazewell
35
2
37
Vermilion
33
3
36
De Kalb
31
4
35
Macoupin
35
Rock Island
34
1
35
Henry
30
2
32
Livingston
30
1
31
Jackson
28
2
30
Williamson
30
Lee
27
1
28
Coles
26
1
27
Marion
26
1
27
Christian
26
Iroquois
22
Whiteside
22
Woodford
26
Bureau
24
1
25
Clinton
23
2
25
Morgan
22
3
25
Subtotal
4,422
330
4,752
640
47
687
5,062
377
5,439
Other Counties
Total
35
30
26
26
4
4
26
26
Page 18
6···>
w:/
Distribution By County
...• •• •. }i:f....~ ,• ... : ;:zr.-::.:~::~;::%~:::::::~::..:.
¥:·'
ICHIP 01/09/08
12:19
:·:.:::--~..::::::=:w...@":~zy.··...t.:-=~-==$.=;;:*· f-*:':f.~=-:q.::::::::~:~:··.•.···:>·:.
Participation Key
D
•
Ill
D
II
Ill
.
.
501 - 2,000
251 - 500
51 - 250
11 -50
1 - 10
None
Page 19
------------------------------------~
ICHIP 01/09/08
12:19
Benefits Paid to Participants
•
.
.
•
v
... .
.
'I'
•
,''~'
~$S!!~..
....
•
~
A health insurance plan experiences a
lag
between the time an insured receives medical
services and the time bills for these services are
submitted and finally processed for payment.
Because of this, the claims that are paid by the
end of any given month do not represent all of
the claims which were incurred prior to the end
of that month which will eventually result in
payment. For this reason, in recognition of
claims that have been incurred but not reported,
a reserve must be established.
The following pie chart and the comparable
numbers for Section 15 table on the next page
summarizes paid claims by major categories.
The tables on the following pages summarize
charges by major diagnosis categories.
HIPAA-CHIP
3%
During calendar year 1997, paid losses for the
Section 7 pool again exceeded $40 million. In
anticipation of claims that were not submitted by
year-end, a reserve of $7.8 million was
established for this Traditional CHIP pool and
$1.0 million for the HIPAA-CHIP plan.
TRADITIONAL CHIP
4%
36%
D Inpatient
DPhysician
mOutpatient
EJ Major Medical
!;~All Other
Page 20
ICHIP 01/09/08
12:19
1
· .·
Claims Paid in 1997 by Plan Type and Averag~·~peren~
.. . •
[1 npatient
i
i
[Physician Service
!I
1
[Outpatient
Non-PPO
1
PPO
CHIP Total
Non-PPO
1
PPO
I
HIPAA Total
1
Total/All
7,815,894\
3,427,7121
14,843,568
22,337
35,893
58,229
--14.901,798j
3,148,731
6,576,443
16,231
29,669
45,900
6,622,343
1
1,964,5301
980,396
2,944,926
2,812
7,680
10,492
2,955.418
1-:-IL-o."-os~e-;B""ilc:-ls'•------+!-----;:5-;:;-62::o-.""'69""1c+l----~1-;:c93:::-,-;:c28:;-:;1:t-- 755,973 -----;:;3-;;,9:-:o8""1i-------::6=2c=-O-I----~~~4:-,6=o1-~---760,574
Home
!
~~~r;/SNF
t
Medicare Deductible
I
1
1
7,027,674
-~~~~---~~~~----~~~--~~~------~~~---~~~~
[Major MedicaP
ICoordinated
!
$:::7:-:,5::::8~3.::::8~9:2::+:1----:$::::8-:,1::::2-:-1,-::::89::-1:+---::$:-:1-=-5,-=7::::05::-c,7=-:8:-:3+----=$~39::-.~63::-:5:+---::$-c47::::-.-=-56:::-1+----:$:-::8-=7-:,1.,..95+-$:::-1:-::5:-::,7:.-::9-=-2.~978
~
1
245,0731
-·-7
29=~7:-.1703""1+----·-=-54:-;;2:-:,2..-::0-:-4t--------+-----1:-,0cc-8.--.34 - - ~---1,083 ----54:3,287 1
35,918\
26,2081
96,872
132,790
- - - - - - - · r----132}901
-----t-------;;2e:;;:6-::,2-:::-08+-------+---------l------·----_+------2::-c6.-.,2~081
1
I $21.661.918.31 $1_9_.8_65_._9_7_6_.1_2-+_$_4_1__
.5_27_.8_9_4_.4_3+-$·8_4_._99_4_.9_6·"-:-$_1_22_._50_6_.4_3"'"
1
1
$207,501.39! $41,735,395.82[
1
~rage Enrollment
_j
r~erage_ Cia~~~~-
i
2,4301
$8,914L____
988
7 9 30
~~,2~~j --~---_-___$-=_8_._o_5~0__LI-_-_~_-_$_1_,9_~_7+-I--_~~==$7__~-4+1-_-.--~=--~~=-----~----~
_·
2,728;
5,1591
431
167,
·-·-
$2 QQJ
10 i~~----~-·-=-$__5_. 2_6 3_..·',
Average Claim Cost Comparison
HIPAA
oPPO
•Standard
CHIP
0
2000
4000
6000
8000
10000
There is only 6 months of HIPAA experience reflected in this report
1
CHIP is the plan name for enrollees in both the standard plan and the Medicare plan.
There is only 6 months experience for the HIPAA program reflected in this report.
3
Major Medical refers to claims submitted for any type of service by the participant with a Major Medical
claim form attached. Most other items represent claims filed by the providers. Hence, major medical may
include services for inpatient, outpatient and physician services.
4
This means precisely what it says: loose bills submitted by anyone (participant, provider, etc.) without a
claim form.
2
Page 21
ICHIP 01/09/08
12:19
Inpatient Utilization by Major Diagnostic Categories Calendar Year 1997
J
[Major Diagnostic
Categor~·
Total
I
I Pet of I Total I Pet of Total i Avg Chg
I Total AdmlCharges I Charges I Per Adm
Avg Chg
Avg
Total Amt
Per Oa)'
Los
Paid
I
I
Adm
I
1
Pet of
1 Avg Paid I Avg !'aid
I
I
ITotal Paid ! Per Adm I l'er Oa)'
____)____ - - - '
~·
L
OS D&D Circulatory System
237
22.4
4,198,972
26.6
17,717
4,190
4.2
2,319,849
06 D&D Digestive System
115
10.87
1,308,678
8.3
11,379
2,299
4.9
1,656,198
10.5
15,194
2,309
8.79
08 D&D Musculoskeletal Sys. Con
93
1,291,531
8.2
13,887
Tissue
--------------------------------------------79
7.47
1,003,842
12,706
01 D&D Nervous System
6.4
26.9
9,788
2,315
665,745
7.7
5,789
1,170
6.6
976,555
11.3
8,959
1,362
3,337
4.2
779,579
9
8,382
2,014
2,297
5.5
473,529
5.5
5,994
1,083
---~----~---~-------~----~------
04 D&D Respiratory System
109
10.3
---------------------
~-----~-----------
-----·-·---· ------------
67
10 Endocrine System
--------~-------
--
57
19 Mental Diseases & Disorders
------------ ....
--------------
~--
07 D&D Hepatobiliary Sys. & Pancreas
-------------·-· ------------ --
11 D&D Kidney & Urinary Tract
__________ _________
,
13 D&D Female Reproductive System
4.2
9,912
2,101
4.7
302,547
3.5
4,515
957
5.39
482,122
3.1
8,458
1,054
8
240,645
2.8
4,221
526
43
4.06
1,105,805
7
25.716
5,003
5.1
648,894
7.5
15,090
2,936
2,846
3.9
267,972
3.1
6,380
1,644
-----------------~------------
42
35
3.97
464,035
----·-·-- ----------
3.31
2.9
11,048
------------~--·-~~------------
329,070
2.1
9,402
2,788
3.4
186,732
-·-------··------
2.2
5,335
1,582
3.1
8,069
1,244
--------~---------~~-~--.~~~---------------------
18 Infectious & Parasitic Diseases
·-
664,130
----- ------------------------
--·-------- -------------····
- - - - · - - · - - ----------------
--------~-·-
6.33
--------------·-·-·---~--------------·
33
3.12
528,255
3.3
16,007
2,468
6.5
266,299
--------------
~-~---------~---
1.5
7,753
1,602
4.8
122,231
1.4
3,942
814
790,305
5
37,633
5,339
7
470,752
5.5
22,416
3,180
1.23
141,599
0.9
10,892
2,889
3.8
97,158
1.1
7,473
1,982
13
1.23
739,768
4.7
56,905
7,252
7.8
337,079
3.9
25,~29
3,304
12
1.13
69,729
0.4
5,810
1,223
4.8
33,477
0.4
2,789
587
11
1.04
108,905
0.7
9,900
3,203
3.1
47,395
0.6
4,308
1,393
11
1.04
138,620
0.9
Organ~-------------------------------
12,601
2,772
4.5
64,982
0.8
5,907
1,299
09 D&D Skin, Subcutan Tissue &
Breast_____ - - - - - - - - - - - - ·
17 Myeloproliferative Disorders
31
2.93
21
1.98
21 Injy.(Poisoning/Toxic Effect of Drug
13
25 Human Immunodeficiency Virus
Infect
2oSub Use/Induced Organic Mental
Dis.
03 D&D Ear, Nose, Mouth & Throat
240,347
----------
16 D&D Blood & Blood Forming
Page 22
ICHIP 01/09/08
12:19
Outpatient Utilization by Major Diagnostic COde Categories Calendar Year :}997 .
.
,
I[!CD9 Diagnosis Divisions
, Total
Cases
Total
Charges
Total
·
·1---Ca"""
I Per 1000
t~-=s,-lg_n_s_-=-&-:s=-y-m-p-to-~--~-~=-=r::-II--=D:-e-:::fl-n~-d""c=-o-n._,d,lt.-,-lo._ns-i--1~:
IFactors Influenc1ng
~~
Health Status - - - - - - · - - 1 549
!Benign and Malignant Neoplasms
.
I
1
I
297.9
,
225.2
1,171
I
Cha'lles
1
Per 1000
1
988,565
\
190,109
j
610,711
[
1,312,7601
I
..
Amt Paidj
Amt Paid , Per 1000 i
617,540
118,758
117,444
427,254
82,164
252,454
919,871
176,898
1
!Diseases of the Circulatory System____ - - - r··'1;69s--:--211.2-r-l,oo3, 767
~culoskeletal & connect. Tissue Disease·---~IDiseases of the Genitourinary System ·--~
'
1,015
195.2
853
164
T
I
635,601
--861-;-iss-·-:
----------·------·-~ ---~--~-j________L__ ---:-:::::--:--c---:
i
L___
:rnjury and Poisoning
!Dis. of Nervous System & Sense
Organs----~i
:
!Diseases of the Digestive System
jMentallllness
565
554
108.7
j
106.5
379,193
I
~s. of Blood & Blood Forming Organs
!Infectious and Parasitic Diseases
275
·---~.---238
'
570,828
109,775
---!------·--244,134
!
46,949
Diseases of Skin and Subcutaneous Tissue
107,690
i
i
75,644
I
'
I
.. J,
281,592
!258,830
54,152
i
I
49,775
i
352,796 ]--=6=-7,-=-8-::45=--
41,84::;9---:+--:1:-::3-=-4,-=7=-=75
~--25,918-- ·1
J
.
52.9
89,453
17,203
57,816
1
11,118
45.8
186,326
35,832
149,004
I
28,655
13,338
-=-----+-------"
46,548
8,952
i
1
-~----·
150
:
28.8
;
!
i-:::-:---·-------------·---------1
I
165,632
_j____
i
i
i
559,989
i
.J
393,351
72,922
-------------r--3~-~--74-·----r-----2-17,613-
+--6-96-,-28-9--i---------i
133,902
122,231
69,562
:
822
:
158.1
361,720
L ________J___-:-::-:::-::----;-------·
i
566
1
108.8
425,662
'
81,858
!Endocrine and Immunity Disorders
1
193,032
congenii:ai'A-nomalies___________ ·--·--,- -ill---~--- 26.3
69,356
1
I
.
44,1cl5' --'---8=-,-48-c-2:-----1--2-6-,6-3_4_
-+--
,
5,122--i
1
1
isubstance--Abuse/Ch-emiCal Dependency
'
123
23.7
~------· ----------------------1
101,838
:
19-::,5-=-8-4--c-::------+----68,469
13,167
1
---:--::-::-:--·---1----:-cc:--+--...,-11,305
IPregnancy, Childbirth and Puerperium
!
29
5.6
:
23,690
4,556
2,174
--·~-~-------·------------~ --~+~-----~~--+----___J__ _______ ~~1,482
3,969
iPerinatal Conditions
l
12
:
2.3
!
7,707
'
763
"-·
1_,
!
'
1
'
I
!Total Client __________ -~-----~----s·~-+---~~------------ ---- _ _ _ _!_ _ _ _ _ _ _ ___! ________
1
L .........._ -----------------·-·-------
11,2o1
,
2,154.00
•
1,096
211
72
7,880,437
1,515,469
5,261,077
' --------~----'----------------C
Jllinois Comprehensive Health Insurance Plan
14
_;_ __
1,011,746
--------------
Page 23
ICHIP 01/09/08
12:19
.
Cost Containment
~
I.
,..·. :>
Section7- Traditional CHIP and Section 15HIPAA-CHIP
Cost containment measures are critical for a
state subsidized health care program since they
allow more eligible Illinois residents to
participate within the amount of deficit funding
available to the Plan.
The PPO plan, which first was offered in 1995,
allows participants to pay a lower premium and
receive the same level of benefits by using only
CHIP preferred hospitals, it appears to have
resulted in an average decrease in costs (see
previous section on benefits). This program has
been well received. As of year-end 1997, 62
percent of new applicants for the traditional
CHIP program were choosing the PPO plan.
Costs are also contained by virtue of the
contract CHIP has with its Administrator, Blue
Cross and Blue Shield of Illinois. The agreement
provides for the Administrator to be paid a fixed
administrative fee per month per participant. As
claims are processed, certain discounts which
the Administrator has negotiated with various
providers are partially passed back from the
Administrator both to CHIP and the participant
based on actual usage. Discounts vary based
on the region in which services are provided, the
type of service provided, and the place of
treatment. Larger discounts are available for
persons who are PPO participants and who use
those facilities which are PPO facilities. This
allows the plan's claims liability to be less than it
would have been had it not participated in these
It also reduces the
discount arrangements.
plan's participant's liability for their medical care
costs.
CHIP
participants
also
benefit
through
participation in the Blue Script program offered
by Blue Cross and Blue Shield. Under this
program, participants' claims for prescriptions
are automatically submitted to the Administrator
whenever a prescription is filled at a participating
pharmacy reducing the processing time of their
claims.
Cost containment measures are
critical for a state subsidized
health care program.
CHIP requires pre-admission review of all
hospital and skilled nursing facility confinements
and medical management of all large cases.
Penalties for non-compliance with the preadmission review are spelled out in the CHIP
policy, and may involve benefit reductions or, in
some cases, denial of payment for hospital
charges. Pre-certification is conducted for CHIP
by the plan Administrator.
Prior approval is also required before purchase
or receipt of services in order to receive any
benefits for certain durable medical equipment,
hospice and home health care services, and
specified organ transplants.
Discount arrangements have been in place
since 1992, and have saved the state millions of
dollars since they were first implemented, thus
greatly assisting the Board in expanding
enrollment and eliminating the previous waiting
list.
CHIP participants are issued CHIP Blue
and Blue Shield identification cards,
facilitates quick admission to hospitals
contract with Blue Cross and Blue Shield.
allows, in many cases, for hospital bills
submitted
electronically
to
the
Administrator.
Cross
which
under
It also
to be
plan
Page 24
ICHIP 01/09/08
12:19
Financial Summary Data
Section 7 Traditional CHIP
Year Ended December 31, 1997 (unaudited)*
Plan Income:
Net Written Premiums
Change In Unearned Premiums
Net Earned Premiums
Investment Income
$18,408,077
894,952
$19,303,029
4,578,097
Total Plan Income
Plan Expenses:
Paid Losses
Change In Incurred But Not Reported
Total Incurred Losses
Agent Referral Fees
Administrator Expense
CHIP Board Office Expenses
Total Administration Expense
$23,881 '126
$35,274,747
600,000
$35,874,747
$24,400
1,430,052
1 '156,465
$2,610,917
Total Plan Expenses
Plan Deficit, January 1, 1997-December 31, 1997
$38,485,664
($14,604,538)
*CHIP Plan Financial Statements are audited annually on a fiscal year basis ending June 30.
-------------------~--------------------
ICHIP 01/09/08
12:19
Financial Summary Data
Section 15 HIPAA-CHIP
Year Ended December 31, 1997 (unaudited)*
Plan Income:
Net Written Premiums
Less: Change in Unearned Premiums
Net Earned Premiums
Investment Income
$681,797
(287,794)
$394,003
206,616
Total Plan Income
Plan Expenses:
Paid Losses
Change in Incurred But Not Reported
Total Incurred Losses
Agent Referral Fees
Administrator Expense
CHIP Board Office Expenses
Implementation Expenses
Total Administration Expense
$600,619
$167,212
400,000
$567,212
$7,200
28,541
218,069
618,000
$871,810
Total Plan Expenses
$1,439,022
Plan Deficit, July 1, 1997-December 31, 1997
($838,403)
*CHIP Plan Financial Statements are audited annually on a fiscal year basis ending June 30.
ICHIP 01/09/08
12:19
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how to apply, call, write or visit our worldwide web site:
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1997 Annual Report - Illinois Comprehensive Health Insurance Plan

Transcription

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