(820 ILCS 305/29.2)
Sec. 29.2. Insurance oversight.
(a) The Department of Insurance shall annually submit to the Governor, the Chairman of the Commission, the President of the Senate, the Speaker of the House of Representatives, the Minority Leader of the Senate, and the Minority Leader of the House of Representatives a written report that details the state of the workers' compensation insurance market in Illinois. The report shall be completed by April 1 of each year, beginning in 2012, or later if necessary data or analyses are only available to the Department at a later date. The report shall be posted on the Department of Insurance's Internet website. Information to be included in the report shall be for the preceding calendar year. The report shall include, at a minimum, the following:
(1) Gross premiums collected by workers' compensation
carriers in Illinois and the national rank of Illinois based on premium volume.
(2) The number of insurance companies actively
engaged in Illinois in the workers' compensation insurance market, including both holding companies and subsidiaries or affiliates, and the national rank of Illinois based on number of competing insurers.
(3) The total number of insured participants in the
Illinois workers' compensation assigned risk insurance pool, and the size of the assigned risk pool as a proportion of the total Illinois workers' compensation insurance market.
(4) The advisory organization premium rate for
workers' compensation insurance in Illinois for the previous year.
(5) The advisory organization prescribed assigned
risk pool premium rate.
(6) The total amount of indemnity payments made by
workers' compensation insurers in Illinois.
(7) The total amount of medical payments made by
workers' compensation insurers in Illinois, and the national rank of Illinois based on average cost of medical claims per injured worker.
(8) The gross profitability of workers' compensation
insurers in Illinois, and the national rank of Illinois based on profitability of workers' compensation insurers.
(9) The loss ratio of workers' compensation insurers
in Illinois and the national rank of Illinois based on the loss ratio of workers' compensation insurers. For purposes of this loss ratio calculation, the denominator shall include all premiums and other fees collected by workers' compensation insurers and the numerator shall include the total amount paid by the insurer for care or compensation to injured workers.
(10) The growth of total paid indemnity benefits by
temporary total disability, scheduled and non-scheduled permanent partial disability, and total disability.
(11) The number of injured workers receiving wage
loss differential awards and the average wage loss differential award payout.
(12) Illinois' rank, relative to other states, for:
(i) the maximum and minimum temporary total
disability benefit level;
(ii) the maximum and minimum scheduled and
non-scheduled permanent partial disability benefit level;
(iii) the maximum and minimum total disability
benefit level; and
(iv) the maximum and minimum death benefit level.
(13) The aggregate growth of medical benefit payout
by non-hospital providers and hospitals.
(14) The aggregate growth of medical utilization for
the top 10 most common injuries to specific body parts by non-hospital providers and hospitals.
(15) The percentage of injured workers filing claims
at the Commission that are represented by an attorney.
(16) The total amount paid by injured workers for
attorney representation.
(b) The Director of Insurance shall promulgate rules requiring each insurer licensed to write workers' compensation coverage in the State to record and report the following information on an aggregate basis to the Department of Insurance before March 1 of each year, relating to claims in the State opened within the prior calendar year:
(1) The number of claims opened.
(2) The number of reported medical only claims.
(3) The number of contested claims.
(4) The number of claims for which the employee has
attorney representation.
(5) The number of claims with lost time and the
number of claims for which temporary total disability was paid.
(6) The number of claim adjusters employed to adjust
workers' compensation claims.
(7) The number of claims for which temporary total
disability was not paid within 14 days from the first full day off, regardless of reason.
(8) The number of medical bills paid 60 days or later
from date of service and the average days paid on those paid after 60 days for the previous calendar year.
(9) The number of claims in which in-house defense
counsel participated, and the total amount spent on in-house legal services.
(10) The number of claims in which outside defense
counsel participated, and the total amount paid to outside defense counsel.
(11) The total amount billed to employers for bill
review.
(12) The total amount billed to employers for fee
schedule savings.
(13) The total amount charged to employers for any
and all managed care fees.
(14) The number of claims involving in-house medical
nurse case management, and the total amount spent on in-house medical nurse case management.
(15) The number of claims involving outside medical
nurse case management, and the total amount paid for outside medical nurse case management.
(16) The total amount paid for Independent Medical
exams.
(17) The total amount spent on in-house Utilization
Review for the previous calendar year.
(18) The total amount paid for outside Utilization
Review for the previous calendar year.
The Department shall make the submitted information publicly available on the Department's Internet website or such other media as appropriate in a form useful for consumers.
(Source: P.A. 97-18, eff. 6-28-11.)
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Last modified: February 18, 2015