80 Ill. Adm. Code 2160.250
Other Administrative Responsibilities
Section 2160
Section 2160.250Â Other Administrative Responsibilities
a)Â Â Â Â Â Â Â Â The Department shall
offer an annual Benefits Choice Period for Units to:
1)Â Â Â Â Â Â Â Â add or drop coverage
for Annuitants as a group;
2)Â Â Â Â Â Â Â Â allow Members to add or
drop Dependent coverage;
3)Â Â Â Â Â Â Â Â allow Members to change
health plans.
b)Â Â Â Â Â Â Â Â 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)Â Â Â Â Â Â Â Â The
Department shall prepare and distribute an administrative procedures manual
with periodic updates for the Health Plan Representatives designated by the
Units.
d)Â Â Â Â Â Â Â Â The
Department will provide training seminars for Health Plan Representatives
designated by the Units.
e)Â Â Â Â Â Â Â Â The
Department shall establish an Advisory Board. The responsibilities of the
Board are described in Section 2160.520.
f)Â Â Â Â Â Â Â Â 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)Â Â Â Â Â Â Â Â 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)Â Â Â Â Â Â Â Â The
Department shall audit records of participating Units, such as payroll information,
to verify enrollment and enforce eligibility rules under the Plan.