SB1282 EnrolledLRB103 27271 BMS 53642 b


  
1    AN ACT concerning regulation.
  
 
2    Be it enacted by the People of the State of Illinois,
 
3represented in the General Assembly:
  


 
 
4    Section 5. The State Employees Group Insurance Act of 1971 
5is amended  by changing Section 6.11 as follows:
 


6    (5 ILCS 375/6.11)

7    (Text of Section before amendment by P.A. 102-768)
8    Sec. 6.11. Required health benefits; Illinois Insurance 
9Code
requirements.   The program of health
benefits shall 
10provide the post-mastectomy care benefits required to be 
11covered
by a policy of accident and health insurance under 
12Section 356t of the Illinois
Insurance Code.  The program of 
13health benefits shall provide the coverage
required under 
14Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, 
15356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 
16356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, 
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of 
20the
Illinois Insurance Code.
The program of health benefits 
21must comply with Sections 155.22a, 155.37, 355b, 356z.19, 
22370c, and 370c.1 and Article XXXIIB of the
Illinois Insurance 
23Code. The Department of Insurance shall enforce the 
 
 
SB1282 Enrolled- 2 -LRB103 27271 BMS 53642 b

1requirements of this Section with respect to Sections 370c and 
2370c.1 of the Illinois Insurance Code; all other requirements 
3of this Section shall be enforced by the Department of Central 
4Management Services.

5    Rulemaking authority to implement Public Act 95-1045, if 
6any, is conditioned on the rules being adopted in accordance 
7with all provisions of the Illinois Administrative Procedure 
8Act and all rules and procedures of the Joint Committee on 
9Administrative Rules; any purported rule not so adopted, for 
10whatever reason, is unauthorized. 
11(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; 
12101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 
131-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, 
14eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 
15102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 
161-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, 
17eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 
18revised 12-13-22.)
 
19    (Text of Section after amendment by P.A. 102-768)
20    Sec. 6.11. Required health benefits; Illinois Insurance 
21Code
requirements.   The program of health
benefits shall 
22provide the post-mastectomy care benefits required to be 
23covered
by a policy of accident and health insurance under 
24Section 356t of the Illinois
Insurance Code.  The program of 
25health benefits shall provide the coverage
required under 
 
 
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1Sections 356g, 356g.5, 356g.5-1, 356m, 356q,
356u, 356w, 356x, 
2356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 
3356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 
5356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, 
6356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and 
7356z.60, and 356z.61 of the
Illinois Insurance Code.
The 
8program of health benefits must comply with Sections 155.22a, 
9155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of 
10the
Illinois Insurance Code. The Department of Insurance shall 
11enforce the requirements of this Section with respect to 
12Sections 370c and 370c.1 of the Illinois Insurance Code; all 
13other requirements of this Section shall be enforced by the 
14Department of Central Management Services.

15    Rulemaking authority to implement Public Act 95-1045, if 
16any, is conditioned on the rules being adopted in accordance 
17with all provisions of the Illinois Administrative Procedure 
18Act and all rules and procedures of the Joint Committee on 
19Administrative Rules; any purported rule not so adopted, for 
20whatever reason, is unauthorized. 
21(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20; 
22101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 
231-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103, 
24eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 
25102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 
261-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, 
 
 
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1eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 
2102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
3    Section 10. The Counties Code is amended  by changing 
4Section 5-1069.3 as follows:
 
5    (55 ILCS 5/5-1069.3)

6    Sec. 5-1069.3. Required health benefits.   If a county, 
7including a home
rule
county, is a self-insurer for purposes 
8of providing health insurance coverage
for its employees, the 
9coverage shall include coverage for the post-mastectomy
care 
10benefits required to be covered by a policy of accident and 
11health
insurance under Section 356t and the coverage required 
12under Sections 356g, 356g.5, 356g.5-1, 356q, 356u,
356w, 356x, 
13356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 
14356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 
15356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 
16356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 
17356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 
18of
the Illinois Insurance Code. The coverage shall comply with 
19Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois 
20Insurance Code.  The Department of Insurance shall enforce the 
21requirements of this Section. The requirement that health 
22benefits be covered
as provided in this Section is an

23exclusive power and function of the State and is a denial and 
24limitation under
Article VII, Section 6, subsection (h) of the 
 
 
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1Illinois Constitution.  A home
rule county to which this 
2Section applies must comply with every provision of
this 
3Section.


4    Rulemaking authority to implement Public Act 95-1045, if 
5any, is conditioned on the rules being adopted in accordance 
6with all provisions of the Illinois Administrative Procedure 
7Act and all rules and procedures of the Joint Committee on 
8Administrative Rules; any purported rule not so adopted, for 
9whatever reason, is unauthorized. 
10(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; 
11101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. 
121-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, 
13eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; 
14102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 
151-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, 
16eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 
17102-1117, eff. 1-13-23.)
 
18    Section 15. The Illinois Municipal Code is amended  by 
19changing Section 10-4-2.3 as follows:
 
20    (65 ILCS 5/10-4-2.3)

21    Sec. 10-4-2.3. Required health benefits.   If a 
22municipality, including a
home rule municipality, is a 
23self-insurer for purposes of providing health
insurance 
24coverage for its employees, the coverage shall include 
 
 
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1coverage for
the post-mastectomy care benefits required to be 
2covered by a policy of
accident and health insurance under 
3Section 356t and the coverage required
under Sections 356g, 
4356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a, 
5356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 
6356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 
7356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 
8356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 
9356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the 
10Illinois
Insurance
Code. The coverage shall comply with 
11Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois 
12Insurance Code.  The Department of Insurance shall enforce the 
13requirements of this Section. The requirement that health

14benefits be covered as provided in this is an exclusive power 
15and function of
the State and is a denial and limitation under 
16Article VII, Section 6,
subsection (h) of the Illinois 
17Constitution.  A home rule municipality to which
this Section 
18applies must comply with every provision of this Section.


19    Rulemaking authority to implement Public Act 95-1045, if 
20any, is conditioned on the rules being adopted in accordance 
21with all provisions of the Illinois Administrative Procedure 
22Act and all rules and procedures of the Joint Committee on 
23Administrative Rules; any purported rule not so adopted, for 
24whatever reason, is unauthorized. 
25(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; 
26101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. 
 
 
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11-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, 
2eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22; 
3102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 
41-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, 
5eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 
6102-1117, eff. 1-13-23.)
 
7    Section 20. The School Code is amended  by changing Section 
810-22.3f as follows:
 
9    (105 ILCS 5/10-22.3f)

10    Sec. 10-22.3f. Required health benefits.   Insurance 
11protection and
benefits
for employees shall provide the 
12post-mastectomy care benefits required to be
covered by a 
13policy of accident and health insurance under Section 356t and 
14the
coverage required under Sections 356g, 356g.5, 356g.5-1, 
15356q, 356u, 356w, 356x, 356z.4, 356z.4a,

356z.6, 356z.8, 
16356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, 
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 
20356z.61 of
the
Illinois Insurance Code.
Insurance policies 
21shall comply with Section 356z.19 of the Illinois Insurance 
22Code. The coverage shall comply with Sections 155.22a, 355b, 
23and 370c  of
the Illinois Insurance Code. The Department of 
24Insurance shall enforce the requirements of this Section. 

 
 
SB1282 Enrolled- 8 -LRB103 27271 BMS 53642 b

1    Rulemaking authority to implement Public Act 95-1045, if 
2any, is conditioned on the rules being adopted in accordance 
3with all provisions of the Illinois Administrative Procedure 
4Act and all rules and procedures of the Joint Committee on 
5Administrative Rules; any purported rule not so adopted, for 
6whatever reason, is unauthorized. 
7(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; 
8101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff. 
91-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203, 
10eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 
11102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff. 
121-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, 
13eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
14    Section 25. The Illinois Insurance Code is amended by 
15adding Section 356z.61 as follows:
 
16    (215 ILCS 5/356z.61 new)
17    Sec. 356z.61. Coverage for liver disease screening. A 
18group or individual policy of accident and health insurance or 
19a managed care plan that is amended, delivered, issued, or 
20renewed on or after January 1, 2025 shall provide coverage for 
21preventative liver disease screenings for individuals 35 years 
22of age or older and under the age of 65 at high risk for liver 
23disease, including liver ultrasounds and alpha-fetoprotein 
24blood tests every 6 months, without imposing a deductible, 
 
 
SB1282 Enrolled- 9 -LRB103 27271 BMS 53642 b

1coinsurance, copayment, or any other cost-sharing requirement 
2on the coverage provided; except that this Section does not 
3apply to coverage of liver disease screenings to the extent 
4such coverage would disqualify a high-deductible health plan 
5from eligibility for a health savings account pursuant to 
6Section 223 of the Internal Revenue Code.
 
7    Section 30. The Health Maintenance Organization Act is 
8amended  by changing Section 5-3 as follows:
 
 


9    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)


  
10    Sec. 5-3. Insurance Code provisions. 

11    (a) Health Maintenance Organizations
shall be subject to 
12the provisions of Sections 133, 134, 136, 137, 139, 140, 
13141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 
14154, 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, 
15355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x, 
16356y,
356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 
17356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 
18356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 
19356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33, 
20356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48, 
21356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57, 
22356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5, 
23367i, 368a, 368b, 368c, 368d, 368e, 370c,
370c.1, 401, 401.1, 
24402, 403, 403A,
408, 408.2, 409, 412, 444,
and
444.1,

 
 
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1paragraph (c) of subsection (2) of Section 367, and Articles 
2IIA, VIII 1/2,
XII,
XII 1/2, XIII, XIII 1/2, XXV, XXVI, and 
3XXXIIB of the Illinois Insurance Code.

4    (b) For purposes of the Illinois Insurance Code, except 
5for Sections 444
and 444.1 and Articles XIII and XIII 1/2, 
6Health Maintenance Organizations in
the following categories 
7are deemed to be "domestic companies":

8        (1) a corporation authorized under the
Dental Service 
9    Plan Act or the Voluntary Health Services Plans Act;

10        (2) a corporation organized under the laws of this 
11    State; or

12        (3) a corporation organized under the laws of another 
13    state, 30% or more
of the enrollees of which are residents 
14    of this State, except a
corporation subject to 
15    substantially the same requirements in its state of

16    organization as is a "domestic company" under Article VIII 
17    1/2 of the
Illinois Insurance Code.

18    (c) In considering the merger, consolidation, or other 
19acquisition of
control of a Health Maintenance Organization 
20pursuant to Article VIII 1/2
of the Illinois Insurance Code,

21        (1) the Director shall give primary consideration to 
22    the continuation of
benefits to enrollees and the 
23    financial conditions of the acquired Health
Maintenance 
24    Organization after the merger, consolidation, or other

25    acquisition of control takes effect;

26        (2)(i) the criteria specified in subsection (1)(b) of 
 
 
SB1282 Enrolled- 11 -LRB103 27271 BMS 53642 b

1    Section 131.8 of
the Illinois Insurance Code shall not 
2    apply and (ii) the Director, in making
his determination 
3    with respect to the merger, consolidation, or other

4    acquisition of control, need not take into account the 
5    effect on
competition of the merger, consolidation, or 
6    other acquisition of control;

7        (3) the Director shall have the power to require the 
8    following
information:

9            (A) certification by an independent actuary of the 
10        adequacy
of the reserves of the Health Maintenance 
11        Organization sought to be acquired;

12            (B) pro forma financial statements reflecting the 
13        combined balance
sheets of the acquiring company and 
14        the Health Maintenance Organization sought
to be 
15        acquired as of the end of the preceding year and as of 
16        a date 90 days
prior to the acquisition, as well as pro 
17        forma financial statements
reflecting projected 
18        combined operation for a period of 2 years;

19            (C) a pro forma business plan detailing an 
20        acquiring party's plans with
respect to the operation 
21        of the Health Maintenance Organization sought to
be 
22        acquired for a period of not less than 3 years; and

23            (D) such other information as the Director shall 
24        require.

25    (d) The provisions of Article VIII 1/2 of the Illinois 
26Insurance Code
and this Section 5-3 shall apply to the sale by 
 
 
SB1282 Enrolled- 12 -LRB103 27271 BMS 53642 b

1any health maintenance
organization of greater than 10% of its

2enrollee population (including without limitation the health 
3maintenance
organization's right, title, and interest in and 
4to its health care
certificates).

5    (e) In considering any management contract or service 
6agreement subject
to Section 141.1 of the Illinois Insurance 
7Code, the Director (i) shall, in
addition to the criteria 
8specified in Section 141.2 of the Illinois
Insurance Code, 
9take into account the effect of the management contract or

10service agreement on the continuation of benefits to enrollees 
11and the
financial condition of the health maintenance 
12organization to be managed or
serviced, and (ii) need not take 
13into account the effect of the management
contract or service 
14agreement on competition.

15    (f) Except for small employer groups as defined in the 
16Small Employer
Rating, Renewability and Portability Health 
17Insurance Act and except for
medicare supplement policies as 
18defined in Section 363 of the Illinois
Insurance Code, a 
19Health Maintenance Organization may by contract agree with a

20group or other enrollment unit to effect refunds or charge 
21additional premiums
under the following terms and conditions:

22        (i) the amount of, and other terms and conditions with 
23    respect to, the
refund or additional premium are set forth 
24    in the group or enrollment unit
contract agreed in advance 
25    of the period for which a refund is to be paid or

26    additional premium is to be charged (which period shall 
 
 
SB1282 Enrolled- 13 -LRB103 27271 BMS 53642 b

1    not be less than one
year); and

2        (ii) the amount of the refund or additional premium 
3    shall not exceed 20%
of the Health Maintenance 
4    Organization's profitable or unprofitable experience
with 
5    respect to the group or other enrollment unit for the 
6    period (and, for
purposes of a refund or additional 
7    premium, the profitable or unprofitable
experience shall 
8    be calculated taking into account a pro rata share of the

9    Health Maintenance Organization's administrative and 
10    marketing expenses, but
shall not include any refund to be 
11    made or additional premium to be paid
pursuant to this 
12    subsection (f)).  The Health Maintenance Organization and 
13    the
group or enrollment unit may agree that the profitable 
14    or unprofitable
experience may be calculated taking into 
15    account the refund period and the
immediately preceding 2 
16    plan years.

17    The Health Maintenance Organization shall include a 
18statement in the
evidence of coverage issued to each enrollee 
19describing the possibility of a
refund or additional premium, 
20and upon request of any group or enrollment unit,
provide to 
21the group or enrollment unit a description of the method used 
22to
calculate (1) the Health Maintenance Organization's 
23profitable experience with
respect to the group or enrollment 
24unit and the resulting refund to the group
or enrollment unit 
25or (2) the Health Maintenance Organization's unprofitable

26experience with respect to the group or enrollment unit and 
 
 
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1the resulting
additional premium to be paid by the group or 
2enrollment unit.

3    In no event shall the Illinois Health Maintenance 
4Organization
Guaranty Association be liable to pay any 
5contractual obligation of an
insolvent organization to pay any 
6refund authorized under this Section.

7    (g) Rulemaking authority to implement Public Act 95-1045, 
8if any, is conditioned on the rules being adopted in 
9accordance with all provisions of the Illinois Administrative 
10Procedure Act and all rules and procedures of the Joint 
11Committee on Administrative Rules; any purported rule not so 
12adopted, for whatever reason, is unauthorized. 
13(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; 
14101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff. 
151-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, 
16eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; 
17102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 
181-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, 
19eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 
20102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 
211-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, 
22eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
23    Section 35. The Limited Health Service Organization Act is 
24amended  by changing Section 4003 as follows:
 


 
 
SB1282 Enrolled- 15 -LRB103 27271 BMS 53642 b

1    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)


2    Sec. 4003. Illinois Insurance Code provisions. Limited 
3health service
organizations shall be subject to the 
4provisions of Sections 133, 134, 136, 137, 139,
140, 141.1, 
5141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 
6154.5,
154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 
7355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22, 
8356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 
9356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57, 
10356z.59, 356z.61, 364.3, 368a, 401, 401.1,
402,
403, 403A, 
11408,
408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII 
121/2, XII, XII 1/2,
XIII,
XIII 1/2, XXV, and XXVI of the 
13Illinois Insurance Code. Nothing in this Section shall require 
14a limited health care plan to cover any service that is not a 
15limited health service.  For purposes of the
Illinois Insurance 
16Code, except for Sections 444 and 444.1 and Articles XIII
and 
17XIII 1/2, limited health service organizations in the 
18following categories
are deemed to be domestic companies:

19        (1) a corporation under the laws of this State; or

20        (2) a corporation organized under the laws of another 
21    state, 30% or more
of the enrollees of which are residents 
22    of this State, except a corporation
subject to 
23    substantially the same requirements in its state of 
24    organization as
is a domestic company under Article VIII 
25    1/2 of the Illinois Insurance Code.

26(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; 
 
 
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1101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 
21-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, 
3eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 
4102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 
51-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
6    Section 40. The Voluntary Health Services Plans Act is 
7amended  by changing Section 10 as follows:
 


8    (215 ILCS 165/10)  (from Ch. 32, par. 604)

9    Sec. 10. Application of Insurance Code provisions. Health 
10services
plan corporations and all persons interested therein 
11or dealing therewith
shall be subject to the provisions of 
12Articles IIA and XII 1/2 and Sections
3.1, 133, 136, 139, 140, 
13143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 
14356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v,
356w, 
15356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 
16356z.6, 356z.8, 356z.9,
356z.10, 356z.11, 356z.12, 356z.13, 
17356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 
18356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33, 
19356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 
20356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3, 
21367.2, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, 
22and paragraphs (7) and (15) of Section 367 of the Illinois

23Insurance Code.

24    Rulemaking authority to implement Public Act 95-1045, if 
 
 
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1any, is conditioned on the rules being adopted in accordance 
2with all provisions of the Illinois Administrative Procedure 
3Act and all rules and procedures of the Joint Committee on 
4Administrative Rules; any purported rule not so adopted, for 
5whatever reason, is unauthorized. 
6(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; 
7101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. 
81-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, 
9eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 
10102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff. 
111-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, 
12eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23; 
13102-1117, eff. 1-13-23.)
 
14    Section 45. The Illinois Public Aid Code is amended  by 
15changing Section 5-16.8 as follows:
 


16    (305 ILCS 5/5-16.8)

17    Sec. 5-16.8. Required health benefits. The medical 
18assistance program
shall
(i) provide the post-mastectomy care 
19benefits required to be covered by a policy of
accident and 
20health insurance under Section 356t and the coverage required

21under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, 
22356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46, 
23356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and 
24356z.61 of the Illinois
Insurance Code, (ii) be subject to the 
 
 
SB1282 Enrolled- 18 -LRB103 27271 BMS 53642 b

1provisions of Sections 356z.19, 356z.44, 356z.49, 364.01, 
2370c, and 370c.1 of the Illinois
Insurance Code, and (iii) be 
3subject to the provisions of subsection (d-5) of Section 10 of 
4the Network Adequacy and Transparency Act.

5    The Department, by rule, shall adopt a model similar to 
6the requirements of Section 356z.39 of the Illinois Insurance 
7Code. 
8    On and after July 1, 2012, the Department shall reduce any 
9rate of reimbursement for services or other payments or alter 
10any methodologies authorized by this Code to reduce any rate 
11of reimbursement for services or other payments in accordance 
12with Section 5-5e. 
13    To ensure full access to the benefits set forth in this 
14Section, on and after January 1, 2016, the Department shall 
15ensure that provider and hospital reimbursement  for 
16post-mastectomy care benefits required under this Section are 
17no lower than the Medicare reimbursement rate. 
18(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20; 
19101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff. 
201-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144, 
21eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 
22102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff. 
231-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, 
24eff. 1-1-23; 102-1117, eff. 1-13-23.)








  
 
25    Section 95. No acceleration or delay. Where this Act makes 
 
 
SB1282 Enrolled- 19 -LRB103 27271 BMS 53642 b

1changes in a statute that is represented in this Act by text 
2that is not yet or no longer in effect (for example, a Section 
3represented by multiple versions), the use of that text does 
4not accelerate or delay the taking effect of (i) the changes 
5made by this Act or (ii) provisions derived from any other 
6Public Act.