093_HB3060eng HB3060 Engrossed LRB093 11021 JLS 11689 b 1 AN ACT concerning health insurance coverage. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 3. The Department of Insurance Law of the Civil 5 Administrative Code of Illinois is amended by adding Section 6 1405-35 as follows: 7 (20 ILCS 1405/1405-35 new) 8 Sec. 1405-35. Brain injury coverage study. 9 (a) The Department of Insurance shall conduct an 10 analysis and study of costs and benefits derived from the 11 implementation of the coverage requirements for treatment of 12 brain injuries established under Section 356z.4 of the 13 Illinois Insurance Code. The study shall cover the years 14 2004, 2005, and 2006. The study shall include an analysis of 15 the effect of the coverage requirements on the cost of 16 insurance and health care, the results of the treatments to 17 patients, any improvements in the care of patients, and any 18 improvements in the quality of life of patients. 19 (b) The Department shall report the results of its study 20 to the General Assembly and the Governor on or before March 21 1, 2007. 22 Section 5. The State Employees Group Insurance Act of 23 1971 is amended by changing Section 6.11 as follows: 24 (5 ILCS 375/6.11) 25 Sec. 6.11. Required health benefits; Illinois Insurance 26 Code requirements. The program of health benefits shall 27 provide the post-mastectomy care benefits required to be 28 covered by a policy of accident and health insurance under 29 Section 356t of the Illinois Insurance Code. The program of HB3060 Engrossed -2- LRB093 11021 JLS 11689 b 1 health benefits shall provide the coverage required under 2 Sections 356u, 356w, 356x,and356z.2, and 356z.4 of the 3 Illinois Insurance Code. The program of health benefits must 4 comply with Section 155.37 of the Illinois Insurance Code. 5 (Source: P.A. 92-440, eff. 8-17-01; 92-764, eff. 1-1-03.) 6 Section 10. The Counties Code is amended by changing 7 Section 5-1069.3 as follows: 8 (55 ILCS 5/5-1069.3) 9 Sec. 5-1069.3. Required health benefits. If a county, 10 including a home rule county, is a self-insurer for purposes 11 of providing health insurance coverage for its employees, the 12 coverage shall include coverage for the post-mastectomy care 13 benefits required to be covered by a policy of accident and 14 health insurance under Section 356t and the coverage required 15 under Sections 356u, 356w,and356x, and 356z.4 of the 16 Illinois Insurance Code. The requirement that health 17 benefits be covered as provided in this Section is an 18 exclusive power and function of the State and is a denial and 19 limitation under Article VII, Section 6, subsection (h) of 20 the Illinois Constitution. A home rule county to which this 21 Section applies must comply with every provision of this 22 Section. 23 (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.) 24 Section 15. The Illinois Municipal Code is amended by 25 changing Section 10-4-2.3 as follows: 26 (65 ILCS 5/10-4-2.3) 27 Sec. 10-4-2.3. Required health benefits. If a 28 municipality, including a home rule municipality, is a 29 self-insurer for purposes of providing health insurance 30 coverage for its employees, the coverage shall include HB3060 Engrossed -3- LRB093 11021 JLS 11689 b 1 coverage for the post-mastectomy care benefits required to be 2 covered by a policy of accident and health insurance under 3 Section 356t and the coverage required under Sections 356u, 4 356w,and356x, and 356z.4 of the Illinois Insurance Code. 5 The requirement that health benefits be covered as provided 6 in this is an exclusive power and function of the State and 7 is a denial and limitation under Article VII, Section 6, 8 subsection (h) of the Illinois Constitution. A home rule 9 municipality to which this Section applies must comply with 10 every provision of this Section. 11 (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.) 12 Section 20. The Illinois Insurance Code is amended by 13 changing Section 351B-5 and adding Section 356z.4 as follows: 14 (215 ILCS 5/351B-5) (from Ch. 73, par. 963B-5) 15 Sec. 351B-5. Applicability of other Code provisions. All 16 policies of accident and health insurance issued under this 17 Article shall be subject to the provisions of Sections 356c, 18 subsection (a) of Section 356g, 356h, 356n, 356z.4, 367c, 19 367d, 370, 370a, and 370e of this Code. 20 (Source: P.A. 86-1407; 87-792; 87-1066.) 21 (215 ILCS 5/356z.4 new) 22 Sec. 356z.4. Coverage for certain benefits related to 23 brain injury. 24 (a) A group or individual policy of accident and health 25 insurance, a managed care plan, or multiple employer welfare 26 arrangement, that is amended, delivered, issued, or renewed 27 after the effective date of this amendatory Act of the 93rd 28 General Assembly may not exclude coverage for cognitive 29 rehabilitation therapy, cognitive communication therapy, 30 neurocognitive therapy and rehabilitation, neurobehavioral, 31 neurophysiological, neuropsychological, and HB3060 Engrossed -4- LRB093 11021 JLS 11689 b 1 psychophysiological testing or treatment, neurofeedback 2 therapy, remediation, post-acute transition services, or 3 community reintegration services necessary as a result of and 4 related to an acquired brain injury. 5 (b) Coverage required under this Section may be subject 6 to deductibles, copayments, coinsurance, or annual or maximum 7 payment limits that are consistent with deductibles, 8 copayments, coinsurance, and annual or maximum payment limits 9 applicable to other similar coverage under the policy. 10 (c) The Department shall adopt rules as necessary to 11 implement this Section. 12 (d) This Section is inoperative after December 31, 2007. 13 Section 25. The Health Maintenance Organization Act is 14 amended by changing Section 4-6.5 as follows: 15 (215 ILCS 125/4-6.5) 16 Sec. 4-6.5. Required health benefits; Illinois Insurance 17 Code requirements. A health maintenance organization is 18 subject to the provisions of Sections 155.37, 356t, 356u,and19 356z.1, and 356z.4 of the Illinois Insurance Code. 20 (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01; 21 92-651, eff. 7-11-02.) 22 Section 30. The Voluntary Health Services Plans Act is 23 amended by changing Section 10 as follows: 24 (215 ILCS 165/10) (from Ch. 32, par. 604) 25 Sec. 10. Application of Insurance Code provisions. 26 Health services plan corporations and all persons interested 27 therein or dealing therewith shall be subject to the 28 provisions of Articles IIA and XII 1/2 and Sections 3.1, 133, 29 140, 143, 143c, 149, 155.37, 354, 355.2, 356r, 356t, 356u, 30 356v, 356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 367.2, 368a, HB3060 Engrossed -5- LRB093 11021 JLS 11689 b 1 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, and 2 paragraphs (7) and (15) of Section 367 of the Illinois 3 Insurance Code. 4 (Source: P.A. 91-406, eff. 1-1-00; 91-549, eff. 8-14-99; 5 91-605, eff. 12-14-99; 91-788, eff. 6-9-00; 92-130, eff. 6 7-20-01; 92-440, eff. 8-17-01; 92-651, eff. 7-11-02; 92-764, 7 eff. 1-1-03.) 8 Section 90. The State Mandates Act is amended by adding 9 Section 8.27 as follows: 10 (30 ILCS 805/8.27 new) 11 Sec. 8.27. Exempt mandate. Notwithstanding Sections 6 12 and 8 of this Act, no reimbursement by the State is required 13 for the implementation of any mandate created by this 14 amendatory Act of the 93rd General Assembly.