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1 | AN ACT in relation to insurance.
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2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||||||||||||||||||
3 | represented in the General Assembly:
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4 | Section 3. The Department of Insurance Law of the Civil
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5 | Administrative Code of Illinois is amended by adding Section
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6 | 1405-35 as follows:
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7 | (20 ILCS 1405/1405-35 new)
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8 | Sec. 1405-35. Brain injury coverage study.
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9 | (a) The Department of Insurance shall conduct an
analysis | |||||||||||||||||||||||||||||||||||
10 | and study of costs and benefits derived from the
implementation | |||||||||||||||||||||||||||||||||||
11 | of the coverage requirements for treatment of
brain injuries | |||||||||||||||||||||||||||||||||||
12 | established under Section 356z.6 of the
Illinois Insurance | |||||||||||||||||||||||||||||||||||
13 | Code. The study shall cover the years
2005, 2006, and 2007. The | |||||||||||||||||||||||||||||||||||
14 | study shall include an analysis of
the effect of the coverage | |||||||||||||||||||||||||||||||||||
15 | requirements on the cost of
insurance and health care, the | |||||||||||||||||||||||||||||||||||
16 | results of the treatments to
patients, any improvements in the | |||||||||||||||||||||||||||||||||||
17 | care of patients, and any
improvements in the quality of life | |||||||||||||||||||||||||||||||||||
18 | of patients.
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19 | (b) The Department shall report the results of its study
to | |||||||||||||||||||||||||||||||||||
20 | the General Assembly and the Governor on or before March
1, | |||||||||||||||||||||||||||||||||||
21 | 2008.
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22 | Section 5. The State Employees Group Insurance Act of 1971 | |||||||||||||||||||||||||||||||||||
23 | is amended by
changing Section 6.11 as follows:
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24 | (5 ILCS 375/6.11)
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25 | Sec. 6.11. Required health benefits; Illinois Insurance | |||||||||||||||||||||||||||||||||||
26 | Code
requirements. The program of health
benefits shall provide | |||||||||||||||||||||||||||||||||||
27 | the post-mastectomy care benefits required to be covered
by a | |||||||||||||||||||||||||||||||||||
28 | policy of accident and health insurance under Section 356t of | |||||||||||||||||||||||||||||||||||
29 | the Illinois
Insurance Code. The program of health benefits | |||||||||||||||||||||||||||||||||||
30 | shall provide the coverage
required under Sections 356u, 356w, |
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1 | 356x, 356z.2, and 356z.4 , and 356z.6 of the
Illinois Insurance | ||||||
2 | Code.
The program of health benefits must comply with Section | ||||||
3 | 155.37 of the
Illinois Insurance Code.
| ||||||
4 | (Source: P.A. 92-440, eff. 8-17-01; 92-764, eff. 1-1-03; | ||||||
5 | 93-102, eff. 1-1-04.)
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6 | Section 10. The Counties Code is amended by changing
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7 | Section 5-1069.3 as follows:
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8 | (55 ILCS 5/5-1069.3)
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9 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
10 | including a home
rule
county, is a self-insurer for purposes of | ||||||
11 | 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, and 356x , and 356z.6 of
the Illinois | ||||||
16 | Insurance Code. The requirement that health benefits be covered
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17 | as provided in this Section is an
exclusive power and function | ||||||
18 | of the State and is a denial and limitation under
Article VII, | ||||||
19 | Section 6, subsection (h) of the Illinois Constitution. A home
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20 | rule county to which this Section applies must comply with | ||||||
21 | every provision of
this Section.
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22 | (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.)
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23 | Section 15. The Illinois Municipal Code is amended by | ||||||
24 | changing
Section 10-4-2.3 as follows:
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25 | (65 ILCS 5/10-4-2.3)
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26 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
27 | municipality, including a
home rule municipality, is a | ||||||
28 | self-insurer for purposes of providing health
insurance | ||||||
29 | coverage for its employees, the coverage shall include coverage | ||||||
30 | for
the post-mastectomy care benefits required to be covered by | ||||||
31 | a policy of
accident and health insurance under Section 356t | ||||||
32 | and the coverage required
under Sections 356u, 356w, and 356x , |
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1 | and 356z.6 of the Illinois
Insurance
Code. The requirement that | ||||||
2 | health
benefits be covered as provided in this is an exclusive | ||||||
3 | power and function of
the State and is a denial and limitation | ||||||
4 | under Article VII, Section 6,
subsection (h) of the Illinois | ||||||
5 | Constitution. A home rule municipality to which
this Section | ||||||
6 | applies must comply with every provision of this Section.
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7 | (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.)
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8 | Section 20. The Illinois Insurance Code is amended by | ||||||
9 | changing
Section 351B-5 and adding Section 356z.6 as follows:
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10 | (215 ILCS 5/351B-5)
(from Ch. 73, par. 963B-5)
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11 | Sec. 351B-5. Applicability of other Code provisions. All | ||||||
12 | policies of
accident and health insurance issued
under this | ||||||
13 | Article shall be subject to the provisions of Sections 356c,
| ||||||
14 | subsection (a) of Section 356g, 356h, 356n, 356z.6, 367c, 367d, | ||||||
15 | 370, 370a,
and
370e of
this Code.
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16 | (Source: P.A. 86-1407; 87-792; 87-1066.)
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17 | (215 ILCS 5/356z.6 new)
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18 | Sec. 356z.6. Coverage for certain benefits related to brain
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19 | injury.
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20 | (a) A group or individual policy of accident and
health | ||||||
21 | insurance, a managed care plan, or multiple employer
welfare | ||||||
22 | arrangement, that is amended, delivered, issued, or
renewed | ||||||
23 | after the effective date of this amendatory Act of
the 93rd | ||||||
24 | General Assembly may not exclude coverage for
cognitive | ||||||
25 | rehabilitation therapy, cognitive communication
therapy, | ||||||
26 | neurocognitive therapy and rehabilitation,
neurobehavioral, | ||||||
27 | neurophysiological, neuropsychological,
and | ||||||
28 | psychophysiological testing or treatment, neurofeedback
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29 | therapy, remediation, post-acute transition services, or
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30 | community reintegration services necessary as a result of
and | ||||||
31 | related to an acquired brain injury.
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32 | (b) Coverage required under this Section may be
subject to | ||||||
33 | deductibles, copayments, coinsurance, or annual
or maximum |
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1 | payment limits that are consistent with
deductibles, | ||||||
2 | copayments, coinsurance, and annual or maximum
payment limits | ||||||
3 | applicable to other similar coverage under
the policy.
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4 | (c) The Department shall adopt rules as necessary to
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5 | implement this Section.
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6 | (d) This Section is inoperative after December
31, 2008.
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7 | Section 25. The Health Maintenance Organization Act is | ||||||
8 | amended by changing
Section 4-6.5 as follows:
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9 | (215 ILCS 125/4-6.5)
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10 | Sec. 4-6.5. Required health benefits; Illinois Insurance | ||||||
11 | Code
requirements. A health maintenance organization is | ||||||
12 | subject to the provisions
of Sections 155.37, 356t, 356u, and
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13 | 356z.1 , and 356z.6 of the Illinois
Insurance Code.
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14 | (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01; | ||||||
15 | 92-651, eff.
7-11-02.)
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16 | Section 30. The Voluntary Health Services Plans Act is | ||||||
17 | amended by changing
Section 10 as follows:
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18 | (215 ILCS 165/10) (from Ch. 32, par. 604)
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19 | Sec. 10. Application of Insurance Code provisions. Health | ||||||
20 | services
plan corporations and all persons interested therein | ||||||
21 | or dealing therewith
shall be subject to the provisions of | ||||||
22 | Articles IIA and XII 1/2 and Sections
3.1, 133, 140, 143, 143c, | ||||||
23 | 149, 155.37, 354, 355.2, 356r, 356t, 356u, 356v,
356w, 356x, | ||||||
24 | 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 367.2, 368a, 401, | ||||||
25 | 401.1,
402,
403, 403A, 408,
408.2, and 412, and paragraphs (7) | ||||||
26 | and (15) of Section 367 of the Illinois
Insurance Code.
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27 | (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01;
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28 | 92-651, eff. 7-11-02; 92-764, eff. 1-1-03; 93-102, eff. 1-1-04; | ||||||
29 | 93-529, eff.
8-14-03; revised 9-25-03.)
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30 | Section 90. The State Mandates Act is amended by adding | ||||||
31 | Section 8.28 as
follows:
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1 | (30 ILCS 805/8.28 new)
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2 | Sec. 8.28. Exempt mandate. Notwithstanding Sections 6 and 8 | ||||||
3 | of this
Act, no reimbursement by the State is required for the | ||||||
4 | implementation of
any mandate created by this amendatory Act of | ||||||
5 | the 93rd General Assembly.
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