94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB0774


 
Introduced 2/18/2005, by Sen. John J. Cullerton
 
SYNOPSIS AS INTRODUCED:
 		














215 ILCS 5/356z.2









    Amends the Illinois Insurance Code.  Requires an accident and health insurance policy to cover charges incurred and anesthetics provided in conjunction with dental care that is provided to certain covered individuals in a dental office.
















LRB094 08848 LJB 39067 b

















 


 


A BILL FOR









 











SB0774

LRB094 08848 LJB 39067 b






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    AN ACT concerning insurance.

 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:


 
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    Section 5. The Illinois Insurance Code is amended  by 
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changing Section 356z.2 as follows:
 



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    (215 ILCS 5/356z.2)


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    Sec. 356z.2. Coverage for adjunctive services in dental 
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care. 

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    (a) An individual or group policy of accident and health 
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insurance
amended, delivered, issued, or renewed after the 
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effective date of this
amendatory Act of the 94th
92nd General 
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Assembly shall cover
charges incurred, and anesthetics 
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provided, in
conjunction with dental care that is provided to a 
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covered individual in a
hospital,
or
an ambulatory surgical 
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treatment center, or a dental office
if any of the
following

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applies:


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        (1) the individual is a child age 6 or under;


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        (2) the individual has a medical condition that 
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    requires
hospitalization or general anesthesia for dental 
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    care; or


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        (3) the individual is disabled.

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    (b) For purposes of this Section, "ambulatory surgical 
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treatment center"
has the meaning given to that term in Section 
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3 of the Ambulatory
Surgical Treatment Center Act.

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    For purposes of this Section, "disabled" means a person, 
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regardless of age,
with a chronic
disability if the chronic 
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disability meets all of the following conditions:


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        (1) It is attributable to a mental or physical 
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    impairment or
    combination of mental and physical 
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    impairments.


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        (2) It is likely to continue.


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        (3) It results in substantial functional limitations 
 


 






SB0774
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LRB094 08848 LJB 39067 b




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    in one or more of
the following areas of major life 
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    activity:


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            (A) self-care;


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            (B) receptive and expressive language;


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            (C) learning;


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            (D) mobility;


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            (E) capacity for independent living; or


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            (F) economic self-sufficiency.

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    (c) The coverage required under this Section may be subject 
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to any
limitations, exclusions, or cost-sharing provisions 
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that apply generally under
the insurance policy.

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    (d) This Section does not apply to a policy that covers 
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only dental care.

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    (e) Nothing in this Section requires that the dental 
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services be
covered.

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    (f) The provisions of this Section do not apply to 
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short-term travel,
accident-only, limited, or specified 
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disease policies, nor to policies or
contracts designed for 
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issuance to persons eligible for coverage under Title
XVIII of 
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the Social Security Act, known as Medicare, or any other 
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similar
coverage under State or federal governmental plans.

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(Source: P.A. 92-764, eff. 1-1-03.)