| |||||||||||||||||||||||||
| |||||||||||||||||||||||||
| |||||||||||||||||||||||||
| |||||||||||||||||||||||||
| |||||||||||||||||||||||||
1 | AN ACT concerning regulation.
| ||||||||||||||||||||||||
2 | Be it enacted by the People of the State of Illinois,
| ||||||||||||||||||||||||
3 | represented in the General Assembly:
| ||||||||||||||||||||||||
4 | Section 1. Short title. This Act may be referred to as the | ||||||||||||||||||||||||
5 | Fair Insurance Coverage for Early Treatment of Serious Mental | ||||||||||||||||||||||||
6 | Health Conditions Act. | ||||||||||||||||||||||||
7 | Section 5. Legislative findings. The General Assembly | ||||||||||||||||||||||||
8 | finds the following: | ||||||||||||||||||||||||
9 | (1) An estimated 60% of Illinoisans have private | ||||||||||||||||||||||||
10 | insurance coverage. | ||||||||||||||||||||||||
11 | (2) Most mental health conditions begin to manifest | ||||||||||||||||||||||||
12 | before the age of 24. | ||||||||||||||||||||||||
13 | (3) On average, it takes 10 years for individuals with | ||||||||||||||||||||||||
14 | a serious mental health condition to receive the right | ||||||||||||||||||||||||
15 | diagnosis and treatment. | ||||||||||||||||||||||||
16 | (4) During the lag time between initial symptom | ||||||||||||||||||||||||
17 | manifestation and when the right treatment is received, an | ||||||||||||||||||||||||
18 | individual often experiences debilitating symptoms that | ||||||||||||||||||||||||
19 | can lead to permanent disability. | ||||||||||||||||||||||||
20 | (5) Early treatment can mean wellness, symptom | ||||||||||||||||||||||||
21 | management, and full recovery. | ||||||||||||||||||||||||
22 | (6) Private insurance does not cover the | ||||||||||||||||||||||||
23 | evidence-based or evidence-informed community-based |
| |||||||
| |||||||
1 | treatment approaches that the public sector covers that are | ||||||
2 | proven, effective treatments for serious mental illnesses | ||||||
3 | and serious emotional disturbances. | ||||||
4 | (7) Community-based treatment has demonstrated | ||||||
5 | positive mental health outcomes over many decades and | ||||||
6 | enables wellness and supports recovery by providing | ||||||
7 | intensive services through team-based models in a person's | ||||||
8 | natural environment. | ||||||
9 | (8) The 60% of Illinoisans with private insurance | ||||||
10 | coverage do not have access to these evidence-based | ||||||
11 | treatment approaches. | ||||||
12 | (9) If private insurance covered these community-based | ||||||
13 | treatment approaches when an individual is in the early | ||||||
14 | stages of a serious mental health condition, permanent | ||||||
15 | disability and a life of public coverage could be avoided | ||||||
16 | for thousands across Illinois. | ||||||
17 | Section 10. The State Employees Group Insurance Act of 1971 | ||||||
18 | is amended by changing Section 6.11 as follows:
| ||||||
19 | (5 ILCS 375/6.11)
| ||||||
20 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
21 | Code
requirements. The program of health
benefits shall provide | ||||||
22 | the post-mastectomy care benefits required to be covered
by a | ||||||
23 | policy of accident and health insurance under Section 356t of | ||||||
24 | the Illinois
Insurance Code. The program of health benefits |
| |||||||
| |||||||
1 | shall provide the coverage
required under Sections 356g, | ||||||
2 | 356g.5, 356g.5-1, 356m,
356u, 356w, 356x, 356z.2, 356z.4, | ||||||
3 | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | ||||||
4 | 356z.14, 356z.15, 356z.17, 356z.22, and 356z.25 , 356z.26, and | ||||||
5 | 356z.29 of the
Illinois Insurance Code.
The program of health | ||||||
6 | benefits must comply with Sections 155.22a, 155.37, 355b, | ||||||
7 | 356z.19, 370c, and 370c.1 of the
Illinois Insurance Code.
| ||||||
8 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
9 | any, is conditioned on the rules being adopted in accordance | ||||||
10 | with all provisions of the Illinois Administrative Procedure | ||||||
11 | Act and all rules and procedures of the Joint Committee on | ||||||
12 | Administrative Rules; any purported rule not so adopted, for | ||||||
13 | whatever reason, is unauthorized. | ||||||
14 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
15 | 100-138, eff. 8-18-17; revised 10-3-17.) | ||||||
16 | Section 15. The Counties Code is amended by changing | ||||||
17 | Section 5-1069.3 as follows: | ||||||
18 | (55 ILCS 5/5-1069.3)
| ||||||
19 | Sec. 5-1069.3. Required health benefits. If a county, | ||||||
20 | including a home
rule
county, is a self-insurer for purposes of | ||||||
21 | providing health insurance coverage
for its employees, the | ||||||
22 | coverage shall include coverage for the post-mastectomy
care | ||||||
23 | benefits required to be covered by a policy of accident and | ||||||
24 | health
insurance under Section 356t and the coverage required |
| |||||||
| |||||||
1 | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, | ||||||
2 | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | ||||||
3 | 356z.14, 356z.15, 356z.22, and 356z.25 , 356z.26, and 356z.29 of
| ||||||
4 | the Illinois Insurance Code. The coverage shall comply with | ||||||
5 | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois | ||||||
6 | Insurance Code. The requirement that health benefits be covered
| ||||||
7 | as provided in this Section is an
exclusive power and function | ||||||
8 | of the State and is a denial and limitation under
Article VII, | ||||||
9 | Section 6, subsection (h) of the Illinois Constitution. A home
| ||||||
10 | rule county to which this Section applies must comply with | ||||||
11 | every provision of
this Section.
| ||||||
12 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
13 | any, is conditioned on the rules being adopted in accordance | ||||||
14 | with all provisions of the Illinois Administrative Procedure | ||||||
15 | Act and all rules and procedures of the Joint Committee on | ||||||
16 | Administrative Rules; any purported rule not so adopted, for | ||||||
17 | whatever reason, is unauthorized. | ||||||
18 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
19 | 100-138, eff. 8-18-17; revised 10-5-17.) | ||||||
20 | Section 20. The Illinois Municipal Code is amended by | ||||||
21 | changing Section 10-4-2.3 as follows: | ||||||
22 | (65 ILCS 5/10-4-2.3)
| ||||||
23 | Sec. 10-4-2.3. Required health benefits. If a | ||||||
24 | municipality, including a
home rule municipality, is a |
| |||||||
| |||||||
1 | self-insurer for purposes of providing health
insurance | ||||||
2 | coverage for its employees, the coverage shall include coverage | ||||||
3 | for
the post-mastectomy care benefits required to be covered by | ||||||
4 | a policy of
accident and health insurance under Section 356t | ||||||
5 | and the coverage required
under Sections 356g, 356g.5, | ||||||
6 | 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10, | ||||||
7 | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and | ||||||
8 | 356z.25 , 356z.26, and 356z.29 of the Illinois
Insurance
Code. | ||||||
9 | The coverage shall comply with Sections 155.22a, 355b, 356z.19, | ||||||
10 | and 370c of
the Illinois Insurance Code. The requirement that | ||||||
11 | health
benefits be covered as provided in this is an exclusive | ||||||
12 | power and function of
the State and is a denial and limitation | ||||||
13 | under Article VII, Section 6,
subsection (h) of the Illinois | ||||||
14 | Constitution. A home rule municipality to which
this Section | ||||||
15 | applies must comply with every provision of this Section.
| ||||||
16 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
17 | any, is conditioned on the rules being adopted in accordance | ||||||
18 | with all provisions of the Illinois Administrative Procedure | ||||||
19 | Act and all rules and procedures of the Joint Committee on | ||||||
20 | Administrative Rules; any purported rule not so adopted, for | ||||||
21 | whatever reason, is unauthorized. | ||||||
22 | (Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; | ||||||
23 | 100-138, eff. 8-18-17; revised 10-5-17.) | ||||||
24 | Section 25. The School Code is amended by changing Section | ||||||
25 | 10-22.3f as follows: |
| |||||||
| |||||||
1 | (105 ILCS 5/10-22.3f)
| ||||||
2 | Sec. 10-22.3f. Required health benefits. Insurance | ||||||
3 | protection and
benefits
for employees shall provide the | ||||||
4 | post-mastectomy care benefits required to be
covered by a | ||||||
5 | policy of accident and health insurance under Section 356t and | ||||||
6 | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | ||||||
7 | 356u, 356w, 356x,
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, | ||||||
8 | 356z.13, 356z.14, 356z.15, 356z.22, and 356z.25 , 356z.26, and | ||||||
9 | 356z.29 of
the
Illinois Insurance Code.
Insurance policies | ||||||
10 | shall comply with Section 356z.19 of the Illinois Insurance | ||||||
11 | Code. The coverage shall comply with Sections 155.22a and 355b | ||||||
12 | of
the Illinois Insurance Code.
| ||||||
13 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
14 | any, is conditioned on the rules being adopted in accordance | ||||||
15 | with all provisions of the Illinois Administrative Procedure | ||||||
16 | Act and all rules and procedures of the Joint Committee on | ||||||
17 | Administrative Rules; any purported rule not so adopted, for | ||||||
18 | whatever reason, is unauthorized. | ||||||
19 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
20 | revised 9-25-17.) | ||||||
21 | Section 30. The Illinois Insurance Code is amended by | ||||||
22 | adding Section 356z.29 as follows: | ||||||
23 | (215 ILCS 5/356z.29 new) |
| |||||||
| |||||||
1 | Sec. 356z.29. Coverage for the early treatment of serious | ||||||
2 | mental illnesses and serious emotional disturbances. | ||||||
3 | (a) For purposes of this Section: | ||||||
4 | "Serious emotional disturbance" has the meaning as | ||||||
5 | interpreted by the federal Substance Abuse and Mental | ||||||
6 | Health Services Administration. | ||||||
7 | "Serious mental illness" has the same meaning as in the | ||||||
8 | most recent edition of the Diagnostic and Statistical | ||||||
9 | Manual of Mental Disorders. | ||||||
10 | (b) For purposes of treatment in the early stages of a | ||||||
11 | mental health condition, a group or individual policy of | ||||||
12 | accident and health insurance or managed care plan that is | ||||||
13 | amended, delivered, issued, or renewed after the effective date | ||||||
14 | of this amendatory Act of the 100th General Assembly shall | ||||||
15 | provide coverage for the treatment of serious mental illnesses | ||||||
16 | and serious emotional disturbances, including, but not limited | ||||||
17 | to, the following evidence-based and evidence-informed bundled | ||||||
18 | treatment approaches: | ||||||
19 | (1) assertive community treatment and community | ||||||
20 | support team treatment, which are both community-based | ||||||
21 | treatment models that are covered for individuals under the | ||||||
22 | Medical Assistance Program under Article V of the Public | ||||||
23 | Aid Code; the covered bundled services for assertive | ||||||
24 | community treatment and community support team treatment | ||||||
25 | shall be comparable in scope to those covered under the | ||||||
26 | treatment models through the Medical Assistance Program; |
| |||||||
| |||||||
1 | and | ||||||
2 | (2) first episode psychosis treatment, covering at a | ||||||
3 | minimum the elements of the coordinated specialty care | ||||||
4 | model applied in the research trials conducted by the | ||||||
5 | National Institute of Mental Health in the Recovery of an | ||||||
6 | Initial Schizophrenia Episode studies. | ||||||
7 | Payment for the services performed under the treatment | ||||||
8 | models in paragraphs (1) and (2) shall be based on all the | ||||||
9 | components of the treatment model combined, rather than for | ||||||
10 | each separate service. | ||||||
11 | (c) For purposes of determining medical necessity for the | ||||||
12 | treatment approaches covered by this Section, neither | ||||||
13 | disability nor functional impairment shall be a precondition to | ||||||
14 | receive the treatment approaches since the goal of coverage | ||||||
15 | under this Section is early treatment of a serious mental | ||||||
16 | illness or serious emotional disturbance and preventing | ||||||
17 | progression of the illness or condition. Medical necessity | ||||||
18 | shall be presumed following a psychiatric inpatient | ||||||
19 | hospitalization if the treatment approaches are recommended by | ||||||
20 | a licensed physician, licensed clinical psychologist, licensed | ||||||
21 | professional clinical counselor, or licensed clinical social | ||||||
22 | worker. If, at any time, the Secretary of the United States | ||||||
23 | Department of Health and Human Services, or its successor | ||||||
24 | agency, promulgates rules or regulations to be published in the | ||||||
25 | Federal Register or publishes a comment in the Federal Register | ||||||
26 | or issues an opinion, guidance, or other action that would |
| |||||||
| |||||||
1 | require the State, pursuant to any provision of the Patient | ||||||
2 | Protection and Affordable Care Act, including, but not limited | ||||||
3 | to, 42 U.S.C. 18031(d)(3)(b), or any successor provision, to | ||||||
4 | defray the cost of any coverage for serious mental illnesses or | ||||||
5 | serious emotional disturbances outlined in this Section, then | ||||||
6 | the requirement that a group or individual policy of accident | ||||||
7 | and health insurance or managed care plan cover the bundled | ||||||
8 | treatment approaches outlined in this Section is inoperative | ||||||
9 | other than any such coverage authorized under Section 1902 of | ||||||
10 | the Social Security Act, 42 U.S.C. 1396a, and the State shall | ||||||
11 | not assume any obligation for the cost of the coverage. | ||||||
12 | Section 35. The Health Maintenance Organization Act is | ||||||
13 | amended by changing Section 5-3 as follows:
| ||||||
14 | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
| ||||||
15 | Sec. 5-3. Insurance Code provisions.
| ||||||
16 | (a) Health Maintenance Organizations
shall be subject to | ||||||
17 | the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
| ||||||
18 | 141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 154, | ||||||
19 | 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, 355.3, | ||||||
20 | 355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y,
356z.2, 356z.4, | ||||||
21 | 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, | ||||||
22 | 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, | ||||||
23 | 356z.22, 356z.25, 356z.26, 356z.29, 364, 364.01, 367.2, | ||||||
24 | 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370c,
370c.1, 401, |
| |||||||
| |||||||
1 | 401.1, 402, 403, 403A,
408, 408.2, 409, 412, 444,
and
444.1,
| ||||||
2 | paragraph (c) of subsection (2) of Section 367, and Articles | ||||||
3 | IIA, VIII 1/2,
XII,
XII 1/2, XIII, XIII 1/2, XXV, and XXVI of | ||||||
4 | the Illinois Insurance Code.
| ||||||
5 | (b) For purposes of the Illinois Insurance Code, except for | ||||||
6 | Sections 444
and 444.1 and Articles XIII and XIII 1/2, Health | ||||||
7 | Maintenance Organizations in
the following categories are | ||||||
8 | deemed to be "domestic companies":
| ||||||
9 | (1) a corporation authorized under the
Dental Service | ||||||
10 | Plan Act or the Voluntary Health Services Plans Act;
| ||||||
11 | (2) a corporation organized under the laws of this | ||||||
12 | State; or
| ||||||
13 | (3) a corporation organized under the laws of another | ||||||
14 | state, 30% or more
of the enrollees of which are residents | ||||||
15 | of this State, except a
corporation subject to | ||||||
16 | substantially the same requirements in its state of
| ||||||
17 | organization as is a "domestic company" under Article VIII | ||||||
18 | 1/2 of the
Illinois Insurance Code.
| ||||||
19 | (c) In considering the merger, consolidation, or other | ||||||
20 | acquisition of
control of a Health Maintenance Organization | ||||||
21 | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
| ||||||
22 | (1) the Director shall give primary consideration to | ||||||
23 | the continuation of
benefits to enrollees and the financial | ||||||
24 | conditions of the acquired Health
Maintenance Organization | ||||||
25 | after the merger, consolidation, or other
acquisition of | ||||||
26 | control takes effect;
|
| |||||||
| |||||||
1 | (2)(i) the criteria specified in subsection (1)(b) of | ||||||
2 | Section 131.8 of
the Illinois Insurance Code shall not | ||||||
3 | apply and (ii) the Director, in making
his determination | ||||||
4 | with respect to the merger, consolidation, or other
| ||||||
5 | acquisition of control, need not take into account the | ||||||
6 | effect on
competition of the merger, consolidation, or | ||||||
7 | other acquisition of control;
| ||||||
8 | (3) the Director shall have the power to require the | ||||||
9 | following
information:
| ||||||
10 | (A) certification by an independent actuary of the | ||||||
11 | adequacy
of the reserves of the Health Maintenance | ||||||
12 | Organization sought to be acquired;
| ||||||
13 | (B) pro forma financial statements reflecting the | ||||||
14 | combined balance
sheets of the acquiring company and | ||||||
15 | the Health Maintenance Organization sought
to be | ||||||
16 | acquired as of the end of the preceding year and as of | ||||||
17 | a date 90 days
prior to the acquisition, as well as pro | ||||||
18 | forma financial statements
reflecting projected | ||||||
19 | combined operation for a period of 2 years;
| ||||||
20 | (C) a pro forma business plan detailing an | ||||||
21 | acquiring party's plans with
respect to the operation | ||||||
22 | of the Health Maintenance Organization sought to
be | ||||||
23 | acquired for a period of not less than 3 years; and
| ||||||
24 | (D) such other information as the Director shall | ||||||
25 | require.
| ||||||
26 | (d) The provisions of Article VIII 1/2 of the Illinois |
| |||||||
| |||||||
1 | Insurance Code
and this Section 5-3 shall apply to the sale by | ||||||
2 | any health maintenance
organization of greater than 10% of its
| ||||||
3 | enrollee population (including without limitation the health | ||||||
4 | maintenance
organization's right, title, and interest in and to | ||||||
5 | its health care
certificates).
| ||||||
6 | (e) In considering any management contract or service | ||||||
7 | agreement subject
to Section 141.1 of the Illinois Insurance | ||||||
8 | Code, the Director (i) shall, in
addition to the criteria | ||||||
9 | specified in Section 141.2 of the Illinois
Insurance Code, take | ||||||
10 | into account the effect of the management contract or
service | ||||||
11 | agreement on the continuation of benefits to enrollees and the
| ||||||
12 | financial condition of the health maintenance organization to | ||||||
13 | be managed or
serviced, and (ii) need not take into account the | ||||||
14 | effect of the management
contract or service agreement on | ||||||
15 | competition.
| ||||||
16 | (f) Except for small employer groups as defined in the | ||||||
17 | Small Employer
Rating, Renewability and Portability Health | ||||||
18 | Insurance Act and except for
medicare supplement policies as | ||||||
19 | defined in Section 363 of the Illinois
Insurance Code, a Health | ||||||
20 | Maintenance Organization may by contract agree with a
group or | ||||||
21 | other enrollment unit to effect refunds or charge additional | ||||||
22 | premiums
under the following terms and conditions:
| ||||||
23 | (i) the amount of, and other terms and conditions with | ||||||
24 | respect to, the
refund or additional premium are set forth | ||||||
25 | in the group or enrollment unit
contract agreed in advance | ||||||
26 | of the period for which a refund is to be paid or
|
| |||||||
| |||||||
1 | additional premium is to be charged (which period shall not | ||||||
2 | be less than one
year); and
| ||||||
3 | (ii) the amount of the refund or additional premium | ||||||
4 | shall not exceed 20%
of the Health Maintenance | ||||||
5 | Organization's profitable or unprofitable experience
with | ||||||
6 | respect to the group or other enrollment unit for the | ||||||
7 | period (and, for
purposes of a refund or additional | ||||||
8 | premium, the profitable or unprofitable
experience shall | ||||||
9 | be calculated taking into account a pro rata share of the
| ||||||
10 | Health Maintenance Organization's administrative and | ||||||
11 | marketing expenses, but
shall not include any refund to be | ||||||
12 | made or additional premium to be paid
pursuant to this | ||||||
13 | subsection (f)). The Health Maintenance Organization and | ||||||
14 | the
group or enrollment unit may agree that the profitable | ||||||
15 | or unprofitable
experience may be calculated taking into | ||||||
16 | account the refund period and the
immediately preceding 2 | ||||||
17 | plan years.
| ||||||
18 | The Health Maintenance Organization shall include a | ||||||
19 | statement in the
evidence of coverage issued to each enrollee | ||||||
20 | describing the possibility of a
refund or additional premium, | ||||||
21 | and upon request of any group or enrollment unit,
provide to | ||||||
22 | the group or enrollment unit a description of the method used | ||||||
23 | to
calculate (1) the Health Maintenance Organization's | ||||||
24 | profitable experience with
respect to the group or enrollment | ||||||
25 | unit and the resulting refund to the group
or enrollment unit | ||||||
26 | or (2) the Health Maintenance Organization's unprofitable
|
| |||||||
| |||||||
1 | experience with respect to the group or enrollment unit and the | ||||||
2 | resulting
additional premium to be paid by the group or | ||||||
3 | enrollment unit.
| ||||||
4 | In no event shall the Illinois Health Maintenance | ||||||
5 | Organization
Guaranty Association be liable to pay any | ||||||
6 | contractual obligation of an
insolvent organization to pay any | ||||||
7 | refund authorized under this Section.
| ||||||
8 | (g) Rulemaking authority to implement Public Act 95-1045, | ||||||
9 | if any, is conditioned on the rules being adopted in accordance | ||||||
10 | with all provisions of the Illinois Administrative Procedure | ||||||
11 | Act and all rules and procedures of the Joint Committee on | ||||||
12 | Administrative Rules; any purported rule not so adopted, for | ||||||
13 | whatever reason, is unauthorized. | ||||||
14 | (Source: P.A. 99-761, eff. 1-1-18; 100-24, eff. 7-18-17; | ||||||
15 | 100-138, eff. 8-18-17; revised 10-5-17.) | ||||||
16 | Section 40. The Limited Health Service Organization Act is | ||||||
17 | amended by changing Section 4003 as follows:
| ||||||
18 | (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
| ||||||
19 | Sec. 4003. Illinois Insurance Code provisions. Limited | ||||||
20 | health service
organizations shall be subject to the provisions | ||||||
21 | of Sections 133, 134, 136, 137, 139,
140, 141.1, 141.2, 141.3, | ||||||
22 | 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, | ||||||
23 | 154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v, | ||||||
24 | 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 368a, |
| |||||||
| |||||||
1 | 401, 401.1,
402,
403, 403A, 408,
408.2, 409, 412, 444, and | ||||||
2 | 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2,
XIII,
XIII 1/2, | ||||||
3 | XXV, and XXVI of the Illinois Insurance Code. For purposes of | ||||||
4 | the
Illinois Insurance Code, except for Sections 444 and 444.1 | ||||||
5 | and Articles XIII
and XIII 1/2, limited health service | ||||||
6 | organizations in the following categories
are deemed to be | ||||||
7 | domestic companies:
| ||||||
8 | (1) a corporation under the laws of this State; or
| ||||||
9 | (2) a corporation organized under the laws of another | ||||||
10 | state, 30% or more
of the enrollees of which are residents | ||||||
11 | of this State, except a corporation
subject to | ||||||
12 | substantially the same requirements in its state of | ||||||
13 | organization as
is a domestic company under Article VIII | ||||||
14 | 1/2 of the Illinois Insurance Code.
| ||||||
15 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | ||||||
16 | 100-201, eff. 8-18-17; revised 10-5-17.)
| ||||||
17 | Section 45. The Voluntary Health Services Plans Act is | ||||||
18 | amended by changing Section 10 as follows:
| ||||||
19 | (215 ILCS 165/10) (from Ch. 32, par. 604)
| ||||||
20 | Sec. 10. Application of Insurance Code provisions. Health | ||||||
21 | services
plan corporations and all persons interested therein | ||||||
22 | or dealing therewith
shall be subject to the provisions of | ||||||
23 | Articles IIA and XII 1/2 and Sections
3.1, 133, 136, 139, 140, | ||||||
24 | 143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g, |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 | 356g.5, 356g.5-1, 356r, 356t, 356u, 356v,
356w, 356x, 356y, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
2 | 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3 | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
4 | 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 364.01, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
5 | 367.2, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
6 | and paragraphs (7) and (15) of Section 367 of the Illinois
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
7 | Insurance Code.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
8 | Rulemaking authority to implement Public Act 95-1045, if | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
9 | any, is conditioned on the rules being adopted in accordance | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
10 | with all provisions of the Illinois Administrative Procedure | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
11 | Act and all rules and procedures of the Joint Committee on | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
12 | Administrative Rules; any purported rule not so adopted, for | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
13 | whatever reason, is unauthorized. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
14 | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 | revised 10-5-17.)
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
16 | Section 99. Effective date. This Act takes effect upon | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
17 | becoming law.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||