103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1288

 

Introduced 2/3/2023, by Sen. Laura Fine

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/355.4

    Amends the Illinois Insurance Code. In provisions concerning provider notification of dental plan changes, provides that no insurer, service corporation, dental service plan corporation, insurance network leasing company, or any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act that provides dental insurance may automatically enroll a provider in a leased network without the provider's written consent. Provides that any contract entered into or renewed on or after the effective date of the amendatory Act that allows the rights and obligations of the contract to be assigned or leased to another insurer shall provide for notice that informs each provider in writing via certified mail 90 days before any scheduled assignment or lease of the network to which the provider is a contracted provider (rather than shall provide notice of that assignment or lease within 30 days after the assignment or lease to the contracting dentist). Provides that an insurer, service corporation, dental service plan corporation, insurance network leasing company, or any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act that provides dental insurance that leases or assigns its network shall not cancel a network participating dentist's contractual relationship or otherwise penalize a network participating dentist in any way based on whether or not the dentist accepts the terms of the assignment or lease.


LRB103 04626 BMS 51013 b

 

 

A BILL FOR

 

SB1288LRB103 04626 BMS 51013 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 Illinois Insurance Code is amended by
5changing Section 355.4 as follows:
 
6    (215 ILCS 5/355.4)
7    Sec. 355.4. Provider notification of network plan changes.
8    (a) No insurer, service corporation, dental service plan
9corporation, insurance network leasing company, or any company
10that issues, delivers, amends, or renews an individual or
11group policy of accident and health insurance on or after the
12effective date of this amendatory Act of the 103rd General
13Assembly that provides dental insurance may automatically
14enroll a provider in a leased network without the provider's
15written consent.
16    (b) Any contract entered into or renewed on or after the
17effective date of this amendatory Act of the 103rd General
18Assembly this amendatory Act of the 99th General Assembly that
19allows the rights and obligations of the contract to be
20assigned or leased to another insurer shall provide for notice
21that informs each provider in writing via certified mail 90
22days before any scheduled assignment or lease of the network
23to which the provider is a contracted provider. The

 

 

SB1288- 2 -LRB103 04626 BMS 51013 b

1notification must include all contract terms, a policy manual,
2a fee schedule, and a form whereby the provider must choose to
3opt in to the network of the insurer that gains access to the
4dentist's contractual relationship in order to be in
5compliance with this Section of that assignment or lease
6within 30 days after the assignment or lease to the
7contracting dentist.
8    (c) An insurer, service corporation, dental service plan
9corporation, insurance network leasing company, or any company
10that issues, delivers, amends, or renews an individual or
11group policy of accident and health insurance on or after the
12effective date of this amendatory Act of the 103rd General
13Assembly that provides dental insurance that leases or assigns
14its network shall not cancel a network participating dentist's
15contractual relationship or otherwise penalize a network
16participating dentist in any way based on whether or not the
17dentist accepts the terms of the assignment or lease. Before
18accepting the terms of an assignment or lease agreement as
19described in this Section, any provider who receives
20notification of an impending assignment or lease must be given
21the option to contract directly with the entities proposing to
22gain access to the provider's network.
23(Source: P.A. 99-568, eff. 7-15-16.)