Illinois General Assembly - Full Text of SB2623
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Full Text of SB2623  103rd General Assembly

SB2623 103RD GENERAL ASSEMBLY

  
  

 


 
103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2623

 

Introduced 10/24/2023, by Sen. Natalie Toro

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
215 ILCS 5/356z.32a new
215 ILCS 125/5-3  from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003  from Ch. 73, par. 1504-3
215 ILCS 165/10  from Ch. 32, par. 604
305 ILCS 5/5-16.8

    Amends the Illinois Insurance Code. Requires an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in the State after June 1, 2024 to provide coverage for expenses for standard fertility preservation services and follow-up services related to that coverage. Defines "standard fertility preservation services" as procedures based upon current evidence-based standards of care established by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or other national medical associations that follow current evidence-based standards of care. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code. Effective immediately.


LRB103 34217 LNS 64041 b

 

 

A BILL FOR

 

SB2623LRB103 34217 LNS 64041 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 State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    (Text of Section before amendment by P.A. 102-768)
8    Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall
10provide the post-mastectomy care benefits required to be
11covered by a policy of accident and health insurance under
12Section 356t of the Illinois Insurance Code. The program of
13health benefits shall provide the coverage required under
14Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
15356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
16356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.32a,
18356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
19356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and
20356z.60 of the Illinois Insurance Code. The program of health
21benefits must comply with Sections 155.22a, 155.37, 355b,
22356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
23Insurance Code. The Department of Insurance shall enforce the

 

 

SB2623- 2 -LRB103 34217 LNS 64041 b

1requirements of this Section with respect to Sections 370c and
2370c.1 of the Illinois Insurance Code; all other requirements
3of this Section shall be enforced by the Department of Central
4Management Services.
5    Rulemaking authority to implement Public Act 95-1045, if
6any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
12101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
131-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
14eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
15102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
161-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
17eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
18revised 12-13-22.)
 
19    (Text of Section after amendment by P.A. 102-768)
20    Sec. 6.11. Required health benefits; Illinois Insurance
21Code requirements. The program of health benefits shall
22provide the post-mastectomy care benefits required to be
23covered by a policy of accident and health insurance under
24Section 356t of the Illinois Insurance Code. The program of
25health benefits shall provide the coverage required under

 

 

SB2623- 3 -LRB103 34217 LNS 64041 b

1Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
2356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
3356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.32a,
5356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
6356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59,
7and 356z.60 of the Illinois Insurance Code. The program of
8health benefits must comply with Sections 155.22a, 155.37,
9355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the
10Illinois Insurance Code. The Department of Insurance shall
11enforce the requirements of this Section with respect to
12Sections 370c and 370c.1 of the Illinois Insurance Code; all
13other requirements of this Section shall be enforced by the
14Department of Central Management Services.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
22101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
231-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
24eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
25102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
261-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,

 

 

SB2623- 4 -LRB103 34217 LNS 64041 b

1eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
2102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
3    Section 10. The Counties Code is amended by changing
4Section 5-1069.3 as follows:
 
5    (55 ILCS 5/5-1069.3)
6    Sec. 5-1069.3. Required health benefits. If a county,
7including a home rule county, is a self-insurer for purposes
8of providing health insurance coverage for its employees, the
9coverage shall include coverage for the post-mastectomy care
10benefits required to be covered by a policy of accident and
11health insurance under Section 356t and the coverage required
12under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
13356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
14356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
15356z.29, 356z.30a, 356z.32, 356z.32a, 356z.33, 356z.36,
16356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
17356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
18the Illinois Insurance Code. The coverage shall comply with
19Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
20Insurance Code. The Department of Insurance shall enforce the
21requirements of this Section. The requirement that health
22benefits be covered as provided in this Section is an
23exclusive power and function of the State and is a denial and
24limitation under Article VII, Section 6, subsection (h) of the

 

 

SB2623- 5 -LRB103 34217 LNS 64041 b

1Illinois Constitution. A home rule county to which this
2Section applies must comply with every provision of this
3Section.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
11101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
121-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
13eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
14102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
151-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
16eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
17102-1117, eff. 1-13-23.)
 
18    Section 15. The Illinois Municipal Code is amended by
19changing Section 10-4-2.3 as follows:
 
20    (65 ILCS 5/10-4-2.3)
21    Sec. 10-4-2.3. Required health benefits. If a
22municipality, including a home rule municipality, is a
23self-insurer for purposes of providing health insurance
24coverage for its employees, the coverage shall include

 

 

SB2623- 6 -LRB103 34217 LNS 64041 b

1coverage for the post-mastectomy care benefits required to be
2covered by a policy of accident and health insurance under
3Section 356t and the coverage required under Sections 356g,
4356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
5356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
6356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
7356z.30a, 356z.32, 356z.32a, 356z.33, 356z.36, 356z.40,
8356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
9356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of the
10Illinois Insurance Code. The coverage shall comply with
11Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
12Insurance Code. The Department of Insurance shall enforce the
13requirements of this Section. The requirement that health
14benefits be covered as provided in this is an exclusive power
15and function of the State and is a denial and limitation under
16Article VII, Section 6, subsection (h) of the Illinois
17Constitution. A home rule municipality to which this Section
18applies must comply with every provision of this Section.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
26101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.

 

 

SB2623- 7 -LRB103 34217 LNS 64041 b

11-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
2eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
3102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
41-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
5eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
6102-1117, eff. 1-13-23.)
 
7    Section 20. The School Code is amended by changing Section
810-22.3f as follows:
 
9    (105 ILCS 5/10-22.3f)
10    Sec. 10-22.3f. Required health benefits. Insurance
11protection and benefits for employees shall provide the
12post-mastectomy care benefits required to be covered by a
13policy of accident and health insurance under Section 356t and
14the coverage required under Sections 356g, 356g.5, 356g.5-1,
15356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
16356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.32a,
18356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
19356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and
20356z.60 of the Illinois Insurance Code. Insurance policies
21shall comply with Section 356z.19 of the Illinois Insurance
22Code. The coverage shall comply with Sections 155.22a, 355b,
23and 370c of the Illinois Insurance Code. The Department of
24Insurance shall enforce the requirements of this Section.

 

 

SB2623- 8 -LRB103 34217 LNS 64041 b

1    Rulemaking authority to implement Public Act 95-1045, if
2any, is conditioned on the rules being adopted in accordance
3with all provisions of the Illinois Administrative Procedure
4Act and all rules and procedures of the Joint Committee on
5Administrative Rules; any purported rule not so adopted, for
6whatever reason, is unauthorized.
7(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
8101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
91-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
10eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
11102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
121-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
13eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
14    Section 25. The Illinois Insurance Code is amended by
15adding Section 356z.32a as follows:
 
16    (215 ILCS 5/356z.32a new)
17    Sec. 356z.32a. Coverage for standard fertility
18preservation services.
19    (a) As used in this Section, "standard fertility
20preservation services" means procedures based upon current
21evidence-based standards of care established by the American
22Society for Reproductive Medicine, the American Society of
23Clinical Oncology, or other national medical associations that
24follow current evidence-based standards of care, including,

 

 

SB2623- 9 -LRB103 34217 LNS 64041 b

1but not limited to, cryopreservation.
2    (b) An individual or group policy of accident and health
3insurance amended, delivered, issued, or renewed in this State
4after June 1, 2024 must provide coverage for expenses for
5standard fertility preservation services and follow-up
6services related to that coverage, including storage.
7    (c) In determining coverage under this Section, an insurer
8shall not discriminate based on an individual's:
9        (1) expected length of life, present or predicted
10disability, degree of medical dependency, quality of life, or
11other health conditions; or
12        (2) personal characteristics, including age, sex,
13sexual orientation, or marital status.
14    (d) An individual or group policy of accident and health
15insurance may not:
16        (1) impose any exclusions, limitations, or other
17    restrictions on coverage of standard fertility
18    preservation services that are different from those
19    imposed on any other prescription medications;
20        (2) impose any exclusions, limitations, or other
21    restrictions on coverage of any standard fertility
22    preservation services based on a covered individual's
23    participation in fertility services provided by or to a
24    third party; or
25        (2) impose deductibles, copayments, coinsurance,
26    benefit maximums, waiting periods, or any other

 

 

SB2623- 10 -LRB103 34217 LNS 64041 b

1    limitations on coverage for standard fertility
2    preservation services that are different from those
3    imposed upon benefits for services not related to
4    fertility.
 
5    Section 30. The Health Maintenance Organization Act is
6amended by changing Section 5-3 as follows:
 
7    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
8    Sec. 5-3. Insurance Code provisions.
9    (a) Health Maintenance Organizations shall be subject to
10the provisions of Sections 133, 134, 136, 137, 139, 140,
11141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
12154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
13355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
14356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
15356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
16356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
17356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.32a,
18356z.33, 356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47,
19356z.48, 356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56,
20356z.57, 356z.59, 356z.60, 364, 364.01, 364.3, 367.2, 367.2-5,
21367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
22402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
23paragraph (c) of subsection (2) of Section 367, and Articles
24IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and

 

 

SB2623- 11 -LRB103 34217 LNS 64041 b

1XXXIIB of the Illinois Insurance Code.
2    (b) For purposes of the Illinois Insurance Code, except
3for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
4Health Maintenance Organizations in the following categories
5are deemed to be "domestic companies":
6        (1) a corporation authorized under the Dental Service
7    Plan Act or the Voluntary Health Services Plans Act;
8        (2) a corporation organized under the laws of this
9    State; or
10        (3) a corporation organized under the laws of another
11    state, 30% or more of the enrollees of which are residents
12    of this State, except a corporation subject to
13    substantially the same requirements in its state of
14    organization as is a "domestic company" under Article VIII
15    1/2 of the Illinois Insurance Code.
16    (c) In considering the merger, consolidation, or other
17acquisition of control of a Health Maintenance Organization
18pursuant to Article VIII 1/2 of the Illinois Insurance Code,
19        (1) the Director shall give primary consideration to
20    the continuation of benefits to enrollees and the
21    financial conditions of the acquired Health Maintenance
22    Organization after the merger, consolidation, or other
23    acquisition of control takes effect;
24        (2)(i) the criteria specified in subsection (1)(b) of
25    Section 131.8 of the Illinois Insurance Code shall not
26    apply and (ii) the Director, in making his determination

 

 

SB2623- 12 -LRB103 34217 LNS 64041 b

1    with respect to the merger, consolidation, or other
2    acquisition of control, need not take into account the
3    effect on competition of the merger, consolidation, or
4    other acquisition of control;
5        (3) the Director shall have the power to require the
6    following information:
7            (A) certification by an independent actuary of the
8        adequacy of the reserves of the Health Maintenance
9        Organization sought to be acquired;
10            (B) pro forma financial statements reflecting the
11        combined balance sheets of the acquiring company and
12        the Health Maintenance Organization sought to be
13        acquired as of the end of the preceding year and as of
14        a date 90 days prior to the acquisition, as well as pro
15        forma financial statements reflecting projected
16        combined operation for a period of 2 years;
17            (C) a pro forma business plan detailing an
18        acquiring party's plans with respect to the operation
19        of the Health Maintenance Organization sought to be
20        acquired for a period of not less than 3 years; and
21            (D) such other information as the Director shall
22        require.
23    (d) The provisions of Article VIII 1/2 of the Illinois
24Insurance Code and this Section 5-3 shall apply to the sale by
25any health maintenance organization of greater than 10% of its
26enrollee population (including without limitation the health

 

 

SB2623- 13 -LRB103 34217 LNS 64041 b

1maintenance organization's right, title, and interest in and
2to its health care certificates).
3    (e) In considering any management contract or service
4agreement subject to Section 141.1 of the Illinois Insurance
5Code, the Director (i) shall, in addition to the criteria
6specified in Section 141.2 of the Illinois Insurance Code,
7take into account the effect of the management contract or
8service agreement on the continuation of benefits to enrollees
9and the financial condition of the health maintenance
10organization to be managed or serviced, and (ii) need not take
11into account the effect of the management contract or service
12agreement on competition.
13    (f) Except for small employer groups as defined in the
14Small Employer Rating, Renewability and Portability Health
15Insurance Act and except for medicare supplement policies as
16defined in Section 363 of the Illinois Insurance Code, a
17Health Maintenance Organization may by contract agree with a
18group or other enrollment unit to effect refunds or charge
19additional premiums under the following terms and conditions:
20        (i) the amount of, and other terms and conditions with
21    respect to, the refund or additional premium are set forth
22    in the group or enrollment unit contract agreed in advance
23    of the period for which a refund is to be paid or
24    additional premium is to be charged (which period shall
25    not be less than one year); and
26        (ii) the amount of the refund or additional premium

 

 

SB2623- 14 -LRB103 34217 LNS 64041 b

1    shall not exceed 20% of the Health Maintenance
2    Organization's profitable or unprofitable experience with
3    respect to the group or other enrollment unit for the
4    period (and, for purposes of a refund or additional
5    premium, the profitable or unprofitable experience shall
6    be calculated taking into account a pro rata share of the
7    Health Maintenance Organization's administrative and
8    marketing expenses, but shall not include any refund to be
9    made or additional premium to be paid pursuant to this
10    subsection (f)). The Health Maintenance Organization and
11    the group or enrollment unit may agree that the profitable
12    or unprofitable experience may be calculated taking into
13    account the refund period and the immediately preceding 2
14    plan years.
15    The Health Maintenance Organization shall include a
16statement in the evidence of coverage issued to each enrollee
17describing the possibility of a refund or additional premium,
18and upon request of any group or enrollment unit, provide to
19the group or enrollment unit a description of the method used
20to calculate (1) the Health Maintenance Organization's
21profitable experience with respect to the group or enrollment
22unit and the resulting refund to the group or enrollment unit
23or (2) the Health Maintenance Organization's unprofitable
24experience with respect to the group or enrollment unit and
25the resulting additional premium to be paid by the group or
26enrollment unit.

 

 

SB2623- 15 -LRB103 34217 LNS 64041 b

1    In no event shall the Illinois Health Maintenance
2Organization Guaranty Association be liable to pay any
3contractual obligation of an insolvent organization to pay any
4refund authorized under this Section.
5    (g) Rulemaking authority to implement Public Act 95-1045,
6if any, is conditioned on the rules being adopted in
7accordance with all provisions of the Illinois Administrative
8Procedure Act and all rules and procedures of the Joint
9Committee on Administrative Rules; any purported rule not so
10adopted, for whatever reason, is unauthorized.
11(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
12101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
131-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
14eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
15102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
161-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
17eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
18102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
191-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
20eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
21    Section 35. The Limited Health Service Organization Act is
22amended by changing Section 4003 as follows:
 
23    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
24    Sec. 4003. Illinois Insurance Code provisions. Limited

 

 

SB2623- 16 -LRB103 34217 LNS 64041 b

1health service organizations shall be subject to the
2provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
3141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
4154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
5355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
6356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.32a,
7356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
8356z.57, 356z.59, 364.3, 368a, 401, 401.1, 402, 403, 403A,
9408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
101/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
11Illinois Insurance Code. Nothing in this Section shall require
12a limited health care plan to cover any service that is not a
13limited health service. For purposes of the Illinois Insurance
14Code, except for Sections 444 and 444.1 and Articles XIII and
15XIII 1/2, limited health service organizations in the
16following categories are deemed to be domestic companies:
17        (1) a corporation under the laws of this State; or
18        (2) a corporation organized under the laws of another
19    state, 30% or more of the enrollees of which are residents
20    of this State, except a corporation subject to
21    substantially the same requirements in its state of
22    organization as is a domestic company under Article VIII
23    1/2 of the Illinois Insurance Code.
24(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
25101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
261-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,

 

 

SB2623- 17 -LRB103 34217 LNS 64041 b

1eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
2102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
31-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
4    Section 40. The Voluntary Health Services Plans Act is
5amended by changing Section 10 as follows:
 
6    (215 ILCS 165/10)  (from Ch. 32, par. 604)
7    Sec. 10. Application of Insurance Code provisions. Health
8services plan corporations and all persons interested therein
9or dealing therewith shall be subject to the provisions of
10Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
11143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
12356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
13356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
14356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
15356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
16356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.32a,
17356z.33, 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53,
18356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 364.01, 364.3,
19367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
20and paragraphs (7) and (15) of Section 367 of the Illinois
21Insurance Code.
22    Rulemaking authority to implement Public Act 95-1045, if
23any, is conditioned on the rules being adopted in accordance
24with all provisions of the Illinois Administrative Procedure

 

 

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1Act and all rules and procedures of the Joint Committee on
2Administrative Rules; any purported rule not so adopted, for
3whatever reason, is unauthorized.
4(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
5101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
61-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
7eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
8102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
91-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
10eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
11102-1117, eff. 1-13-23.)
 
12    Section 45. The Illinois Public Aid Code is amended by
13changing Section 5-16.8 as follows:
 
14    (305 ILCS 5/5-16.8)
15    Sec. 5-16.8. Required health benefits. The medical
16assistance program shall (i) provide the post-mastectomy care
17benefits required to be covered by a policy of accident and
18health insurance under Section 356t and the coverage required
19under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
20356z.26, 356z.29, 356z.32, 356z.32a, 356z.33, 356z.34,
21356z.35, 356z.46, 356z.47, 356z.51, 356z.53, 356z.56, 356z.59,
22and 356z.60 of the Illinois Insurance Code, (ii) be subject to
23the provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
24370c, and 370c.1 of the Illinois Insurance Code, and (iii) be

 

 

SB2623- 19 -LRB103 34217 LNS 64041 b

1subject to the provisions of subsection (d-5) of Section 10 of
2the Network Adequacy and Transparency Act.
3    The Department, by rule, shall adopt a model similar to
4the requirements of Section 356z.39 of the Illinois Insurance
5Code.
6    On and after July 1, 2012, the Department shall reduce any
7rate of reimbursement for services or other payments or alter
8any methodologies authorized by this Code to reduce any rate
9of reimbursement for services or other payments in accordance
10with Section 5-5e.
11    To ensure full access to the benefits set forth in this
12Section, on and after January 1, 2016, the Department shall
13ensure that provider and hospital reimbursement for
14post-mastectomy care benefits required under this Section are
15no lower than the Medicare reimbursement rate.
16(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
17101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
181-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
19eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
20102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
211-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
22eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
23    Section 95. No acceleration or delay. Where this Act makes
24changes in a statute that is represented in this Act by text
25that is not yet or no longer in effect (for example, a Section

 

 

SB2623- 20 -LRB103 34217 LNS 64041 b

1represented by multiple versions), the use of that text does
2not accelerate or delay the taking effect of (i) the changes
3made by this Act or (ii) provisions derived from any other
4Public Act.
 
5    Section 99. Effective date. This Act takes effect upon
6becoming law.