Illinois General Assembly - Full Text of HB1745
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Full Text of HB1745  102nd General Assembly

HB1745enr 102ND GENERAL ASSEMBLY

  
  
  

 


 
HB1745 EnrolledLRB102 14220 BMS 19572 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 Managed Care Reform and Patient Rights Act
5is amended by adding Section 45.3 as follows:
 
6    (215 ILCS 134/45.3 new)
7    Sec. 45.3. Prescription drug benefits; plan choice.
8    (a) Notwithstanding any other provision of law, beginning
9January 1, 2023, every health insurance carrier that offers an
10individual health plan that provides coverage for prescription
11drugs shall ensure that at least 10% of individual health care
12plans offered in each applicable service area and at each
13level of coverage as defined in 42 U.S.C. 18022 apply a
14flat-dollar copayment structure to the entire drug benefit.
15Beginning January 1, 2024, every health insurance carrier that
16offers an individual health plan that provides coverage for
17prescription drugs shall ensure that at least 25% of
18individual health care plans offered in each applicable
19service area and at each level of coverage as defined in 42
20U.S.C. 18022 apply a flat-dollar copayment structure to the
21entire drug benefit. If a health insurance carrier offers
22fewer than 4 plans in a service area, then the health insurance
23carrier shall ensure that one plan applies a flat-dollar

 

 

HB1745 Enrolled- 2 -LRB102 14220 BMS 19572 b

1copayment structure to the entire drug benefit.
2    (b) Beginning January 1, 2023, every health insurance
3carrier that offers a group health plan that provides coverage
4for prescription drugs shall offer at least one group health
5plan in each applicable service area and at each level of
6coverage as defined in 42 U.S.C. 18022 that applies a
7flat-dollar copayment structure to the entire drug benefit.
8Beginning January 1, 2024, every health insurance carrier that
9offers a group health plan that provides coverage for
10prescription drugs shall offer at least 2 group health plans
11in each applicable service area and at each level of coverage
12as defined in 42 U.S.C. 18022 that apply a flat-dollar
13copayment structure to the entire drug benefit.
14    (c) The flat-dollar copayment structure for prescription
15drugs under subsections (a) and (b) must be applied
16pre-deductible and be reasonably graduated and proportionately
17related in all tier levels such that the copayment structure
18as a whole does not discriminate against or discourage the
19enrollment of individuals with significant health care needs.
20    (d) A health insurance carrier that offers individual or
21group health care plans shall clearly and appropriately name
22the plans described in subsections (a) and (b) to aid in the
23individual or group plan selection process.
24    (e) A health insurance carrier shall market plans
25described in subsections (a) and (b) in the same manner as
26plans not described in subsections (a) and (b).

 

 

HB1745 Enrolled- 3 -LRB102 14220 BMS 19572 b

1    (f) The Department shall adopt rules necessary to
2implement and enforce the provisions of this Section.
 
3    Section 99. Effective date. This Act takes effect January
41, 2023.