Illinois General Assembly - Full Text of SB3203
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Full Text of SB3203  103rd General Assembly



SB3203 EnrolledLRB103 37942 CES 68074 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    Sec. 6.11. Required health benefits; Illinois Insurance
8Code requirements. The program of health benefits shall
9provide the post-mastectomy care benefits required to be
10covered by a policy of accident and health insurance under
11Section 356t of the Illinois Insurance Code. The program of
12health benefits shall provide the coverage required under
13Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
14356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
15356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
16356z.22, 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32,
17356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
18356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59,
19356z.60, and 356z.61, and 356z.62, 356z.64, 356z.67, 356z.68,
20and 356z.70 of the Illinois Insurance Code. The program of
21health benefits must comply with Sections 155.22a, 155.37,
22355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the
23Illinois Insurance Code. The program of health benefits shall



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1provide the coverage required under Section 356m of the
2Illinois Insurance Code and, for the employees of the State
3Employee Group Insurance Program only, the coverage as also
4provided in Section 6.11B of this Act. The Department of
5Insurance shall enforce the requirements of this Section with
6respect to Sections 370c and 370c.1 of the Illinois Insurance
7Code; all other requirements of this Section shall be enforced
8by the Department of Central Management Services.
9    Rulemaking authority to implement Public Act 95-1045, if
10any, is conditioned on the rules being adopted in accordance
11with all provisions of the Illinois Administrative Procedure
12Act and all rules and procedures of the Joint Committee on
13Administrative Rules; any purported rule not so adopted, for
14whatever reason, is unauthorized.
15(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
16102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
171-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768,
18eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
19102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
201-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84,
21eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24;
22103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff.
238-11-23; revised 8-29-23.)
24    Section 10. The Illinois Insurance Code is amended by
25changing Section 356z.5 as follows:



SB3203 Enrolled- 3 -LRB103 37942 CES 68074 b

1    (215 ILCS 5/356z.5)
2    Sec. 356z.5. Prescription inhalants.
3    (a) In this Section, "prescription inhaler" means a
4prescribed medical device that delivers inhaled medications
5used to treat breathing for persons suffering from asthma or
6other life-threatening bronchial ailments. "Prescription
7inhaler" includes metered-dose inhalers, nebulizers, and dry
8powder inhalers. "Prescription inhaler" does not include
9inhalers available over the counter without a prescription to
10provide temporary relief from respiratory symptoms.
11    (b) A group or individual policy of accident and health
12insurance or managed care plan amended, delivered, issued, or
13renewed through December 31, 2025 after the effective date of
14this amendatory Act of the 93rd General Assembly that provides
15coverage for prescription drugs may not deny or limit coverage
16for prescription inhalers inhalants to enable persons to
17breathe when suffering from asthma or other life-threatening
18bronchial ailments based upon any restriction on the number of
19days before an inhaler refill may be obtained if, contrary to
20those restrictions, the inhalants have been ordered or
21prescribed by the treating physician and are medically
23    (c) A group or individual policy of accident and health
24insurance or managed care plan amended, delivered, issued, or
25renewed on or after January 1, 2026 that provides coverage for



SB3203 Enrolled- 4 -LRB103 37942 CES 68074 b

1prescription drugs may not deny or limit, except as otherwise
2provided in this subsection, coverage for prescription
3inhalers to enable persons to breathe when suffering from
4asthma or other life-threatening bronchial ailments based upon
5any restriction on the number of days before an inhaler refill
6may be obtained if, contrary to those restrictions, the
7inhalants have been ordered or prescribed by the treating
8physician and are medically appropriate. A group or individual
9policy of accident and health insurance or managed care plan
10subject to this subsection shall limit the total amount that a
11covered person is required to pay for a covered prescription
12inhaler to an amount not to exceed $25 per 30-day supply.
13    (d) Nothing in this Section prevents a group or individual
14policy of accident and health insurance or managed care plan
15from reducing a covered person's cost sharing to an amount
16less than the amount specified in subsection (c).
17    (e) Coverage for prescription inhalers shall not be
18subject to any deductible; except that this provision does not
19apply to the extent such coverage would disqualify a
20high-deductible health plan from eligibility for a health
21savings account pursuant to Section 223 of the Internal
22Revenue Code (26 U.S.C. 223).
23    (f) The Department may adopt rules necessary to implement
24and administer this Section and to align with federal
25requirements. The Department may use any of its enforcement
26powers to obtain a group or individual policy of accident and



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1health insurance's or managed care plan's compliance with this
3(Source: P.A. 95-331, eff. 8-21-07.)