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093_HB3060
LRB093 11021 JLS 11689 b
1 AN ACT concerning health insurance coverage.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The State Employees Group Insurance Act of
5 1971 is amended by changing Section 6.11 as follows:
6 (5 ILCS 375/6.11)
7 Sec. 6.11. Required health benefits; Illinois Insurance
8 Code requirements. The program of health benefits shall
9 provide the post-mastectomy care benefits required to be
10 covered by a policy of accident and health insurance under
11 Section 356t of the Illinois Insurance Code. The program of
12 health benefits shall provide the coverage required under
13 Sections 356u, 356w, 356x, and 356z.2, and 356z.4 of the
14 Illinois Insurance Code. The program of health benefits must
15 comply with Section 155.37 of the Illinois Insurance Code.
16 (Source: P.A. 92-440, eff. 8-17-01; 92-764, eff. 1-1-03.)
17 Section 10. The Counties Code is amended by changing
18 Section 5-1069.3 as follows:
19 (55 ILCS 5/5-1069.3)
20 Sec. 5-1069.3. Required health benefits. If a county,
21 including a home rule county, is a self-insurer for purposes
22 of providing health insurance coverage for its employees, the
23 coverage shall include coverage for the post-mastectomy care
24 benefits required to be covered by a policy of accident and
25 health insurance under Section 356t and the coverage required
26 under Sections 356u, 356w, and 356x, and 356z.4 of the
27 Illinois Insurance Code. The requirement that health
28 benefits be covered as provided in this Section is an
29 exclusive power and function of the State and is a denial and
-2- LRB093 11021 JLS 11689 b
1 limitation under Article VII, Section 6, subsection (h) of
2 the Illinois Constitution. A home rule county to which this
3 Section applies must comply with every provision of this
4 Section.
5 (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.)
6 Section 15. The Illinois Municipal Code is amended by
7 changing Section 10-4-2.3 as follows:
8 (65 ILCS 5/10-4-2.3)
9 Sec. 10-4-2.3. Required health benefits. If a
10 municipality, including a home rule municipality, is a
11 self-insurer for purposes of providing health insurance
12 coverage for its employees, the coverage shall include
13 coverage for the post-mastectomy care benefits required to be
14 covered by a policy of accident and health insurance under
15 Section 356t and the coverage required under Sections 356u,
16 356w, and 356x, and 356z.4 of the Illinois Insurance Code.
17 The requirement that health benefits be covered as provided
18 in this is an exclusive power and function of the State and
19 is a denial and limitation under Article VII, Section 6,
20 subsection (h) of the Illinois Constitution. A home rule
21 municipality to which this Section applies must comply with
22 every provision of this Section.
23 (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.)
24 Section 20. The Illinois Insurance Code is amended by
25 changing Section 351B-5 and adding Section 356z.4 as follows:
26 (215 ILCS 5/351B-5) (from Ch. 73, par. 963B-5)
27 Sec. 351B-5. Applicability of other Code provisions. All
28 policies of accident and health insurance issued under this
29 Article shall be subject to the provisions of Sections 356c,
30 subsection (a) of Section 356g, 356h, 356n, 356z.4, 367c,
-3- LRB093 11021 JLS 11689 b
1 367d, 370, 370a, and 370e of this Code.
2 (Source: P.A. 86-1407; 87-792; 87-1066.)
3 (215 ILCS 5/356z.4 new)
4 Sec. 356z.4. Coverage for certain benefits related to
5 brain injury.
6 (a) A group or individual policy of accident and health
7 insurance, a managed care plan, or multiple employer welfare
8 arrangement, that is amended, delivered, issued, or renewed
9 after the effective date of this amendatory Act of the 93rd
10 General Assembly may not exclude coverage for cognitive
11 rehabilitation therapy, cognitive communication therapy,
12 neurocognitive therapy and rehabilitation, neurobehavioral,
13 neurophysiological, neuropsychological, and
14 psychophysiological testing or treatment, neurofeedback
15 therapy, remediation, post-acute transition services, or
16 community reintegration services necessary as a result of and
17 related to an acquired brain injury.
18 (b) Coverage required under this Section may be subject
19 to deductibles, copayments, coinsurance, or annual or maximum
20 payment limits that are consistent with deductibles,
21 copayments, coinsurance, and annual or maximum payment limits
22 applicable to other similar coverage under the policy.
23 (c) The Department shall adopt rules as necessary to
24 implement this Section.
25 Section 25. The Health Maintenance Organization Act is
26 amended by changing Section 4-6.5 as follows:
27 (215 ILCS 125/4-6.5)
28 Sec. 4-6.5. Required health benefits; Illinois Insurance
29 Code requirements. A health maintenance organization is
30 subject to the provisions of Sections 155.37, 356t, 356u, and
31 356z.1, and 356z.4 of the Illinois Insurance Code.
-4- LRB093 11021 JLS 11689 b
1 (Source: P.A. 92-130, eff. 7-20-01; 92-440, eff. 8-17-01;
2 92-651, eff. 7-11-02.)
3 Section 30. The Voluntary Health Services Plans Act is
4 amended by changing Section 10 as follows:
5 (215 ILCS 165/10) (from Ch. 32, par. 604)
6 Sec. 10. Application of Insurance Code provisions.
7 Health services plan corporations and all persons interested
8 therein or dealing therewith shall be subject to the
9 provisions of Articles IIA and XII 1/2 and Sections 3.1, 133,
10 140, 143, 143c, 149, 155.37, 354, 355.2, 356r, 356t, 356u,
11 356v, 356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 367.2, 368a,
12 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, and
13 paragraphs (7) and (15) of Section 367 of the Illinois
14 Insurance Code.
15 (Source: P.A. 91-406, eff. 1-1-00; 91-549, eff. 8-14-99;
16 91-605, eff. 12-14-99; 91-788, eff. 6-9-00; 92-130, eff.
17 7-20-01; 92-440, eff. 8-17-01; 92-651, eff. 7-11-02; 92-764,
18 eff. 1-1-03.)
19 Section 90. The State Mandates Act is amended by adding
20 Section 8.27 as follows:
21 (30 ILCS 805/8.27 new)
22 Sec. 8.27. Exempt mandate. Notwithstanding Sections 6
23 and 8 of this Act, no reimbursement by the State is required
24 for the implementation of any mandate created by this
25 amendatory Act of the 93rd General Assembly.
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