Illinois General Assembly - Full Text of HB1745
Illinois General Assembly

  Bills & Resolutions  
  Compiled Statutes  
  Public Acts  
  Legislative Reports  
  IL Constitution  
  Legislative Guide  
  Legislative Glossary  

 Search By Number
 (example: HB0001)
Search Tips

Search By Keyword

Full Text of HB1745  102nd General Assembly

HB1745ham001 102ND GENERAL ASSEMBLY

Rep. Greg Harris

Filed: 3/19/2021

 

 


 

 


 
10200HB1745ham001LRB102 14220 BMS 24017 a

1
AMENDMENT TO HOUSE BILL 1745

2    AMENDMENT NO. ______. Amend House Bill 1745 by replacing
3everything after the enacting clause with the following:
 
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

 

 

10200HB1745ham001- 2 -LRB102 14220 BMS 24017 a

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

 

 

10200HB1745ham001- 3 -LRB102 14220 BMS 24017 a

1    (d) A health insurance carrier that offers individual or
2group health care plans shall clearly and appropriately name
3the plans described in subsections (a) and (b) to aid in the
4individual or group plan selection process.
5    (e) A health insurance carrier shall market plans
6described in subsections (a) and (b) in the same manner as
7plans not described in subsections (a) and (b).
8    (f) The Department shall adopt rules necessary to
9implement and enforce the provisions of this Section.
 
10    Section 99. Effective date. This Act takes effect January
111, 2023.".