Illinois General Assembly - Full Text of HB1779
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Full Text of HB1779  102nd General Assembly

HB1779ham001 102ND GENERAL ASSEMBLY

Rep. Mary E. Flowers

Filed: 3/21/2021

 

 


 

 


 
10200HB1779ham001LRB102 10161 BMS 23338 a

1
AMENDMENT TO HOUSE BILL 1779

2    AMENDMENT NO. ______. Amend House Bill 1779 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of
51971 is 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, 356u, 356w, 356x,
14356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
15356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
16356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,

 

 

10200HB1779ham001- 2 -LRB102 10161 BMS 23338 a

1356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
2Code. The program of health benefits must comply with Sections
3155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article
4XXXIIB of the Illinois Insurance Code. 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. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
16100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
171-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
18eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
19101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
201-1-21.)
 
21    Section 10. The Counties Code is amended by changing
22Section 5-1069.3 as follows:
 
23    (55 ILCS 5/5-1069.3)
24    Sec. 5-1069.3. Required health benefits. If a county,

 

 

10200HB1779ham001- 3 -LRB102 10161 BMS 23338 a

1including a home rule county, is a self-insurer for purposes
2of providing health insurance coverage for its employees, the
3coverage shall include coverage for the post-mastectomy care
4benefits required to be covered by a policy of accident and
5health insurance under Section 356t and the coverage required
6under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
7356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
8356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
9356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
10of the Illinois 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 Section is an
15exclusive power and function of the State and is a denial and
16limitation under Article VII, Section 6, subsection (h) of the
17Illinois Constitution. A home rule county to which this
18Section applies must comply with every provision of this
19Section.
20    Rulemaking authority to implement Public Act 95-1045, if
21any, is conditioned on the rules being adopted in accordance
22with all provisions of the Illinois Administrative Procedure
23Act and all rules and procedures of the Joint Committee on
24Administrative Rules; any purported rule not so adopted, for
25whatever reason, is unauthorized.
26(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;

 

 

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1100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
21-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
3eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
4101-625, eff. 1-1-21.)
 
5    Section 15. The Illinois Municipal Code is amended by
6changing Section 10-4-2.3 as follows:
 
7    (65 ILCS 5/10-4-2.3)
8    Sec. 10-4-2.3. Required health benefits. If a
9municipality, including a home rule municipality, is a
10self-insurer for purposes of providing health insurance
11coverage for its employees, the coverage shall include
12coverage for the post-mastectomy care benefits required to be
13covered by a policy of accident and health insurance under
14Section 356t and the coverage required under Sections 356g,
15356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9,
16356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, and 356z.41, and 356z.43 of the Illinois Insurance
19Code. The coverage shall comply with Sections 155.22a, 355b,
20356z.19, and 370c of the Illinois Insurance Code. The
21Department of Insurance shall enforce the requirements of this
22Section. The requirement that health benefits be covered as
23provided in this is an exclusive power and function of the
24State and is a denial and limitation under Article VII,

 

 

10200HB1779ham001- 5 -LRB102 10161 BMS 23338 a

1Section 6, subsection (h) of the Illinois Constitution. A home
2rule municipality to which this Section applies must comply
3with every provision of this Section.
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. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
11100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
121-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
13eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
14101-625, eff. 1-1-21.)
 
15    Section 20. The School Code is amended by changing Section
1610-22.3f as follows:
 
17    (105 ILCS 5/10-22.3f)
18    Sec. 10-22.3f. Required health benefits. Insurance
19protection and benefits for employees shall provide the
20post-mastectomy care benefits required to be covered by a
21policy of accident and health insurance under Section 356t and
22the coverage required under Sections 356g, 356g.5, 356g.5-1,
23356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
24356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,

 

 

10200HB1779ham001- 6 -LRB102 10161 BMS 23338 a

1356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
2of the Illinois Insurance Code. Insurance policies shall
3comply with Section 356z.19 of the Illinois Insurance Code.
4The coverage shall comply with Sections 155.22a, 355b, and
5370c of the Illinois Insurance Code. The Department of
6Insurance shall enforce the requirements of this Section.
7    Rulemaking authority to implement Public Act 95-1045, if
8any, is conditioned on the rules being adopted in accordance
9with all provisions of the Illinois Administrative Procedure
10Act and all rules and procedures of the Joint Committee on
11Administrative Rules; any purported rule not so adopted, for
12whatever reason, is unauthorized.
13(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
14100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
151-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
16eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
17101-625, eff. 1-1-21.)
 
18    Section 25. The Illinois Insurance Code is amended by
19adding Section 356z.43 as follows:
 
20    (215 ILCS 5/356z.43 new)
21    Sec. 356z.43. Biomarker testing.
22    (a) As used in this Section:
23    "Biomarker" means a characteristic that is objectively
24measured and evaluated as an indicator of normal biological

 

 

10200HB1779ham001- 7 -LRB102 10161 BMS 23338 a

1processes, pathogenic processes, or pharmacologic responses to
2a specific therapeutic intervention. "Biomarker" includes, but
3is not limited to, gene mutations or protein expression.
4    "Biomarker testing" means the analysis of a patient's
5tissue, blood, or fluid biospecimen for the presence of a
6biomarker. "Biomarker testing" includes, but is not limited
7to, single-analyte tests, multi-plex panel tests, and partial
8or whole genome sequencing.
9    (b) A group or individual policy of accident and health
10insurance or managed care plan amended, delivered, issued, or
11renewed on or after January 1, 2022 shall include coverage for
12biomarker testing as defined in this Section pursuant to
13criteria established under subsection (d).
14    (c) Biomarker testing shall be covered and conducted in an
15efficient manner to provide the most complete range of results
16to the patient's health care provider without requiring
17multiple biopsies, biospecimen samples, or other delays or
18disruptions in patient care.
19    (d) Biomarker testing must be covered for the purposes of
20diagnosis, treatment, appropriate management, or ongoing
21monitoring of an enrollee's disease or condition when the test
22is supported by medical and scientific evidence, including,
23but not limited to:
24        (1) labeled indications for an FDA-approved test or
25    indicated tests for an FDA-approved drug;
26        (2) federal Centers for Medicare and Medicaid Services

 

 

10200HB1779ham001- 8 -LRB102 10161 BMS 23338 a

1    National Coverage Determinations;
2        (3) nationally recognized clinical practice
3    guidelines;
4        (4) consensus statements;
5        (5) professional society recommendations;
6        (6) peer-reviewed literature, biomedical compendia,
7    and other medical literature that meet the criteria of the
8    National Institutes of Health's National Library of
9    Medicine for indexing in Index Medicus, Excerpta Medicus,
10    Medline, and MEDLARS database of Health Services
11    Technology Assessment Research; and
12        (7) peer-reviewed scientific studies published in or
13    accepted for publication by medical journals that meet
14    nationally recognized requirements for scientific
15    manuscripts and that submit most of their published
16    articles for review by experts who are not part of the
17    editorial staff.
18    (e) When coverage of biomarker testing for the purpose of
19diagnosis, treatment, or ongoing monitoring of any medical
20condition is restricted for use by a group or individual
21policy of accident and health insurance or managed care plan,
22the patient and prescribing practitioner shall have access to
23a clear, readily accessible, and convenient processes to
24request an exception. The process shall be made readily
25accessible on the insurer's website.
 

 

 

10200HB1779ham001- 9 -LRB102 10161 BMS 23338 a

1    Section 30. The Health Maintenance Organization Act is
2amended by changing Section 5-3 as follows:
 
3    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
4    Sec. 5-3. Insurance Code provisions.
5    (a) Health Maintenance Organizations shall be subject to
6the provisions of Sections 133, 134, 136, 137, 139, 140,
7141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
8154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
9355.3, 355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2,
10356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10,
11356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18,
12356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
13356z.30a, 356z.32, 356z.33, 356z.35, 356z.36, 356z.41,
14356z.43, 364, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c,
15368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408,
16408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection
17(2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2,
18XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois
19Insurance Code.
20    (b) For purposes of the Illinois Insurance Code, except
21for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
22Health Maintenance Organizations in the following categories
23are deemed to be "domestic companies":
24        (1) a corporation authorized under the Dental Service
25    Plan Act or the Voluntary Health Services Plans Act;

 

 

10200HB1779ham001- 10 -LRB102 10161 BMS 23338 a

1        (2) a corporation organized under the laws of this
2    State; or
3        (3) a corporation organized under the laws of another
4    state, 30% or more of the enrollees of which are residents
5    of this State, except a corporation subject to
6    substantially the same requirements in its state of
7    organization as is a "domestic company" under Article VIII
8    1/2 of the Illinois Insurance Code.
9    (c) In considering the merger, consolidation, or other
10acquisition of control of a Health Maintenance Organization
11pursuant to Article VIII 1/2 of the Illinois Insurance Code,
12        (1) the Director shall give primary consideration to
13    the continuation of benefits to enrollees and the
14    financial conditions of the acquired Health Maintenance
15    Organization after the merger, consolidation, or other
16    acquisition of control takes effect;
17        (2)(i) the criteria specified in subsection (1)(b) of
18    Section 131.8 of the Illinois Insurance Code shall not
19    apply and (ii) the Director, in making his determination
20    with respect to the merger, consolidation, or other
21    acquisition of control, need not take into account the
22    effect on competition of the merger, consolidation, or
23    other acquisition of control;
24        (3) the Director shall have the power to require the
25    following information:
26            (A) certification by an independent actuary of the

 

 

10200HB1779ham001- 11 -LRB102 10161 BMS 23338 a

1        adequacy of the reserves of the Health Maintenance
2        Organization sought to be acquired;
3            (B) pro forma financial statements reflecting the
4        combined balance sheets of the acquiring company and
5        the Health Maintenance Organization sought to be
6        acquired as of the end of the preceding year and as of
7        a date 90 days prior to the acquisition, as well as pro
8        forma financial statements reflecting projected
9        combined operation for a period of 2 years;
10            (C) a pro forma business plan detailing an
11        acquiring party's plans with respect to the operation
12        of the Health Maintenance Organization sought to be
13        acquired for a period of not less than 3 years; and
14            (D) such other information as the Director shall
15        require.
16    (d) The provisions of Article VIII 1/2 of the Illinois
17Insurance Code and this Section 5-3 shall apply to the sale by
18any health maintenance organization of greater than 10% of its
19enrollee population (including without limitation the health
20maintenance organization's right, title, and interest in and
21to its health care certificates).
22    (e) In considering any management contract or service
23agreement subject to Section 141.1 of the Illinois Insurance
24Code, the Director (i) shall, in addition to the criteria
25specified in Section 141.2 of the Illinois Insurance Code,
26take into account the effect of the management contract or

 

 

10200HB1779ham001- 12 -LRB102 10161 BMS 23338 a

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

 

 

10200HB1779ham001- 13 -LRB102 10161 BMS 23338 a

1    marketing expenses, but shall not include any refund to be
2    made or additional premium to be paid pursuant to this
3    subsection (f)). The Health Maintenance Organization and
4    the group or enrollment unit may agree that the profitable
5    or unprofitable experience may be calculated taking into
6    account the refund period and the immediately preceding 2
7    plan years.
8    The Health Maintenance Organization shall include a
9statement in the evidence of coverage issued to each enrollee
10describing the possibility of a refund or additional premium,
11and upon request of any group or enrollment unit, provide to
12the group or enrollment unit a description of the method used
13to calculate (1) the Health Maintenance Organization's
14profitable experience with respect to the group or enrollment
15unit and the resulting refund to the group or enrollment unit
16or (2) the Health Maintenance Organization's unprofitable
17experience with respect to the group or enrollment unit and
18the resulting additional premium to be paid by the group or
19enrollment unit.
20    In no event shall the Illinois Health Maintenance
21Organization Guaranty Association be liable to pay any
22contractual obligation of an insolvent organization to pay any
23refund authorized under this Section.
24    (g) Rulemaking authority to implement Public Act 95-1045,
25if any, is conditioned on the rules being adopted in
26accordance with all provisions of the Illinois Administrative

 

 

10200HB1779ham001- 14 -LRB102 10161 BMS 23338 a

1Procedure Act and all rules and procedures of the Joint
2Committee on Administrative Rules; any purported rule not so
3adopted, for whatever reason, is unauthorized.
4(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
5100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
61-1-19; 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19; 101-81,
7eff. 7-12-19; 101-281, eff. 1-1-20; 101-371, eff. 1-1-20;
8101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
91-1-20; 101-625, eff. 1-1-21.)
 
10    Section 35. The Limited Health Service Organization Act is
11amended by changing Section 4003 as follows:
 
12    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
13    Sec. 4003. Illinois Insurance Code provisions. Limited
14health service organizations shall be subject to the
15provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
16141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
17154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
18355b, 356v, 356z.10, 356z.21, 356z.22, 356z.25, 356z.26,
19356z.29, 356z.30a, 356z.32, 356z.33, 356z.41, 356z.43, 368a,
20401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and
21444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2,
22XXV, and XXVI of the Illinois Insurance Code. For purposes of
23the Illinois Insurance Code, except for Sections 444 and 444.1
24and Articles XIII and XIII 1/2, limited health service

 

 

10200HB1779ham001- 15 -LRB102 10161 BMS 23338 a

1organizations in the following categories are deemed to be
2domestic companies:
3        (1) a corporation under the laws of this State; or
4        (2) a corporation organized under the laws of another
5    state, 30% or more of the enrollees of which are residents
6    of this State, except a corporation subject to
7    substantially the same requirements in its state of
8    organization as is a domestic company under Article VIII
9    1/2 of the Illinois Insurance Code.
10(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
11100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff.
121-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
13eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. 1-1-21.)
 
14    Section 40. The Voluntary Health Services Plans Act is
15amended by changing Section 10 as follows:
 
16    (215 ILCS 165/10)  (from Ch. 32, par. 604)
17    Sec. 10. Application of Insurance Code provisions. Health
18services plan corporations and all persons interested therein
19or dealing therewith shall be subject to the provisions of
20Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
21143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
22356g, 356g.5, 356g.5-1, 356r, 356t, 356u, 356v, 356w, 356x,
23356y, 356z.1, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
24356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,

 

 

10200HB1779ham001- 16 -LRB102 10161 BMS 23338 a

1356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
2356z.30, 356z.30a, 356z.32, 356z.33, 356z.41, 356z.43, 364.01,
3367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
4and paragraphs (7) and (15) of Section 367 of the Illinois
5Insurance Code.
6    Rulemaking authority to implement Public Act 95-1045, if
7any, is conditioned on the rules being adopted in accordance
8with all provisions of the Illinois Administrative Procedure
9Act and all rules and procedures of the Joint Committee on
10Administrative Rules; any purported rule not so adopted, for
11whatever reason, is unauthorized.
12(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
13100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
141-1-19; 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19; 101-81,
15eff. 7-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
16101-625, eff. 1-1-21.)
 
17    Section 45. The Illinois Public Aid Code is amended by
18changing Section 5-16.8 as follows:
 
19    (305 ILCS 5/5-16.8)
20    Sec. 5-16.8. Required health benefits. The medical
21assistance program shall (i) provide the post-mastectomy care
22benefits required to be covered by a policy of accident and
23health insurance under Section 356t and the coverage required
24under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26,

 

 

10200HB1779ham001- 17 -LRB102 10161 BMS 23338 a

1356z.29, 356z.32, 356z.33, 356z.34, and 356z.35, and 356z.43
2of the Illinois Insurance Code and (ii) be subject to the
3provisions of Sections 356z.19, 364.01, 370c, and 370c.1 of
4the Illinois Insurance Code.
5    The Department, by rule, shall adopt a model similar to
6the requirements of Section 356z.39 of the Illinois Insurance
7Code.
8    On and after July 1, 2012, the Department shall reduce any
9rate of reimbursement for services or other payments or alter
10any methodologies authorized by this Code to reduce any rate
11of reimbursement for services or other payments in accordance
12with Section 5-5e.
13    To ensure full access to the benefits set forth in this
14Section, on and after January 1, 2016, the Department shall
15ensure that provider and hospital reimbursement for
16post-mastectomy care benefits required under this Section are
17no lower than the Medicare reimbursement rate.
18(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18;
19100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff.
207-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371,
21eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)".