Illinois General Assembly - Full Text of SB1344
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 SB1344  103rd General Assembly




State of Illinois
2023 and 2024


Introduced 2/6/2023, by Sen. Celina Villanueva


215 ILCS 5/356z.60

    Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in the State on or after (rather than only after) January 1, 2024 shall provide coverage for all abortifacients, hormonal therapy medication, human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis drugs approved by the United States Food and Drug Administration, and follow-up services related to that coverage. Effective immediately.

LRB103 28584 LNS 54965 b





SB1344LRB103 28584 LNS 54965 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 Illinois Insurance Code is amended by
5changing Section 356z.60 as follows:
6    (215 ILCS 5/356z.60)
7    Sec. 356z.60. Coverage for abortifacients, hormonal
8therapy, and human immunodeficiency virus pre-exposure
9prophylaxis and post-exposure prophylaxis.
10    (a) As used in this Section:
11    "Abortifacients" means any medication administered to
12terminate a pregnancy by a health care professional.
13    "Health care professional" means a physician licensed to
14practice medicine in all of its branches, licensed advanced
15practice registered nurse, or physician assistant.
16    "Hormonal therapy medication" means hormonal treatment
17administered to treat gender dysphoria.
18    "Therapeutic equivalent version" means drugs, devices, or
19products that can be expected to have the same clinical effect
20and safety profile when administered to patients under the
21conditions specified in the labeling and that satisfy the
22following general criteria:
23        (1) it is approved as safe and effective;



SB1344- 2 -LRB103 28584 LNS 54965 b

1        (2) it is a pharmaceutical equivalent in that it:
2            (A) contains identical amounts of the same active
3        drug ingredient in the same dosage form and route of
4        administration; and
5            (B) meets compendial or other applicable standards
6        of strength, quality, purity, and identity;
7        (3) it is bioequivalent in that:
8            (A) it does not present a known or potential
9        bioequivalence problem and it meets an acceptable in
10        vitro standard; or
11            (B) if it does present such a known or potential
12        problem, it is shown to meet an appropriate
13        bioequivalence standard;
14        (4) it is adequately labeled; and
15        (5) it is manufactured in compliance with Current Good
16    Manufacturing Practice regulations adopted by the United
17    States Food and Drug Administration.
18    (b) An individual or group policy of accident and health
19insurance amended, delivered, issued, or renewed in this State
20on or after January 1, 2024 shall provide coverage for all
21abortifacients, hormonal therapy medication, human
22immunodeficiency virus pre-exposure prophylaxis and
23post-exposure prophylaxis drugs approved by the United States
24Food and Drug Administration, and follow-up services related
25to that coverage, including, but not limited to, management of
26side effects, medication self-management or adherence



SB1344- 3 -LRB103 28584 LNS 54965 b

1counseling, risk reduction strategies, and mental health
3    (c) The coverage required under subsection (b) is subject
4to the following conditions:
5        (1) If the United States Food and Drug Administration
6    has approved one or more therapeutic equivalent versions
7    of an abortifacient drug, a policy is not required to
8    include all such therapeutic equivalent versions in its
9    formulary so long as at least one is included and covered
10    without cost sharing and in accordance with this Section.
11        (2) If an individual's attending provider recommends a
12    particular drug approved by the United States Food and
13    Drug Administration based on a determination of medical
14    necessity with respect to that individual, the plan or
15    issuer must defer to the determination of the attending
16    provider and must cover that service or item without cost
17    sharing.
18        (3) If a drug is not covered, plans and issuers must
19    have an easily accessible, transparent, and sufficiently
20    expedient process that is not unduly burdensome on the
21    individual or a provider or other individual acting as a
22    patient's authorized representative to ensure coverage
23    without cost sharing.
24    (d) Except as otherwise provided in this Section, a policy
25subject to this Section shall not impose a deductible,
26coinsurance, copayment, or any other cost-sharing requirement



SB1344- 4 -LRB103 28584 LNS 54965 b

1on the coverage provided. The provisions of this subsection do
2not apply to coverage of procedures to the extent such
3coverage would disqualify a high-deductible health plan from
4eligibility for a health savings account pursuant to the
5federal Internal Revenue Code, 26 U.S.C. 223.
6    (e) Except as otherwise authorized under this Section, a
7policy shall not impose any restrictions or delays on the
8coverage required under this Section.
9    (f) The coverage requirements in this Section for
10abortifacients do not, pursuant to 42 U.S.C. 18054(a)(6),
11apply to a multistate plan that does not provide coverage for
13    (g) If the Department concludes that enforcement of any
14coverage requirement of this Section for abortifacients may
15adversely affect the allocation of federal funds to this
16State, the Department may grant an exemption to that
17requirement, but only to the minimum extent necessary to
18ensure the continued receipt of federal funds.
19(Source: P.A. 102-1117, eff. 1-13-23.)
20    Section 99. Effective date. This Act takes effect upon
21becoming law.