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


Sen. Mattie Hunter

Filed: 3/4/2024





10300SB3203sam001LRB103 37942 RPS 70305 a


2    AMENDMENT NO. ______. Amend Senate Bill 3203 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, 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,



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1356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
2356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59,
3356z.60, and 356z.61, and 356z.62, 356z.64, 356z.67, 356z.68,
4and 356z.70 of the Illinois Insurance Code. The program of
5health benefits must comply with Sections 155.22a, 155.37,
6355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the
7Illinois Insurance Code. The program of health benefits shall
8provide the coverage required under Section 356m of the
9Illinois Insurance Code and, for the employees of the State
10Employee Group Insurance Program only, the coverage as also
11provided in Section 6.11B of this Act. The Department of
12Insurance shall enforce the requirements of this Section with
13respect to Sections 370c and 370c.1 of the Illinois Insurance
14Code; all other requirements of this Section shall be enforced
15by the Department of Central Management Services.
16    Rulemaking authority to implement Public Act 95-1045, if
17any, is conditioned on the rules being adopted in accordance
18with all provisions of the Illinois Administrative Procedure
19Act and all rules and procedures of the Joint Committee on
20Administrative Rules; any purported rule not so adopted, for
21whatever reason, is unauthorized.
22(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
23102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
241-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768,
25eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
26102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.



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11-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84,
2eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24;
3103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff.
48-11-23; revised 8-29-23.)
5    Section 10. The Illinois Insurance Code is amended by
6changing Section 356z.5 as follows:
7    (215 ILCS 5/356z.5)
8    Sec. 356z.5. Prescription inhalants.
9    (a) In this Section, "prescription inhaler" means a
10prescribed medical device that delivers inhaled medications
11used to treat breathing for persons suffering from asthma or
12other life-threatening bronchial ailments. "Prescription
13inhaler" includes metered-dose inhalers, nebulizers, and dry
14powder inhalers. "Prescription inhaler" does not include
15inhalers available over the counter without a prescription to
16provide temporary relief from respiratory symptoms.
17    (b) A group or individual policy of accident and health
18insurance or managed care plan amended, delivered, issued, or
19renewed through December 31, 2025 after the effective date of
20this amendatory Act of the 93rd General Assembly that provides
21coverage for prescription drugs may not deny or limit coverage
22for prescription inhalers inhalants to enable persons to
23breathe when suffering from asthma or other life-threatening
24bronchial ailments based upon any restriction on the number of



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1days before an inhaler refill may be obtained if, contrary to
2those restrictions, the inhalants have been ordered or
3prescribed by the treating physician and are medically
5    (c) A group or individual policy of accident and health
6insurance or managed care plan amended, delivered, issued, or
7renewed on or after January 1, 2026 that provides coverage for
8prescription drugs may not deny or limit, except as otherwise
9provided in this subsection, coverage for prescription
10inhalers to enable persons to breathe when suffering from
11asthma or other life-threatening bronchial ailments based upon
12any restriction on the number of days before an inhaler refill
13may be obtained if, contrary to those restrictions, the
14inhalants have been ordered or prescribed by the treating
15physician and are medically appropriate. A group or individual
16policy of accident and health insurance or managed care plan
17subject to this subsection shall limit the total amount that a
18covered person is required to pay for a covered prescription
19inhaler to an amount not to exceed $25 dollars per 30-day
21    (d) Nothing in this Section prevents a group or individual
22policy of accident and health insurance or managed care plan
23from reducing a covered person's cost sharing to an amount
24less than the amount specified in subsection (c).
25    (e) Coverage for prescription inhalers shall not be
26subject to any deductible; except that this provision does not



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1apply to the extent such coverage would disqualify a
2high-deductible health plan from eligibility for a health
3savings account pursuant to Section 223 of the Internal
4Revenue Code (26 U.S.C. 223).
5    (f) The Department may adopt rules necessary to implement
6and administer this Section and to align with federal
7requirements. The Department may use any of its enforcement
8powers to obtain a group or individual policy of accident and
9health insurance's or managed care plan's compliance with this
11(Source: P.A. 95-331, eff. 8-21-07.)".