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92_SB1742
LRB9215768JStm
1 AN ACT concerning the immunization of children.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Childhood Immunization Insurance Act.
6 Section 5. Definitions. As used in this Act:
7 "Child immunizations" means immunizations, including the
8 immunizing agent (reimbursement for which shall not exceed
9 150% of the average wholesale price) which, as determined by
10 the Department of Public Health, conform with the standards
11 of the Advisory Committee on Immunization Practices of the
12 Centers for Disease Control of the United States Department
13 of Health and Human Services.
14 "Health insurance policy" means any individual or group
15 accident and health insurance policy, contract, or plan
16 (other than a specified-disease policy) that provides medical
17 coverage on an expense-incurred, service, or prepaid basis
18 and provides dependent coverage for children. The term
19 includes, but is not limited to, the following:
20 (1) an accident and health insurance policy issued
21 by a corporation organized under the Voluntary Health
22 Services Plans Act or by a company authorized to transact
23 business under the Illinois Insurance Code;
24 (2) a health care plan operated under the Health
25 Maintenance Organization Act; and
26 (3) an employee welfare benefit plan as defined in
27 Section 3 of the federal Employee Retirement Income
28 Security Act of 1974 (ERISA).
29 Section 10. Child immunizations. Except as provided in
30 Section 25, a health insurance policy that is delivered,
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1 issued for delivery, renewed, extended, or modified in this
2 State after the effective date of this Act must provide that
3 the health insurance benefits applicable under the policy
4 include coverage for child immunizations. A health insurance
5 policy must provide for coverage for medically necessary
6 booster doses of all immunizing agents used in child
7 immunizations.
8 Section 15. Delivery of policy. Except as provided in
9 Section 25, if a health insurance policy provides coverage or
10 benefits to a resident of this State, it shall be deemed to
11 be delivered in this State within the meaning of this Act,
12 regardless of whether the health care insurer issuing or
13 delivering the policy is located within or outside this
14 State.
15 Section 20. Copayments and deductibles.
16 (a) Benefits for child immunization services are subject
17 to copayment and coinsurance provisions of a health insurance
18 policy to the extent that other medical services covered by
19 the policy are subject to those provisions.
20 (b) Benefits for child immunization services are exempt
21 from deductible or dollar limit provisions in a health
22 insurance policy. This exemption must be explicitly provided
23 for in the policy.
24 Section 25. Exemption. Notwithstanding Sections 10 and
25 15, this Act shall not be construed to require a health
26 insurance policy to include coverage for child immunizations
27 for an individual who is a resident of this State if both of
28 the following apply:
29 (1) The individual is employed outside this State.
30 (2) The individual's employer maintains a health
31 insurance policy for the individual as an employment
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1 benefit.
2 Section 30. Rules. The Department of Public Health and
3 the Department of Insurance shall promulgate rules necessary
4 to implement this Act.
5 Section 35. Application of Act. This Act applies to all
6 group and individual policies of accident and health
7 insurance, subscriber contracts, and group insurance
8 certificates issued under any group master policy that are
9 amended, delivered, issued, or renewed after the effective
10 date of this Act.
11 Section 99. Effective date. This Act takes effect upon
12 becoming law.