Illinois 2023-2024 Regular Session

Illinois House Bill HB2445 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2445 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8 Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for basic fitness center membership costs for individuals 65 years of age and older. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code. LRB103 30341 BMS 56771 b STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2445 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8 Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for basic fitness center membership costs for individuals 65 years of age and older. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code. LRB103 30341 BMS 56771 b LRB103 30341 BMS 56771 b STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2445 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED:
3	3	5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8
4	4	5 ILCS 375/6.11
5	5	55 ILCS 5/5-1069.3
6	6	65 ILCS 5/10-4-2.3
7	7	105 ILCS 5/10-22.3f
8	8	215 ILCS 5/356z.61 new
9	9	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
10	10	215 ILCS 130/4003 from Ch. 73, par. 1504-3
11	11	215 ILCS 165/10 from Ch. 32, par. 604
12	12	305 ILCS 5/5-16.8
13	13	Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for basic fitness center membership costs for individuals 65 years of age and older. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.
14	14	LRB103 30341 BMS 56771 b LRB103 30341 BMS 56771 b
15	15	LRB103 30341 BMS 56771 b
16	16	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
17	17	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
18	18	A BILL FOR
19	19	HB2445LRB103 30341 BMS 56771 b HB2445 LRB103 30341 BMS 56771 b
20	20	HB2445 LRB103 30341 BMS 56771 b
21	21	1 AN ACT concerning regulation.
22	22	2 Be it enacted by the People of the State of Illinois,
23	23	3 represented in the General Assembly:
24	24	4 Section 5. The State Employees Group Insurance Act of 1971
25	25	5 is amended by changing Section 6.11 as follows:
26	26	6 (5 ILCS 375/6.11)
27	27	7 (Text of Section before amendment by P.A. 102-768)
28	28	8 Sec. 6.11. Required health benefits; Illinois Insurance
29	29	9 Code requirements. The program of health benefits shall
30	30	10 provide the post-mastectomy care benefits required to be
31	31	11 covered by a policy of accident and health insurance under
32	32	12 Section 356t of the Illinois Insurance Code. The program of
33	33	13 health benefits shall provide the coverage required under
34	34	14 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
35	35	15 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
36	36	16 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
37	37	17 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
38	38	18 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
39	39	19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
40	40	20 the Illinois Insurance Code. The program of health benefits
41	41	21 must comply with Sections 155.22a, 155.37, 355b, 356z.19,
42	42	22 370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
43	43	23 Code. The Department of Insurance shall enforce the
44	44
45	45
46	46
47	47	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB2445 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED:
48	48	5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 305 ILCS 5/5-16.8
49	49	5 ILCS 375/6.11
50	50	55 ILCS 5/5-1069.3
51	51	65 ILCS 5/10-4-2.3
52	52	105 ILCS 5/10-22.3f
53	53	215 ILCS 5/356z.61 new
54	54	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
55	55	215 ILCS 130/4003 from Ch. 73, par. 1504-3
56	56	215 ILCS 165/10 from Ch. 32, par. 604
57	57	305 ILCS 5/5-16.8
58	58	Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for basic fitness center membership costs for individuals 65 years of age and older. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.
59	59	LRB103 30341 BMS 56771 b LRB103 30341 BMS 56771 b
60	60	LRB103 30341 BMS 56771 b
61	61	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
62	62	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
63	63	A BILL FOR
64	64
65	65
66	66
67	67
68	68
69	69	5 ILCS 375/6.11
70	70	55 ILCS 5/5-1069.3
71	71	65 ILCS 5/10-4-2.3
72	72	105 ILCS 5/10-22.3f
73	73	215 ILCS 5/356z.61 new
74	74	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
75	75	215 ILCS 130/4003 from Ch. 73, par. 1504-3
76	76	215 ILCS 165/10 from Ch. 32, par. 604
77	77	305 ILCS 5/5-16.8
78	78
79	79
80	80
81	81	LRB103 30341 BMS 56771 b
82	82
83	83	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
84	84
85	85
86	86
87	87
88	88
89	89
90	90
91	91
92	92
93	93
94	94
95	95	HB2445 LRB103 30341 BMS 56771 b
96	96
97	97
98	98	HB2445- 2 -LRB103 30341 BMS 56771 b HB2445 - 2 - LRB103 30341 BMS 56771 b
99	99	HB2445 - 2 - LRB103 30341 BMS 56771 b
100	100	1 requirements of this Section with respect to Sections 370c and
101	101	2 370c.1 of the Illinois Insurance Code; all other requirements
102	102	3 of this Section shall be enforced by the Department of Central
103	103	4 Management Services.
104	104	5 Rulemaking authority to implement Public Act 95-1045, if
105	105	6 any, is conditioned on the rules being adopted in accordance
106	106	7 with all provisions of the Illinois Administrative Procedure
107	107	8 Act and all rules and procedures of the Joint Committee on
108	108	9 Administrative Rules; any purported rule not so adopted, for
109	109	10 whatever reason, is unauthorized.
110	110	11 (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
111	111	12 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
112	112	13 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
113	113	14 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
114	114	15 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
115	115	16 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
116	116	17 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
117	117	18 revised 12-13-22.)
118	118	19 (Text of Section after amendment by P.A. 102-768)
119	119	20 Sec. 6.11. Required health benefits; Illinois Insurance
120	120	21 Code requirements. The program of health benefits shall
121	121	22 provide the post-mastectomy care benefits required to be
122	122	23 covered by a policy of accident and health insurance under
123	123	24 Section 356t of the Illinois Insurance Code. The program of
124	124	25 health benefits shall provide the coverage required under
125	125
126	126
127	127
128	128
129	129
130	130	HB2445 - 2 - LRB103 30341 BMS 56771 b
131	131
132	132
133	133	HB2445- 3 -LRB103 30341 BMS 56771 b HB2445 - 3 - LRB103 30341 BMS 56771 b
134	134	HB2445 - 3 - LRB103 30341 BMS 56771 b
135	135	1 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
136	136	2 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
137	137	3 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
138	138	4 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
139	139	5 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
140	140	6 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
141	141	7 356z.60, and 356z.61 of the Illinois Insurance Code. The
142	142	8 program of health benefits must comply with Sections 155.22a,
143	143	9 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
144	144	10 the Illinois Insurance Code. The Department of Insurance shall
145	145	11 enforce the requirements of this Section with respect to
146	146	12 Sections 370c and 370c.1 of the Illinois Insurance Code; all
147	147	13 other requirements of this Section shall be enforced by the
148	148	14 Department of Central Management Services.
149	149	15 Rulemaking authority to implement Public Act 95-1045, if
150	150	16 any, is conditioned on the rules being adopted in accordance
151	151	17 with all provisions of the Illinois Administrative Procedure
152	152	18 Act and all rules and procedures of the Joint Committee on
153	153	19 Administrative Rules; any purported rule not so adopted, for
154	154	20 whatever reason, is unauthorized.
155	155	21 (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
156	156	22 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
157	157	23 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
158	158	24 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
159	159	25 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
160	160	26 1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
161	161
162	162
163	163
164	164
165	165
166	166	HB2445 - 3 - LRB103 30341 BMS 56771 b
167	167
168	168
169	169	HB2445- 4 -LRB103 30341 BMS 56771 b HB2445 - 4 - LRB103 30341 BMS 56771 b
170	170	HB2445 - 4 - LRB103 30341 BMS 56771 b
171	171	1 eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
172	172	2 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
173	173	3 Section 10. The Counties Code is amended by changing
174	174	4 Section 5-1069.3 as follows:
175	175	5 (55 ILCS 5/5-1069.3)
176	176	6 Sec. 5-1069.3. Required health benefits. If a county,
177	177	7 including a home rule county, is a self-insurer for purposes
178	178	8 of providing health insurance coverage for its employees, the
179	179	9 coverage shall include coverage for the post-mastectomy care
180	180	10 benefits required to be covered by a policy of accident and
181	181	11 health insurance under Section 356t and the coverage required
182	182	12 under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
183	183	13 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
184	184	14 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
185	185	15 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
186	186	16 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
187	187	17 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
188	188	18 of the Illinois Insurance Code. The coverage shall comply with
189	189	19 Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
190	190	20 Insurance Code. The Department of Insurance shall enforce the
191	191	21 requirements of this Section. The requirement that health
192	192	22 benefits be covered as provided in this Section is an
193	193	23 exclusive power and function of the State and is a denial and
194	194	24 limitation under Article VII, Section 6, subsection (h) of the
195	195
196	196
197	197
198	198
199	199
200	200	HB2445 - 4 - LRB103 30341 BMS 56771 b
201	201
202	202
203	203	HB2445- 5 -LRB103 30341 BMS 56771 b HB2445 - 5 - LRB103 30341 BMS 56771 b
204	204	HB2445 - 5 - LRB103 30341 BMS 56771 b
205	205	1 Illinois Constitution. A home rule county to which this
206	206	2 Section applies must comply with every provision of this
207	207	3 Section.
208	208	4 Rulemaking authority to implement Public Act 95-1045, if
209	209	5 any, is conditioned on the rules being adopted in accordance
210	210	6 with all provisions of the Illinois Administrative Procedure
211	211	7 Act and all rules and procedures of the Joint Committee on
212	212	8 Administrative Rules; any purported rule not so adopted, for
213	213	9 whatever reason, is unauthorized.
214	214	10 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
215	215	11 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
216	216	12 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
217	217	13 eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
218	218	14 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
219	219	15 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
220	220	16 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
221	221	17 102-1117, eff. 1-13-23.)
222	222	18 Section 15. The Illinois Municipal Code is amended by
223	223	19 changing Section 10-4-2.3 as follows:
224	224	20 (65 ILCS 5/10-4-2.3)
225	225	21 Sec. 10-4-2.3. Required health benefits. If a
226	226	22 municipality, including a home rule municipality, is a
227	227	23 self-insurer for purposes of providing health insurance
228	228	24 coverage for its employees, the coverage shall include
229	229
230	230
231	231
232	232
233	233
234	234	HB2445 - 5 - LRB103 30341 BMS 56771 b
235	235
236	236
237	237	HB2445- 6 -LRB103 30341 BMS 56771 b HB2445 - 6 - LRB103 30341 BMS 56771 b
238	238	HB2445 - 6 - LRB103 30341 BMS 56771 b
239	239	1 coverage for the post-mastectomy care benefits required to be
240	240	2 covered by a policy of accident and health insurance under
241	241	3 Section 356t and the coverage required under Sections 356g,
242	242	4 356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
243	243	5 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
244	244	6 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
245	245	7 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
246	246	8 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
247	247	9 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
248	248	10 Illinois Insurance Code. The coverage shall comply with
249	249	11 Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
250	250	12 Insurance Code. The Department of Insurance shall enforce the
251	251	13 requirements of this Section. The requirement that health
252	252	14 benefits be covered as provided in this is an exclusive power
253	253	15 and function of the State and is a denial and limitation under
254	254	16 Article VII, Section 6, subsection (h) of the Illinois
255	255	17 Constitution. A home rule municipality to which this Section
256	256	18 applies must comply with every provision of this Section.
257	257	19 Rulemaking authority to implement Public Act 95-1045, if
258	258	20 any, is conditioned on the rules being adopted in accordance
259	259	21 with all provisions of the Illinois Administrative Procedure
260	260	22 Act and all rules and procedures of the Joint Committee on
261	261	23 Administrative Rules; any purported rule not so adopted, for
262	262	24 whatever reason, is unauthorized.
263	263	25 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
264	264	26 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
265	265
266	266
267	267
268	268
269	269
270	270	HB2445 - 6 - LRB103 30341 BMS 56771 b
271	271
272	272
273	273	HB2445- 7 -LRB103 30341 BMS 56771 b HB2445 - 7 - LRB103 30341 BMS 56771 b
274	274	HB2445 - 7 - LRB103 30341 BMS 56771 b
275	275	1 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
276	276	2 eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
277	277	3 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
278	278	4 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
279	279	5 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
280	280	6 102-1117, eff. 1-13-23.)
281	281	7 Section 20. The School Code is amended by changing Section
282	282	8 10-22.3f as follows:
283	283	9 (105 ILCS 5/10-22.3f)
284	284	10 Sec. 10-22.3f. Required health benefits. Insurance
285	285	11 protection and benefits for employees shall provide the
286	286	12 post-mastectomy care benefits required to be covered by a
287	287	13 policy of accident and health insurance under Section 356t and
288	288	14 the coverage required under Sections 356g, 356g.5, 356g.5-1,
289	289	15 356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
290	290	16 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
291	291	17 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
292	292	18 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
293	293	19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
294	294	20 356z.61 of the Illinois Insurance Code. Insurance policies
295	295	21 shall comply with Section 356z.19 of the Illinois Insurance
296	296	22 Code. The coverage shall comply with Sections 155.22a, 355b,
297	297	23 and 370c of the Illinois Insurance Code. The Department of
298	298	24 Insurance shall enforce the requirements of this Section.
299	299
300	300
301	301
302	302
303	303
304	304	HB2445 - 7 - LRB103 30341 BMS 56771 b
305	305
306	306
307	307	HB2445- 8 -LRB103 30341 BMS 56771 b HB2445 - 8 - LRB103 30341 BMS 56771 b
308	308	HB2445 - 8 - LRB103 30341 BMS 56771 b
309	309	1 Rulemaking authority to implement Public Act 95-1045, if
310	310	2 any, is conditioned on the rules being adopted in accordance
311	311	3 with all provisions of the Illinois Administrative Procedure
312	312	4 Act and all rules and procedures of the Joint Committee on
313	313	5 Administrative Rules; any purported rule not so adopted, for
314	314	6 whatever reason, is unauthorized.
315	315	7 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
316	316	8 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
317	317	9 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
318	318	10 eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
319	319	11 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
320	320	12 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
321	321	13 eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
322	322	14 Section 25. The Illinois Insurance Code is amended by
323	323	15 adding Section 356z.61 as follows:
324	324	16 (215 ILCS 5/356z.61 new)
325	325	17 Sec. 356z.61. Senior fitness membership coverage. A group
326	326	18 or individual policy of accident and health insurance or a
327	327	19 managed care plan that is amended, delivered, issued, or
328	328	20 renewed on or after the effective date of this amendatory Act
329	329	21 of the 103rd General Assembly shall provide coverage for basic
330	330	22 fitness center membership costs for individuals 65 years of
331	331	23 age and older.
332	332
333	333
334	334
335	335
336	336
337	337	HB2445 - 8 - LRB103 30341 BMS 56771 b
338	338
339	339
340	340	HB2445- 9 -LRB103 30341 BMS 56771 b HB2445 - 9 - LRB103 30341 BMS 56771 b
341	341	HB2445 - 9 - LRB103 30341 BMS 56771 b
342	342	1 Section 30. The Health Maintenance Organization Act is
343	343	2 amended by changing Section 5-3 as follows:
344	344	3 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
345	345	4 Sec. 5-3. Insurance Code provisions.
346	346	5 (a) Health Maintenance Organizations shall be subject to
347	347	6 the provisions of Sections 133, 134, 136, 137, 139, 140,
348	348	7 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
349	349	8 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
350	350	9 355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
351	351	10 356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
352	352	11 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
353	353	12 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
354	354	13 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
355	355	14 356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
356	356	15 356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
357	357	16 356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
358	358	17 367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
359	359	18 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
360	360	19 paragraph (c) of subsection (2) of Section 367, and Articles
361	361	20 IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
362	362	21 XXXIIB of the Illinois Insurance Code.
363	363	22 (b) For purposes of the Illinois Insurance Code, except
364	364	23 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
365	365	24 Health Maintenance Organizations in the following categories
366	366	25 are deemed to be "domestic companies":
367	367
368	368
369	369
370	370
371	371
372	372	HB2445 - 9 - LRB103 30341 BMS 56771 b
373	373
374	374
375	375	HB2445- 10 -LRB103 30341 BMS 56771 b HB2445 - 10 - LRB103 30341 BMS 56771 b
376	376	HB2445 - 10 - LRB103 30341 BMS 56771 b
377	377	1 (1) a corporation authorized under the Dental Service
378	378	2 Plan Act or the Voluntary Health Services Plans Act;
379	379	3 (2) a corporation organized under the laws of this
380	380	4 State; or
381	381	5 (3) a corporation organized under the laws of another
382	382	6 state, 30% or more of the enrollees of which are residents
383	383	7 of this State, except a corporation subject to
384	384	8 substantially the same requirements in its state of
385	385	9 organization as is a "domestic company" under Article VIII
386	386	10 1/2 of the Illinois Insurance Code.
387	387	11 (c) In considering the merger, consolidation, or other
388	388	12 acquisition of control of a Health Maintenance Organization
389	389	13 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
390	390	14 (1) the Director shall give primary consideration to
391	391	15 the continuation of benefits to enrollees and the
392	392	16 financial conditions of the acquired Health Maintenance
393	393	17 Organization after the merger, consolidation, or other
394	394	18 acquisition of control takes effect;
395	395	19 (2)(i) the criteria specified in subsection (1)(b) of
396	396	20 Section 131.8 of the Illinois Insurance Code shall not
397	397	21 apply and (ii) the Director, in making his determination
398	398	22 with respect to the merger, consolidation, or other
399	399	23 acquisition of control, need not take into account the
400	400	24 effect on competition of the merger, consolidation, or
401	401	25 other acquisition of control;
402	402	26 (3) the Director shall have the power to require the
403	403
404	404
405	405
406	406
407	407
408	408	HB2445 - 10 - LRB103 30341 BMS 56771 b
409	409
410	410
411	411	HB2445- 11 -LRB103 30341 BMS 56771 b HB2445 - 11 - LRB103 30341 BMS 56771 b
412	412	HB2445 - 11 - LRB103 30341 BMS 56771 b
413	413	1 following information:
414	414	2 (A) certification by an independent actuary of the
415	415	3 adequacy of the reserves of the Health Maintenance
416	416	4 Organization sought to be acquired;
417	417	5 (B) pro forma financial statements reflecting the
418	418	6 combined balance sheets of the acquiring company and
419	419	7 the Health Maintenance Organization sought to be
420	420	8 acquired as of the end of the preceding year and as of
421	421	9 a date 90 days prior to the acquisition, as well as pro
422	422	10 forma financial statements reflecting projected
423	423	11 combined operation for a period of 2 years;
424	424	12 (C) a pro forma business plan detailing an
425	425	13 acquiring party's plans with respect to the operation
426	426	14 of the Health Maintenance Organization sought to be
427	427	15 acquired for a period of not less than 3 years; and
428	428	16 (D) such other information as the Director shall
429	429	17 require.
430	430	18 (d) The provisions of Article VIII 1/2 of the Illinois
431	431	19 Insurance Code and this Section 5-3 shall apply to the sale by
432	432	20 any health maintenance organization of greater than 10% of its
433	433	21 enrollee population (including without limitation the health
434	434	22 maintenance organization's right, title, and interest in and
435	435	23 to its health care certificates).
436	436	24 (e) In considering any management contract or service
437	437	25 agreement subject to Section 141.1 of the Illinois Insurance
438	438	26 Code, the Director (i) shall, in addition to the criteria
439	439
440	440
441	441
442	442
443	443
444	444	HB2445 - 11 - LRB103 30341 BMS 56771 b
445	445
446	446
447	447	HB2445- 12 -LRB103 30341 BMS 56771 b HB2445 - 12 - LRB103 30341 BMS 56771 b
448	448	HB2445 - 12 - LRB103 30341 BMS 56771 b
449	449	1 specified in Section 141.2 of the Illinois Insurance Code,
450	450	2 take into account the effect of the management contract or
451	451	3 service agreement on the continuation of benefits to enrollees
452	452	4 and the financial condition of the health maintenance
453	453	5 organization to be managed or serviced, and (ii) need not take
454	454	6 into account the effect of the management contract or service
455	455	7 agreement on competition.
456	456	8 (f) Except for small employer groups as defined in the
457	457	9 Small Employer Rating, Renewability and Portability Health
458	458	10 Insurance Act and except for medicare supplement policies as
459	459	11 defined in Section 363 of the Illinois Insurance Code, a
460	460	12 Health Maintenance Organization may by contract agree with a
461	461	13 group or other enrollment unit to effect refunds or charge
462	462	14 additional premiums under the following terms and conditions:
463	463	15 (i) the amount of, and other terms and conditions with
464	464	16 respect to, the refund or additional premium are set forth
465	465	17 in the group or enrollment unit contract agreed in advance
466	466	18 of the period for which a refund is to be paid or
467	467	19 additional premium is to be charged (which period shall
468	468	20 not be less than one year); and
469	469	21 (ii) the amount of the refund or additional premium
470	470	22 shall not exceed 20% of the Health Maintenance
471	471	23 Organization's profitable or unprofitable experience with
472	472	24 respect to the group or other enrollment unit for the
473	473	25 period (and, for purposes of a refund or additional
474	474	26 premium, the profitable or unprofitable experience shall
475	475
476	476
477	477
478	478
479	479
480	480	HB2445 - 12 - LRB103 30341 BMS 56771 b
481	481
482	482
483	483	HB2445- 13 -LRB103 30341 BMS 56771 b HB2445 - 13 - LRB103 30341 BMS 56771 b
484	484	HB2445 - 13 - LRB103 30341 BMS 56771 b
485	485	1 be calculated taking into account a pro rata share of the
486	486	2 Health Maintenance Organization's administrative and
487	487	3 marketing expenses, but shall not include any refund to be
488	488	4 made or additional premium to be paid pursuant to this
489	489	5 subsection (f)). The Health Maintenance Organization and
490	490	6 the group or enrollment unit may agree that the profitable
491	491	7 or unprofitable experience may be calculated taking into
492	492	8 account the refund period and the immediately preceding 2
493	493	9 plan years.
494	494	10 The Health Maintenance Organization shall include a
495	495	11 statement in the evidence of coverage issued to each enrollee
496	496	12 describing the possibility of a refund or additional premium,
497	497	13 and upon request of any group or enrollment unit, provide to
498	498	14 the group or enrollment unit a description of the method used
499	499	15 to calculate (1) the Health Maintenance Organization's
500	500	16 profitable experience with respect to the group or enrollment
501	501	17 unit and the resulting refund to the group or enrollment unit
502	502	18 or (2) the Health Maintenance Organization's unprofitable
503	503	19 experience with respect to the group or enrollment unit and
504	504	20 the resulting additional premium to be paid by the group or
505	505	21 enrollment unit.
506	506	22 In no event shall the Illinois Health Maintenance
507	507	23 Organization Guaranty Association be liable to pay any
508	508	24 contractual obligation of an insolvent organization to pay any
509	509	25 refund authorized under this Section.
510	510	26 (g) Rulemaking authority to implement Public Act 95-1045,
511	511
512	512
513	513
514	514
515	515
516	516	HB2445 - 13 - LRB103 30341 BMS 56771 b
517	517
518	518
519	519	HB2445- 14 -LRB103 30341 BMS 56771 b HB2445 - 14 - LRB103 30341 BMS 56771 b
520	520	HB2445 - 14 - LRB103 30341 BMS 56771 b
521	521	1 if any, is conditioned on the rules being adopted in
522	522	2 accordance with all provisions of the Illinois Administrative
523	523	3 Procedure Act and all rules and procedures of the Joint
524	524	4 Committee on Administrative Rules; any purported rule not so
525	525	5 adopted, for whatever reason, is unauthorized.
526	526	6 (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
527	527	7 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
528	528	8 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
529	529	9 eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
530	530	10 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
531	531	11 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
532	532	12 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
533	533	13 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
534	534	14 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
535	535	15 eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
536	536	16 Section 35. The Limited Health Service Organization Act is
537	537	17 amended by changing Section 4003 as follows:
538	538	18 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
539	539	19 Sec. 4003. Illinois Insurance Code provisions. Limited
540	540	20 health service organizations shall be subject to the
541	541	21 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
542	542	22 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
543	543	23 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
544	544	24 355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
545	545
546	546
547	547
548	548
549	549
550	550	HB2445 - 14 - LRB103 30341 BMS 56771 b
551	551
552	552
553	553	HB2445- 15 -LRB103 30341 BMS 56771 b HB2445 - 15 - LRB103 30341 BMS 56771 b
554	554	HB2445 - 15 - LRB103 30341 BMS 56771 b
555	555	1 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
556	556	2 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
557	557	3 356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
558	558	4 408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
559	559	5 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
560	560	6 Illinois Insurance Code. Nothing in this Section shall require
561	561	7 a limited health care plan to cover any service that is not a
562	562	8 limited health service. For purposes of the Illinois Insurance
563	563	9 Code, except for Sections 444 and 444.1 and Articles XIII and
564	564	10 XIII 1/2, limited health service organizations in the
565	565	11 following categories are deemed to be domestic companies:
566	566	12 (1) a corporation under the laws of this State; or
567	567	13 (2) a corporation organized under the laws of another
568	568	14 state, 30% or more of the enrollees of which are residents
569	569	15 of this State, except a corporation subject to
570	570	16 substantially the same requirements in its state of
571	571	17 organization as is a domestic company under Article VIII
572	572	18 1/2 of the Illinois Insurance Code.
573	573	19 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
574	574	20 101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
575	575	21 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
576	576	22 eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
577	577	23 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
578	578	24 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
579	579	25 Section 40. The Voluntary Health Services Plans Act is
580	580
581	581
582	582
583	583
584	584
585	585	HB2445 - 15 - LRB103 30341 BMS 56771 b
586	586
587	587
588	588	HB2445- 16 -LRB103 30341 BMS 56771 b HB2445 - 16 - LRB103 30341 BMS 56771 b
589	589	HB2445 - 16 - LRB103 30341 BMS 56771 b
590	590	1 amended by changing Section 10 as follows:
591	591	2 (215 ILCS 165/10) (from Ch. 32, par. 604)
592	592	3 Sec. 10. Application of Insurance Code provisions. Health
593	593	4 services plan corporations and all persons interested therein
594	594	5 or dealing therewith shall be subject to the provisions of
595	595	6 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
596	596	7 143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
597	597	8 356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
598	598	9 356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
599	599	10 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
600	600	11 356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
601	601	12 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
602	602	13 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
603	603	14 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
604	604	15 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
605	605	16 and paragraphs (7) and (15) of Section 367 of the Illinois
606	606	17 Insurance Code.
607	607	18 Rulemaking authority to implement Public Act 95-1045, if
608	608	19 any, is conditioned on the rules being adopted in accordance
609	609	20 with all provisions of the Illinois Administrative Procedure
610	610	21 Act and all rules and procedures of the Joint Committee on
611	611	22 Administrative Rules; any purported rule not so adopted, for
612	612	23 whatever reason, is unauthorized.
613	613	24 (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
614	614	25 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
615	615
616	616
617	617
618	618
619	619
620	620	HB2445 - 16 - LRB103 30341 BMS 56771 b
621	621
622	622
623	623	HB2445- 17 -LRB103 30341 BMS 56771 b HB2445 - 17 - LRB103 30341 BMS 56771 b
624	624	HB2445 - 17 - LRB103 30341 BMS 56771 b
625	625	1 1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
626	626	2 eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
627	627	3 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
628	628	4 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
629	629	5 eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
630	630	6 102-1117, eff. 1-13-23.)
631	631	7 Section 45. The Illinois Public Aid Code is amended by
632	632	8 changing Section 5-16.8 as follows:
633	633	9 (305 ILCS 5/5-16.8)
634	634	10 Sec. 5-16.8. Required health benefits. The medical
635	635	11 assistance program shall (i) provide the post-mastectomy care
636	636	12 benefits required to be covered by a policy of accident and
637	637	13 health insurance under Section 356t and the coverage required
638	638	14 under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
639	639	15 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
640	640	16 356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and
641	641	17 356z.61 of the Illinois Insurance Code, (ii) be subject to the
642	642	18 provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
643	643	19 370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
644	644	20 subject to the provisions of subsection (d-5) of Section 10 of
645	645	21 the Network Adequacy and Transparency Act.
646	646	22 The Department, by rule, shall adopt a model similar to
647	647	23 the requirements of Section 356z.39 of the Illinois Insurance
648	648	24 Code.
649	649
650	650
651	651
652	652
653	653
654	654	HB2445 - 17 - LRB103 30341 BMS 56771 b
655	655
656	656
657	657	HB2445- 18 -LRB103 30341 BMS 56771 b HB2445 - 18 - LRB103 30341 BMS 56771 b
658	658	HB2445 - 18 - LRB103 30341 BMS 56771 b
659	659	1 On and after July 1, 2012, the Department shall reduce any
660	660	2 rate of reimbursement for services or other payments or alter
661	661	3 any methodologies authorized by this Code to reduce any rate
662	662	4 of reimbursement for services or other payments in accordance
663	663	5 with Section 5-5e.
664	664	6 To ensure full access to the benefits set forth in this
665	665	7 Section, on and after January 1, 2016, the Department shall
666	666	8 ensure that provider and hospital reimbursement for
667	667	9 post-mastectomy care benefits required under this Section are
668	668	10 no lower than the Medicare reimbursement rate.
669	669	11 (Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
670	670	12 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
671	671	13 1-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
672	672	14 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
673	673	15 102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
674	674	16 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
675	675	17 eff. 1-1-23; 102-1117, eff. 1-13-23.)
676	676	18 Section 95. No acceleration or delay. Where this Act makes
677	677	19 changes in a statute that is represented in this Act by text
678	678	20 that is not yet or no longer in effect (for example, a Section
679	679	21 represented by multiple versions), the use of that text does
680	680	22 not accelerate or delay the taking effect of (i) the changes
681	681	23 made by this Act or (ii) provisions derived from any other
682	682	24 Public Act.
683	683
684	684
685	685
686	686
687	687
688	688	HB2445 - 18 - LRB103 30341 BMS 56771 b