Illinois 2023-2024 Regular Session

Illinois House Bill HB2499 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Public Act 103-0649
2	1		HB2499 EnrolledLRB103 30875 AMQ 57395 b HB2499 Enrolled LRB103 30875 AMQ 57395 b
3	2		HB2499 Enrolled LRB103 30875 AMQ 57395 b
4		-	AN ACT concerning regulation.
5		-	Be it enacted by the People of the State of Illinois,
6		-	represented in the General Assembly:
7		-	Section 5. The Illinois Insurance Code is amended by
8		-	changing Sections 121-2.05, 356z.18, 367.3, 367a, and 368f and
9		-	by adding Section 352c as follows:
10		-	(215 ILCS 5/121-2.05) (from Ch. 73, par. 733-2.05)
11		-	Sec. 121-2.05. Group insurance policies issued and
12		-	delivered in other State-Transactions in this State. With the
13		-	exception of insurance transactions authorized under Sections
14		-	230.2 or 367.3 of this Code or transactions described under
15		-	Section 352c, transactions in this State involving group
16		-	legal, group life and group accident and health or blanket
17		-	accident and health insurance or group annuities where the
18		-	master policy of such groups was lawfully issued and delivered
19		-	in, and under the laws of, a State in which the insurer was
20		-	authorized to do an insurance business, to a group properly
21		-	established pursuant to law or regulation, and where the
22		-	policyholder is domiciled or otherwise has a bona fide situs.
23		-	(Source: P.A. 86-753.)
24		-	(215 ILCS 5/352c new)
25		-	Sec. 352c. Short-term, limited-duration insurance
	3	+	1 AN ACT concerning regulation.
	4	+	2 Be it enacted by the People of the State of Illinois,
	5	+	3 represented in the General Assembly:
	6	+	4 Section 5. The Illinois Insurance Code is amended by
	7	+	5 changing Sections 121-2.05, 356z.18, 367.3, 367a, and 368f and
	8	+	6 by adding Section 352c as follows:
	9	+	7 (215 ILCS 5/121-2.05) (from Ch. 73, par. 733-2.05)
	10	+	8 Sec. 121-2.05. Group insurance policies issued and
	11	+	9 delivered in other State-Transactions in this State. With the
	12	+	10 exception of insurance transactions authorized under Sections
	13	+	11 230.2 or 367.3 of this Code or transactions described under
	14	+	12 Section 352c, transactions in this State involving group
	15	+	13 legal, group life and group accident and health or blanket
	16	+	14 accident and health insurance or group annuities where the
	17	+	15 master policy of such groups was lawfully issued and delivered
	18	+	16 in, and under the laws of, a State in which the insurer was
	19	+	17 authorized to do an insurance business, to a group properly
	20	+	18 established pursuant to law or regulation, and where the
	21	+	19 policyholder is domiciled or otherwise has a bona fide situs.
	22	+	20 (Source: P.A. 86-753.)
	23	+	21 (215 ILCS 5/352c new)
	24	+	22 Sec. 352c. Short-term, limited-duration insurance
26	25
27	26
28	27
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30	29
31	30
32		-	prohibited.
33		-	(a) In this Section:
34		-	"Excepted benefits" has the meaning given to that term in
35		-	42 U.S.C. 300gg-91 and implementing regulations. "Excepted
36		-	benefits" includes individual, group, or blanket coverage.
37		-	"Short-term, limited-duration insurance" means any type of
38		-	accident and health insurance offered or provided within this
39		-	State pursuant to a group or individual policy or individual
40		-	certificate by a company, regardless of the situs state of the
41		-	delivery of the policy, that has an expiration date specified
42		-	in the contract that is fewer than 365 days after the original
43		-	effective date. Regardless of the duration of coverage,
44		-	"short-term, limited-duration insurance" does not include
45		-	excepted benefits or any student health insurance coverage.
46		-	(b) On and after January 1, 2025, no company shall issue,
47		-	deliver, amend, or renew short-term, limited-duration
48		-	insurance to any natural or legal person that is a resident or
49		-	domiciled in this State.
50		-	(215 ILCS 5/356z.18)
51		-	(Text of Section before amendment by P.A. 103-512)
52		-	Sec. 356z.18. Prosthetic and customized orthotic devices.
53		-	(a) For the purposes of this Section:
54		-	"Customized orthotic device" means a supportive device for
55		-	the body or a part of the body, the head, neck, or extremities,
56		-	and includes the replacement or repair of the device based on
	31	+	HB2499 Enrolled- 2 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 2 - LRB103 30875 AMQ 57395 b
	32	+	HB2499 Enrolled - 2 - LRB103 30875 AMQ 57395 b
	33	+	1 prohibited.
	34	+	2 (a) In this Section:
	35	+	3 "Excepted benefits" has the meaning given to that term in
	36	+	4 42 U.S.C. 300gg-91 and implementing regulations. "Excepted
	37	+	5 benefits" includes individual, group, or blanket coverage.
	38	+	6 "Short-term, limited-duration insurance" means any type of
	39	+	7 accident and health insurance offered or provided within this
	40	+	8 State pursuant to a group or individual policy or individual
	41	+	9 certificate by a company, regardless of the situs state of the
	42	+	10 delivery of the policy, that has an expiration date specified
	43	+	11 in the contract that is fewer than 365 days after the original
	44	+	12 effective date. Regardless of the duration of coverage,
	45	+	13 "short-term, limited-duration insurance" does not include
	46	+	14 excepted benefits or any student health insurance coverage.
	47	+	15 (b) On and after January 1, 2025, no company shall issue,
	48	+	16 deliver, amend, or renew short-term, limited-duration
	49	+	17 insurance to any natural or legal person that is a resident or
	50	+	18 domiciled in this State.
	51	+	19 (215 ILCS 5/356z.18)
	52	+	20 (Text of Section before amendment by P.A. 103-512)
	53	+	21 Sec. 356z.18. Prosthetic and customized orthotic devices.
	54	+	22 (a) For the purposes of this Section:
	55	+	23 "Customized orthotic device" means a supportive device for
	56	+	24 the body or a part of the body, the head, neck, or extremities,
	57	+	25 and includes the replacement or repair of the device based on
57	58
58	59
59		-	the patient's physical condition as medically necessary,
60		-	excluding foot orthotics defined as an in-shoe device designed
61		-	to support the structural components of the foot during
62		-	weight-bearing activities.
63		-	"Licensed provider" means a prosthetist, orthotist, or
64		-	pedorthist licensed to practice in this State.
65		-	"Prosthetic device" means an artificial device to replace,
66		-	in whole or in part, an arm or leg and includes accessories
67		-	essential to the effective use of the device and the
68		-	replacement or repair of the device based on the patient's
69		-	physical condition as medically necessary.
70		-	(b) This amendatory Act of the 96th General Assembly shall
71		-	provide benefits to any person covered thereunder for expenses
72		-	incurred in obtaining a prosthetic or custom orthotic device
73		-	from any Illinois licensed prosthetist, licensed orthotist, or
74		-	licensed pedorthist as required under the Orthotics,
75		-	Prosthetics, and Pedorthics Practice Act.
76		-	(c) A group or individual major medical policy of accident
77		-	or health insurance or managed care plan or medical, health,
78		-	or hospital service corporation contract that provides
79		-	coverage for prosthetic or custom orthotic care and is
80		-	amended, delivered, issued, or renewed 6 months after the
81		-	effective date of this amendatory Act of the 96th General
82		-	Assembly must provide coverage for prosthetic and orthotic
83		-	devices in accordance with this subsection (c). The coverage
84		-	required under this Section shall be subject to the other
85	60
86	61
87		-	general exclusions, limitations, and financial requirements of
88		-	the policy, including coordination of benefits, participating
89		-	provider requirements, utilization review of health care
90		-	services, including review of medical necessity, case
91		-	management, and experimental and investigational treatments,
92		-	and other managed care provisions under terms and conditions
93		-	that are no less favorable than the terms and conditions that
94		-	apply to substantially all medical and surgical benefits
95		-	provided under the plan or coverage.
96		-	(d) The policy or plan or contract may require prior
97		-	authorization for the prosthetic or orthotic devices in the
98		-	same manner that prior authorization is required for any other
99		-	covered benefit.
100		-	(e) Repairs and replacements of prosthetic and orthotic
101		-	devices are also covered, subject to the co-payments and
102		-	deductibles, unless necessitated by misuse or loss.
103		-	(f) A policy or plan or contract may require that, if
104		-	coverage is provided through a managed care plan, the benefits
105		-	mandated pursuant to this Section shall be covered benefits
106		-	only if the prosthetic or orthotic devices are provided by a
107		-	licensed provider employed by a provider service who contracts
108		-	with or is designated by the carrier, to the extent that the
109		-	carrier provides in-network and out-of-network service, the
110		-	coverage for the prosthetic or orthotic device shall be
111		-	offered no less extensively.
112		-	(g) The policy or plan or contract shall also meet
	62	+
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113	64
114	65
115		-	adequacy requirements as established by the Health Care
116		-	Reimbursement Reform Act of 1985 of the Illinois Insurance
117		-	Code.
118		-	(h) This Section shall not apply to accident only,
119		-	specified disease, short-term travel hospital or medical,
120		-	hospital confinement indemnity or other fixed indemnity,
121		-	credit, dental, vision, Medicare supplement, long-term care,
122		-	basic hospital and medical-surgical expense coverage,
123		-	disability income insurance coverage, coverage issued as a
124		-	supplement to liability insurance, workers' compensation
125		-	insurance, or automobile medical payment insurance.
126		-	(Source: P.A. 96-833, eff. 6-1-10.)
127		-	(Text of Section after amendment by P.A. 103-512)
128		-	Sec. 356z.18. Prosthetic and customized orthotic devices.
129		-	(a) For the purposes of this Section:
130		-	"Customized orthotic device" means a supportive device for
131		-	the body or a part of the body, the head, neck, or extremities,
132		-	and includes the replacement or repair of the device based on
133		-	the patient's physical condition as medically necessary,
134		-	excluding foot orthotics defined as an in-shoe device designed
135		-	to support the structural components of the foot during
136		-	weight-bearing activities.
137		-	"Licensed provider" means a prosthetist, orthotist, or
138		-	pedorthist licensed to practice in this State.
139		-	"Prosthetic device" means an artificial device to replace,
	66	+	HB2499 Enrolled- 3 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 3 - LRB103 30875 AMQ 57395 b
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	68	+	1 the patient's physical condition as medically necessary,
	69	+	2 excluding foot orthotics defined as an in-shoe device designed
	70	+	3 to support the structural components of the foot during
	71	+	4 weight-bearing activities.
	72	+	5 "Licensed provider" means a prosthetist, orthotist, or
	73	+	6 pedorthist licensed to practice in this State.
	74	+	7 "Prosthetic device" means an artificial device to replace,
	75	+	8 in whole or in part, an arm or leg and includes accessories
	76	+	9 essential to the effective use of the device and the
	77	+	10 replacement or repair of the device based on the patient's
	78	+	11 physical condition as medically necessary.
	79	+	12 (b) This amendatory Act of the 96th General Assembly shall
	80	+	13 provide benefits to any person covered thereunder for expenses
	81	+	14 incurred in obtaining a prosthetic or custom orthotic device
	82	+	15 from any Illinois licensed prosthetist, licensed orthotist, or
	83	+	16 licensed pedorthist as required under the Orthotics,
	84	+	17 Prosthetics, and Pedorthics Practice Act.
	85	+	18 (c) A group or individual major medical policy of accident
	86	+	19 or health insurance or managed care plan or medical, health,
	87	+	20 or hospital service corporation contract that provides
	88	+	21 coverage for prosthetic or custom orthotic care and is
	89	+	22 amended, delivered, issued, or renewed 6 months after the
	90	+	23 effective date of this amendatory Act of the 96th General
	91	+	24 Assembly must provide coverage for prosthetic and orthotic
	92	+	25 devices in accordance with this subsection (c). The coverage
	93	+	26 required under this Section shall be subject to the other
140	94
141	95
142		-	in whole or in part, an arm or leg and includes accessories
143		-	essential to the effective use of the device and the
144		-	replacement or repair of the device based on the patient's
145		-	physical condition as medically necessary.
146		-	(b) This amendatory Act of the 96th General Assembly shall
147		-	provide benefits to any person covered thereunder for expenses
148		-	incurred in obtaining a prosthetic or custom orthotic device
149		-	from any Illinois licensed prosthetist, licensed orthotist, or
150		-	licensed pedorthist as required under the Orthotics,
151		-	Prosthetics, and Pedorthics Practice Act.
152		-	(c) A group or individual major medical policy of accident
153		-	or health insurance or managed care plan or medical, health,
154		-	or hospital service corporation contract that provides
155		-	coverage for prosthetic or custom orthotic care and is
156		-	amended, delivered, issued, or renewed 6 months after the
157		-	effective date of this amendatory Act of the 96th General
158		-	Assembly must provide coverage for prosthetic and orthotic
159		-	devices in accordance with this subsection (c). The coverage
160		-	required under this Section shall be subject to the other
161		-	general exclusions, limitations, and financial requirements of
162		-	the policy, including coordination of benefits, participating
163		-	provider requirements, utilization review of health care
164		-	services, including review of medical necessity, case
165		-	management, and experimental and investigational treatments,
166		-	and other managed care provisions under terms and conditions
167		-	that are no less favorable than the terms and conditions that
168	96
169	97
170		-	apply to substantially all medical and surgical benefits
171		-	provided under the plan or coverage.
172		-	(d) With respect to an enrollee at any age, in addition to
173		-	coverage of a prosthetic or custom orthotic device required by
174		-	this Section, benefits shall be provided for a prosthetic or
175		-	custom orthotic device determined by the enrollee's provider
176		-	to be the most appropriate model that is medically necessary
177		-	for the enrollee to perform physical activities, as
178		-	applicable, such as running, biking, swimming, and lifting
179		-	weights, and to maximize the enrollee's whole body health and
180		-	strengthen the lower and upper limb function.
181		-	(e) The requirements of this Section do not constitute an
182		-	addition to this State's essential health benefits that
183		-	requires defrayal of costs by this State pursuant to 42 U.S.C.
184		-	18031(d)(3)(B).
185		-	(f) The policy or plan or contract may require prior
186		-	authorization for the prosthetic or orthotic devices in the
187		-	same manner that prior authorization is required for any other
188		-	covered benefit.
189		-	(g) Repairs and replacements of prosthetic and orthotic
190		-	devices are also covered, subject to the co-payments and
191		-	deductibles, unless necessitated by misuse or loss.
192		-	(h) A policy or plan or contract may require that, if
193		-	coverage is provided through a managed care plan, the benefits
194		-	mandated pursuant to this Section shall be covered benefits
195		-	only if the prosthetic or orthotic devices are provided by a
	98	+
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196	100
197	101
198		-	licensed provider employed by a provider service who contracts
199		-	with or is designated by the carrier, to the extent that the
200		-	carrier provides in-network and out-of-network service, the
201		-	coverage for the prosthetic or orthotic device shall be
202		-	offered no less extensively.
203		-	(i) The policy or plan or contract shall also meet
204		-	adequacy requirements as established by the Health Care
205		-	Reimbursement Reform Act of 1985 of the Illinois Insurance
206		-	Code.
207		-	(j) This Section shall not apply to accident only,
208		-	specified disease, short-term travel hospital or medical,
209		-	hospital confinement indemnity or other fixed indemnity,
210		-	credit, dental, vision, Medicare supplement, long-term care,
211		-	basic hospital and medical-surgical expense coverage,
212		-	disability income insurance coverage, coverage issued as a
213		-	supplement to liability insurance, workers' compensation
214		-	insurance, or automobile medical payment insurance.
215		-	(Source: P.A. 103-512, eff. 1-1-25.)
216		-	(215 ILCS 5/367.3) (from Ch. 73, par. 979.3)
217		-	Sec. 367.3. Group accident and health insurance;
218		-	discretionary groups.
219		-	(a) No group health insurance offered to a resident of
220		-	this State under a policy issued to a group, other than one
221		-	specifically described in Section 367(1), shall be delivered
222		-	or issued for delivery in this State unless the Director
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	104	+	1 general exclusions, limitations, and financial requirements of
	105	+	2 the policy, including coordination of benefits, participating
	106	+	3 provider requirements, utilization review of health care
	107	+	4 services, including review of medical necessity, case
	108	+	5 management, and experimental and investigational treatments,
	109	+	6 and other managed care provisions under terms and conditions
	110	+	7 that are no less favorable than the terms and conditions that
	111	+	8 apply to substantially all medical and surgical benefits
	112	+	9 provided under the plan or coverage.
	113	+	10 (d) The policy or plan or contract may require prior
	114	+	11 authorization for the prosthetic or orthotic devices in the
	115	+	12 same manner that prior authorization is required for any other
	116	+	13 covered benefit.
	117	+	14 (e) Repairs and replacements of prosthetic and orthotic
	118	+	15 devices are also covered, subject to the co-payments and
	119	+	16 deductibles, unless necessitated by misuse or loss.
	120	+	17 (f) A policy or plan or contract may require that, if
	121	+	18 coverage is provided through a managed care plan, the benefits
	122	+	19 mandated pursuant to this Section shall be covered benefits
	123	+	20 only if the prosthetic or orthotic devices are provided by a
	124	+	21 licensed provider employed by a provider service who contracts
	125	+	22 with or is designated by the carrier, to the extent that the
	126	+	23 carrier provides in-network and out-of-network service, the
	127	+	24 coverage for the prosthetic or orthotic device shall be
	128	+	25 offered no less extensively.
	129	+	26 (g) The policy or plan or contract shall also meet
223	130
224	131
225		-	determines that:
226		-	(1) the issuance of the policy is not contrary to the
227		-	public interest;
228		-	(2) the issuance of the policy will result in
229		-	economies of acquisition and administration; and
230		-	(3) the benefits under the policy are reasonable in
231		-	relation to the premium charged.
232		-	(b) No such group health insurance may be offered in this
233		-	State under a policy issued in another state unless this State
234		-	or the state in which the group policy is issued has made a
235		-	determination that the requirements of subsection (a) have
236		-	been met.
237		-	Where insurance is to be offered in this State under a
238		-	policy described in this subsection, the insurer shall file
239		-	for informational review purposes:
240		-	(1) a copy of the group master contract;
241		-	(2) a copy of the statute authorizing the issuance of
242		-	the group policy in the state of situs, which statute has
243		-	the same or similar requirements as this State, or in the
244		-	absence of such statute, a certification by an officer of
245		-	the company that the policy meets the Illinois minimum
246		-	standards required for individual accident and health
247		-	policies under authority of Section 401 of this Code, as
248		-	now or hereafter amended, as promulgated by rule at 50
249		-	Illinois Administrative Code, Ch. I, Sec. 2007, et seq.,
250		-	as now or hereafter amended, or by a successor rule;
251	132
252	133
253		-	(3) evidence of approval by the state of situs of the
254		-	group master policy; and
255		-	(4) copies of all supportive material furnished to the
256		-	state of situs to satisfy the criteria for approval.
257		-	(c) The Director may, at any time after receipt of the
258		-	information required under subsection (b) and after finding
259		-	that the standards of subsection (a) have not been met, order
260		-	the insurer to cease the issuance or marketing of that
261		-	coverage in this State.
262		-	(d) Notwithstanding subsections (a) and (b), group Group
263		-	accident and health insurance subject to the provisions of
264		-	this Section is also subject to the provisions of Sections
265		-	352c and Section 367i of this Code and rules thereunder.
266		-	(Source: P.A. 90-655, eff. 7-30-98.)
267		-	(215 ILCS 5/367a) (from Ch. 73, par. 979a)
268		-	Sec. 367a. Blanket accident and health insurance.
269		-	(1) Blanket accident and health insurance is the that form
270		-	of accident and health insurance providing excepted benefits,
271		-	as defined in Section 352c, that covers covering special
272		-	groups of persons as enumerated in one of the following
273		-	paragraphs (a) to (g), inclusive:
274		-	(a) Under a policy or contract issued to any carrier for
275		-	hire, which shall be deemed the policyholder, covering a group
276		-	defined as all persons who may become passengers on such
277		-	carrier.
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278	136
279	137
280		-	(b) Under a policy or contract issued to an employer, who
281		-	shall be deemed the policyholder, covering all employees or
282		-	any group of employees defined by reference to exceptional
283		-	hazards incident to such employment.
284		-	(c) Under a policy or contract issued to a college,
285		-	school, or other institution of learning or to the head or
286		-	principal thereof, who or which shall be deemed the
287		-	policyholder, covering students or teachers. However, student
288		-	health insurance coverage, as defined in 45 CFR 147.145, shall
289		-	remain subject to the standards and requirements for
290		-	individual health insurance coverage except where inconsistent
291		-	with that regulation. An issuer providing student health
292		-	insurance coverage or a policy or contract covering students
293		-	for limited-scope dental or vision under 45 CFR 148.220 shall
294		-	require an individual application or enrollment form and shall
295		-	furnish each insured individual a certificate, which shall
296		-	have been approved by the Director under Section 355.
297		-	(d) Under a policy or contract issued in the name of any
298		-	volunteer fire department, first aid, or other such volunteer
299		-	group, which shall be deemed the policyholder, covering all of
300		-	the members of such department or group.
301		-	(e) Under a policy or contract issued to a creditor, who
302		-	shall be deemed the policyholder, to insure debtors of the
303		-	creditors; Provided, however, that in the case of a loan which
304		-	is subject to the Small Loans Act, no insurance premium or
305		-	other cost shall be directly or indirectly charged or assessed
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	139	+	HB2499 Enrolled - 5 - LRB103 30875 AMQ 57395 b
	140	+	1 adequacy requirements as established by the Health Care
	141	+	2 Reimbursement Reform Act of 1985 of the Illinois Insurance
	142	+	3 Code.
	143	+	4 (h) This Section shall not apply to accident only,
	144	+	5 specified disease, short-term travel hospital or medical,
	145	+	6 hospital confinement indemnity or other fixed indemnity,
	146	+	7 credit, dental, vision, Medicare supplement, long-term care,
	147	+	8 basic hospital and medical-surgical expense coverage,
	148	+	9 disability income insurance coverage, coverage issued as a
	149	+	10 supplement to liability insurance, workers' compensation
	150	+	11 insurance, or automobile medical payment insurance.
	151	+	12 (Source: P.A. 96-833, eff. 6-1-10.)
	152	+	13 (Text of Section after amendment by P.A. 103-512)
	153	+	14 Sec. 356z.18. Prosthetic and customized orthotic devices.
	154	+	15 (a) For the purposes of this Section:
	155	+	16 "Customized orthotic device" means a supportive device for
	156	+	17 the body or a part of the body, the head, neck, or extremities,
	157	+	18 and includes the replacement or repair of the device based on
	158	+	19 the patient's physical condition as medically necessary,
	159	+	20 excluding foot orthotics defined as an in-shoe device designed
	160	+	21 to support the structural components of the foot during
	161	+	22 weight-bearing activities.
	162	+	23 "Licensed provider" means a prosthetist, orthotist, or
	163	+	24 pedorthist licensed to practice in this State.
	164	+	25 "Prosthetic device" means an artificial device to replace,
306	165
307	166
308		-	against, or collected or received from the borrower.
309		-	(f) Under a policy or contract issued to a sports team or
310		-	to a camp, which team or camp sponsor shall be deemed the
311		-	policyholder, covering members or campers.
312		-	(g) Under a policy or contract issued to any other
313		-	substantially similar group which, in the discretion of the
314		-	Director, may be subject to the issuance of a blanket accident
315		-	and health policy or contract.
316		-	(2) Any insurance company authorized to write accident and
317		-	health insurance in this state shall have the power to issue
318		-	blanket accident and health insurance. No such blanket policy
319		-	may be issued or delivered in this State unless a copy of the
320		-	form thereof shall have been filed in accordance with Section
321		-	355, and it contains in substance such of those provisions
322		-	contained in Sections 357.1 through 357.30 as may be
323		-	applicable to blanket accident and health insurance and the
324		-	following provisions:
325		-	(a) A provision that the policy and the application shall
326		-	constitute the entire contract between the parties, and that
327		-	all statements made by the policyholder shall, in absence of
328		-	fraud, be deemed representations and not warranties, and that
329		-	no such statements shall be used in defense to a claim under
330		-	the policy, unless it is contained in a written application.
331		-	(b) A provision that to the group or class thereof
332		-	originally insured shall be added from time to time all new
333		-	persons or individuals eligible for coverage.
334	167
335	168
336		-	(3) An individual application shall not be required from a
337		-	person covered under a blanket accident or health policy or
338		-	contract, nor shall it be necessary for the insurer to furnish
339		-	each person a certificate.
340		-	(4) All benefits under any blanket accident and health
341		-	policy shall be payable to the person insured, or to his
342		-	designated beneficiary or beneficiaries, or to his or her
343		-	estate, except that if the person insured be a minor or person
344		-	under legal disability, such benefits may be made payable to
345		-	his or her parent, guardian, or other person actually
346		-	supporting him or her. Provided further, however, that the
347		-	policy may provide that all or any portion of any indemnities
348		-	provided by any such policy on account of hospital, nursing,
349		-	medical or surgical services may, at the insurer's option, be
350		-	paid directly to the hospital or person rendering such
351		-	services; but the policy may not require that the service be
352		-	rendered by a particular hospital or person. Payment so made
353		-	shall discharge the insurer's obligation with respect to the
354		-	amount of insurance so paid.
355		-	(5) Nothing contained in this section shall be deemed to
356		-	affect the legal liability of policyholders for the death of
357		-	or injury to, any such member of such group.
358		-	(Source: P.A. 83-1362.)
359		-	(215 ILCS 5/368f)
360		-	Sec. 368f. Military service member insurance
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361	171
362	172
363		-	reinstatement.
364		-	(a) No Illinois resident activated for military service
365		-	and no spouse or dependent of the resident who becomes
366		-	eligible for a federal government-sponsored health insurance
367		-	program, including the TriCare program providing coverage for
368		-	civilian dependents of military personnel, as a result of the
369		-	activation shall be denied reinstatement into the same
370		-	individual health insurance coverage with the health insurer
371		-	that the resident lapsed as a result of activation or becoming
372		-	covered by the federal government-sponsored health insurance
373		-	program. The resident shall have the right to reinstatement in
374		-	the same individual health insurance coverage without medical
375		-	underwriting, subject to payment of the current premium
376		-	charged to other persons of the same age and gender that are
377		-	covered under the same individual health coverage. Except in
378		-	the case of birth or adoption that occurs during the period of
379		-	activation, reinstatement must be into the same coverage type
380		-	as the resident held prior to lapsing the individual health
381		-	insurance coverage and at the same or, at the option of the
382		-	resident, higher deductible level. The reinstatement rights
383		-	provided under this subsection (a) are not available to a
384		-	resident or dependents if the activated person is discharged
385		-	from the military under other than honorable conditions.
386		-	(b) The health insurer with which the reinstatement is
387		-	being requested must receive a request for reinstatement no
388		-	later than 63 days following the later of (i) deactivation or
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	175	+	1 in whole or in part, an arm or leg and includes accessories
	176	+	2 essential to the effective use of the device and the
	177	+	3 replacement or repair of the device based on the patient's
	178	+	4 physical condition as medically necessary.
	179	+	5 (b) This amendatory Act of the 96th General Assembly shall
	180	+	6 provide benefits to any person covered thereunder for expenses
	181	+	7 incurred in obtaining a prosthetic or custom orthotic device
	182	+	8 from any Illinois licensed prosthetist, licensed orthotist, or
	183	+	9 licensed pedorthist as required under the Orthotics,
	184	+	10 Prosthetics, and Pedorthics Practice Act.
	185	+	11 (c) A group or individual major medical policy of accident
	186	+	12 or health insurance or managed care plan or medical, health,
	187	+	13 or hospital service corporation contract that provides
	188	+	14 coverage for prosthetic or custom orthotic care and is
	189	+	15 amended, delivered, issued, or renewed 6 months after the
	190	+	16 effective date of this amendatory Act of the 96th General
	191	+	17 Assembly must provide coverage for prosthetic and orthotic
	192	+	18 devices in accordance with this subsection (c). The coverage
	193	+	19 required under this Section shall be subject to the other
	194	+	20 general exclusions, limitations, and financial requirements of
	195	+	21 the policy, including coordination of benefits, participating
	196	+	22 provider requirements, utilization review of health care
	197	+	23 services, including review of medical necessity, case
	198	+	24 management, and experimental and investigational treatments,
	199	+	25 and other managed care provisions under terms and conditions
	200	+	26 that are no less favorable than the terms and conditions that
389	201
390	202
391		-	(ii) loss of coverage under the federal government-sponsored
392		-	health insurance program. The health insurer may request proof
393		-	of loss of coverage and the timing of the loss of coverage of
394		-	the government-sponsored coverage in order to determine
395		-	eligibility for reinstatement into the individual coverage.
396		-	The effective date of the reinstatement of individual health
397		-	coverage shall be the first of the month following receipt of
398		-	the notice requesting reinstatement.
399		-	(c) All insurers must provide written notice to the
400		-	policyholder of individual health coverage of the rights
401		-	described in subsection (a) of this Section. In lieu of the
402		-	inclusion of the notice in the individual health insurance
403		-	policy, an insurance company may satisfy the notification
404		-	requirement by providing a single written notice:
405		-	(1) in conjunction with the enrollment process for a
406		-	policyholder initially enrolling in the individual
407		-	coverage on or after the effective date of this amendatory
408		-	Act of the 94th General Assembly; or
409		-	(2) by mailing written notice to policyholders whose
410		-	coverage was effective prior to the effective date of this
411		-	amendatory Act of the 94th General Assembly no later than
412		-	90 days following the effective date of this amendatory
413		-	Act of the 94th General Assembly.
414		-	(d) The provisions of subsection (a) of this Section do
415		-	not apply to any policy or certificate providing coverage for
416		-	any specified disease, specified accident or accident-only
417	203
418	204
419		-	coverage, credit, dental, disability income, hospital
420		-	indemnity or other fixed indemnity, long-term care, Medicare
421		-	supplement, vision care, or short-term travel nonrenewable
422		-	health policy or other limited-benefit supplemental insurance,
423		-	or any coverage issued as a supplement to any liability
424		-	insurance, workers' compensation or similar insurance, or any
425		-	insurance under which benefits are payable with or without
426		-	regard to fault, whether written on a group, blanket, or
427		-	individual basis.
428		-	(e) Nothing in this Section shall require an insurer to
429		-	reinstate the resident if the insurer requires residency in an
430		-	enrollment area and those residency requirements are not met
431		-	after deactivation or loss of coverage under the
432		-	government-sponsored health insurance program.
433		-	(f) All terms, conditions, and limitations of the
434		-	individual coverage into which reinstatement is made apply
435		-	equally to all insureds enrolled in the coverage.
436		-	(g) The Secretary may adopt rules as may be necessary to
437		-	carry out the provisions of this Section.
438		-	(Source: P.A. 94-1037, eff. 7-20-06.)
439		-	Section 10. The Health Maintenance Organization Act is
440		-	amended by changing Section 5-3 as follows:
441		-	(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
442		-	Sec. 5-3. Insurance Code provisions.
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443	207
444	208
445		-	(a) Health Maintenance Organizations shall be subject to
446		-	the provisions of Sections 133, 134, 136, 137, 139, 140,
447		-	141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
448		-	154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 155.49,
449		-	352c, 355.2, 355.3, 355b, 355c, 356f, 356g.5-1, 356m, 356q,
450		-	356v, 356w, 356x, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
451		-	356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
452		-	356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.20, 356z.21,
453		-	356z.22, 356z.23, 356z.24, 356z.25, 356z.26, 356z.28, 356z.29,
454		-	356z.30, 356z.30a, 356z.31, 356z.32, 356z.33, 356z.34,
455		-	356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40, 356z.41,
456		-	356z.44, 356z.45, 356z.46, 356z.47, 356z.48, 356z.49, 356z.50,
457		-	356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.58,
458		-	356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.65, 356z.67,
459		-	356z.68, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b,
460		-	368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A,
461		-	408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of
462		-	subsection (2) of Section 367, and Articles IIA, VIII 1/2,
463		-	XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
464		-	Illinois Insurance Code.
465		-	(b) For purposes of the Illinois Insurance Code, except
466		-	for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
467		-	Health Maintenance Organizations in the following categories
468		-	are deemed to be "domestic companies":
469		-	(1) a corporation authorized under the Dental Service
470		-	Plan Act or the Voluntary Health Services Plans Act;
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	210	+	HB2499 Enrolled - 7 - LRB103 30875 AMQ 57395 b
	211	+	1 apply to substantially all medical and surgical benefits
	212	+	2 provided under the plan or coverage.
	213	+	3 (d) With respect to an enrollee at any age, in addition to
	214	+	4 coverage of a prosthetic or custom orthotic device required by
	215	+	5 this Section, benefits shall be provided for a prosthetic or
	216	+	6 custom orthotic device determined by the enrollee's provider
	217	+	7 to be the most appropriate model that is medically necessary
	218	+	8 for the enrollee to perform physical activities, as
	219	+	9 applicable, such as running, biking, swimming, and lifting
	220	+	10 weights, and to maximize the enrollee's whole body health and
	221	+	11 strengthen the lower and upper limb function.
	222	+	12 (e) The requirements of this Section do not constitute an
	223	+	13 addition to this State's essential health benefits that
	224	+	14 requires defrayal of costs by this State pursuant to 42 U.S.C.
	225	+	15 18031(d)(3)(B).
	226	+	16 (f) The policy or plan or contract may require prior
	227	+	17 authorization for the prosthetic or orthotic devices in the
	228	+	18 same manner that prior authorization is required for any other
	229	+	19 covered benefit.
	230	+	20 (g) Repairs and replacements of prosthetic and orthotic
	231	+	21 devices are also covered, subject to the co-payments and
	232	+	22 deductibles, unless necessitated by misuse or loss.
	233	+	23 (h) A policy or plan or contract may require that, if
	234	+	24 coverage is provided through a managed care plan, the benefits
	235	+	25 mandated pursuant to this Section shall be covered benefits
	236	+	26 only if the prosthetic or orthotic devices are provided by a
471	237
472	238
473		-	(2) a corporation organized under the laws of this
474		-	State; or
475		-	(3) a corporation organized under the laws of another
476		-	state, 30% or more of the enrollees of which are residents
477		-	of this State, except a corporation subject to
478		-	substantially the same requirements in its state of
479		-	organization as is a "domestic company" under Article VIII
480		-	1/2 of the Illinois Insurance Code.
481		-	(c) In considering the merger, consolidation, or other
482		-	acquisition of control of a Health Maintenance Organization
483		-	pursuant to Article VIII 1/2 of the Illinois Insurance Code,
484		-	(1) the Director shall give primary consideration to
485		-	the continuation of benefits to enrollees and the
486		-	financial conditions of the acquired Health Maintenance
487		-	Organization after the merger, consolidation, or other
488		-	acquisition of control takes effect;
489		-	(2)(i) the criteria specified in subsection (1)(b) of
490		-	Section 131.8 of the Illinois Insurance Code shall not
491		-	apply and (ii) the Director, in making his determination
492		-	with respect to the merger, consolidation, or other
493		-	acquisition of control, need not take into account the
494		-	effect on competition of the merger, consolidation, or
495		-	other acquisition of control;
496		-	(3) the Director shall have the power to require the
497		-	following information:
498		-	(A) certification by an independent actuary of the
499	239
500	240
501		-	adequacy of the reserves of the Health Maintenance
502		-	Organization sought to be acquired;
503		-	(B) pro forma financial statements reflecting the
504		-	combined balance sheets of the acquiring company and
505		-	the Health Maintenance Organization sought to be
506		-	acquired as of the end of the preceding year and as of
507		-	a date 90 days prior to the acquisition, as well as pro
508		-	forma financial statements reflecting projected
509		-	combined operation for a period of 2 years;
510		-	(C) a pro forma business plan detailing an
511		-	acquiring party's plans with respect to the operation
512		-	of the Health Maintenance Organization sought to be
513		-	acquired for a period of not less than 3 years; and
514		-	(D) such other information as the Director shall
515		-	require.
516		-	(d) The provisions of Article VIII 1/2 of the Illinois
517		-	Insurance Code and this Section 5-3 shall apply to the sale by
518		-	any health maintenance organization of greater than 10% of its
519		-	enrollee population (including, without limitation, the health
520		-	maintenance organization's right, title, and interest in and
521		-	to its health care certificates).
522		-	(e) In considering any management contract or service
523		-	agreement subject to Section 141.1 of the Illinois Insurance
524		-	Code, the Director (i) shall, in addition to the criteria
525		-	specified in Section 141.2 of the Illinois Insurance Code,
526		-	take into account the effect of the management contract or
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527	243
528	244
529		-	service agreement on the continuation of benefits to enrollees
530		-	and the financial condition of the health maintenance
531		-	organization to be managed or serviced, and (ii) need not take
532		-	into account the effect of the management contract or service
533		-	agreement on competition.
534		-	(f) Except for small employer groups as defined in the
535		-	Small Employer Rating, Renewability and Portability Health
536		-	Insurance Act and except for medicare supplement policies as
537		-	defined in Section 363 of the Illinois Insurance Code, a
538		-	Health Maintenance Organization may by contract agree with a
539		-	group or other enrollment unit to effect refunds or charge
540		-	additional premiums under the following terms and conditions:
541		-	(i) the amount of, and other terms and conditions with
542		-	respect to, the refund or additional premium are set forth
543		-	in the group or enrollment unit contract agreed in advance
544		-	of the period for which a refund is to be paid or
545		-	additional premium is to be charged (which period shall
546		-	not be less than one year); and
547		-	(ii) the amount of the refund or additional premium
548		-	shall not exceed 20% of the Health Maintenance
549		-	Organization's profitable or unprofitable experience with
550		-	respect to the group or other enrollment unit for the
551		-	period (and, for purposes of a refund or additional
552		-	premium, the profitable or unprofitable experience shall
553		-	be calculated taking into account a pro rata share of the
554		-	Health Maintenance Organization's administrative and
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	247	+	1 licensed provider employed by a provider service who contracts
	248	+	2 with or is designated by the carrier, to the extent that the
	249	+	3 carrier provides in-network and out-of-network service, the
	250	+	4 coverage for the prosthetic or orthotic device shall be
	251	+	5 offered no less extensively.
	252	+	6 (i) The policy or plan or contract shall also meet
	253	+	7 adequacy requirements as established by the Health Care
	254	+	8 Reimbursement Reform Act of 1985 of the Illinois Insurance
	255	+	9 Code.
	256	+	10 (j) This Section shall not apply to accident only,
	257	+	11 specified disease, short-term travel hospital or medical,
	258	+	12 hospital confinement indemnity or other fixed indemnity,
	259	+	13 credit, dental, vision, Medicare supplement, long-term care,
	260	+	14 basic hospital and medical-surgical expense coverage,
	261	+	15 disability income insurance coverage, coverage issued as a
	262	+	16 supplement to liability insurance, workers' compensation
	263	+	17 insurance, or automobile medical payment insurance.
	264	+	18 (Source: P.A. 103-512, eff. 1-1-25.)
	265	+	19 (215 ILCS 5/367.3) (from Ch. 73, par. 979.3)
	266	+	20 Sec. 367.3. Group accident and health insurance;
	267	+	21 discretionary groups.
	268	+	22 (a) No group health insurance offered to a resident of
	269	+	23 this State under a policy issued to a group, other than one
	270	+	24 specifically described in Section 367(1), shall be delivered
	271	+	25 or issued for delivery in this State unless the Director
555	272
556	273
557		-	marketing expenses, but shall not include any refund to be
558		-	made or additional premium to be paid pursuant to this
559		-	subsection (f)). The Health Maintenance Organization and
560		-	the group or enrollment unit may agree that the profitable
561		-	or unprofitable experience may be calculated taking into
562		-	account the refund period and the immediately preceding 2
563		-	plan years.
564		-	The Health Maintenance Organization shall include a
565		-	statement in the evidence of coverage issued to each enrollee
566		-	describing the possibility of a refund or additional premium,
567		-	and upon request of any group or enrollment unit, provide to
568		-	the group or enrollment unit a description of the method used
569		-	to calculate (1) the Health Maintenance Organization's
570		-	profitable experience with respect to the group or enrollment
571		-	unit and the resulting refund to the group or enrollment unit
572		-	or (2) the Health Maintenance Organization's unprofitable
573		-	experience with respect to the group or enrollment unit and
574		-	the resulting additional premium to be paid by the group or
575		-	enrollment unit.
576		-	In no event shall the Illinois Health Maintenance
577		-	Organization Guaranty Association be liable to pay any
578		-	contractual obligation of an insolvent organization to pay any
579		-	refund authorized under this Section.
580		-	(g) Rulemaking authority to implement Public Act 95-1045,
581		-	if any, is conditioned on the rules being adopted in
582		-	accordance with all provisions of the Illinois Administrative
583	274
584	275
585		-	Procedure Act and all rules and procedures of the Joint
586		-	Committee on Administrative Rules; any purported rule not so
587		-	adopted, for whatever reason, is unauthorized.
588		-	(Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
589		-	102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
590		-	1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
591		-	eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
592		-	102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
593		-	1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
594		-	eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
595		-	103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
596		-	6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
597		-	eff. 1-1-24; 103-551, eff. 8-11-23; revised 8-29-23.)
598		-	Section 15. The Limited Health Service Organization Act is
599		-	amended by changing Section 4003 as follows:
600		-	(215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
601		-	Sec. 4003. Illinois Insurance Code provisions. Limited
602		-	health service organizations shall be subject to the
603		-	provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
604		-	141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
605		-	154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
606		-	355.2, 355.3, 355b, 356q, 356v, 356z.4, 356z.4a, 356z.10,
607		-	356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30a,
608		-	356z.32, 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53,
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609	278
610	279
611		-	356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68,
612		-	364.3, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412,
613		-	444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
614		-	XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
615		-	Nothing in this Section shall require a limited health care
616		-	plan to cover any service that is not a limited health service.
617		-	For purposes of the Illinois Insurance Code, except for
618		-	Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited
619		-	health service organizations in the following categories are
620		-	deemed to be domestic companies:
621		-	(1) a corporation under the laws of this State; or
622		-	(2) a corporation organized under the laws of another
623		-	state, 30% or more of the enrollees of which are residents
624		-	of this State, except a corporation subject to
625		-	substantially the same requirements in its state of
626		-	organization as is a domestic company under Article VIII
627		-	1/2 of the Illinois Insurance Code.
628		-	(Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
629		-	102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff.
630		-	1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816,
631		-	eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
632		-	102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
633		-	1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
634		-	eff. 1-1-24; revised 8-29-23.)
635		-	(215 ILCS 190/Act rep.)
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	282	+	1 determines that:
	283	+	2 (1) the issuance of the policy is not contrary to the
	284	+	3 public interest;
	285	+	4 (2) the issuance of the policy will result in
	286	+	5 economies of acquisition and administration; and
	287	+	6 (3) the benefits under the policy are reasonable in
	288	+	7 relation to the premium charged.
	289	+	8 (b) No such group health insurance may be offered in this
	290	+	9 State under a policy issued in another state unless this State
	291	+	10 or the state in which the group policy is issued has made a
	292	+	11 determination that the requirements of subsection (a) have
	293	+	12 been met.
	294	+	13 Where insurance is to be offered in this State under a
	295	+	14 policy described in this subsection, the insurer shall file
	296	+	15 for informational review purposes:
	297	+	16 (1) a copy of the group master contract;
	298	+	17 (2) a copy of the statute authorizing the issuance of
	299	+	18 the group policy in the state of situs, which statute has
	300	+	19 the same or similar requirements as this State, or in the
	301	+	20 absence of such statute, a certification by an officer of
	302	+	21 the company that the policy meets the Illinois minimum
	303	+	22 standards required for individual accident and health
	304	+	23 policies under authority of Section 401 of this Code, as
	305	+	24 now or hereafter amended, as promulgated by rule at 50
	306	+	25 Illinois Administrative Code, Ch. I, Sec. 2007, et seq.,
	307	+	26 as now or hereafter amended, or by a successor rule;
636	308
637	309
638		-	Section 20. The Short-Term, Limited-Duration Health
639		-	Insurance Coverage Act is repealed.
640		-	Section 95. No acceleration or delay. Where this Act makes
641		-	changes in a statute that is represented in this Act by text
642		-	that is not yet or no longer in effect (for example, a Section
643		-	represented by multiple versions), the use of that text does
644		-	not accelerate or delay the taking effect of (i) the changes
645		-	made by this Act or (ii) provisions derived from any other
646		-	Public Act.
	310	+
	311	+
	312	+
	313	+	HB2499 Enrolled - 9 - LRB103 30875 AMQ 57395 b
	314	+
	315	+
	316	+	HB2499 Enrolled- 10 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 10 - LRB103 30875 AMQ 57395 b
	317	+	HB2499 Enrolled - 10 - LRB103 30875 AMQ 57395 b
	318	+	1 (3) evidence of approval by the state of situs of the
	319	+	2 group master policy; and
	320	+	3 (4) copies of all supportive material furnished to the
	321	+	4 state of situs to satisfy the criteria for approval.
	322	+	5 (c) The Director may, at any time after receipt of the
	323	+	6 information required under subsection (b) and after finding
	324	+	7 that the standards of subsection (a) have not been met, order
	325	+	8 the insurer to cease the issuance or marketing of that
	326	+	9 coverage in this State.
	327	+	10 (d) Notwithstanding subsections (a) and (b), group Group
	328	+	11 accident and health insurance subject to the provisions of
	329	+	12 this Section is also subject to the provisions of Sections
	330	+	13 352c and Section 367i of this Code and rules thereunder.
	331	+	14 (Source: P.A. 90-655, eff. 7-30-98.)
	332	+	15 (215 ILCS 5/367a) (from Ch. 73, par. 979a)
	333	+	16 Sec. 367a. Blanket accident and health insurance.
	334	+	17 (1) Blanket accident and health insurance is the that form
	335	+	18 of accident and health insurance providing excepted benefits,
	336	+	19 as defined in Section 352c, that covers covering special
	337	+	20 groups of persons as enumerated in one of the following
	338	+	21 paragraphs (a) to (g), inclusive:
	339	+	22 (a) Under a policy or contract issued to any carrier for
	340	+	23 hire, which shall be deemed the policyholder, covering a group
	341	+	24 defined as all persons who may become passengers on such
	342	+	25 carrier.
	343	+
	344	+
	345	+
	346	+
	347	+
	348	+	HB2499 Enrolled - 10 - LRB103 30875 AMQ 57395 b
	349	+
	350	+
	351	+	HB2499 Enrolled- 11 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 11 - LRB103 30875 AMQ 57395 b
	352	+	HB2499 Enrolled - 11 - LRB103 30875 AMQ 57395 b
	353	+	1 (b) Under a policy or contract issued to an employer, who
	354	+	2 shall be deemed the policyholder, covering all employees or
	355	+	3 any group of employees defined by reference to exceptional
	356	+	4 hazards incident to such employment.
	357	+	5 (c) Under a policy or contract issued to a college,
	358	+	6 school, or other institution of learning or to the head or
	359	+	7 principal thereof, who or which shall be deemed the
	360	+	8 policyholder, covering students or teachers. However, student
	361	+	9 health insurance coverage, as defined in 45 CFR 147.145, shall
	362	+	10 remain subject to the standards and requirements for
	363	+	11 individual health insurance coverage except where inconsistent
	364	+	12 with that regulation. An issuer providing student health
	365	+	13 insurance coverage or a policy or contract covering students
	366	+	14 for limited-scope dental or vision under 45 CFR 148.220 shall
	367	+	15 require an individual application or enrollment form and shall
	368	+	16 furnish each insured individual a certificate, which shall
	369	+	17 have been approved by the Director under Section 355.
	370	+	18 (d) Under a policy or contract issued in the name of any
	371	+	19 volunteer fire department, first aid, or other such volunteer
	372	+	20 group, which shall be deemed the policyholder, covering all of
	373	+	21 the members of such department or group.
	374	+	22 (e) Under a policy or contract issued to a creditor, who
	375	+	23 shall be deemed the policyholder, to insure debtors of the
	376	+	24 creditors; Provided, however, that in the case of a loan which
	377	+	25 is subject to the Small Loans Act, no insurance premium or
	378	+	26 other cost shall be directly or indirectly charged or assessed
	379	+
	380	+
	381	+
	382	+
	383	+
	384	+	HB2499 Enrolled - 11 - LRB103 30875 AMQ 57395 b
	385	+
	386	+
	387	+	HB2499 Enrolled- 12 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 12 - LRB103 30875 AMQ 57395 b
	388	+	HB2499 Enrolled - 12 - LRB103 30875 AMQ 57395 b
	389	+	1 against, or collected or received from the borrower.
	390	+	2 (f) Under a policy or contract issued to a sports team or
	391	+	3 to a camp, which team or camp sponsor shall be deemed the
	392	+	4 policyholder, covering members or campers.
	393	+	5 (g) Under a policy or contract issued to any other
	394	+	6 substantially similar group which, in the discretion of the
	395	+	7 Director, may be subject to the issuance of a blanket accident
	396	+	8 and health policy or contract.
	397	+	9 (2) Any insurance company authorized to write accident and
	398	+	10 health insurance in this state shall have the power to issue
	399	+	11 blanket accident and health insurance. No such blanket policy
	400	+	12 may be issued or delivered in this State unless a copy of the
	401	+	13 form thereof shall have been filed in accordance with Section
	402	+	14 355, and it contains in substance such of those provisions
	403	+	15 contained in Sections 357.1 through 357.30 as may be
	404	+	16 applicable to blanket accident and health insurance and the
	405	+	17 following provisions:
	406	+	18 (a) A provision that the policy and the application shall
	407	+	19 constitute the entire contract between the parties, and that
	408	+	20 all statements made by the policyholder shall, in absence of
	409	+	21 fraud, be deemed representations and not warranties, and that
	410	+	22 no such statements shall be used in defense to a claim under
	411	+	23 the policy, unless it is contained in a written application.
	412	+	24 (b) A provision that to the group or class thereof
	413	+	25 originally insured shall be added from time to time all new
	414	+	26 persons or individuals eligible for coverage.
	415	+
	416	+
	417	+
	418	+
	419	+
	420	+	HB2499 Enrolled - 12 - LRB103 30875 AMQ 57395 b
	421	+
	422	+
	423	+	HB2499 Enrolled- 13 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 13 - LRB103 30875 AMQ 57395 b
	424	+	HB2499 Enrolled - 13 - LRB103 30875 AMQ 57395 b
	425	+	1 (3) An individual application shall not be required from a
	426	+	2 person covered under a blanket accident or health policy or
	427	+	3 contract, nor shall it be necessary for the insurer to furnish
	428	+	4 each person a certificate.
	429	+	5 (4) All benefits under any blanket accident and health
	430	+	6 policy shall be payable to the person insured, or to his
	431	+	7 designated beneficiary or beneficiaries, or to his or her
	432	+	8 estate, except that if the person insured be a minor or person
	433	+	9 under legal disability, such benefits may be made payable to
	434	+	10 his or her parent, guardian, or other person actually
	435	+	11 supporting him or her. Provided further, however, that the
	436	+	12 policy may provide that all or any portion of any indemnities
	437	+	13 provided by any such policy on account of hospital, nursing,
	438	+	14 medical or surgical services may, at the insurer's option, be
	439	+	15 paid directly to the hospital or person rendering such
	440	+	16 services; but the policy may not require that the service be
	441	+	17 rendered by a particular hospital or person. Payment so made
	442	+	18 shall discharge the insurer's obligation with respect to the
	443	+	19 amount of insurance so paid.
	444	+	20 (5) Nothing contained in this section shall be deemed to
	445	+	21 affect the legal liability of policyholders for the death of
	446	+	22 or injury to, any such member of such group.
	447	+	23 (Source: P.A. 83-1362.)
	448	+	24 (215 ILCS 5/368f)
	449	+	25 Sec. 368f. Military service member insurance
	450	+
	451	+
	452	+
	453	+
	454	+
	455	+	HB2499 Enrolled - 13 - LRB103 30875 AMQ 57395 b
	456	+
	457	+
	458	+	HB2499 Enrolled- 14 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 14 - LRB103 30875 AMQ 57395 b
	459	+	HB2499 Enrolled - 14 - LRB103 30875 AMQ 57395 b
	460	+	1 reinstatement.
	461	+	2 (a) No Illinois resident activated for military service
	462	+	3 and no spouse or dependent of the resident who becomes
	463	+	4 eligible for a federal government-sponsored health insurance
	464	+	5 program, including the TriCare program providing coverage for
	465	+	6 civilian dependents of military personnel, as a result of the
	466	+	7 activation shall be denied reinstatement into the same
	467	+	8 individual health insurance coverage with the health insurer
	468	+	9 that the resident lapsed as a result of activation or becoming
	469	+	10 covered by the federal government-sponsored health insurance
	470	+	11 program. The resident shall have the right to reinstatement in
	471	+	12 the same individual health insurance coverage without medical
	472	+	13 underwriting, subject to payment of the current premium
	473	+	14 charged to other persons of the same age and gender that are
	474	+	15 covered under the same individual health coverage. Except in
	475	+	16 the case of birth or adoption that occurs during the period of
	476	+	17 activation, reinstatement must be into the same coverage type
	477	+	18 as the resident held prior to lapsing the individual health
	478	+	19 insurance coverage and at the same or, at the option of the
	479	+	20 resident, higher deductible level. The reinstatement rights
	480	+	21 provided under this subsection (a) are not available to a
	481	+	22 resident or dependents if the activated person is discharged
	482	+	23 from the military under other than honorable conditions.
	483	+	24 (b) The health insurer with which the reinstatement is
	484	+	25 being requested must receive a request for reinstatement no
	485	+	26 later than 63 days following the later of (i) deactivation or
	486	+
	487	+
	488	+
	489	+
	490	+
	491	+	HB2499 Enrolled - 14 - LRB103 30875 AMQ 57395 b
	492	+
	493	+
	494	+	HB2499 Enrolled- 15 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 15 - LRB103 30875 AMQ 57395 b
	495	+	HB2499 Enrolled - 15 - LRB103 30875 AMQ 57395 b
	496	+	1 (ii) loss of coverage under the federal government-sponsored
	497	+	2 health insurance program. The health insurer may request proof
	498	+	3 of loss of coverage and the timing of the loss of coverage of
	499	+	4 the government-sponsored coverage in order to determine
	500	+	5 eligibility for reinstatement into the individual coverage.
	501	+	6 The effective date of the reinstatement of individual health
	502	+	7 coverage shall be the first of the month following receipt of
	503	+	8 the notice requesting reinstatement.
	504	+	9 (c) All insurers must provide written notice to the
	505	+	10 policyholder of individual health coverage of the rights
	506	+	11 described in subsection (a) of this Section. In lieu of the
	507	+	12 inclusion of the notice in the individual health insurance
	508	+	13 policy, an insurance company may satisfy the notification
	509	+	14 requirement by providing a single written notice:
	510	+	15 (1) in conjunction with the enrollment process for a
	511	+	16 policyholder initially enrolling in the individual
	512	+	17 coverage on or after the effective date of this amendatory
	513	+	18 Act of the 94th General Assembly; or
	514	+	19 (2) by mailing written notice to policyholders whose
	515	+	20 coverage was effective prior to the effective date of this
	516	+	21 amendatory Act of the 94th General Assembly no later than
	517	+	22 90 days following the effective date of this amendatory
	518	+	23 Act of the 94th General Assembly.
	519	+	24 (d) The provisions of subsection (a) of this Section do
	520	+	25 not apply to any policy or certificate providing coverage for
	521	+	26 any specified disease, specified accident or accident-only
	522	+
	523	+
	524	+
	525	+
	526	+
	527	+	HB2499 Enrolled - 15 - LRB103 30875 AMQ 57395 b
	528	+
	529	+
	530	+	HB2499 Enrolled- 16 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 16 - LRB103 30875 AMQ 57395 b
	531	+	HB2499 Enrolled - 16 - LRB103 30875 AMQ 57395 b
	532	+	1 coverage, credit, dental, disability income, hospital
	533	+	2 indemnity or other fixed indemnity, long-term care, Medicare
	534	+	3 supplement, vision care, or short-term travel nonrenewable
	535	+	4 health policy or other limited-benefit supplemental insurance,
	536	+	5 or any coverage issued as a supplement to any liability
	537	+	6 insurance, workers' compensation or similar insurance, or any
	538	+	7 insurance under which benefits are payable with or without
	539	+	8 regard to fault, whether written on a group, blanket, or
	540	+	9 individual basis.
	541	+	10 (e) Nothing in this Section shall require an insurer to
	542	+	11 reinstate the resident if the insurer requires residency in an
	543	+	12 enrollment area and those residency requirements are not met
	544	+	13 after deactivation or loss of coverage under the
	545	+	14 government-sponsored health insurance program.
	546	+	15 (f) All terms, conditions, and limitations of the
	547	+	16 individual coverage into which reinstatement is made apply
	548	+	17 equally to all insureds enrolled in the coverage.
	549	+	18 (g) The Secretary may adopt rules as may be necessary to
	550	+	19 carry out the provisions of this Section.
	551	+	20 (Source: P.A. 94-1037, eff. 7-20-06.)
	552	+	21 Section 10. The Health Maintenance Organization Act is
	553	+	22 amended by changing Section 5-3 as follows:
	554	+	23 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
	555	+	24 Sec. 5-3. Insurance Code provisions.
	556	+
	557	+
	558	+
	559	+
	560	+
	561	+	HB2499 Enrolled - 16 - LRB103 30875 AMQ 57395 b
	562	+
	563	+
	564	+	HB2499 Enrolled- 17 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 17 - LRB103 30875 AMQ 57395 b
	565	+	HB2499 Enrolled - 17 - LRB103 30875 AMQ 57395 b
	566	+	1 (a) Health Maintenance Organizations shall be subject to
	567	+	2 the provisions of Sections 133, 134, 136, 137, 139, 140,
	568	+	3 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
	569	+	4 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 155.49,
	570	+	5 352c, 355.2, 355.3, 355b, 355c, 356f, 356g.5-1, 356m, 356q,
	571	+	6 356v, 356w, 356x, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
	572	+	7 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
	573	+	8 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.20, 356z.21,
	574	+	9 356z.22, 356z.23, 356z.24, 356z.25, 356z.26, 356z.28, 356z.29,
	575	+	10 356z.30, 356z.30a, 356z.31, 356z.32, 356z.33, 356z.34,
	576	+	11 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40, 356z.41,
	577	+	12 356z.44, 356z.45, 356z.46, 356z.47, 356z.48, 356z.49, 356z.50,
	578	+	13 356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.58,
	579	+	14 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.65, 356z.67,
	580	+	15 356z.68, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b,
	581	+	16 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A,
	582	+	17 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of
	583	+	18 subsection (2) of Section 367, and Articles IIA, VIII 1/2,
	584	+	19 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
	585	+	20 Illinois Insurance Code.
	586	+	21 (b) For purposes of the Illinois Insurance Code, except
	587	+	22 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
	588	+	23 Health Maintenance Organizations in the following categories
	589	+	24 are deemed to be "domestic companies":
	590	+	25 (1) a corporation authorized under the Dental Service
	591	+	26 Plan Act or the Voluntary Health Services Plans Act;
	592	+
	593	+
	594	+
	595	+
	596	+
	597	+	HB2499 Enrolled - 17 - LRB103 30875 AMQ 57395 b
	598	+
	599	+
	600	+	HB2499 Enrolled- 18 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 18 - LRB103 30875 AMQ 57395 b
	601	+	HB2499 Enrolled - 18 - LRB103 30875 AMQ 57395 b
	602	+	1 (2) a corporation organized under the laws of this
	603	+	2 State; or
	604	+	3 (3) a corporation organized under the laws of another
	605	+	4 state, 30% or more of the enrollees of which are residents
	606	+	5 of this State, except a corporation subject to
	607	+	6 substantially the same requirements in its state of
	608	+	7 organization as is a "domestic company" under Article VIII
	609	+	8 1/2 of the Illinois Insurance Code.
	610	+	9 (c) In considering the merger, consolidation, or other
	611	+	10 acquisition of control of a Health Maintenance Organization
	612	+	11 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
	613	+	12 (1) the Director shall give primary consideration to
	614	+	13 the continuation of benefits to enrollees and the
	615	+	14 financial conditions of the acquired Health Maintenance
	616	+	15 Organization after the merger, consolidation, or other
	617	+	16 acquisition of control takes effect;
	618	+	17 (2)(i) the criteria specified in subsection (1)(b) of
	619	+	18 Section 131.8 of the Illinois Insurance Code shall not
	620	+	19 apply and (ii) the Director, in making his determination
	621	+	20 with respect to the merger, consolidation, or other
	622	+	21 acquisition of control, need not take into account the
	623	+	22 effect on competition of the merger, consolidation, or
	624	+	23 other acquisition of control;
	625	+	24 (3) the Director shall have the power to require the
	626	+	25 following information:
	627	+	26 (A) certification by an independent actuary of the
	628	+
	629	+
	630	+
	631	+
	632	+
	633	+	HB2499 Enrolled - 18 - LRB103 30875 AMQ 57395 b
	634	+
	635	+
	636	+	HB2499 Enrolled- 19 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 19 - LRB103 30875 AMQ 57395 b
	637	+	HB2499 Enrolled - 19 - LRB103 30875 AMQ 57395 b
	638	+	1 adequacy of the reserves of the Health Maintenance
	639	+	2 Organization sought to be acquired;
	640	+	3 (B) pro forma financial statements reflecting the
	641	+	4 combined balance sheets of the acquiring company and
	642	+	5 the Health Maintenance Organization sought to be
	643	+	6 acquired as of the end of the preceding year and as of
	644	+	7 a date 90 days prior to the acquisition, as well as pro
	645	+	8 forma financial statements reflecting projected
	646	+	9 combined operation for a period of 2 years;
	647	+	10 (C) a pro forma business plan detailing an
	648	+	11 acquiring party's plans with respect to the operation
	649	+	12 of the Health Maintenance Organization sought to be
	650	+	13 acquired for a period of not less than 3 years; and
	651	+	14 (D) such other information as the Director shall
	652	+	15 require.
	653	+	16 (d) The provisions of Article VIII 1/2 of the Illinois
	654	+	17 Insurance Code and this Section 5-3 shall apply to the sale by
	655	+	18 any health maintenance organization of greater than 10% of its
	656	+	19 enrollee population (including, without limitation, the health
	657	+	20 maintenance organization's right, title, and interest in and
	658	+	21 to its health care certificates).
	659	+	22 (e) In considering any management contract or service
	660	+	23 agreement subject to Section 141.1 of the Illinois Insurance
	661	+	24 Code, the Director (i) shall, in addition to the criteria
	662	+	25 specified in Section 141.2 of the Illinois Insurance Code,
	663	+	26 take into account the effect of the management contract or
	664	+
	665	+
	666	+
	667	+
	668	+
	669	+	HB2499 Enrolled - 19 - LRB103 30875 AMQ 57395 b
	670	+
	671	+
	672	+	HB2499 Enrolled- 20 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 20 - LRB103 30875 AMQ 57395 b
	673	+	HB2499 Enrolled - 20 - LRB103 30875 AMQ 57395 b
	674	+	1 service agreement on the continuation of benefits to enrollees
	675	+	2 and the financial condition of the health maintenance
	676	+	3 organization to be managed or serviced, and (ii) need not take
	677	+	4 into account the effect of the management contract or service
	678	+	5 agreement on competition.
	679	+	6 (f) Except for small employer groups as defined in the
	680	+	7 Small Employer Rating, Renewability and Portability Health
	681	+	8 Insurance Act and except for medicare supplement policies as
	682	+	9 defined in Section 363 of the Illinois Insurance Code, a
	683	+	10 Health Maintenance Organization may by contract agree with a
	684	+	11 group or other enrollment unit to effect refunds or charge
	685	+	12 additional premiums under the following terms and conditions:
	686	+	13 (i) the amount of, and other terms and conditions with
	687	+	14 respect to, the refund or additional premium are set forth
	688	+	15 in the group or enrollment unit contract agreed in advance
	689	+	16 of the period for which a refund is to be paid or
	690	+	17 additional premium is to be charged (which period shall
	691	+	18 not be less than one year); and
	692	+	19 (ii) the amount of the refund or additional premium
	693	+	20 shall not exceed 20% of the Health Maintenance
	694	+	21 Organization's profitable or unprofitable experience with
	695	+	22 respect to the group or other enrollment unit for the
	696	+	23 period (and, for purposes of a refund or additional
	697	+	24 premium, the profitable or unprofitable experience shall
	698	+	25 be calculated taking into account a pro rata share of the
	699	+	26 Health Maintenance Organization's administrative and
	700	+
	701	+
	702	+
	703	+
	704	+
	705	+	HB2499 Enrolled - 20 - LRB103 30875 AMQ 57395 b
	706	+
	707	+
	708	+	HB2499 Enrolled- 21 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 21 - LRB103 30875 AMQ 57395 b
	709	+	HB2499 Enrolled - 21 - LRB103 30875 AMQ 57395 b
	710	+	1 marketing expenses, but shall not include any refund to be
	711	+	2 made or additional premium to be paid pursuant to this
	712	+	3 subsection (f)). The Health Maintenance Organization and
	713	+	4 the group or enrollment unit may agree that the profitable
	714	+	5 or unprofitable experience may be calculated taking into
	715	+	6 account the refund period and the immediately preceding 2
	716	+	7 plan years.
	717	+	8 The Health Maintenance Organization shall include a
	718	+	9 statement in the evidence of coverage issued to each enrollee
	719	+	10 describing the possibility of a refund or additional premium,
	720	+	11 and upon request of any group or enrollment unit, provide to
	721	+	12 the group or enrollment unit a description of the method used
	722	+	13 to calculate (1) the Health Maintenance Organization's
	723	+	14 profitable experience with respect to the group or enrollment
	724	+	15 unit and the resulting refund to the group or enrollment unit
	725	+	16 or (2) the Health Maintenance Organization's unprofitable
	726	+	17 experience with respect to the group or enrollment unit and
	727	+	18 the resulting additional premium to be paid by the group or
	728	+	19 enrollment unit.
	729	+	20 In no event shall the Illinois Health Maintenance
	730	+	21 Organization Guaranty Association be liable to pay any
	731	+	22 contractual obligation of an insolvent organization to pay any
	732	+	23 refund authorized under this Section.
	733	+	24 (g) Rulemaking authority to implement Public Act 95-1045,
	734	+	25 if any, is conditioned on the rules being adopted in
	735	+	26 accordance with all provisions of the Illinois Administrative
	736	+
	737	+
	738	+
	739	+
	740	+
	741	+	HB2499 Enrolled - 21 - LRB103 30875 AMQ 57395 b
	742	+
	743	+
	744	+	HB2499 Enrolled- 22 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 22 - LRB103 30875 AMQ 57395 b
	745	+	HB2499 Enrolled - 22 - LRB103 30875 AMQ 57395 b
	746	+	1 Procedure Act and all rules and procedures of the Joint
	747	+	2 Committee on Administrative Rules; any purported rule not so
	748	+	3 adopted, for whatever reason, is unauthorized.
	749	+	4 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
	750	+	5 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
	751	+	6 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
	752	+	7 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
	753	+	8 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
	754	+	9 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
	755	+	10 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
	756	+	11 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
	757	+	12 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
	758	+	13 eff. 1-1-24; 103-551, eff. 8-11-23; revised 8-29-23.)
	759	+	14 Section 15. The Limited Health Service Organization Act is
	760	+	15 amended by changing Section 4003 as follows:
	761	+	16 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
	762	+	17 Sec. 4003. Illinois Insurance Code provisions. Limited
	763	+	18 health service organizations shall be subject to the
	764	+	19 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
	765	+	20 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
	766	+	21 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
	767	+	22 355.2, 355.3, 355b, 356q, 356v, 356z.4, 356z.4a, 356z.10,
	768	+	23 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30a,
	769	+	24 356z.32, 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53,
	770	+
	771	+
	772	+
	773	+
	774	+
	775	+	HB2499 Enrolled - 22 - LRB103 30875 AMQ 57395 b
	776	+
	777	+
	778	+	HB2499 Enrolled- 23 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 23 - LRB103 30875 AMQ 57395 b
	779	+	HB2499 Enrolled - 23 - LRB103 30875 AMQ 57395 b
	780	+	1 356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68,
	781	+	2 364.3, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412,
	782	+	3 444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
	783	+	4 XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
	784	+	5 Nothing in this Section shall require a limited health care
	785	+	6 plan to cover any service that is not a limited health service.
	786	+	7 For purposes of the Illinois Insurance Code, except for
	787	+	8 Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited
	788	+	9 health service organizations in the following categories are
	789	+	10 deemed to be domestic companies:
	790	+	11 (1) a corporation under the laws of this State; or
	791	+	12 (2) a corporation organized under the laws of another
	792	+	13 state, 30% or more of the enrollees of which are residents
	793	+	14 of this State, except a corporation subject to
	794	+	15 substantially the same requirements in its state of
	795	+	16 organization as is a domestic company under Article VIII
	796	+	17 1/2 of the Illinois Insurance Code.
	797	+	18 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
	798	+	19 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff.
	799	+	20 1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816,
	800	+	21 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
	801	+	22 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
	802	+	23 1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
	803	+	24 eff. 1-1-24; revised 8-29-23.)
	804	+	25 (215 ILCS 190/Act rep.)
	805	+
	806	+
	807	+
	808	+
	809	+
	810	+	HB2499 Enrolled - 23 - LRB103 30875 AMQ 57395 b
	811	+
	812	+
	813	+	HB2499 Enrolled- 24 -LRB103 30875 AMQ 57395 b HB2499 Enrolled - 24 - LRB103 30875 AMQ 57395 b
	814	+	HB2499 Enrolled - 24 - LRB103 30875 AMQ 57395 b
	815	+	1 Section 20. The Short-Term, Limited-Duration Health
	816	+	2 Insurance Coverage Act is repealed.
	817	+	3 Section 95. No acceleration or delay. Where this Act makes
	818	+	4 changes in a statute that is represented in this Act by text
	819	+	5 that is not yet or no longer in effect (for example, a Section
	820	+	6 represented by multiple versions), the use of that text does
	821	+	7 not accelerate or delay the taking effect of (i) the changes
	822	+	8 made by this Act or (ii) provisions derived from any other
	823	+	9 Public Act.
	824	+
	825	+
	826	+
	827	+
	828	+
	829	+	HB2499 Enrolled - 24 - LRB103 30875 AMQ 57395 b