Illinois 2023-2024 Regular Session

Illinois House Bill HB3202 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Public Act 103-0445
2	1		HB3202 EnrolledLRB103 28677 BMS 55058 b HB3202 Enrolled LRB103 28677 BMS 55058 b
3	2		HB3202 Enrolled LRB103 28677 BMS 55058 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 State Employees Group Insurance Act of 1971
8		-	is amended by changing Section 6.11 as follows:
9		-	(5 ILCS 375/6.11)
10		-	(Text of Section before amendment by P.A. 102-768)
11		-	Sec. 6.11. Required health benefits; Illinois Insurance
12		-	Code requirements. The program of health benefits shall
13		-	provide the post-mastectomy care benefits required to be
14		-	covered by a policy of accident and health insurance under
15		-	Section 356t of the Illinois Insurance Code. The program of
16		-	health benefits shall provide the coverage required under
17		-	Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
18		-	356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
19		-	356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
20		-	356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
21		-	356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
22		-	356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
23		-	the Illinois Insurance Code. The program of health benefits
24		-	must comply with Sections 155.22a, 155.37, 355b, 356z.19,
25		-	370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
26		-	Code. The Department of Insurance shall enforce the
	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 State Employees Group Insurance Act of 1971
	7	+	5 is amended by changing Section 6.11 as follows:
	8	+	6 (5 ILCS 375/6.11)
	9	+	7 (Text of Section before amendment by P.A. 102-768)
	10	+	8 Sec. 6.11. Required health benefits; Illinois Insurance
	11	+	9 Code requirements. The program of health benefits shall
	12	+	10 provide the post-mastectomy care benefits required to be
	13	+	11 covered by a policy of accident and health insurance under
	14	+	12 Section 356t of the Illinois Insurance Code. The program of
	15	+	13 health benefits shall provide the coverage required under
	16	+	14 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
	17	+	15 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
	18	+	16 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
	19	+	17 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
	20	+	18 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
	21	+	19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
	22	+	20 the Illinois Insurance Code. The program of health benefits
	23	+	21 must comply with Sections 155.22a, 155.37, 355b, 356z.19,
	24	+	22 370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
	25	+	23 Code. The Department of Insurance shall enforce the
27	26
28	27
29	28
30	29		HB3202 Enrolled LRB103 28677 BMS 55058 b
31	30
32	31
33		-	requirements of this Section with respect to Sections 370c and
34		-	370c.1 of the Illinois Insurance Code; all other requirements
35		-	of this Section shall be enforced by the Department of Central
36		-	Management Services.
37		-	Rulemaking authority to implement Public Act 95-1045, if
38		-	any, is conditioned on the rules being adopted in accordance
39		-	with all provisions of the Illinois Administrative Procedure
40		-	Act and all rules and procedures of the Joint Committee on
41		-	Administrative Rules; any purported rule not so adopted, for
42		-	whatever reason, is unauthorized.
43		-	(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
44		-	101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
45		-	1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
46		-	eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
47		-	102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
48		-	1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
49		-	eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
50		-	revised 12-13-22.)
51		-	(Text of Section after amendment by P.A. 102-768)
52		-	Sec. 6.11. Required health benefits; Illinois Insurance
53		-	Code requirements. The program of health benefits shall
54		-	provide the post-mastectomy care benefits required to be
55		-	covered by a policy of accident and health insurance under
56		-	Section 356t of the Illinois Insurance Code. The program of
57		-	health benefits shall provide the coverage required under
	32	+	HB3202 Enrolled- 2 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 2 - LRB103 28677 BMS 55058 b
	33	+	HB3202 Enrolled - 2 - LRB103 28677 BMS 55058 b
	34	+	1 requirements of this Section with respect to Sections 370c and
	35	+	2 370c.1 of the Illinois Insurance Code; all other requirements
	36	+	3 of this Section shall be enforced by the Department of Central
	37	+	4 Management Services.
	38	+	5 Rulemaking authority to implement Public Act 95-1045, if
	39	+	6 any, is conditioned on the rules being adopted in accordance
	40	+	7 with all provisions of the Illinois Administrative Procedure
	41	+	8 Act and all rules and procedures of the Joint Committee on
	42	+	9 Administrative Rules; any purported rule not so adopted, for
	43	+	10 whatever reason, is unauthorized.
	44	+	11 (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
	45	+	12 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
	46	+	13 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
	47	+	14 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
	48	+	15 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
	49	+	16 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
	50	+	17 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
	51	+	18 revised 12-13-22.)
	52	+	19 (Text of Section after amendment by P.A. 102-768)
	53	+	20 Sec. 6.11. Required health benefits; Illinois Insurance
	54	+	21 Code requirements. The program of health benefits shall
	55	+	22 provide the post-mastectomy care benefits required to be
	56	+	23 covered by a policy of accident and health insurance under
	57	+	24 Section 356t of the Illinois Insurance Code. The program of
	58	+	25 health benefits shall provide the coverage required under
58	59
59	60
60		-	Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
61		-	356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
62		-	356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
63		-	356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
64		-	356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
65		-	356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
66		-	356z.60, and 356z.61 of the Illinois Insurance Code. The
67		-	program of health benefits must comply with Sections 155.22a,
68		-	155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
69		-	the Illinois Insurance Code. The Department of Insurance shall
70		-	enforce the requirements of this Section with respect to
71		-	Sections 370c and 370c.1 of the Illinois Insurance Code; all
72		-	other requirements of this Section shall be enforced by the
73		-	Department of Central Management Services.
74		-	Rulemaking authority to implement Public Act 95-1045, if
75		-	any, is conditioned on the rules being adopted in accordance
76		-	with all provisions of the Illinois Administrative Procedure
77		-	Act and all rules and procedures of the Joint Committee on
78		-	Administrative Rules; any purported rule not so adopted, for
79		-	whatever reason, is unauthorized.
80		-	(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
81		-	101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
82		-	1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
83		-	eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
84		-	102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
85		-	1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
86	61
87	62
88		-	eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
89		-	102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
90		-	Section 10. The Counties Code is amended by changing
91		-	Section 5-1069.3 as follows:
92		-	(55 ILCS 5/5-1069.3)
93		-	Sec. 5-1069.3. Required health benefits. If a county,
94		-	including a home rule county, is a self-insurer for purposes
95		-	of providing health insurance coverage for its employees, the
96		-	coverage shall include coverage for the post-mastectomy care
97		-	benefits required to be covered by a policy of accident and
98		-	health insurance under Section 356t and the coverage required
99		-	under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
100		-	356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
101		-	356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
102		-	356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
103		-	356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
104		-	356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
105		-	of the Illinois Insurance Code. The coverage shall comply with
106		-	Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
107		-	Insurance Code. The Department of Insurance shall enforce the
108		-	requirements of this Section. The requirement that health
109		-	benefits be covered as provided in this Section is an
110		-	exclusive power and function of the State and is a denial and
111		-	limitation under Article VII, Section 6, subsection (h) of the
	63	+
	64	+	HB3202 Enrolled - 2 - LRB103 28677 BMS 55058 b
112	65
113	66
114		-	Illinois Constitution. A home rule county to which this
115		-	Section applies must comply with every provision of this
116		-	Section.
117		-	Rulemaking authority to implement Public Act 95-1045, if
118		-	any, is conditioned on the rules being adopted in accordance
119		-	with all provisions of the Illinois Administrative Procedure
120		-	Act and all rules and procedures of the Joint Committee on
121		-	Administrative Rules; any purported rule not so adopted, for
122		-	whatever reason, is unauthorized.
123		-	(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
124		-	101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
125		-	1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
126		-	eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
127		-	102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
128		-	1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
129		-	eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
130		-	102-1117, eff. 1-13-23.)
131		-	Section 15. The Illinois Municipal Code is amended by
132		-	changing Section 10-4-2.3 as follows:
133		-	(65 ILCS 5/10-4-2.3)
134		-	Sec. 10-4-2.3. Required health benefits. If a
135		-	municipality, including a home rule municipality, is a
136		-	self-insurer for purposes of providing health insurance
137		-	coverage for its employees, the coverage shall include
	67	+	HB3202 Enrolled- 3 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 3 - LRB103 28677 BMS 55058 b
	68	+	HB3202 Enrolled - 3 - LRB103 28677 BMS 55058 b
	69	+	1 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
	70	+	2 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
	71	+	3 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
	72	+	4 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
	73	+	5 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
	74	+	6 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
	75	+	7 356z.60, and 356z.61 of the Illinois Insurance Code. The
	76	+	8 program of health benefits must comply with Sections 155.22a,
	77	+	9 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
	78	+	10 the Illinois Insurance Code. The Department of Insurance shall
	79	+	11 enforce the requirements of this Section with respect to
	80	+	12 Sections 370c and 370c.1 of the Illinois Insurance Code; all
	81	+	13 other requirements of this Section shall be enforced by the
	82	+	14 Department of Central Management Services.
	83	+	15 Rulemaking authority to implement Public Act 95-1045, if
	84	+	16 any, is conditioned on the rules being adopted in accordance
	85	+	17 with all provisions of the Illinois Administrative Procedure
	86	+	18 Act and all rules and procedures of the Joint Committee on
	87	+	19 Administrative Rules; any purported rule not so adopted, for
	88	+	20 whatever reason, is unauthorized.
	89	+	21 (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
	90	+	22 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
	91	+	23 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
	92	+	24 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
	93	+	25 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
	94	+	26 1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
138	95
139	96
140		-	coverage for the post-mastectomy care benefits required to be
141		-	covered by a policy of accident and health insurance under
142		-	Section 356t and the coverage required under Sections 356g,
143		-	356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
144		-	356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
145		-	356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
146		-	356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
147		-	356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
148		-	356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
149		-	Illinois Insurance Code. The coverage shall comply with
150		-	Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
151		-	Insurance Code. The Department of Insurance shall enforce the
152		-	requirements of this Section. The requirement that health
153		-	benefits be covered as provided in this is an exclusive power
154		-	and function of the State and is a denial and limitation under
155		-	Article VII, Section 6, subsection (h) of the Illinois
156		-	Constitution. A home rule municipality to which this Section
157		-	applies must comply with every provision of this Section.
158		-	Rulemaking authority to implement Public Act 95-1045, if
159		-	any, is conditioned on the rules being adopted in accordance
160		-	with all provisions of the Illinois Administrative Procedure
161		-	Act and all rules and procedures of the Joint Committee on
162		-	Administrative Rules; any purported rule not so adopted, for
163		-	whatever reason, is unauthorized.
164		-	(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
165		-	101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
166	97
167	98
168		-	1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
169		-	eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
170		-	102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
171		-	1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
172		-	eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
173		-	102-1117, eff. 1-13-23.)
174		-	Section 20. The School Code is amended by changing Section
175		-	10-22.3f as follows:
176		-	(105 ILCS 5/10-22.3f)
177		-	Sec. 10-22.3f. Required health benefits. Insurance
178		-	protection and benefits for employees shall provide the
179		-	post-mastectomy care benefits required to be covered by a
180		-	policy of accident and health insurance under Section 356t and
181		-	the coverage required under Sections 356g, 356g.5, 356g.5-1,
182		-	356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
183		-	356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
184		-	356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
185		-	356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
186		-	356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
187		-	356z.61 of the Illinois Insurance Code. Insurance policies
188		-	shall comply with Section 356z.19 of the Illinois Insurance
189		-	Code. The coverage shall comply with Sections 155.22a, 355b,
190		-	and 370c of the Illinois Insurance Code. The Department of
191		-	Insurance shall enforce the requirements of this Section.
	99	+
	100	+	HB3202 Enrolled - 3 - LRB103 28677 BMS 55058 b
192	101
193	102
194		-	Rulemaking authority to implement Public Act 95-1045, if
195		-	any, is conditioned on the rules being adopted in accordance
196		-	with all provisions of the Illinois Administrative Procedure
197		-	Act and all rules and procedures of the Joint Committee on
198		-	Administrative Rules; any purported rule not so adopted, for
199		-	whatever reason, is unauthorized.
200		-	(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
201		-	101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
202		-	1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
203		-	eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
204		-	102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
205		-	1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
206		-	eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
207		-	Section 25. The Illinois Insurance Code is amended by
208		-	adding Section 356z.61 as follows:
209		-	(215 ILCS 5/356z.61 new)
210		-	Sec. 356z.61. Home saliva cancer screening.
211		-	(a) As used in this Section, "home saliva cancer
212		-	screening" means an outpatient test that utilizes an
213		-	individual's saliva to detect biomarkers for early-stage
214		-	cancer.
215		-	(b) An individual or group policy of accident and health
216		-	insurance that is amended, delivered, issued, or renewed on or
217		-	after January 1, 2025 shall cover a medically necessary home
	103	+	HB3202 Enrolled- 4 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 4 - LRB103 28677 BMS 55058 b
	104	+	HB3202 Enrolled - 4 - LRB103 28677 BMS 55058 b
	105	+	1 eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
	106	+	2 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
	107	+	3 Section 10. The Counties Code is amended by changing
	108	+	4 Section 5-1069.3 as follows:
	109	+	5 (55 ILCS 5/5-1069.3)
	110	+	6 Sec. 5-1069.3. Required health benefits. If a county,
	111	+	7 including a home rule county, is a self-insurer for purposes
	112	+	8 of providing health insurance coverage for its employees, the
	113	+	9 coverage shall include coverage for the post-mastectomy care
	114	+	10 benefits required to be covered by a policy of accident and
	115	+	11 health insurance under Section 356t and the coverage required
	116	+	12 under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
	117	+	13 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
	118	+	14 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
	119	+	15 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
	120	+	16 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
	121	+	17 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
	122	+	18 of the Illinois Insurance Code. The coverage shall comply with
	123	+	19 Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
	124	+	20 Insurance Code. The Department of Insurance shall enforce the
	125	+	21 requirements of this Section. The requirement that health
	126	+	22 benefits be covered as provided in this Section is an
	127	+	23 exclusive power and function of the State and is a denial and
	128	+	24 limitation under Article VII, Section 6, subsection (h) of the
218	129
219	130
220		-	saliva cancer screening every 24 months if the patient:
221		-	(1) is asymptomatic and at high risk for the disease
222		-	being tested for; or
223		-	(2) demonstrates symptoms of the disease being tested
224		-	for at a physical exam.
225		-	Section 30. The Health Maintenance Organization Act is
226		-	amended by changing Section 5-3 as follows:
227		-	(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
228		-	Sec. 5-3. Insurance Code provisions.
229		-	(a) Health Maintenance Organizations shall be subject to
230		-	the provisions of Sections 133, 134, 136, 137, 139, 140,
231		-	141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
232		-	154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
233		-	355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
234		-	356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
235		-	356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
236		-	356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
237		-	356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
238		-	356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
239		-	356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
240		-	356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
241		-	367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
242		-	402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
243		-	paragraph (c) of subsection (2) of Section 367, and Articles
244	131
245	132
246		-	IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
247		-	XXXIIB of the Illinois Insurance Code.
248		-	(b) For purposes of the Illinois Insurance Code, except
249		-	for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
250		-	Health Maintenance Organizations in the following categories
251		-	are deemed to be "domestic companies":
252		-	(1) a corporation authorized under the Dental Service
253		-	Plan Act or the Voluntary Health Services Plans Act;
254		-	(2) a corporation organized under the laws of this
255		-	State; or
256		-	(3) a corporation organized under the laws of another
257		-	state, 30% or more of the enrollees of which are residents
258		-	of this State, except a corporation subject to
259		-	substantially the same requirements in its state of
260		-	organization as is a "domestic company" under Article VIII
261		-	1/2 of the Illinois Insurance Code.
262		-	(c) In considering the merger, consolidation, or other
263		-	acquisition of control of a Health Maintenance Organization
264		-	pursuant to Article VIII 1/2 of the Illinois Insurance Code,
265		-	(1) the Director shall give primary consideration to
266		-	the continuation of benefits to enrollees and the
267		-	financial conditions of the acquired Health Maintenance
268		-	Organization after the merger, consolidation, or other
269		-	acquisition of control takes effect;
270		-	(2)(i) the criteria specified in subsection (1)(b) of
271		-	Section 131.8 of the Illinois Insurance Code shall not
	133	+
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272	135
273	136
274		-	~~apply and (ii) the Director,~~ ~~in making his determination~~
275		-	~~with respect to the merger,~~ ~~consolidation, or other~~
276		-	~~acquisition of control,~~ ~~need not take into account the~~
277		-	~~effect on competition~~ of ~~the merger, consolidation, or~~
278		-	~~other acquisition of control;~~
279		-	~~(3) the Director shall have the power~~ to ~~require the~~
280		-	~~following information:~~
281		-	~~(A) certification by an independent actuary~~ of the
282		-	~~adequacy~~ of the ~~reserves of the Health Maintenance~~
283		-	~~Organization sought to be acquired;~~
284		-	~~(B) pro forma financial statements reflecting the~~
285		-	~~combined balance sheets of the acquiring company and~~
286		-	~~the Health Maintenance Organization sought to be~~
287		-	~~acquired as of the end of the preceding year and as of~~
288		-	~~a date 90 days prior to the acquisition~~, ~~as well as pro~~
289		-	~~forma financial statements reflecting projected~~
290		-	~~combined operation for a period of 2 years~~;
291		-	~~(C) a pro forma business plan detailing an~~
292		-	~~acquiring party's plans with respect to the operation~~
293		-	of the ~~Health Maintenance Organization sought to be~~
294		-	~~acquired for a period of not less than~~ 3 ~~years; and~~
295		-	(D) ~~such other information as the Director shall~~
296		-	~~require~~.
297		-	~~(d) The provisions of Article VIII 1/2 of the Illinois~~
298		-	Insurance ~~Code and this Section 5-3 shall apply to the sale by~~
299		-	~~any health maintenance organization of greater than 10% of~~ its
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	139	+	1 Illinois Constitution. A home rule county to which this
	140	+	2 Section applies must comply with every provision of this
	141	+	3 Section.
	142	+	4 Rulemaking authority to implement Public Act 95-1045, if
	143	+	5 any, is conditioned on the rules being adopted in accordance
	144	+	6 with all provisions of the Illinois Administrative Procedure
	145	+	7 Act and all rules and procedures of the Joint Committee on
	146	+	8 Administrative Rules; any purported rule not so adopted, for
	147	+	9 whatever reason, is unauthorized.
	148	+	10 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
	149	+	11 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
	150	+	12 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
	151	+	13 eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
	152	+	14 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
	153	+	15 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
	154	+	16 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
	155	+	17 102-1117, eff. 1-13-23.)
	156	+	18 Section 15. The Illinois Municipal Code is amended by
	157	+	19 changing Section 10-4-2.3 as follows:
	158	+	20 (65 ILCS 5/10-4-2.3)
	159	+	21 Sec. 10-4-2.3. Required health benefits. If a
	160	+	22 municipality, including a home rule municipality, is a
	161	+	23 self-insurer for purposes of providing health insurance
	162	+	24 coverage for its employees, the coverage shall include
300	163
301	164
302		-	enrollee population (including without limitation the health
303		-	maintenance organization's right, title, and interest in and
304		-	to its health care certificates).
305		-	(e) In considering any management contract or service
306		-	agreement subject to Section 141.1 of the Illinois Insurance
307		-	Code, the Director (i) shall, in addition to the criteria
308		-	specified in Section 141.2 of the Illinois Insurance Code,
309		-	take into account the effect of the management contract or
310		-	service agreement on the continuation of benefits to enrollees
311		-	and the financial condition of the health maintenance
312		-	organization to be managed or serviced, and (ii) need not take
313		-	into account the effect of the management contract or service
314		-	agreement on competition.
315		-	(f) Except for small employer groups as defined in the
316		-	Small Employer Rating, Renewability and Portability Health
317		-	Insurance Act and except for medicare supplement policies as
318		-	defined in Section 363 of the Illinois Insurance Code, a
319		-	Health Maintenance Organization may by contract agree with a
320		-	group or other enrollment unit to effect refunds or charge
321		-	additional premiums under the following terms and conditions:
322		-	(i) the amount of, and other terms and conditions with
323		-	respect to, the refund or additional premium are set forth
324		-	in the group or enrollment unit contract agreed in advance
325		-	of the period for which a refund is to be paid or
326		-	additional premium is to be charged (which period shall
327		-	not be less than one year); and
328	165
329	166
330		-	(ii) the amount of the refund or additional premium
331		-	shall not exceed 20% of the Health Maintenance
332		-	Organization's profitable or unprofitable experience with
333		-	respect to the group or other enrollment unit for the
334		-	period (and, for purposes of a refund or additional
335		-	premium, the profitable or unprofitable experience shall
336		-	be calculated taking into account a pro rata share of the
337		-	Health Maintenance Organization's administrative and
338		-	marketing expenses, but shall not include any refund to be
339		-	made or additional premium to be paid pursuant to this
340		-	subsection (f)). The Health Maintenance Organization and
341		-	the group or enrollment unit may agree that the profitable
342		-	or unprofitable experience may be calculated taking into
343		-	account the refund period and the immediately preceding 2
344		-	plan years.
345		-	The Health Maintenance Organization shall include a
346		-	statement in the evidence of coverage issued to each enrollee
347		-	describing the possibility of a refund or additional premium,
348		-	and upon request of any group or enrollment unit, provide to
349		-	the group or enrollment unit a description of the method used
350		-	to calculate (1) the Health Maintenance Organization's
351		-	profitable experience with respect to the group or enrollment
352		-	unit and the resulting refund to the group or enrollment unit
353		-	or (2) the Health Maintenance Organization's unprofitable
354		-	experience with respect to the group or enrollment unit and
355		-	the resulting additional premium to be paid by the group or
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356	169
357	170
358		-	enrollment unit.
359		-	In no event shall the Illinois Health Maintenance
360		-	Organization Guaranty Association be liable to pay any
361		-	contractual obligation of an insolvent organization to pay any
362		-	refund authorized under this Section.
363		-	(g) Rulemaking authority to implement Public Act 95-1045,
364		-	if any, is conditioned on the rules being adopted in
365		-	accordance with all provisions of the Illinois Administrative
366		-	Procedure Act and all rules and procedures of the Joint
367		-	Committee on Administrative Rules; any purported rule not so
368		-	adopted, for whatever reason, is unauthorized.
369		-	(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
370		-	101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
371		-	1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
372		-	eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
373		-	102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
374		-	1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
375		-	eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
376		-	102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
377		-	1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
378		-	eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
379		-	Section 35. The Limited Health Service Organization Act is
380		-	amended by changing Section 4003 as follows:
381		-	(215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
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	172	+	HB3202 Enrolled - 6 - LRB103 28677 BMS 55058 b
	173	+	1 coverage for the post-mastectomy care benefits required to be
	174	+	2 covered by a policy of accident and health insurance under
	175	+	3 Section 356t and the coverage required under Sections 356g,
	176	+	4 356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
	177	+	5 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
	178	+	6 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
	179	+	7 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
	180	+	8 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
	181	+	9 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
	182	+	10 Illinois Insurance Code. The coverage shall comply with
	183	+	11 Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
	184	+	12 Insurance Code. The Department of Insurance shall enforce the
	185	+	13 requirements of this Section. The requirement that health
	186	+	14 benefits be covered as provided in this is an exclusive power
	187	+	15 and function of the State and is a denial and limitation under
	188	+	16 Article VII, Section 6, subsection (h) of the Illinois
	189	+	17 Constitution. A home rule municipality to which this Section
	190	+	18 applies must comply with every provision of this Section.
	191	+	19 Rulemaking authority to implement Public Act 95-1045, if
	192	+	20 any, is conditioned on the rules being adopted in accordance
	193	+	21 with all provisions of the Illinois Administrative Procedure
	194	+	22 Act and all rules and procedures of the Joint Committee on
	195	+	23 Administrative Rules; any purported rule not so adopted, for
	196	+	24 whatever reason, is unauthorized.
	197	+	25 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
	198	+	26 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
382	199
383	200
384		-	Sec. 4003. Illinois Insurance Code provisions. Limited
385		-	health service organizations shall be subject to the
386		-	provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
387		-	141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
388		-	154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
389		-	355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
390		-	356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
391		-	356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
392		-	356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
393		-	408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
394		-	1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
395		-	Illinois Insurance Code. Nothing in this Section shall require
396		-	a limited health care plan to cover any service that is not a
397		-	limited health service. For purposes of the Illinois Insurance
398		-	Code, except for Sections 444 and 444.1 and Articles XIII and
399		-	XIII 1/2, limited health service organizations in the
400		-	following categories are deemed to be domestic companies:
401		-	(1) a corporation under the laws of this State; or
402		-	(2) a corporation organized under the laws of another
403		-	state, 30% or more of the enrollees of which are residents
404		-	of this State, except a corporation subject to
405		-	substantially the same requirements in its state of
406		-	organization as is a domestic company under Article VIII
407		-	1/2 of the Illinois Insurance Code.
408		-	(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
409		-	101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
410	201
411	202
412		-	1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
413		-	eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
414		-	102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
415		-	1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
416		-	Section 40. The Voluntary Health Services Plans Act is
417		-	amended by changing Section 10 as follows:
418		-	(215 ILCS 165/10) (from Ch. 32, par. 604)
419		-	Sec. 10. Application of Insurance Code provisions. Health
420		-	services plan corporations and all persons interested therein
421		-	or dealing therewith shall be subject to the provisions of
422		-	Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
423		-	143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
424		-	356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
425		-	356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
426		-	356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
427		-	356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
428		-	356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
429		-	356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
430		-	356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
431		-	367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
432		-	and paragraphs (7) and (15) of Section 367 of the Illinois
433		-	Insurance Code.
434		-	Rulemaking authority to implement Public Act 95-1045, if
435		-	any, is conditioned on the rules being adopted in accordance
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436	205
437	206
438		-	with all provisions of the Illinois Administrative Procedure
439		-	Act and all rules and procedures of the Joint Committee on
440		-	Administrative Rules; any purported rule not so adopted, for
441		-	whatever reason, is unauthorized.
442		-	(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
443		-	101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
444		-	1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
445		-	eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
446		-	102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
447		-	1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
448		-	eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
449		-	102-1117, eff. 1-13-23.)
450		-	Section 95. No acceleration or delay. Where this Act makes
451		-	changes in a statute that is represented in this Act by text
452		-	that is not yet or no longer in effect (for example, a Section
453		-	represented by multiple versions), the use of that text does
454		-	not accelerate or delay the taking effect of (i) the changes
455		-	made by this Act or (ii) provisions derived from any other
456		-	Public Act.
457		-	Section 99. Effective date. This Act takes effect January
458		-	1, 2024.
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	208	+	HB3202 Enrolled - 7 - LRB103 28677 BMS 55058 b
	209	+	1 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
	210	+	2 eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
	211	+	3 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
	212	+	4 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
	213	+	5 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
	214	+	6 102-1117, eff. 1-13-23.)
	215	+	7 Section 20. The School Code is amended by changing Section
	216	+	8 10-22.3f as follows:
	217	+	9 (105 ILCS 5/10-22.3f)
	218	+	10 Sec. 10-22.3f. Required health benefits. Insurance
	219	+	11 protection and benefits for employees shall provide the
	220	+	12 post-mastectomy care benefits required to be covered by a
	221	+	13 policy of accident and health insurance under Section 356t and
	222	+	14 the coverage required under Sections 356g, 356g.5, 356g.5-1,
	223	+	15 356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
	224	+	16 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
	225	+	17 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
	226	+	18 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
	227	+	19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
	228	+	20 356z.61 of the Illinois Insurance Code. Insurance policies
	229	+	21 shall comply with Section 356z.19 of the Illinois Insurance
	230	+	22 Code. The coverage shall comply with Sections 155.22a, 355b,
	231	+	23 and 370c of the Illinois Insurance Code. The Department of
	232	+	24 Insurance shall enforce the requirements of this Section.
	233	+
	234	+
	235	+
	236	+
	237	+
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	239	+
	240	+
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	242	+	HB3202 Enrolled - 8 - LRB103 28677 BMS 55058 b
	243	+	1 Rulemaking authority to implement Public Act 95-1045, if
	244	+	2 any, is conditioned on the rules being adopted in accordance
	245	+	3 with all provisions of the Illinois Administrative Procedure
	246	+	4 Act and all rules and procedures of the Joint Committee on
	247	+	5 Administrative Rules; any purported rule not so adopted, for
	248	+	6 whatever reason, is unauthorized.
	249	+	7 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
	250	+	8 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
	251	+	9 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
	252	+	10 eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
	253	+	11 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
	254	+	12 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
	255	+	13 eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
	256	+	14 Section 25. The Illinois Insurance Code is amended by
	257	+	15 adding Section 356z.61 as follows:
	258	+	16 (215 ILCS 5/356z.61 new)
	259	+	17 Sec. 356z.61. Home saliva cancer screening.
	260	+	18 (a) As used in this Section, "home saliva cancer
	261	+	19 screening" means an outpatient test that utilizes an
	262	+	20 individual's saliva to detect biomarkers for early-stage
	263	+	21 cancer.
	264	+	22 (b) An individual or group policy of accident and health
	265	+	23 insurance that is amended, delivered, issued, or renewed on or
	266	+	24 after January 1, 2025 shall cover a medically necessary home
	267	+
	268	+
	269	+
	270	+
	271	+
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	273	+
	274	+
	275	+	HB3202 Enrolled- 9 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 9 - LRB103 28677 BMS 55058 b
	276	+	HB3202 Enrolled - 9 - LRB103 28677 BMS 55058 b
	277	+	1 saliva cancer screening every 24 months if the patient:
	278	+	2 (1) is asymptomatic and at high risk for the disease
	279	+	3 being tested for; or
	280	+	4 (2) demonstrates symptoms of the disease being tested
	281	+	5 for at a physical exam.
	282	+	6 Section 30. The Health Maintenance Organization Act is
	283	+	7 amended by changing Section 5-3 as follows:
	284	+	8 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
	285	+	9 Sec. 5-3. Insurance Code provisions.
	286	+	10 (a) Health Maintenance Organizations shall be subject to
	287	+	11 the provisions of Sections 133, 134, 136, 137, 139, 140,
	288	+	12 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
	289	+	13 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
	290	+	14 355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
	291	+	15 356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
	292	+	16 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
	293	+	17 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
	294	+	18 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
	295	+	19 356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
	296	+	20 356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
	297	+	21 356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
	298	+	22 367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
	299	+	23 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
	300	+	24 paragraph (c) of subsection (2) of Section 367, and Articles
	301	+
	302	+
	303	+
	304	+
	305	+
	306	+	HB3202 Enrolled - 9 - LRB103 28677 BMS 55058 b
	307	+
	308	+
	309	+	HB3202 Enrolled- 10 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 10 - LRB103 28677 BMS 55058 b
	310	+	HB3202 Enrolled - 10 - LRB103 28677 BMS 55058 b
	311	+	1 IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
	312	+	2 XXXIIB of the Illinois Insurance Code.
	313	+	3 (b) For purposes of the Illinois Insurance Code, except
	314	+	4 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
	315	+	5 Health Maintenance Organizations in the following categories
	316	+	6 are deemed to be "domestic companies":
	317	+	7 (1) a corporation authorized under the Dental Service
	318	+	8 Plan Act or the Voluntary Health Services Plans Act;
	319	+	9 (2) a corporation organized under the laws of this
	320	+	10 State; or
	321	+	11 (3) a corporation organized under the laws of another
	322	+	12 state, 30% or more of the enrollees of which are residents
	323	+	13 of this State, except a corporation subject to
	324	+	14 substantially the same requirements in its state of
	325	+	15 organization as is a "domestic company" under Article VIII
	326	+	16 1/2 of the Illinois Insurance Code.
	327	+	17 (c) In considering the merger, consolidation, or other
	328	+	18 acquisition of control of a Health Maintenance Organization
	329	+	19 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
	330	+	20 (1) the Director shall give primary consideration to
	331	+	21 the continuation of benefits to enrollees and the
	332	+	22 financial conditions of the acquired Health Maintenance
	333	+	23 Organization after the merger, consolidation, or other
	334	+	24 acquisition of control takes effect;
	335	+	25 (2)(i) the criteria specified in subsection (1)(b) of
	336	+	26 Section 131.8 of the Illinois Insurance Code shall not
	337	+
	338	+
	339	+
	340	+
	341	+
	342	+	HB3202 Enrolled - 10 - LRB103 28677 BMS 55058 b
	343	+
	344	+
	345	+	HB3202 Enrolled- 11 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 11 - LRB103 28677 BMS 55058 b
	346	+	HB3202 Enrolled - 11 - LRB103 28677 BMS 55058 b
	347	+	1 apply and (ii) the Director, in making his determination
	348	+	2 with respect to the merger, consolidation, or other
	349	+	3 acquisition of control, need not take into account the
	350	+	4 effect on competition of the merger, consolidation, or
	351	+	5 other acquisition of control;
	352	+	6 (3) the Director shall have the power to require the
	353	+	7 following information:
	354	+	8 (A) certification by an independent actuary of the
	355	+	9 adequacy of the reserves of the Health Maintenance
	356	+	10 Organization sought to be acquired;
	357	+	11 (B) pro forma financial statements reflecting the
	358	+	12 combined balance sheets of the acquiring company and
	359	+	13 the Health Maintenance Organization sought to be
	360	+	14 acquired as of the end of the preceding year and as of
	361	+	15 a date 90 days prior to the acquisition, as well as pro
	362	+	16 forma financial statements reflecting projected
	363	+	17 combined operation for a period of 2 years;
	364	+	18 (C) a pro forma business plan detailing an
	365	+	19 acquiring party's plans with respect to the operation
	366	+	20 of the Health Maintenance Organization sought to be
	367	+	21 acquired for a period of not less than 3 years; and
	368	+	22 (D) such other information as the Director shall
	369	+	23 require.
	370	+	24 (d) The provisions of Article VIII 1/2 of the Illinois
	371	+	25 Insurance Code and this Section 5-3 shall apply to the sale by
	372	+	26 any health maintenance organization of greater than 10% of its
	373	+
	374	+
	375	+
	376	+
	377	+
	378	+	HB3202 Enrolled - 11 - LRB103 28677 BMS 55058 b
	379	+
	380	+
	381	+	HB3202 Enrolled- 12 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 12 - LRB103 28677 BMS 55058 b
	382	+	HB3202 Enrolled - 12 - LRB103 28677 BMS 55058 b
	383	+	1 enrollee population (including without limitation the health
	384	+	2 maintenance organization's right, title, and interest in and
	385	+	3 to its health care certificates).
	386	+	4 (e) In considering any management contract or service
	387	+	5 agreement subject to Section 141.1 of the Illinois Insurance
	388	+	6 Code, the Director (i) shall, in addition to the criteria
	389	+	7 specified in Section 141.2 of the Illinois Insurance Code,
	390	+	8 take into account the effect of the management contract or
	391	+	9 service agreement on the continuation of benefits to enrollees
	392	+	10 and the financial condition of the health maintenance
	393	+	11 organization to be managed or serviced, and (ii) need not take
	394	+	12 into account the effect of the management contract or service
	395	+	13 agreement on competition.
	396	+	14 (f) Except for small employer groups as defined in the
	397	+	15 Small Employer Rating, Renewability and Portability Health
	398	+	16 Insurance Act and except for medicare supplement policies as
	399	+	17 defined in Section 363 of the Illinois Insurance Code, a
	400	+	18 Health Maintenance Organization may by contract agree with a
	401	+	19 group or other enrollment unit to effect refunds or charge
	402	+	20 additional premiums under the following terms and conditions:
	403	+	21 (i) the amount of, and other terms and conditions with
	404	+	22 respect to, the refund or additional premium are set forth
	405	+	23 in the group or enrollment unit contract agreed in advance
	406	+	24 of the period for which a refund is to be paid or
	407	+	25 additional premium is to be charged (which period shall
	408	+	26 not be less than one year); and
	409	+
	410	+
	411	+
	412	+
	413	+
	414	+	HB3202 Enrolled - 12 - LRB103 28677 BMS 55058 b
	415	+
	416	+
	417	+	HB3202 Enrolled- 13 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 13 - LRB103 28677 BMS 55058 b
	418	+	HB3202 Enrolled - 13 - LRB103 28677 BMS 55058 b
	419	+	1 (ii) the amount of the refund or additional premium
	420	+	2 shall not exceed 20% of the Health Maintenance
	421	+	3 Organization's profitable or unprofitable experience with
	422	+	4 respect to the group or other enrollment unit for the
	423	+	5 period (and, for purposes of a refund or additional
	424	+	6 premium, the profitable or unprofitable experience shall
	425	+	7 be calculated taking into account a pro rata share of the
	426	+	8 Health Maintenance Organization's administrative and
	427	+	9 marketing expenses, but shall not include any refund to be
	428	+	10 made or additional premium to be paid pursuant to this
	429	+	11 subsection (f)). The Health Maintenance Organization and
	430	+	12 the group or enrollment unit may agree that the profitable
	431	+	13 or unprofitable experience may be calculated taking into
	432	+	14 account the refund period and the immediately preceding 2
	433	+	15 plan years.
	434	+	16 The Health Maintenance Organization shall include a
	435	+	17 statement in the evidence of coverage issued to each enrollee
	436	+	18 describing the possibility of a refund or additional premium,
	437	+	19 and upon request of any group or enrollment unit, provide to
	438	+	20 the group or enrollment unit a description of the method used
	439	+	21 to calculate (1) the Health Maintenance Organization's
	440	+	22 profitable experience with respect to the group or enrollment
	441	+	23 unit and the resulting refund to the group or enrollment unit
	442	+	24 or (2) the Health Maintenance Organization's unprofitable
	443	+	25 experience with respect to the group or enrollment unit and
	444	+	26 the resulting additional premium to be paid by the group or
	445	+
	446	+
	447	+
	448	+
	449	+
	450	+	HB3202 Enrolled - 13 - LRB103 28677 BMS 55058 b
	451	+
	452	+
	453	+	HB3202 Enrolled- 14 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 14 - LRB103 28677 BMS 55058 b
	454	+	HB3202 Enrolled - 14 - LRB103 28677 BMS 55058 b
	455	+	1 enrollment unit.
	456	+	2 In no event shall the Illinois Health Maintenance
	457	+	3 Organization Guaranty Association be liable to pay any
	458	+	4 contractual obligation of an insolvent organization to pay any
	459	+	5 refund authorized under this Section.
	460	+	6 (g) Rulemaking authority to implement Public Act 95-1045,
	461	+	7 if any, is conditioned on the rules being adopted in
	462	+	8 accordance with all provisions of the Illinois Administrative
	463	+	9 Procedure Act and all rules and procedures of the Joint
	464	+	10 Committee on Administrative Rules; any purported rule not so
	465	+	11 adopted, for whatever reason, is unauthorized.
	466	+	12 (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
	467	+	13 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
	468	+	14 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
	469	+	15 eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
	470	+	16 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
	471	+	17 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
	472	+	18 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
	473	+	19 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
	474	+	20 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
	475	+	21 eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
	476	+	22 Section 35. The Limited Health Service Organization Act is
	477	+	23 amended by changing Section 4003 as follows:
	478	+	24 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
	479	+
	480	+
	481	+
	482	+
	483	+
	484	+	HB3202 Enrolled - 14 - LRB103 28677 BMS 55058 b
	485	+
	486	+
	487	+	HB3202 Enrolled- 15 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 15 - LRB103 28677 BMS 55058 b
	488	+	HB3202 Enrolled - 15 - LRB103 28677 BMS 55058 b
	489	+	1 Sec. 4003. Illinois Insurance Code provisions. Limited
	490	+	2 health service organizations shall be subject to the
	491	+	3 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
	492	+	4 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
	493	+	5 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
	494	+	6 355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
	495	+	7 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
	496	+	8 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
	497	+	9 356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
	498	+	10 408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
	499	+	11 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
	500	+	12 Illinois Insurance Code. Nothing in this Section shall require
	501	+	13 a limited health care plan to cover any service that is not a
	502	+	14 limited health service. For purposes of the Illinois Insurance
	503	+	15 Code, except for Sections 444 and 444.1 and Articles XIII and
	504	+	16 XIII 1/2, limited health service organizations in the
	505	+	17 following categories are deemed to be domestic companies:
	506	+	18 (1) a corporation under the laws of this State; or
	507	+	19 (2) a corporation organized under the laws of another
	508	+	20 state, 30% or more of the enrollees of which are residents
	509	+	21 of this State, except a corporation subject to
	510	+	22 substantially the same requirements in its state of
	511	+	23 organization as is a domestic company under Article VIII
	512	+	24 1/2 of the Illinois Insurance Code.
	513	+	25 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
	514	+	26 101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
	515	+
	516	+
	517	+
	518	+
	519	+
	520	+	HB3202 Enrolled - 15 - LRB103 28677 BMS 55058 b
	521	+
	522	+
	523	+	HB3202 Enrolled- 16 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 16 - LRB103 28677 BMS 55058 b
	524	+	HB3202 Enrolled - 16 - LRB103 28677 BMS 55058 b
	525	+	1 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
	526	+	2 eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
	527	+	3 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
	528	+	4 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
	529	+	5 Section 40. The Voluntary Health Services Plans Act is
	530	+	6 amended by changing Section 10 as follows:
	531	+	7 (215 ILCS 165/10) (from Ch. 32, par. 604)
	532	+	8 Sec. 10. Application of Insurance Code provisions. Health
	533	+	9 services plan corporations and all persons interested therein
	534	+	10 or dealing therewith shall be subject to the provisions of
	535	+	11 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
	536	+	12 143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
	537	+	13 356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
	538	+	14 356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
	539	+	15 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
	540	+	16 356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
	541	+	17 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
	542	+	18 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
	543	+	19 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
	544	+	20 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
	545	+	21 and paragraphs (7) and (15) of Section 367 of the Illinois
	546	+	22 Insurance Code.
	547	+	23 Rulemaking authority to implement Public Act 95-1045, if
	548	+	24 any, is conditioned on the rules being adopted in accordance
	549	+
	550	+
	551	+
	552	+
	553	+
	554	+	HB3202 Enrolled - 16 - LRB103 28677 BMS 55058 b
	555	+
	556	+
	557	+	HB3202 Enrolled- 17 -LRB103 28677 BMS 55058 b HB3202 Enrolled - 17 - LRB103 28677 BMS 55058 b
	558	+	HB3202 Enrolled - 17 - LRB103 28677 BMS 55058 b
	559	+	1 with all provisions of the Illinois Administrative Procedure
	560	+	2 Act and all rules and procedures of the Joint Committee on
	561	+	3 Administrative Rules; any purported rule not so adopted, for
	562	+	4 whatever reason, is unauthorized.
	563	+	5 (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
	564	+	6 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
	565	+	7 1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
	566	+	8 eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
	567	+	9 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
	568	+	10 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
	569	+	11 eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
	570	+	12 102-1117, eff. 1-13-23.)
	571	+	13 Section 95. No acceleration or delay. Where this Act makes
	572	+	14 changes in a statute that is represented in this Act by text
	573	+	15 that is not yet or no longer in effect (for example, a Section
	574	+	16 represented by multiple versions), the use of that text does
	575	+	17 not accelerate or delay the taking effect of (i) the changes
	576	+	18 made by this Act or (ii) provisions derived from any other
	577	+	19 Public Act.
	578	+	20 Section 99. Effective date. This Act takes effect January
	579	+	21 1, 2024.
	580	+
	581	+
	582	+
	583	+
	584	+
	585	+	HB3202 Enrolled - 17 - LRB103 28677 BMS 55058 b