Illinois 2023-2024 Regular Session

Illinois Senate Bill SB1708 Compare Versions

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

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1708 Introduced 2/9/2023, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 Amends the Accident and Health Article of the Illinois Insurance Code. Provides that a group policy of accident and health insurance or a managed care plan amended, delivered, issued, or renewed on or after the effective date of the amendatory Act that an employer makes available to any employee shall also be made available to all individuals employed by the employer, regardless of the amount of hours per week an employee works. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. LRB103 29109 BMS 55495 b STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1708 Introduced 2/9/2023, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 Amends the Accident and Health Article of the Illinois Insurance Code. Provides that a group policy of accident and health insurance or a managed care plan amended, delivered, issued, or renewed on or after the effective date of the amendatory Act that an employer makes available to any employee shall also be made available to all individuals employed by the employer, regardless of the amount of hours per week an employee works. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. LRB103 29109 BMS 55495 b LRB103 29109 BMS 55495 b STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1708 Introduced 2/9/2023, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED:
3	3	5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604
4	4	5 ILCS 375/6.11
5	5	55 ILCS 5/5-1069.3
6	6	65 ILCS 5/10-4-2.3
7	7	105 ILCS 5/10-22.3f
8	8	215 ILCS 5/356z.61 new
9	9	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
10	10	215 ILCS 130/4003 from Ch. 73, par. 1504-3
11	11	215 ILCS 165/10 from Ch. 32, par. 604
12	12	Amends the Accident and Health Article of the Illinois Insurance Code. Provides that a group policy of accident and health insurance or a managed care plan amended, delivered, issued, or renewed on or after the effective date of the amendatory Act that an employer makes available to any employee shall also be made available to all individuals employed by the employer, regardless of the amount of hours per week an employee works. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act.
13	13	LRB103 29109 BMS 55495 b LRB103 29109 BMS 55495 b
14	14	LRB103 29109 BMS 55495 b
15	15	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
16	16	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
17	17	A BILL FOR
18	18	SB1708LRB103 29109 BMS 55495 b SB1708 LRB103 29109 BMS 55495 b
19	19	SB1708 LRB103 29109 BMS 55495 b
20	20	1 AN ACT concerning regulation.
21	21	2 Be it enacted by the People of the State of Illinois,
22	22	3 represented in the General Assembly:
23	23	4 Section 5. The State Employees Group Insurance Act of 1971
24	24	5 is amended by changing Section 6.11 as follows:
25	25	6 (5 ILCS 375/6.11)
26	26	7 (Text of Section before amendment by P.A. 102-768)
27	27	8 Sec. 6.11. Required health benefits; Illinois Insurance
28	28	9 Code requirements. The program of health benefits shall
29	29	10 provide the post-mastectomy care benefits required to be
30	30	11 covered by a policy of accident and health insurance under
31	31	12 Section 356t of the Illinois Insurance Code. The program of
32	32	13 health benefits shall provide the coverage required under
33	33	14 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
34	34	15 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
35	35	16 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
36	36	17 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
37	37	18 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
38	38	19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
39	39	20 the Illinois Insurance Code. The program of health benefits
40	40	21 must comply with Sections 155.22a, 155.37, 355b, 356z.19,
41	41	22 370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
42	42	23 Code. The Department of Insurance shall enforce the
43	43
44	44
45	45
46	46	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1708 Introduced 2/9/2023, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED:
47	47	5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.61 new 215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2 215 ILCS 130/4003 from Ch. 73, par. 1504-3 215 ILCS 165/10 from Ch. 32, par. 604
48	48	5 ILCS 375/6.11
49	49	55 ILCS 5/5-1069.3
50	50	65 ILCS 5/10-4-2.3
51	51	105 ILCS 5/10-22.3f
52	52	215 ILCS 5/356z.61 new
53	53	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
54	54	215 ILCS 130/4003 from Ch. 73, par. 1504-3
55	55	215 ILCS 165/10 from Ch. 32, par. 604
56	56	Amends the Accident and Health Article of the Illinois Insurance Code. Provides that a group policy of accident and health insurance or a managed care plan amended, delivered, issued, or renewed on or after the effective date of the amendatory Act that an employer makes available to any employee shall also be made available to all individuals employed by the employer, regardless of the amount of hours per week an employee works. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act.
57	57	LRB103 29109 BMS 55495 b LRB103 29109 BMS 55495 b
58	58	LRB103 29109 BMS 55495 b
59	59	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
60	60	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
61	61	A BILL FOR
62	62
63	63
64	64
65	65
66	66
67	67	5 ILCS 375/6.11
68	68	55 ILCS 5/5-1069.3
69	69	65 ILCS 5/10-4-2.3
70	70	105 ILCS 5/10-22.3f
71	71	215 ILCS 5/356z.61 new
72	72	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
73	73	215 ILCS 130/4003 from Ch. 73, par. 1504-3
74	74	215 ILCS 165/10 from Ch. 32, par. 604
75	75
76	76
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78	78	LRB103 29109 BMS 55495 b
79	79
80	80	STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY
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97	97	1 requirements of this Section with respect to Sections 370c and
98	98	2 370c.1 of the Illinois Insurance Code; all other requirements
99	99	3 of this Section shall be enforced by the Department of Central
100	100	4 Management Services.
101	101	5 Rulemaking authority to implement Public Act 95-1045, if
102	102	6 any, is conditioned on the rules being adopted in accordance
103	103	7 with all provisions of the Illinois Administrative Procedure
104	104	8 Act and all rules and procedures of the Joint Committee on
105	105	9 Administrative Rules; any purported rule not so adopted, for
106	106	10 whatever reason, is unauthorized.
107	107	11 (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
108	108	12 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
109	109	13 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
110	110	14 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
111	111	15 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
112	112	16 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
113	113	17 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
114	114	18 revised 12-13-22.)
115	115	19 (Text of Section after amendment by P.A. 102-768)
116	116	20 Sec. 6.11. Required health benefits; Illinois Insurance
117	117	21 Code requirements. The program of health benefits shall
118	118	22 provide the post-mastectomy care benefits required to be
119	119	23 covered by a policy of accident and health insurance under
120	120	24 Section 356t of the Illinois Insurance Code. The program of
121	121	25 health benefits shall provide the coverage required under
122	122
123	123
124	124
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126	126
127	127	SB1708 - 2 - LRB103 29109 BMS 55495 b
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130	130	SB1708- 3 -LRB103 29109 BMS 55495 b SB1708 - 3 - LRB103 29109 BMS 55495 b
131	131	SB1708 - 3 - LRB103 29109 BMS 55495 b
132	132	1 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
133	133	2 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
134	134	3 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
135	135	4 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
136	136	5 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
137	137	6 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
138	138	7 356z.60, and 356z.61 of the Illinois Insurance Code. The
139	139	8 program of health benefits must comply with Sections 155.22a,
140	140	9 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
141	141	10 the Illinois Insurance Code. The Department of Insurance shall
142	142	11 enforce the requirements of this Section with respect to
143	143	12 Sections 370c and 370c.1 of the Illinois Insurance Code; all
144	144	13 other requirements of this Section shall be enforced by the
145	145	14 Department of Central Management Services.
146	146	15 Rulemaking authority to implement Public Act 95-1045, if
147	147	16 any, is conditioned on the rules being adopted in accordance
148	148	17 with all provisions of the Illinois Administrative Procedure
149	149	18 Act and all rules and procedures of the Joint Committee on
150	150	19 Administrative Rules; any purported rule not so adopted, for
151	151	20 whatever reason, is unauthorized.
152	152	21 (Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
153	153	22 101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
154	154	23 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
155	155	24 eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
156	156	25 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
157	157	26 1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
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160	160
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163	163	SB1708 - 3 - LRB103 29109 BMS 55495 b
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166	166	SB1708- 4 -LRB103 29109 BMS 55495 b SB1708 - 4 - LRB103 29109 BMS 55495 b
167	167	SB1708 - 4 - LRB103 29109 BMS 55495 b
168	168	1 eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
169	169	2 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
170	170	3 Section 10. The Counties Code is amended by changing
171	171	4 Section 5-1069.3 as follows:
172	172	5 (55 ILCS 5/5-1069.3)
173	173	6 Sec. 5-1069.3. Required health benefits. If a county,
174	174	7 including a home rule county, is a self-insurer for purposes
175	175	8 of providing health insurance coverage for its employees, the
176	176	9 coverage shall include coverage for the post-mastectomy care
177	177	10 benefits required to be covered by a policy of accident and
178	178	11 health insurance under Section 356t and the coverage required
179	179	12 under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
180	180	13 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
181	181	14 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
182	182	15 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
183	183	16 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
184	184	17 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
185	185	18 of the Illinois Insurance Code. The coverage shall comply with
186	186	19 Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
187	187	20 Insurance Code. The Department of Insurance shall enforce the
188	188	21 requirements of this Section. The requirement that health
189	189	22 benefits be covered as provided in this Section is an
190	190	23 exclusive power and function of the State and is a denial and
191	191	24 limitation under Article VII, Section 6, subsection (h) of the
192	192
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194	194
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196	196
197	197	SB1708 - 4 - LRB103 29109 BMS 55495 b
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200	200	SB1708- 5 -LRB103 29109 BMS 55495 b SB1708 - 5 - LRB103 29109 BMS 55495 b
201	201	SB1708 - 5 - LRB103 29109 BMS 55495 b
202	202	1 Illinois Constitution. A home rule county to which this
203	203	2 Section applies must comply with every provision of this
204	204	3 Section.
205	205	4 Rulemaking authority to implement Public Act 95-1045, if
206	206	5 any, is conditioned on the rules being adopted in accordance
207	207	6 with all provisions of the Illinois Administrative Procedure
208	208	7 Act and all rules and procedures of the Joint Committee on
209	209	8 Administrative Rules; any purported rule not so adopted, for
210	210	9 whatever reason, is unauthorized.
211	211	10 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
212	212	11 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
213	213	12 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
214	214	13 eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
215	215	14 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
216	216	15 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
217	217	16 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
218	218	17 102-1117, eff. 1-13-23.)
219	219	18 Section 15. The Illinois Municipal Code is amended by
220	220	19 changing Section 10-4-2.3 as follows:
221	221	20 (65 ILCS 5/10-4-2.3)
222	222	21 Sec. 10-4-2.3. Required health benefits. If a
223	223	22 municipality, including a home rule municipality, is a
224	224	23 self-insurer for purposes of providing health insurance
225	225	24 coverage for its employees, the coverage shall include
226	226
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231	231	SB1708 - 5 - LRB103 29109 BMS 55495 b
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236	236	1 coverage for the post-mastectomy care benefits required to be
237	237	2 covered by a policy of accident and health insurance under
238	238	3 Section 356t and the coverage required under Sections 356g,
239	239	4 356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
240	240	5 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
241	241	6 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
242	242	7 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
243	243	8 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
244	244	9 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
245	245	10 Illinois Insurance Code. The coverage shall comply with
246	246	11 Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
247	247	12 Insurance Code. The Department of Insurance shall enforce the
248	248	13 requirements of this Section. The requirement that health
249	249	14 benefits be covered as provided in this is an exclusive power
250	250	15 and function of the State and is a denial and limitation under
251	251	16 Article VII, Section 6, subsection (h) of the Illinois
252	252	17 Constitution. A home rule municipality to which this Section
253	253	18 applies must comply with every provision of this Section.
254	254	19 Rulemaking authority to implement Public Act 95-1045, if
255	255	20 any, is conditioned on the rules being adopted in accordance
256	256	21 with all provisions of the Illinois Administrative Procedure
257	257	22 Act and all rules and procedures of the Joint Committee on
258	258	23 Administrative Rules; any purported rule not so adopted, for
259	259	24 whatever reason, is unauthorized.
260	260	25 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
261	261	26 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
262	262
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267	267	SB1708 - 6 - LRB103 29109 BMS 55495 b
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271	271	SB1708 - 7 - LRB103 29109 BMS 55495 b
272	272	1 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
273	273	2 eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
274	274	3 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
275	275	4 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
276	276	5 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
277	277	6 102-1117, eff. 1-13-23.)
278	278	7 Section 20. The School Code is amended by changing Section
279	279	8 10-22.3f as follows:
280	280	9 (105 ILCS 5/10-22.3f)
281	281	10 Sec. 10-22.3f. Required health benefits. Insurance
282	282	11 protection and benefits for employees shall provide the
283	283	12 post-mastectomy care benefits required to be covered by a
284	284	13 policy of accident and health insurance under Section 356t and
285	285	14 the coverage required under Sections 356g, 356g.5, 356g.5-1,
286	286	15 356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
287	287	16 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
288	288	17 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
289	289	18 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
290	290	19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
291	291	20 356z.61 of the Illinois Insurance Code. Insurance policies
292	292	21 shall comply with Section 356z.19 of the Illinois Insurance
293	293	22 Code. The coverage shall comply with Sections 155.22a, 355b,
294	294	23 and 370c of the Illinois Insurance Code. The Department of
295	295	24 Insurance shall enforce the requirements of this Section.
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306	306	1 Rulemaking authority to implement Public Act 95-1045, if
307	307	2 any, is conditioned on the rules being adopted in accordance
308	308	3 with all provisions of the Illinois Administrative Procedure
309	309	4 Act and all rules and procedures of the Joint Committee on
310	310	5 Administrative Rules; any purported rule not so adopted, for
311	311	6 whatever reason, is unauthorized.
312	312	7 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
313	313	8 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
314	314	9 1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
315	315	10 eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
316	316	11 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
317	317	12 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
318	318	13 eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
319	319	14 Section 25. The Illinois Insurance Code is amended by
320	320	15 adding Section 356z.61 as follows:
321	321	16 (215 ILCS 5/356z.61 new)
322	322	17 Sec. 356z.61. Employee health benefits parity. A group
323	323	18 policy of accident and health insurance or a managed care plan
324	324	19 amended, delivered, issued, or renewed on or after the
325	325	20 effective date of this amendatory Act of the 103rd General
326	326	21 Assembly that an employer makes available to any employee
327	327	22 shall also be made available to all individuals employed by
328	328	23 the employer, regardless of the amount of hours per week an
329	329	24 employee works.
330	330
331	331
332	332
333	333
334	334
335	335	SB1708 - 8 - LRB103 29109 BMS 55495 b
336	336
337	337
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339	339	SB1708 - 9 - LRB103 29109 BMS 55495 b
340	340	1 Section 30. The Health Maintenance Organization Act is
341	341	2 amended by changing Section 5-3 as follows:
342	342	3 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
343	343	4 Sec. 5-3. Insurance Code provisions.
344	344	5 (a) Health Maintenance Organizations shall be subject to
345	345	6 the provisions of Sections 133, 134, 136, 137, 139, 140,
346	346	7 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
347	347	8 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
348	348	9 355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
349	349	10 356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
350	350	11 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
351	351	12 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
352	352	13 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
353	353	14 356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
354	354	15 356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
355	355	16 356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
356	356	17 367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
357	357	18 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
358	358	19 paragraph (c) of subsection (2) of Section 367, and Articles
359	359	20 IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
360	360	21 XXXIIB of the Illinois Insurance Code.
361	361	22 (b) For purposes of the Illinois Insurance Code, except
362	362	23 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
363	363	24 Health Maintenance Organizations in the following categories
364	364
365	365
366	366
367	367
368	368
369	369	SB1708 - 9 - LRB103 29109 BMS 55495 b
370	370
371	371
372	372	SB1708- 10 -LRB103 29109 BMS 55495 b SB1708 - 10 - LRB103 29109 BMS 55495 b
373	373	SB1708 - 10 - LRB103 29109 BMS 55495 b
374	374	1 are deemed to be "domestic companies":
375	375	2 (1) a corporation authorized under the Dental Service
376	376	3 Plan Act or the Voluntary Health Services Plans Act;
377	377	4 (2) a corporation organized under the laws of this
378	378	5 State; or
379	379	6 (3) a corporation organized under the laws of another
380	380	7 state, 30% or more of the enrollees of which are residents
381	381	8 of this State, except a corporation subject to
382	382	9 substantially the same requirements in its state of
383	383	10 organization as is a "domestic company" under Article VIII
384	384	11 1/2 of the Illinois Insurance Code.
385	385	12 (c) In considering the merger, consolidation, or other
386	386	13 acquisition of control of a Health Maintenance Organization
387	387	14 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
388	388	15 (1) the Director shall give primary consideration to
389	389	16 the continuation of benefits to enrollees and the
390	390	17 financial conditions of the acquired Health Maintenance
391	391	18 Organization after the merger, consolidation, or other
392	392	19 acquisition of control takes effect;
393	393	20 (2)(i) the criteria specified in subsection (1)(b) of
394	394	21 Section 131.8 of the Illinois Insurance Code shall not
395	395	22 apply and (ii) the Director, in making his determination
396	396	23 with respect to the merger, consolidation, or other
397	397	24 acquisition of control, need not take into account the
398	398	25 effect on competition of the merger, consolidation, or
399	399	26 other acquisition of control;
400	400
401	401
402	402
403	403
404	404
405	405	SB1708 - 10 - LRB103 29109 BMS 55495 b
406	406
407	407
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409	409	SB1708 - 11 - LRB103 29109 BMS 55495 b
410	410	1 (3) the Director shall have the power to require the
411	411	2 following information:
412	412	3 (A) certification by an independent actuary of the
413	413	4 adequacy of the reserves of the Health Maintenance
414	414	5 Organization sought to be acquired;
415	415	6 (B) pro forma financial statements reflecting the
416	416	7 combined balance sheets of the acquiring company and
417	417	8 the Health Maintenance Organization sought to be
418	418	9 acquired as of the end of the preceding year and as of
419	419	10 a date 90 days prior to the acquisition, as well as pro
420	420	11 forma financial statements reflecting projected
421	421	12 combined operation for a period of 2 years;
422	422	13 (C) a pro forma business plan detailing an
423	423	14 acquiring party's plans with respect to the operation
424	424	15 of the Health Maintenance Organization sought to be
425	425	16 acquired for a period of not less than 3 years; and
426	426	17 (D) such other information as the Director shall
427	427	18 require.
428	428	19 (d) The provisions of Article VIII 1/2 of the Illinois
429	429	20 Insurance Code and this Section 5-3 shall apply to the sale by
430	430	21 any health maintenance organization of greater than 10% of its
431	431	22 enrollee population (including without limitation the health
432	432	23 maintenance organization's right, title, and interest in and
433	433	24 to its health care certificates).
434	434	25 (e) In considering any management contract or service
435	435	26 agreement subject to Section 141.1 of the Illinois Insurance
436	436
437	437
438	438
439	439
440	440
441	441	SB1708 - 11 - LRB103 29109 BMS 55495 b
442	442
443	443
444	444	SB1708- 12 -LRB103 29109 BMS 55495 b SB1708 - 12 - LRB103 29109 BMS 55495 b
445	445	SB1708 - 12 - LRB103 29109 BMS 55495 b
446	446	1 Code, the Director (i) shall, in addition to the criteria
447	447	2 specified in Section 141.2 of the Illinois Insurance Code,
448	448	3 take into account the effect of the management contract or
449	449	4 service agreement on the continuation of benefits to enrollees
450	450	5 and the financial condition of the health maintenance
451	451	6 organization to be managed or serviced, and (ii) need not take
452	452	7 into account the effect of the management contract or service
453	453	8 agreement on competition.
454	454	9 (f) Except for small employer groups as defined in the
455	455	10 Small Employer Rating, Renewability and Portability Health
456	456	11 Insurance Act and except for medicare supplement policies as
457	457	12 defined in Section 363 of the Illinois Insurance Code, a
458	458	13 Health Maintenance Organization may by contract agree with a
459	459	14 group or other enrollment unit to effect refunds or charge
460	460	15 additional premiums under the following terms and conditions:
461	461	16 (i) the amount of, and other terms and conditions with
462	462	17 respect to, the refund or additional premium are set forth
463	463	18 in the group or enrollment unit contract agreed in advance
464	464	19 of the period for which a refund is to be paid or
465	465	20 additional premium is to be charged (which period shall
466	466	21 not be less than one year); and
467	467	22 (ii) the amount of the refund or additional premium
468	468	23 shall not exceed 20% of the Health Maintenance
469	469	24 Organization's profitable or unprofitable experience with
470	470	25 respect to the group or other enrollment unit for the
471	471	26 period (and, for purposes of a refund or additional
472	472
473	473
474	474
475	475
476	476
477	477	SB1708 - 12 - LRB103 29109 BMS 55495 b
478	478
479	479
480	480	SB1708- 13 -LRB103 29109 BMS 55495 b SB1708 - 13 - LRB103 29109 BMS 55495 b
481	481	SB1708 - 13 - LRB103 29109 BMS 55495 b
482	482	1 premium, the profitable or unprofitable experience shall
483	483	2 be calculated taking into account a pro rata share of the
484	484	3 Health Maintenance Organization's administrative and
485	485	4 marketing expenses, but shall not include any refund to be
486	486	5 made or additional premium to be paid pursuant to this
487	487	6 subsection (f)). The Health Maintenance Organization and
488	488	7 the group or enrollment unit may agree that the profitable
489	489	8 or unprofitable experience may be calculated taking into
490	490	9 account the refund period and the immediately preceding 2
491	491	10 plan years.
492	492	11 The Health Maintenance Organization shall include a
493	493	12 statement in the evidence of coverage issued to each enrollee
494	494	13 describing the possibility of a refund or additional premium,
495	495	14 and upon request of any group or enrollment unit, provide to
496	496	15 the group or enrollment unit a description of the method used
497	497	16 to calculate (1) the Health Maintenance Organization's
498	498	17 profitable experience with respect to the group or enrollment
499	499	18 unit and the resulting refund to the group or enrollment unit
500	500	19 or (2) the Health Maintenance Organization's unprofitable
501	501	20 experience with respect to the group or enrollment unit and
502	502	21 the resulting additional premium to be paid by the group or
503	503	22 enrollment unit.
504	504	23 In no event shall the Illinois Health Maintenance
505	505	24 Organization Guaranty Association be liable to pay any
506	506	25 contractual obligation of an insolvent organization to pay any
507	507	26 refund authorized under this Section.
508	508
509	509
510	510
511	511
512	512
513	513	SB1708 - 13 - LRB103 29109 BMS 55495 b
514	514
515	515
516	516	SB1708- 14 -LRB103 29109 BMS 55495 b SB1708 - 14 - LRB103 29109 BMS 55495 b
517	517	SB1708 - 14 - LRB103 29109 BMS 55495 b
518	518	1 (g) Rulemaking authority to implement Public Act 95-1045,
519	519	2 if any, is conditioned on the rules being adopted in
520	520	3 accordance with all provisions of the Illinois Administrative
521	521	4 Procedure Act and all rules and procedures of the Joint
522	522	5 Committee on Administrative Rules; any purported rule not so
523	523	6 adopted, for whatever reason, is unauthorized.
524	524	7 (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
525	525	8 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
526	526	9 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
527	527	10 eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
528	528	11 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
529	529	12 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
530	530	13 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
531	531	14 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
532	532	15 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
533	533	16 eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
534	534	17 Section 35. The Limited Health Service Organization Act is
535	535	18 amended by changing Section 4003 as follows:
536	536	19 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
537	537	20 Sec. 4003. Illinois Insurance Code provisions. Limited
538	538	21 health service organizations shall be subject to the
539	539	22 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
540	540	23 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
541	541	24 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
542	542
543	543
544	544
545	545
546	546
547	547	SB1708 - 14 - LRB103 29109 BMS 55495 b
548	548
549	549
550	550	SB1708- 15 -LRB103 29109 BMS 55495 b SB1708 - 15 - LRB103 29109 BMS 55495 b
551	551	SB1708 - 15 - LRB103 29109 BMS 55495 b
552	552	1 355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
553	553	2 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
554	554	3 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
555	555	4 356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
556	556	5 408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
557	557	6 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
558	558	7 Illinois Insurance Code. Nothing in this Section shall require
559	559	8 a limited health care plan to cover any service that is not a
560	560	9 limited health service. For purposes of the Illinois Insurance
561	561	10 Code, except for Sections 444 and 444.1 and Articles XIII and
562	562	11 XIII 1/2, limited health service organizations in the
563	563	12 following categories are deemed to be domestic companies:
564	564	13 (1) a corporation under the laws of this State; or
565	565	14 (2) a corporation organized under the laws of another
566	566	15 state, 30% or more of the enrollees of which are residents
567	567	16 of this State, except a corporation subject to
568	568	17 substantially the same requirements in its state of
569	569	18 organization as is a domestic company under Article VIII
570	570	19 1/2 of the Illinois Insurance Code.
571	571	20 (Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
572	572	21 101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
573	573	22 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
574	574	23 eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
575	575	24 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
576	576	25 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
577	577
578	578
579	579
580	580
581	581
582	582	SB1708 - 15 - LRB103 29109 BMS 55495 b
583	583
584	584
585	585	SB1708- 16 -LRB103 29109 BMS 55495 b SB1708 - 16 - LRB103 29109 BMS 55495 b
586	586	SB1708 - 16 - LRB103 29109 BMS 55495 b
587	587	1 Section 40. The Voluntary Health Services Plans Act is
588	588	2 amended by changing Section 10 as follows:
589	589	3 (215 ILCS 165/10) (from Ch. 32, par. 604)
590	590	4 Sec. 10. Application of Insurance Code provisions. Health
591	591	5 services plan corporations and all persons interested therein
592	592	6 or dealing therewith shall be subject to the provisions of
593	593	7 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
594	594	8 143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
595	595	9 356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
596	596	10 356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
597	597	11 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
598	598	12 356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
599	599	13 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
600	600	14 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
601	601	15 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
602	602	16 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
603	603	17 and paragraphs (7) and (15) of Section 367 of the Illinois
604	604	18 Insurance Code.
605	605	19 Rulemaking authority to implement Public Act 95-1045, if
606	606	20 any, is conditioned on the rules being adopted in accordance
607	607	21 with all provisions of the Illinois Administrative Procedure
608	608	22 Act and all rules and procedures of the Joint Committee on
609	609	23 Administrative Rules; any purported rule not so adopted, for
610	610	24 whatever reason, is unauthorized.
611	611	25 (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
612	612
613	613
614	614
615	615
616	616
617	617	SB1708 - 16 - LRB103 29109 BMS 55495 b
618	618
619	619
620	620	SB1708- 17 -LRB103 29109 BMS 55495 b SB1708 - 17 - LRB103 29109 BMS 55495 b
621	621	SB1708 - 17 - LRB103 29109 BMS 55495 b
622	622	1 101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
623	623	2 1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
624	624	3 eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
625	625	4 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
626	626	5 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
627	627	6 eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
628	628	7 102-1117, eff. 1-13-23.)
629	629
630	630
631	631
632	632
633	633
634	634	SB1708 - 17 - LRB103 29109 BMS 55495 b