Illinois 2025-2026 Regular Session

Illinois House Bill HB1360 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	HB1360 EngrossedLRB104 07412 BAB 17453 b HB1360 Engrossed LRB104 07412 BAB 17453 b
2		-	HB1360 Engrossed LRB104 07412 BAB 17453 b
	1	+	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB1360 Introduced , by Rep. Mary Gill SYNOPSIS AS INTRODUCED: 55 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356z.80 new215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2215 ILCS 130/4003 from Ch. 73, par. 1504-3215 ILCS 165/10 from Ch. 32, par. 604 Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends 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 to require coverage under those provisions. Effective immediately. LRB104 07412 BAB 17453 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB1360 Introduced , by Rep. Mary Gill SYNOPSIS AS INTRODUCED: 55 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356z.80 new215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2215 ILCS 130/4003 from Ch. 73, par. 1504-3215 ILCS 165/10 from Ch. 32, par. 604 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.80 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 Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends 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 to require coverage under those provisions. Effective immediately. LRB104 07412 BAB 17453 b LRB104 07412 BAB 17453 b A BILL FOR
	2	+	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB1360 Introduced , by Rep. Mary Gill SYNOPSIS AS INTRODUCED:
	3	+	55 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356z.80 new215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2215 ILCS 130/4003 from Ch. 73, par. 1504-3215 ILCS 165/10 from Ch. 32, par. 604 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.80 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	+	55 ILCS 5/5-1069.3
	5	+	65 ILCS 5/10-4-2.3
	6	+	105 ILCS 5/10-22.3f
	7	+	215 ILCS 5/356z.80 new
	8	+	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
	9	+	215 ILCS 130/4003 from Ch. 73, par. 1504-3
	10	+	215 ILCS 165/10 from Ch. 32, par. 604
	11	+	Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends 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 to require coverage under those provisions. Effective immediately.
	12	+	LRB104 07412 BAB 17453 b LRB104 07412 BAB 17453 b
	13	+	LRB104 07412 BAB 17453 b
	14	+	A BILL FOR
	15	+	HB1360LRB104 07412 BAB 17453 b HB1360 LRB104 07412 BAB 17453 b
	16	+	HB1360 LRB104 07412 BAB 17453 b
3	17		1 AN ACT concerning regulation.
4	18		2 Be it enacted by the People of the State of Illinois,
5	19		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 and by renumbering and~~
8		-	6 ~~changing 6~~.~~11D as added by Public Act 103-975 as follows:~~
9		-	7 (5 ~~ILCS 375/6~~.~~11)~~
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,~~ 356u.10,
17		-	15 ~~356w, 356x~~, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
18		-	16 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
19		-	17 356z.17, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
20		-	18 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
21		-	19 356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, ~~356z.59,~~
22		-	20 356z.60, 356z.61, 356z.~~62, 356z~~.~~64, 356z.67, 356z.68, and~~
23		-	21 ~~356z~~.70, ~~and 356z.71~~, ~~356z.74, 356z.76, 356z.77, and 356z.80~~
24		-	22 of the Illinois Insurance Code. The ~~program of health benefits~~
25		-	23 ~~must comply with Sections 155.22a, 155.37, 355b,~~ ~~356z.19,~~
	20	+	4 Section 5. The Counties Code is amended by changing
	21	+	5 Section 5-1069.3 as follows:
	22	+	6 (55 ILCS 5/5-1069.3)
	23	+	7 Sec. 5-1069.3. Required health benefits. If a county,
	24	+	8 including a home rule county, is a self-insurer for purposes
	25	+	9 of providing health insurance coverage for its employees, the
	26	+	10 coverage shall include coverage for the post-mastectomy care
	27	+	11 benefits required to be covered by a policy of accident and
	28	+	12 health insurance under Section 356t and the coverage required
	29	+	13 under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
	30	+	14 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
	31	+	15 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
	32	+	16 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
	33	+	17 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
	34	+	18 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
	35	+	19 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and 356z.71,
	36	+	20 356z.74, 356z.77, and 356z.80 of the Illinois Insurance Code.
	37	+	21 The coverage shall comply with Sections 155.22a, 355b,
	38	+	22 356z.19, and 370c of the Illinois Insurance Code. The
	39	+	23 Department of Insurance shall enforce the requirements of this
26	40
27	41
28	42
29		-	HB1360 Engrossed LRB104 07412 BAB 17453 b
30		-
31		-
32		-	HB1360 Engrossed- 2 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 2 - LRB104 07412 BAB 17453 b
33		-	HB1360 Engrossed - 2 - LRB104 07412 BAB 17453 b
34		-	1 370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
35		-	2 Code. The program of health benefits shall provide the
36		-	3 coverage required under Section 356m of the Illinois Insurance
37		-	4 Code and, for the employees of the State Employee Group
38		-	5 Insurance Program only, the coverage as also provided in
39		-	6 Section 6.11B of this Act. The Department of Insurance shall
40		-	7 enforce the requirements of this Section with respect to
41		-	8 Sections 370c and 370c.1 of the Illinois Insurance Code; all
42		-	9 other requirements of this Section shall be enforced by the
43		-	10 Department of Central Management Services.
44		-	11 Rulemaking authority to implement Public Act 95-1045, if
45		-	12 any, is conditioned on the rules being adopted in accordance
46		-	13 with all provisions of the Illinois Administrative Procedure
47		-	14 Act and all rules and procedures of the Joint Committee on
48		-	15 Administrative Rules; any purported rule not so adopted, for
49		-	16 whatever reason, is unauthorized.
50		-	17 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
51		-	18 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
52		-	19 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768,
53		-	20 eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
54		-	21 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
55		-	22 1-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84,
56		-	23 eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24;
57		-	24 103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff.
58		-	25 8-11-23; 103-605, eff. 7-1-24; 103-718, eff. 7-19-24; 103-751,
59		-	26 eff. 8-2-24; 103-870, eff. 1-1-25; 103-914, eff. 1-1-25;
	43	+	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB1360 Introduced , by Rep. Mary Gill SYNOPSIS AS INTRODUCED:
	44	+	55 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356z.80 new215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2215 ILCS 130/4003 from Ch. 73, par. 1504-3215 ILCS 165/10 from Ch. 32, par. 604 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.80 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
	45	+	55 ILCS 5/5-1069.3
	46	+	65 ILCS 5/10-4-2.3
	47	+	105 ILCS 5/10-22.3f
	48	+	215 ILCS 5/356z.80 new
	49	+	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
	50	+	215 ILCS 130/4003 from Ch. 73, par. 1504-3
	51	+	215 ILCS 165/10 from Ch. 32, par. 604
	52	+	Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends 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 to require coverage under those provisions. Effective immediately.
	53	+	LRB104 07412 BAB 17453 b LRB104 07412 BAB 17453 b
	54	+	LRB104 07412 BAB 17453 b
	55	+	A BILL FOR
60	56
61	57
62	58
63	59
64	60
65		-	HB1360 Engrossed - 2 - LRB104 07412 BAB 17453 b
	61	+	55 ILCS 5/5-1069.3
	62	+	65 ILCS 5/10-4-2.3
	63	+	105 ILCS 5/10-22.3f
	64	+	215 ILCS 5/356z.80 new
	65	+	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
	66	+	215 ILCS 130/4003 from Ch. 73, par. 1504-3
	67	+	215 ILCS 165/10 from Ch. 32, par. 604
66	68
67	69
68		-	HB1360 Engrossed- 3 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 3 - LRB104 07412 BAB 17453 b
69		-	HB1360 Engrossed - 3 - LRB104 07412 BAB 17453 b
70		-	1 103-918, eff. 1-1-25; 103-951, eff. 1-1-25; 103-1024, eff.
71		-	2 1-1-25; revised 11-26-24.)
72		-	3 (5 ILCS 375/6.11E)
73		-	4 Sec. 6.11E 6.11D. Coverage for treatments to slow the
74		-	5 progression of Alzheimer's disease and related dementias.
75		-	6 Beginning on July 1, 2025, the State Employees Group Insurance
76		-	7 Program shall provide coverage for all medically necessary
77		-	8 FDA-approved treatments or medications prescribed to slow the
78		-	9 progression of Alzheimer's disease or another related
79		-	10 dementia, as determined by a physician licensed to practice
80		-	11 medicine in all its branches. Coverage for all FDA-approved
81		-	12 treatments or medications prescribed to slow the progression
82		-	13 of Alzheimer's disease or another related dementia shall not
83		-	14 be subject to step therapy. Any diagnostic testing necessary
84		-	15 for a physician to determine appropriate use of these
85		-	16 treatments or medications shall be covered by the State
86		-	17 Employees Group Insurance Program. This Section is repealed on
87		-	18 July 1, 2027.
88		-	19 (Source: P.A. 103-975, eff. 1-1-25; revised 12-1-24.)
89		-	20 Section 10. The Counties Code is amended by changing
90		-	21 Section 5-1069.3 as follows:
91		-	22 (55 ILCS 5/5-1069.3)
92		-	23 Sec. 5-1069.3. Required health benefits. If a county,
	70	+
	71	+	LRB104 07412 BAB 17453 b
93	72
94	73
95	74
96	75
97	76
98		-	HB1360 Engrossed - 3 - LRB104 07412 BAB 17453 b
99	77
100	78
101		-	HB1360 Engrossed- 4 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 4 - LRB104 07412 BAB 17453 b
102		-	HB1360 Engrossed - 4 - LRB104 07412 BAB 17453 b
103		-	1 including a home rule county, is a self-insurer for purposes
104		-	2 of providing health insurance coverage for its employees, the
105		-	3 coverage shall include coverage for the post-mastectomy care
106		-	4 benefits required to be covered by a policy of accident and
107		-	5 health insurance under Section 356t and the coverage required
108		-	6 under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
109		-	7 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
110		-	8 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
111		-	9 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
112		-	10 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
113		-	11 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
114		-	12 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and 356z.71,
115		-	13 356z.74, 356z.77, and 356z.80 of the Illinois Insurance Code.
116		-	14 The coverage shall comply with Sections 155.22a, 355b,
117		-	15 356z.19, and 370c of the Illinois Insurance Code. The
118		-	16 Department of Insurance shall enforce the requirements of this
119		-	17 Section. The requirement that health benefits be covered as
120		-	18 provided in this Section is an exclusive power and function of
121		-	19 the State and is a denial and limitation under Article VII,
122		-	20 Section 6, subsection (h) of the Illinois Constitution. A home
123		-	21 rule county to which this Section applies must comply with
124		-	22 every provision of this Section.
125		-	23 Rulemaking authority to implement Public Act 95-1045, if
126		-	24 any, is conditioned on the rules being adopted in accordance
127		-	25 with all provisions of the Illinois Administrative Procedure
128		-	26 Act and all rules and procedures of the Joint Committee on
	79	+
	80	+
	81	+	HB1360 LRB104 07412 BAB 17453 b
	82	+
	83	+
	84	+	HB1360- 2 -LRB104 07412 BAB 17453 b HB1360 - 2 - LRB104 07412 BAB 17453 b
	85	+	HB1360 - 2 - LRB104 07412 BAB 17453 b
	86	+	1 Section. The requirement that health benefits be covered as
	87	+	2 provided in this Section is an exclusive power and function of
	88	+	3 the State and is a denial and limitation under Article VII,
	89	+	4 Section 6, subsection (h) of the Illinois Constitution. A home
	90	+	5 rule county to which this Section applies must comply with
	91	+	6 every provision of this Section.
	92	+	7 Rulemaking authority to implement Public Act 95-1045, if
	93	+	8 any, is conditioned on the rules being adopted in accordance
	94	+	9 with all provisions of the Illinois Administrative Procedure
	95	+	10 Act and all rules and procedures of the Joint Committee on
	96	+	11 Administrative Rules; any purported rule not so adopted, for
	97	+	12 whatever reason, is unauthorized.
	98	+	13 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
	99	+	14 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
	100	+	15 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
	101	+	16 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
	102	+	17 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
	103	+	18 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
	104	+	19 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
	105	+	20 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
	106	+	21 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914,
	107	+	22 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25;
	108	+	23 revised 11-26-24.)
	109	+	24 Section 10. The Illinois Municipal Code is amended by
	110	+	25 changing Section 10-4-2.3 as follows:
129	111
130	112
131	113
132	114
133	115
134		-	HB1360 ~~Engrossed - 4~~ - LRB104 07412 BAB 17453 b
	116	+	HB1360 - 2 - LRB104 07412 BAB 17453 b
135	117
136	118
137		-	HB1360 Engrossed- 5 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 5 - LRB104 07412 BAB 17453 b
138		-	HB1360 Engrossed - 5 - LRB104 07412 BAB 17453 b
139		-	1 Administrative Rules; any purported rule not so adopted, for
140		-	2 whatever reason, is unauthorized.
141		-	3 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
142		-	4 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
143		-	5 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
144		-	6 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
145		-	7 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
146		-	8 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
147		-	9 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
148		-	10 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
149		-	11 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914,
150		-	12 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25;
151		-	13 revised 11-26-24.)
152		-	14 Section 15. The Illinois Municipal Code is amended by
153		-	15 changing Section 10-4-2.3 as follows:
154		-	16 (65 ILCS 5/10-4-2.3)
155		-	17 Sec. 10-4-2.3. Required health benefits. If a
156		-	18 municipality, including a home rule municipality, is a
157		-	19 self-insurer for purposes of providing health insurance
158		-	20 coverage for its employees, the coverage shall include
159		-	21 coverage for the post-mastectomy care benefits required to be
160		-	22 covered by a policy of accident and health insurance under
161		-	23 Section 356t and the coverage required under Sections 356g,
162		-	24 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
	119	+	HB1360- 3 -LRB104 07412 BAB 17453 b HB1360 - 3 - LRB104 07412 BAB 17453 b
	120	+	HB1360 - 3 - LRB104 07412 BAB 17453 b
	121	+	1 (65 ILCS 5/10-4-2.3)
	122	+	2 Sec. 10-4-2.3. Required health benefits. If a
	123	+	3 municipality, including a home rule municipality, is a
	124	+	4 self-insurer for purposes of providing health insurance
	125	+	5 coverage for its employees, the coverage shall include
	126	+	6 coverage for the post-mastectomy care benefits required to be
	127	+	7 covered by a policy of accident and health insurance under
	128	+	8 Section 356t and the coverage required under Sections 356g,
	129	+	9 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
	130	+	10 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
	131	+	11 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
	132	+	12 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
	133	+	13 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
	134	+	14 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
	135	+	15 356z.67, 356z.68, and 356z.70, and 356z.71, 356z.74, 356z.77,
	136	+	16 and 356z.80 of the Illinois Insurance Code. The coverage shall
	137	+	17 comply with Sections 155.22a, 355b, 356z.19, and 370c of the
	138	+	18 Illinois Insurance Code. The Department of Insurance shall
	139	+	19 enforce the requirements of this Section. The requirement that
	140	+	20 health benefits be covered as provided in this is an exclusive
	141	+	21 power and function of the State and is a denial and limitation
	142	+	22 under Article VII, Section 6, subsection (h) of the Illinois
	143	+	23 Constitution. A home rule municipality to which this Section
	144	+	24 applies must comply with every provision of this Section.
	145	+	25 Rulemaking authority to implement Public Act 95-1045, if
163	146
164	147
165	148
166	149
167	150
168		-	HB1360 ~~Engrossed - 5~~ - LRB104 07412 BAB 17453 b
	151	+	HB1360 - 3 - LRB104 07412 BAB 17453 b
169	152
170	153
171		-	HB1360 Engrossed- 6 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 6 - LRB104 07412 BAB 17453 b
172		-	HB1360 Engrossed - 6 - LRB104 07412 BAB 17453 b
173		-	1 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
174		-	2 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
175		-	3 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
176		-	4 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
177		-	5 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
178		-	6 356z.67, 356z.68, and 356z.70, and 356z.71, 356z.74, 356z.77,
179		-	7 and 356z.80 of the Illinois Insurance Code. The coverage shall
180		-	8 comply with Sections 155.22a, 355b, 356z.19, and 370c of the
181		-	9 Illinois Insurance Code. The Department of Insurance shall
182		-	10 enforce the requirements of this Section. The requirement that
183		-	11 health benefits be covered as provided in this is an exclusive
184		-	12 power and function of the State and is a denial and limitation
185		-	13 under Article VII, Section 6, subsection (h) of the Illinois
186		-	14 Constitution. A home rule municipality to which this Section
187		-	15 applies must comply with every provision of this Section.
188		-	16 Rulemaking authority to implement Public Act 95-1045, if
189		-	17 any, is conditioned on the rules being adopted in accordance
190		-	18 with all provisions of the Illinois Administrative Procedure
191		-	19 Act and all rules and procedures of the Joint Committee on
192		-	20 Administrative Rules; any purported rule not so adopted, for
193		-	21 whatever reason, is unauthorized.
194		-	22 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
195		-	23 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
196		-	24 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
197		-	25 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
198		-	26 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
	154	+	HB1360- 4 -LRB104 07412 BAB 17453 b HB1360 - 4 - LRB104 07412 BAB 17453 b
	155	+	HB1360 - 4 - LRB104 07412 BAB 17453 b
	156	+	1 any, is conditioned on the rules being adopted in accordance
	157	+	2 with all provisions of the Illinois Administrative Procedure
	158	+	3 Act and all rules and procedures of the Joint Committee on
	159	+	4 Administrative Rules; any purported rule not so adopted, for
	160	+	5 whatever reason, is unauthorized.
	161	+	6 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
	162	+	7 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
	163	+	8 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
	164	+	9 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
	165	+	10 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
	166	+	11 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
	167	+	12 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
	168	+	13 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
	169	+	14 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914,
	170	+	15 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25;
	171	+	16 revised 11-26-24.)
	172	+	17 Section 15. The School Code is amended by changing Section
	173	+	18 10-22.3f as follows:
	174	+	19 (105 ILCS 5/10-22.3f)
	175	+	20 Sec. 10-22.3f. Required health benefits. Insurance
	176	+	21 protection and benefits for employees shall provide the
	177	+	22 post-mastectomy care benefits required to be covered by a
	178	+	23 policy of accident and health insurance under Section 356t and
	179	+	24 the coverage required under Sections 356g, 356g.5, 356g.5-1,
199	180
200	181
201	182
202	183
203	184
204		-	HB1360 ~~Engrossed - 6~~ - LRB104 07412 BAB 17453 b
	185	+	HB1360 - 4 - LRB104 07412 BAB 17453 b
205	186
206	187
207		-	HB1360 Engrossed- 7 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 7 - LRB104 07412 BAB 17453 b
208		-	HB1360 Engrossed - 7 - LRB104 07412 BAB 17453 b
209		-	1 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
210		-	2 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
211		-	3 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
212		-	4 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914,
213		-	5 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25;
214		-	6 revised 11-26-24.)
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 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
224		-	16 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
225		-	17 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
226		-	18 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
227		-	19 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
228		-	20 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and
229		-	21 356z.71, 356z.74, 356z.77, and 356z.80 of the Illinois
230		-	22 Insurance Code. Insurance policies shall comply with Section
231		-	23 356z.19 of the Illinois Insurance Code. The coverage shall
232		-	24 comply with Sections 155.22a, 355b, and 370c of the Illinois
	188	+	HB1360- 5 -LRB104 07412 BAB 17453 b HB1360 - 5 - LRB104 07412 BAB 17453 b
	189	+	HB1360 - 5 - LRB104 07412 BAB 17453 b
	190	+	1 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
	191	+	2 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
	192	+	3 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
	193	+	4 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
	194	+	5 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
	195	+	6 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and
	196	+	7 356z.71, 356z.74, 356z.77, and 356z.80 of the Illinois
	197	+	8 Insurance Code. Insurance policies shall comply with Section
	198	+	9 356z.19 of the Illinois Insurance Code. The coverage shall
	199	+	10 comply with Sections 155.22a, 355b, and 370c of the Illinois
	200	+	11 Insurance Code. The Department of Insurance shall enforce the
	201	+	12 requirements of this Section.
	202	+	13 Rulemaking authority to implement Public Act 95-1045, if
	203	+	14 any, is conditioned on the rules being adopted in accordance
	204	+	15 with all provisions of the Illinois Administrative Procedure
	205	+	16 Act and all rules and procedures of the Joint Committee on
	206	+	17 Administrative Rules; any purported rule not so adopted, for
	207	+	18 whatever reason, is unauthorized.
	208	+	19 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
	209	+	20 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
	210	+	21 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804,
	211	+	22 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
	212	+	23 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff.
	213	+	24 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420,
	214	+	25 eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 8-11-23;
	215	+	26 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, eff.
233	216
234	217
235	218
236	219
237	220
238		-	HB1360 ~~Engrossed - 7~~ - LRB104 07412 BAB 17453 b
	221	+	HB1360 - 5 - LRB104 07412 BAB 17453 b
239	222
240	223
241		-	HB1360 Engrossed- 8 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 8 - LRB104 07412 BAB 17453 b
242		-	HB1360 Engrossed - 8 - LRB104 07412 BAB 17453 b
243		-	1 Insurance Code. The Department of Insurance shall enforce the
244		-	2 requirements of this Section.
245		-	3 Rulemaking authority to implement Public Act 95-1045, if
246		-	4 any, is conditioned on the rules being adopted in accordance
247		-	5 with all provisions of the Illinois Administrative Procedure
248		-	6 Act and all rules and procedures of the Joint Committee on
249		-	7 Administrative Rules; any purported rule not so adopted, for
250		-	8 whatever reason, is unauthorized.
251		-	9 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
252		-	10 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
253		-	11 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804,
254		-	12 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
255		-	13 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff.
256		-	14 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420,
257		-	15 eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 8-11-23;
258		-	16 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, eff.
259		-	17 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918,
260		-	18 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
261		-	19 Section 25. The Illinois Insurance Code is amended by
262		-	20 adding Section 356z.80 as follows:
263		-	21 (215 ILCS 5/356z.80 new)
264		-	22 Sec. 356z.80. Coverage for treatments to slow the
265		-	23 progression of Alzheimer's disease and related dementias.
266		-	24 (a) A group or individual policy of accident and health
	224	+	HB1360- 6 -LRB104 07412 BAB 17453 b HB1360 - 6 - LRB104 07412 BAB 17453 b
	225	+	HB1360 - 6 - LRB104 07412 BAB 17453 b
	226	+	1 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918,
	227	+	2 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
	228	+	3 Section 20. The Illinois Insurance Code is amended by
	229	+	4 adding Section 356z.80 as follows:
	230	+	5 (215 ILCS 5/356z.80 new)
	231	+	6 Sec. 356z.80. Coverage for treatments to slow the
	232	+	7 progression of Alzheimer's disease and related dementias. A
	233	+	8 group or individual policy of accident and health insurance or
	234	+	9 a managed care plan that is amended, delivered, issued, or
	235	+	10 renewed on or after January 1, 2027 shall provide coverage for
	236	+	11 all medically necessary diagnostic testing and U.S. Food and
	237	+	12 Drug Administration-approved treatments or medications
	238	+	13 prescribed to slow the progression of Alzheimer's disease or
	239	+	14 another related dementia, in accordance with the U.S. Food and
	240	+	15 Drug Administration label, as determined by a physician
	241	+	16 licensed to practice medicine in all its branches. Coverage of
	242	+	17 U.S. Food and Drug Administration-approved treatments or
	243	+	18 medications prescribed to slow the progression of Alzheimer's
	244	+	19 disease or another related dementia pursuant to this Section
	245	+	20 shall not be subject to step therapy.
	246	+	21 Section 25. The Health Maintenance Organization Act is
	247	+	22 amended by changing Section 5-3 as follows:
267	248
268	249
269	250
270	251
271	252
272		-	HB1360 ~~Engrossed - 8~~ - LRB104 07412 BAB 17453 b
	253	+	HB1360 - 6 - LRB104 07412 BAB 17453 b
273	254
274	255
275		-	HB1360 ~~Engrossed- 9~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 9~~ - LRB104 07412 BAB 17453 b
276		-	HB1360 ~~Engrossed - 9~~ - LRB104 07412 BAB 17453 b
277		-	1 ~~insurance or a managed care plan that is amended~~, ~~delivered,~~
278		-	2 ~~issued, or renewed on or after January 1, 2027 shall provide~~
279		-	3 ~~coverage for all medically necessary diagnostic testing and~~
280		-	4 ~~U.S. Food and Drug Administration-approved~~ ~~treatments or~~
281		-	5 ~~medications prescribed to slow~~ the ~~progression~~ of ~~Alzheimer's~~
282		-	6 ~~disease or another related dementia~~, ~~in accordance with the~~
283		-	7 ~~U.S. Food and Drug Administration label~~, ~~as determined by a~~
284		-	8 ~~physician licensed to practice medicine in all its branches~~.
285		-	9 ~~Coverage of U~~.S. ~~Food and Drug Administration-approved~~
286		-	10 ~~treatments or medications prescribed to slow the progression~~
287		-	11 ~~of Alzheimer's disease or another related dementia pursuant to~~
288		-	12 ~~this Section shall not be subject to step therapy~~.
289		-	13 ~~(b) Nothing in this Section prohibits a group or~~
290		-	14 ~~individual policy of accident and health insurance or managed~~
291		-	15 ~~care plan~~, ~~by contract~~, ~~written policy~~, ~~procedure~~, ~~or any~~
292		-	16 ~~other agreement or course of conduct~~, ~~from requiring a~~
293		-	17 ~~pharmacist to effect substitutions of prescription drugs~~
294		-	18 ~~consistent with Section 19~~.~~5 of the Pharmacy Practice Act~~,
295		-	19 ~~under which a pharmacist may substitute an interchangeable~~
296		-	20 ~~biologic for a prescribed biologic product~~, ~~and Section 25 of~~
297		-	21 ~~the Pharmacy Practice Act~~, ~~under which a pharmacist may select~~
298		-	22 ~~a generic drug determined to be therapeutically equivalent by~~
299		-	23 ~~the United States Food~~ and ~~Drug Administration and in~~
300		-	24 ~~accordance with the Illinois Food~~, ~~Drug~~ and ~~Cosmetic Act.~~
301		-	25 ~~(c) The coverage required under this Section shall not~~
302		-	26 ~~apply to managed care plans that are under contract with~~ the
	256	+	HB1360- 7 -LRB104 07412 BAB 17453 b HB1360 - 7 - LRB104 07412 BAB 17453 b
	257	+	HB1360 - 7 - LRB104 07412 BAB 17453 b
	258	+	1 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
	259	+	2 (Text of Section before amendment by P.A. 103-808)
	260	+	3 Sec. 5-3. Insurance Code provisions.
	261	+	4 (a) Health Maintenance Organizations shall be subject to
	262	+	5 the provisions of Sections 133, 134, 136, 137, 139, 140,
	263	+	6 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
	264	+	7 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
	265	+	8 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g.5-1,
	266	+	9 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 356z.3a,
	267	+	10 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10,
	268	+	11 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18,
	269	+	12 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 356z.25,
	270	+	13 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 356z.33,
	271	+	14 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40,
	272	+	15 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 356z.47,
	273	+	16 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 356z.55,
	274	+	17 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 356z.62,
	275	+	18 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 356z.69,
	276	+	19 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 356z.77,
	277	+	20 356z.80, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b,
	278	+	21 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A,
	279	+	22 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of
	280	+	23 subsection (2) of Section 367, and Articles IIA, VIII 1/2,
	281	+	24 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
	282	+	25 Illinois Insurance Code.
	283	+	26 (b) For purposes of the Illinois Insurance Code, except
303	284
304	285
305	286
306	287
307	288
308		-	HB1360 ~~Engrossed - 9~~ - LRB104 07412 BAB 17453 b
	289	+	HB1360 - 7 - LRB104 07412 BAB 17453 b
309	290
310	291
311		-	HB1360 Engrossed- 10 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 10 - LRB104 07412 BAB 17453 b
312		-	HB1360 Engrossed - 10 - LRB104 07412 BAB 17453 b
313		-	1 Department of Healthcare and Family Services.
314		-	2 Section 30. The Health Maintenance Organization Act is
315		-	3 amended by changing Section 5-3 as follows:
316		-	4 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
317		-	5 (Text of Section before amendment by P.A. 103-808)
318		-	6 Sec. 5-3. Insurance Code provisions.
319		-	7 (a) Health Maintenance Organizations shall be subject to
320		-	8 the provisions of Sections 133, 134, 136, 137, 139, 140,
321		-	9 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
322		-	10 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
323		-	11 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g.5-1,
324		-	12 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 356z.3a,
325		-	13 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10,
326		-	14 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18,
327		-	15 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 356z.25,
328		-	16 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 356z.33,
329		-	17 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40,
330		-	18 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 356z.47,
331		-	19 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 356z.55,
332		-	20 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 356z.62,
333		-	21 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 356z.69,
334		-	22 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 356z.77,
335		-	23 356z.80, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b,
336		-	24 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A,
	292	+	HB1360- 8 -LRB104 07412 BAB 17453 b HB1360 - 8 - LRB104 07412 BAB 17453 b
	293	+	HB1360 - 8 - LRB104 07412 BAB 17453 b
	294	+	1 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
	295	+	2 Health Maintenance Organizations in the following categories
	296	+	3 are deemed to be "domestic companies":
	297	+	4 (1) a corporation authorized under the Dental Service
	298	+	5 Plan Act or the Voluntary Health Services Plans Act;
	299	+	6 (2) a corporation organized under the laws of this
	300	+	7 State; or
	301	+	8 (3) a corporation organized under the laws of another
	302	+	9 state, 30% or more of the enrollees of which are residents
	303	+	10 of this State, except a corporation subject to
	304	+	11 substantially the same requirements in its state of
	305	+	12 organization as is a "domestic company" under Article VIII
	306	+	13 1/2 of the Illinois Insurance Code.
	307	+	14 (c) In considering the merger, consolidation, or other
	308	+	15 acquisition of control of a Health Maintenance Organization
	309	+	16 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
	310	+	17 (1) the Director shall give primary consideration to
	311	+	18 the continuation of benefits to enrollees and the
	312	+	19 financial conditions of the acquired Health Maintenance
	313	+	20 Organization after the merger, consolidation, or other
	314	+	21 acquisition of control takes effect;
	315	+	22 (2)(i) the criteria specified in subsection (1)(b) of
	316	+	23 Section 131.8 of the Illinois Insurance Code shall not
	317	+	24 apply and (ii) the Director, in making his determination
	318	+	25 with respect to the merger, consolidation, or other
	319	+	26 acquisition of control, need not take into account the
337	320
338	321
339	322
340	323
341	324
342		-	HB1360 ~~Engrossed - 10~~ - LRB104 07412 BAB 17453 b
	325	+	HB1360 - 8 - LRB104 07412 BAB 17453 b
343	326
344	327
345		-	HB1360 ~~Engrossed- 11~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 11~~ - LRB104 07412 BAB 17453 b
346		-	HB1360 ~~Engrossed - 11~~ - LRB104 07412 BAB 17453 b
347		-	1 ~~408~~, ~~408.2~~, ~~409, 412, 444, and 444.1, paragraph (c) of~~
348		-	2 ~~subsection (2)~~ of ~~Section 367, and Articles IIA, VIII 1/2,~~
349		-	3 ~~XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of~~ the
350		-	4 ~~Illinois Insurance Code.~~
351		-	5 (b) ~~For purposes~~ of the ~~Illinois Insurance Code, except~~
352		-	6 ~~for Sections 444 and 444.1 and Articles XIII and XIII 1/2,~~
353		-	7 ~~Health Maintenance Organizations in the following categories~~
354		-	8 ~~are deemed to be "domestic~~ ~~companies":~~
355		-	9 ~~(1) a corporation authorized under~~ the ~~Dental Service~~
356		-	10 ~~Plan Act or~~ the ~~Voluntary~~ Health ~~Services Plans Act;~~
357		-	11 ~~(2) a corporation organized under~~ the ~~laws~~ of ~~this~~
358		-	12 ~~State; or~~
359		-	13 ~~(3) a corporation organized under the laws of another~~
360		-	14 ~~state, 30%~~ ~~or more~~ of ~~the enrollees of which are residents~~
361		-	15 ~~of this State, except~~ a ~~corporation subject to~~
362		-	16 ~~substantially~~ the ~~same requirements in its state of~~
363		-	17 organization ~~as is a "domestic company" under Article VIII~~
364		-	18 ~~1/2~~ of ~~the Illinois Insurance Code.~~
365		-	19 (c) ~~In considering~~ the ~~merger, consolidation, or other~~
366		-	20 ~~acquisition of control of a Health Maintenance Organization~~
367		-	21 ~~pursuant to~~ Article VIII 1/2 of the Illinois ~~Insurance Code,~~
368		-	22 ~~(1)~~ the ~~Director shall give primary consideration to~~
369		-	23 ~~the continuation~~ of ~~benefits to enrollees and the~~
370		-	24 ~~financial conditions of~~ the ~~acquired~~ Health ~~Maintenance~~
371		-	25 Organization ~~after the merger~~, ~~consolidation~~, ~~or other~~
372		-	26 ~~acquisition of control takes effect;~~
	328	+	HB1360- 9 -LRB104 07412 BAB 17453 b HB1360 - 9 - LRB104 07412 BAB 17453 b
	329	+	HB1360 - 9 - LRB104 07412 BAB 17453 b
	330	+	1 effect on competition of the merger, consolidation, or
	331	+	2 other acquisition of control;
	332	+	3 (3) the Director shall have the power to require the
	333	+	4 following information:
	334	+	5 (A) certification by an independent actuary of the
	335	+	6 adequacy of the reserves of the Health Maintenance
	336	+	7 Organization sought to be acquired;
	337	+	8 (B) pro forma financial statements reflecting the
	338	+	9 combined balance sheets of the acquiring company and
	339	+	10 the Health Maintenance Organization sought to be
	340	+	11 acquired as of the end of the preceding year and as of
	341	+	12 a date 90 days prior to the acquisition, as well as pro
	342	+	13 forma financial statements reflecting projected
	343	+	14 combined operation for a period of 2 years;
	344	+	15 (C) a pro forma business plan detailing an
	345	+	16 acquiring party's plans with respect to the operation
	346	+	17 of the Health Maintenance Organization sought to be
	347	+	18 acquired for a period of not less than 3 years; and
	348	+	19 (D) such other information as the Director shall
	349	+	20 require.
	350	+	21 (d) The provisions of Article VIII 1/2 of the Illinois
	351	+	22 Insurance Code and this Section 5-3 shall apply to the sale by
	352	+	23 any health maintenance organization of greater than 10% of its
	353	+	24 enrollee population (including, without limitation, the health
	354	+	25 maintenance organization's right, title, and interest in and
	355	+	26 to its health care certificates).
373	356
374	357
375	358
376	359
377	360
378		-	HB1360 ~~Engrossed - 11~~ - LRB104 07412 BAB 17453 b
	361	+	HB1360 - 9 - LRB104 07412 BAB 17453 b
379	362
380	363
381		-	HB1360 ~~Engrossed- 12~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 12~~ - LRB104 07412 BAB 17453 b
382		-	HB1360 ~~Engrossed - 12~~ - LRB104 07412 BAB 17453 b
383		-	1 (2)~~(i) the criteria specified~~ in ~~subsection (1)(b) of~~
384		-	2 Section ~~131~~.8 of the Illinois Insurance ~~Code shall not~~
385		-	3 ~~apply and (ii)~~ the Director, in ~~making his determination~~
386		-	4 ~~with respect to~~ the ~~merger~~, ~~consolidation, or other~~
387		-	5 ~~acquisition of control, need not~~ take into account the
388		-	6 ~~effect~~ on ~~competition~~ of ~~the merger,~~ ~~consolidation, or~~
389		-	7 ~~other acquisition~~ of ~~control;~~
390		-	8 ~~(3) the Director shall have the power~~ to ~~require the~~
391		-	9 ~~following information:~~
392		-	10 ~~(A) certification by an independent actuary of the~~
393		-	11 ~~adequacy of~~ the ~~reserves of the Health Maintenance~~
394		-	12 ~~Organization sought to be acquired;~~
395		-	13 ~~(B) pro forma financial statements reflecting the~~
396		-	14 ~~combined balance sheets~~ of the ~~acquiring company and~~
397		-	15 ~~the~~ Health Maintenance Organization ~~sought to be~~
398		-	16 ~~acquired as of the end of the preceding year and as of~~
399		-	17 ~~a date 90 days prior to~~ the ~~acquisition, as well as pro~~
400		-	18 ~~forma financial statements reflecting projected~~
401		-	19 ~~combined operation for a period of 2 years;~~
402		-	20 ~~(C) a pro forma business plan detailing an~~
403		-	21 ~~acquiring party's plans with respect~~ to ~~the operation~~
404		-	22 ~~of the Health Maintenance Organization sought~~ to be
405		-	23 ~~acquired for a period of not~~ less than ~~3 years~~; and
406		-	24 (D) ~~such other information as~~ the ~~Director shall~~
407		-	25 ~~require.~~
408		-	26 ~~(d) The provisions of Article VIII 1/2 of the Illinois~~
	364	+	HB1360- 10 -LRB104 07412 BAB 17453 b HB1360 - 10 - LRB104 07412 BAB 17453 b
	365	+	HB1360 - 10 - LRB104 07412 BAB 17453 b
	366	+	1 (e) In considering any management contract or service
	367	+	2 agreement subject to Section 141.1 of the Illinois Insurance
	368	+	3 Code, the Director (i) shall, in addition to the criteria
	369	+	4 specified in Section 141.2 of the Illinois Insurance Code,
	370	+	5 take into account the effect of the management contract or
	371	+	6 service agreement on the continuation of benefits to enrollees
	372	+	7 and the financial condition of the health maintenance
	373	+	8 organization to be managed or serviced, and (ii) need not take
	374	+	9 into account the effect of the management contract or service
	375	+	10 agreement on competition.
	376	+	11 (f) Except for small employer groups as defined in the
	377	+	12 Small Employer Rating, Renewability and Portability Health
	378	+	13 Insurance Act and except for medicare supplement policies as
	379	+	14 defined in Section 363 of the Illinois Insurance Code, a
	380	+	15 Health Maintenance Organization may by contract agree with a
	381	+	16 group or other enrollment unit to effect refunds or charge
	382	+	17 additional premiums under the following terms and conditions:
	383	+	18 (i) the amount of, and other terms and conditions with
	384	+	19 respect to, the refund or additional premium are set forth
	385	+	20 in the group or enrollment unit contract agreed in advance
	386	+	21 of the period for which a refund is to be paid or
	387	+	22 additional premium is to be charged (which period shall
	388	+	23 not be less than one year); and
	389	+	24 (ii) the amount of the refund or additional premium
	390	+	25 shall not exceed 20% of the Health Maintenance
	391	+	26 Organization's profitable or unprofitable experience with
409	392
410	393
411	394
412	395
413	396
414		-	HB1360 ~~Engrossed - 12~~ - LRB104 07412 BAB 17453 b
	397	+	HB1360 - 10 - LRB104 07412 BAB 17453 b
415	398
416	399
417		-	HB1360 ~~Engrossed- 13~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 13~~ - LRB104 07412 BAB 17453 b
418		-	HB1360 ~~Engrossed - 13~~ - LRB104 07412 BAB 17453 b
419		-	1 ~~Insurance Code and this Section 5-3 shall apply~~ to the ~~sale by~~
420		-	2 ~~any health maintenance organization~~ of ~~greater than 10%~~ ~~of its~~
421		-	3 ~~enrollee population (including, without limitation~~, the ~~health~~
422		-	4 ~~maintenance organization's right,~~ ~~title, and interest in and~~
423		-	5 ~~to its~~ health ~~care certificates).~~
424		-	6 ~~(e) In considering~~ any ~~management contract or service~~
425		-	7 ~~agreement subject~~ to ~~Section 141.1 of the Illinois Insurance~~
426		-	8 ~~Code,~~ the ~~Director (i) shall,~~ ~~in addition to the criteria~~
427		-	9 ~~specified in Section 141.2 of~~ the ~~Illinois Insurance Code,~~
428		-	10 ~~take~~ into ~~account the effect of the management contract or~~
429		-	11 ~~service agreement on~~ the ~~continuation of benefits to enrollees~~
430		-	12 ~~and the financial condition of the health maintenance~~
431		-	13 organization ~~to be managed or serviced, and (ii) need not take~~
432		-	14 ~~into account~~ the ~~effect~~ of ~~the management contract or service~~
433		-	15 ~~agreement on competition.~~
434		-	16 ~~(f) Except for small employer groups as defined in the~~
435		-	17 ~~Small Employer Rating,~~ ~~Renewability and Portability Health~~
436		-	18 ~~Insurance Act and except for medicare supplement policies as~~
437		-	19 ~~defined in Section 363 of~~ the ~~Illinois Insurance Code, a~~
438		-	20 ~~Health Maintenance Organization may by contract agree with a~~
439		-	21 ~~group~~ or ~~other enrollment unit to effect refunds or charge~~
440		-	22 ~~additional premiums under~~ the ~~following terms~~ and ~~conditions:~~
441		-	23 ~~(i)~~ the ~~amount of, and other terms and conditions with~~
442		-	24 ~~respect to, the refund or additional premium are set forth~~
443		-	25 in the ~~group or enrollment unit contract agreed in advance~~
444		-	26 ~~of the period for which a refund is~~ to ~~be paid or~~
	400	+	HB1360- 11 -LRB104 07412 BAB 17453 b HB1360 - 11 - LRB104 07412 BAB 17453 b
	401	+	HB1360 - 11 - LRB104 07412 BAB 17453 b
	402	+	1 respect to the group or other enrollment unit for the
	403	+	2 period (and, for purposes of a refund or additional
	404	+	3 premium, the profitable or unprofitable experience shall
	405	+	4 be calculated taking into account a pro rata share of the
	406	+	5 Health Maintenance Organization's administrative and
	407	+	6 marketing expenses, but shall not include any refund to be
	408	+	7 made or additional premium to be paid pursuant to this
	409	+	8 subsection (f)). The Health Maintenance Organization and
	410	+	9 the group or enrollment unit may agree that the profitable
	411	+	10 or unprofitable experience may be calculated taking into
	412	+	11 account the refund period and the immediately preceding 2
	413	+	12 plan years.
	414	+	13 The Health Maintenance Organization shall include a
	415	+	14 statement in the evidence of coverage issued to each enrollee
	416	+	15 describing the possibility of a refund or additional premium,
	417	+	16 and upon request of any group or enrollment unit, provide to
	418	+	17 the group or enrollment unit a description of the method used
	419	+	18 to calculate (1) the Health Maintenance Organization's
	420	+	19 profitable experience with respect to the group or enrollment
	421	+	20 unit and the resulting refund to the group or enrollment unit
	422	+	21 or (2) the Health Maintenance Organization's unprofitable
	423	+	22 experience with respect to the group or enrollment unit and
	424	+	23 the resulting additional premium to be paid by the group or
	425	+	24 enrollment unit.
	426	+	25 In no event shall the Illinois Health Maintenance
	427	+	26 Organization Guaranty Association be liable to pay any
445	428
446	429
447	430
448	431
449	432
450		-	HB1360 ~~Engrossed - 13~~ - LRB104 07412 BAB 17453 b
	433	+	HB1360 - 11 - LRB104 07412 BAB 17453 b
451	434
452	435
453		-	HB1360 Engrossed- 14 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 14 - LRB104 07412 BAB 17453 b
454		-	HB1360 Engrossed - 14 - LRB104 07412 BAB 17453 b
455		-	1 additional premium is to be charged (which period shall
456		-	2 not be less than one year); and
457		-	3 (ii) the amount of the refund or additional premium
458		-	4 shall not exceed 20% of the Health Maintenance
459		-	5 Organization's profitable or unprofitable experience with
460		-	6 respect to the group or other enrollment unit for the
461		-	7 period (and, for purposes of a refund or additional
462		-	8 premium, the profitable or unprofitable experience shall
463		-	9 be calculated taking into account a pro rata share of the
464		-	10 Health Maintenance Organization's administrative and
465		-	11 marketing expenses, but shall not include any refund to be
466		-	12 made or additional premium to be paid pursuant to this
467		-	13 subsection (f)). The Health Maintenance Organization and
468		-	14 the group or enrollment unit may agree that the profitable
469		-	15 or unprofitable experience may be calculated taking into
470		-	16 account the refund period and the immediately preceding 2
471		-	17 plan years.
472		-	18 The Health Maintenance Organization shall include a
473		-	19 statement in the evidence of coverage issued to each enrollee
474		-	20 describing the possibility of a refund or additional premium,
475		-	21 and upon request of any group or enrollment unit, provide to
476		-	22 the group or enrollment unit a description of the method used
477		-	23 to calculate (1) the Health Maintenance Organization's
478		-	24 profitable experience with respect to the group or enrollment
479		-	25 unit and the resulting refund to the group or enrollment unit
480		-	26 or (2) the Health Maintenance Organization's unprofitable
	436	+	HB1360- 12 -LRB104 07412 BAB 17453 b HB1360 - 12 - LRB104 07412 BAB 17453 b
	437	+	HB1360 - 12 - LRB104 07412 BAB 17453 b
	438	+	1 contractual obligation of an insolvent organization to pay any
	439	+	2 refund authorized under this Section.
	440	+	3 (g) Rulemaking authority to implement Public Act 95-1045,
	441	+	4 if any, is conditioned on the rules being adopted in
	442	+	5 accordance with all provisions of the Illinois Administrative
	443	+	6 Procedure Act and all rules and procedures of the Joint
	444	+	7 Committee on Administrative Rules; any purported rule not so
	445	+	8 adopted, for whatever reason, is unauthorized.
	446	+	9 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
	447	+	10 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
	448	+	11 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
	449	+	12 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
	450	+	13 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
	451	+	14 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
	452	+	15 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
	453	+	16 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
	454	+	17 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
	455	+	18 eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24;
	456	+	19 103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff.
	457	+	20 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751,
	458	+	21 eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25;
	459	+	22 103-777, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918, eff.
	460	+	23 1-1-25; 103-1024, eff. 1-1-25; revised 9-26-24.)
	461	+	24 (Text of Section after amendment by P.A. 103-808)
	462	+	25 Sec. 5-3. Insurance Code provisions.
481	463
482	464
483	465
484	466
485	467
486		-	HB1360 ~~Engrossed - 14~~ - LRB104 07412 BAB 17453 b
	468	+	HB1360 - 12 - LRB104 07412 BAB 17453 b
487	469
488	470
489		-	HB1360 ~~Engrossed- 15~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 15~~ - LRB104 07412 BAB 17453 b
490		-	HB1360 ~~Engrossed - 15~~ - LRB104 07412 BAB 17453 b
491		-	1 ~~experience with respect~~ to ~~the group or enrollment unit and~~
492		-	2 the ~~resulting additional premium to be paid by the group or~~
493		-	3 ~~enrollment unit~~.
494		-	4 ~~In no event shall the Illinois Health Maintenance~~
495		-	5 ~~Organization Guaranty Association be liable to pay any~~
496		-	6 ~~contractual obligation of an insolvent organization to pay any~~
497		-	7 ~~refund authorized under this Section~~.
498		-	8 ~~(g) Rulemaking authority to implement Public Act 95-1045~~,
499		-	9 ~~if any~~, ~~is conditioned on the rules being adopted in~~
500		-	10 ~~accordance with all provisions of the Illinois Administrative~~
501		-	11 ~~Procedure Act and all rules and procedures of the Joint~~
502		-	12 ~~Committee on Administrative Rules;~~ ~~any purported rule not so~~
503		-	13 ~~adopted~~, ~~for whatever reason~~, ~~is unauthorized~~.
504		-	14 ~~(Source: P~~.~~A. 102-30~~, ~~eff~~. ~~1-1-22; 102-34~~, ~~eff~~. ~~6-25-21;~~
505		-	15 ~~102-203~~, ~~eff~~. ~~1-1-22; 102-306~~, ~~eff~~. ~~1-1-22; 102-443~~, ~~eff~~.
506		-	16 ~~1-1-22; 102-589~~, ~~eff~~. ~~1-1-22; 102-642~~, ~~eff~~. ~~1-1-22; 102-665~~,
507		-	17 ~~eff~~. ~~10-8-21; 102-731~~, ~~eff~~. ~~1-1-23; 102-775~~, ~~eff~~. 5~~-13-22;~~
508		-	18 ~~102-804~~, ~~eff. 1-1-23; 102-813~~, ~~eff. 5-13-22; 102-816~~, ~~eff~~.
509		-	19 ~~1-1-23; 102-860~~, ~~eff. 1-1-23; 102-901~~, ~~eff~~. 7-1~~-22; 102-1093,~~
510		-	20 ~~eff.~~ 1~~-1-23; 102-1117~~, ~~eff. 1-13-23; 103-84, eff. 1-1-24;~~
511		-	21 ~~103-91~~, ~~eff.~~ 1~~-1-24; 103-123~~, ~~eff.~~ 1~~-1-24; 103-154~~, ~~eff.~~
512		-	22 ~~6-30-23; 103-420, eff~~. ~~1-1-24; 103-426, eff. 8-4-23; 103-445,~~
513		-	23 ~~eff. 1-1-24; 103-551~~, ~~eff. 8-11-23; 103-605, eff. 7-1-24;~~
514		-	24 ~~103-618, eff~~. 1~~-1-25; 103-649~~, ~~eff. 1-1-25; 103-656, eff.~~
515		-	25 ~~1-1-25; 103-700, eff.~~ ~~1-1-25; 103-718, eff.~~ ~~7-19-24; 103-751,~~
516		-	26 ~~eff. 8-2-24; 103-753, eff.~~ ~~8-2-24; 103-758, eff. 1-1-25;~~
	471	+	HB1360- 13 -LRB104 07412 BAB 17453 b HB1360 - 13 - LRB104 07412 BAB 17453 b
	472	+	HB1360 - 13 - LRB104 07412 BAB 17453 b
	473	+	1 (a) Health Maintenance Organizations shall be subject to
	474	+	2 the provisions of Sections 133, 134, 136, 137, 139, 140,
	475	+	3 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
	476	+	4 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
	477	+	5 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g,
	478	+	6 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
	479	+	7 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
	480	+	8 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
	481	+	9 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
	482	+	10 356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
	483	+	11 356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
	484	+	12 356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
	485	+	13 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
	486	+	14 356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
	487	+	15 356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
	488	+	16 356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
	489	+	17 356z.77, 356z.80, 364, 364.01, 364.3, 367.2, 367.2-5, 367i,
	490	+	18 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402,
	491	+	19 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c)
	492	+	20 of subsection (2) of Section 367, and Articles IIA, VIII 1/2,
	493	+	21 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
	494	+	22 Illinois Insurance Code.
	495	+	23 (b) For purposes of the Illinois Insurance Code, except
	496	+	24 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
	497	+	25 Health Maintenance Organizations in the following categories
	498	+	26 are deemed to be "domestic companies":
517	499
518	500
519	501
520	502
521	503
522		-	HB1360 ~~Engrossed - 15~~ - LRB104 07412 BAB 17453 b
	504	+	HB1360 - 13 - LRB104 07412 BAB 17453 b
523	505
524	506
525		-	HB1360 Engrossed- 16 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 16 - LRB104 07412 BAB 17453 b
526		-	HB1360 Engrossed - 16 - LRB104 07412 BAB 17453 b
527		-	1 103-777, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918, eff.
528		-	2 1-1-25; 103-1024, eff. 1-1-25; revised 9-26-24.)
529		-	3 (Text of Section after amendment by P.A. 103-808)
530		-	4 Sec. 5-3. Insurance Code provisions.
531		-	5 (a) Health Maintenance Organizations shall be subject to
532		-	6 the provisions of Sections 133, 134, 136, 137, 139, 140,
533		-	7 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
534		-	8 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
535		-	9 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g,
536		-	10 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
537		-	11 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
538		-	12 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
539		-	13 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
540		-	14 356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
541		-	15 356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
542		-	16 356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
543		-	17 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
544		-	18 356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
545		-	19 356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
546		-	20 356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
547		-	21 356z.77, 356z.80, 364, 364.01, 364.3, 367.2, 367.2-5, 367i,
548		-	22 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402,
549		-	23 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c)
550		-	24 of subsection (2) of Section 367, and Articles IIA, VIII 1/2,
551		-	25 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
	507	+	HB1360- 14 -LRB104 07412 BAB 17453 b HB1360 - 14 - LRB104 07412 BAB 17453 b
	508	+	HB1360 - 14 - LRB104 07412 BAB 17453 b
	509	+	1 (1) a corporation authorized under the Dental Service
	510	+	2 Plan Act or the Voluntary Health Services Plans Act;
	511	+	3 (2) a corporation organized under the laws of this
	512	+	4 State; or
	513	+	5 (3) a corporation organized under the laws of another
	514	+	6 state, 30% or more of the enrollees of which are residents
	515	+	7 of this State, except a corporation subject to
	516	+	8 substantially the same requirements in its state of
	517	+	9 organization as is a "domestic company" under Article VIII
	518	+	10 1/2 of the Illinois Insurance Code.
	519	+	11 (c) In considering the merger, consolidation, or other
	520	+	12 acquisition of control of a Health Maintenance Organization
	521	+	13 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
	522	+	14 (1) the Director shall give primary consideration to
	523	+	15 the continuation of benefits to enrollees and the
	524	+	16 financial conditions of the acquired Health Maintenance
	525	+	17 Organization after the merger, consolidation, or other
	526	+	18 acquisition of control takes effect;
	527	+	19 (2)(i) the criteria specified in subsection (1)(b) of
	528	+	20 Section 131.8 of the Illinois Insurance Code shall not
	529	+	21 apply and (ii) the Director, in making his determination
	530	+	22 with respect to the merger, consolidation, or other
	531	+	23 acquisition of control, need not take into account the
	532	+	24 effect on competition of the merger, consolidation, or
	533	+	25 other acquisition of control;
	534	+	26 (3) the Director shall have the power to require the
552	535
553	536
554	537
555	538
556	539
557		-	HB1360 ~~Engrossed - 16~~ - LRB104 07412 BAB 17453 b
	540	+	HB1360 - 14 - LRB104 07412 BAB 17453 b
558	541
559	542
560		-	HB1360 ~~Engrossed- 17~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 17~~ - LRB104 07412 BAB 17453 b
561		-	HB1360 ~~Engrossed - 17~~ - LRB104 07412 BAB 17453 b
562		-	1 ~~Illinois Insurance Code.~~
563		-	2 (b) ~~For purposes~~ of the ~~Illinois Insurance Code, except~~
564		-	3 ~~for Sections 444 and 444.1 and Articles XIII and XIII 1/2,~~
565		-	4 ~~Health Maintenance Organizations in the following categories~~
566		-	5 ~~are deemed to be "domestic~~ ~~companies":~~
567		-	6 ~~(1) a corporation authorized under~~ the ~~Dental Service~~
568		-	7 ~~Plan Act or~~ the ~~Voluntary~~ Health ~~Services Plans Act;~~
569		-	8 ~~(2) a corporation organized under~~ the ~~laws~~ of ~~this~~
570		-	9 ~~State; or~~
571		-	10 ~~(3) a corporation organized under the laws of another~~
572		-	11 ~~state, 30%~~ ~~or more~~ of ~~the enrollees of which are residents~~
573		-	12 ~~of this State, except~~ a ~~corporation subject to~~
574		-	13 ~~substantially~~ the ~~same requirements in its state of~~
575		-	14 organization ~~as is a "domestic company" under Article VIII~~
576		-	15 ~~1/2~~ of ~~the Illinois Insurance Code.~~
577		-	16 (c) ~~In considering~~ the ~~merger, consolidation, or other~~
578		-	17 ~~acquisition of control of a Health Maintenance Organization~~
579		-	18 ~~pursuant to~~ Article VIII 1/2 of the Illinois ~~Insurance Code,~~
580		-	19 ~~(1)~~ the ~~Director shall give primary consideration to~~
581		-	20 ~~the continuation~~ of ~~benefits to enrollees and the~~
582		-	21 ~~financial conditions of~~ the ~~acquired~~ Health ~~Maintenance~~
583		-	22 Organization ~~after the merger~~, ~~consolidation~~, ~~or other~~
584		-	23 ~~acquisition of control takes effect;~~
585		-	24 (2)~~(i) the criteria specified~~ in ~~subsection (1)(b) of~~
586		-	25 Section ~~131~~.8 of the Illinois Insurance ~~Code shall not~~
587		-	26 ~~apply and (ii)~~ the Director, in ~~making his determination~~
	543	+	HB1360- 15 -LRB104 07412 BAB 17453 b HB1360 - 15 - LRB104 07412 BAB 17453 b
	544	+	HB1360 - 15 - LRB104 07412 BAB 17453 b
	545	+	1 following information:
	546	+	2 (A) certification by an independent actuary of the
	547	+	3 adequacy of the reserves of the Health Maintenance
	548	+	4 Organization sought to be acquired;
	549	+	5 (B) pro forma financial statements reflecting the
	550	+	6 combined balance sheets of the acquiring company and
	551	+	7 the Health Maintenance Organization sought to be
	552	+	8 acquired as of the end of the preceding year and as of
	553	+	9 a date 90 days prior to the acquisition, as well as pro
	554	+	10 forma financial statements reflecting projected
	555	+	11 combined operation for a period of 2 years;
	556	+	12 (C) a pro forma business plan detailing an
	557	+	13 acquiring party's plans with respect to the operation
	558	+	14 of the Health Maintenance Organization sought to be
	559	+	15 acquired for a period of not less than 3 years; and
	560	+	16 (D) such other information as the Director shall
	561	+	17 require.
	562	+	18 (d) The provisions of Article VIII 1/2 of the Illinois
	563	+	19 Insurance Code and this Section 5-3 shall apply to the sale by
	564	+	20 any health maintenance organization of greater than 10% of its
	565	+	21 enrollee population (including, without limitation, the health
	566	+	22 maintenance organization's right, title, and interest in and
	567	+	23 to its health care certificates).
	568	+	24 (e) In considering any management contract or service
	569	+	25 agreement subject to Section 141.1 of the Illinois Insurance
	570	+	26 Code, the Director (i) shall, in addition to the criteria
588	571
589	572
590	573
591	574
592	575
593		-	HB1360 ~~Engrossed - 17~~ - LRB104 07412 BAB 17453 b
	576	+	HB1360 - 15 - LRB104 07412 BAB 17453 b
594	577
595	578
596		-	HB1360 ~~Engrossed- 18~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 18~~ - LRB104 07412 BAB 17453 b
597		-	HB1360 ~~Engrossed - 18~~ - LRB104 07412 BAB 17453 b
598		-	1 ~~with respect to~~ the ~~merger~~, ~~consolidation, or other~~
599		-	2 ~~acquisition of control, need not~~ take into account the
600		-	3 ~~effect~~ on ~~competition~~ of ~~the merger,~~ ~~consolidation, or~~
601		-	4 ~~other acquisition~~ of ~~control;~~
602		-	5 ~~(3) the Director shall have the power~~ to ~~require the~~
603		-	6 ~~following information:~~
604		-	7 ~~(A) certification by an independent actuary of the~~
605		-	8 ~~adequacy of~~ the ~~reserves of the Health Maintenance~~
606		-	9 ~~Organization sought to be acquired;~~
607		-	10 ~~(B) pro forma financial statements reflecting the~~
608		-	11 ~~combined balance sheets~~ of the ~~acquiring company and~~
609		-	12 ~~the~~ Health Maintenance Organization ~~sought to be~~
610		-	13 ~~acquired as of the end of the preceding year and as of~~
611		-	14 ~~a date 90 days prior to~~ the ~~acquisition, as well as pro~~
612		-	15 ~~forma financial statements reflecting projected~~
613		-	16 ~~combined operation for a period of 2 years;~~
614		-	17 ~~(C) a pro forma business plan detailing an~~
615		-	18 ~~acquiring party's plans with respect~~ to ~~the operation~~
616		-	19 ~~of the Health Maintenance Organization sought~~ to be
617		-	20 ~~acquired for a period of not~~ less than ~~3 years~~; and
618		-	21 (D) ~~such other information as~~ the ~~Director shall~~
619		-	22 ~~require.~~
620		-	23 ~~(d) The provisions of Article VIII 1/2 of the Illinois~~
621		-	24 ~~Insurance Code and this Section 5-3 shall apply~~ to the ~~sale by~~
622		-	25 ~~any health maintenance organization~~ of ~~greater than 10%~~ ~~of its~~
623		-	26 ~~enrollee population (including, without limitation~~, the ~~health~~
	579	+	HB1360- 16 -LRB104 07412 BAB 17453 b HB1360 - 16 - LRB104 07412 BAB 17453 b
	580	+	HB1360 - 16 - LRB104 07412 BAB 17453 b
	581	+	1 specified in Section 141.2 of the Illinois Insurance Code,
	582	+	2 take into account the effect of the management contract or
	583	+	3 service agreement on the continuation of benefits to enrollees
	584	+	4 and the financial condition of the health maintenance
	585	+	5 organization to be managed or serviced, and (ii) need not take
	586	+	6 into account the effect of the management contract or service
	587	+	7 agreement on competition.
	588	+	8 (f) Except for small employer groups as defined in the
	589	+	9 Small Employer Rating, Renewability and Portability Health
	590	+	10 Insurance Act and except for medicare supplement policies as
	591	+	11 defined in Section 363 of the Illinois Insurance Code, a
	592	+	12 Health Maintenance Organization may by contract agree with a
	593	+	13 group or other enrollment unit to effect refunds or charge
	594	+	14 additional premiums under the following terms and conditions:
	595	+	15 (i) the amount of, and other terms and conditions with
	596	+	16 respect to, the refund or additional premium are set forth
	597	+	17 in the group or enrollment unit contract agreed in advance
	598	+	18 of the period for which a refund is to be paid or
	599	+	19 additional premium is to be charged (which period shall
	600	+	20 not be less than one year); and
	601	+	21 (ii) the amount of the refund or additional premium
	602	+	22 shall not exceed 20% of the Health Maintenance
	603	+	23 Organization's profitable or unprofitable experience with
	604	+	24 respect to the group or other enrollment unit for the
	605	+	25 period (and, for purposes of a refund or additional
	606	+	26 premium, the profitable or unprofitable experience shall
624	607
625	608
626	609
627	610
628	611
629		-	HB1360 ~~Engrossed - 18~~ - LRB104 07412 BAB 17453 b
	612	+	HB1360 - 16 - LRB104 07412 BAB 17453 b
630	613
631	614
632		-	HB1360 ~~Engrossed- 19~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 19~~ - LRB104 07412 BAB 17453 b
633		-	HB1360 ~~Engrossed - 19~~ - LRB104 07412 BAB 17453 b
634		-	1 ~~maintenance organization's right,~~ ~~title, and interest in and~~
635		-	2 ~~to its~~ health ~~care certificates).~~
636		-	3 ~~(e) In considering~~ any ~~management contract or service~~
637		-	4 ~~agreement subject~~ to ~~Section 141.1 of the Illinois Insurance~~
638		-	5 ~~Code,~~ the ~~Director (i) shall,~~ ~~in addition to the criteria~~
639		-	6 ~~specified in Section 141.2 of~~ the ~~Illinois Insurance Code,~~
640		-	7 ~~take~~ into ~~account the effect of the management contract or~~
641		-	8 ~~service agreement on~~ the ~~continuation of benefits to enrollees~~
642		-	9 ~~and the financial condition of the health maintenance~~
643		-	10 organization ~~to be managed or serviced, and (ii) need not take~~
644		-	11 ~~into account~~ the ~~effect~~ of ~~the management contract or service~~
645		-	12 ~~agreement on competition.~~
646		-	13 ~~(f) Except for small employer groups as defined in the~~
647		-	14 ~~Small Employer Rating,~~ ~~Renewability and Portability Health~~
648		-	15 ~~Insurance Act and except for medicare supplement policies as~~
649		-	16 ~~defined in Section 363 of~~ the ~~Illinois Insurance Code, a~~
650		-	17 ~~Health Maintenance Organization may by contract agree with a~~
651		-	18 ~~group~~ or ~~other enrollment unit to effect refunds or charge~~
652		-	19 ~~additional premiums under~~ the ~~following terms~~ and ~~conditions:~~
653		-	20 ~~(i)~~ the ~~amount of, and other terms and conditions with~~
654		-	21 ~~respect to, the refund or additional premium are set forth~~
655		-	22 in the ~~group or enrollment unit contract agreed in advance~~
656		-	23 ~~of the period for which a refund is~~ to ~~be paid or~~
657		-	24 ~~additional premium is~~ to ~~be charged (which period shall~~
658		-	25 ~~not be less than one year); and~~
659		-	26 (ii) ~~the amount of the refund or additional premium~~
	615	+	HB1360- 17 -LRB104 07412 BAB 17453 b HB1360 - 17 - LRB104 07412 BAB 17453 b
	616	+	HB1360 - 17 - LRB104 07412 BAB 17453 b
	617	+	1 be calculated taking into account a pro rata share of the
	618	+	2 Health Maintenance Organization's administrative and
	619	+	3 marketing expenses, but shall not include any refund to be
	620	+	4 made or additional premium to be paid pursuant to this
	621	+	5 subsection (f)). The Health Maintenance Organization and
	622	+	6 the group or enrollment unit may agree that the profitable
	623	+	7 or unprofitable experience may be calculated taking into
	624	+	8 account the refund period and the immediately preceding 2
	625	+	9 plan years.
	626	+	10 The Health Maintenance Organization shall include a
	627	+	11 statement in the evidence of coverage issued to each enrollee
	628	+	12 describing the possibility of a refund or additional premium,
	629	+	13 and upon request of any group or enrollment unit, provide to
	630	+	14 the group or enrollment unit a description of the method used
	631	+	15 to calculate (1) the Health Maintenance Organization's
	632	+	16 profitable experience with respect to the group or enrollment
	633	+	17 unit and the resulting refund to the group or enrollment unit
	634	+	18 or (2) the Health Maintenance Organization's unprofitable
	635	+	19 experience with respect to the group or enrollment unit and
	636	+	20 the resulting additional premium to be paid by the group or
	637	+	21 enrollment unit.
	638	+	22 In no event shall the Illinois Health Maintenance
	639	+	23 Organization Guaranty Association be liable to pay any
	640	+	24 contractual obligation of an insolvent organization to pay any
	641	+	25 refund authorized under this Section.
	642	+	26 (g) Rulemaking authority to implement Public Act 95-1045,
660	643
661	644
662	645
663	646
664	647
665		-	HB1360 ~~Engrossed - 19~~ - LRB104 07412 BAB 17453 b
	648	+	HB1360 - 17 - LRB104 07412 BAB 17453 b
666	649
667	650
668		-	HB1360 Engrossed- 20 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 20 - LRB104 07412 BAB 17453 b
669		-	HB1360 Engrossed - 20 - LRB104 07412 BAB 17453 b
670		-	1 shall not exceed 20% of the Health Maintenance
671		-	2 Organization's profitable or unprofitable experience with
672		-	3 respect to the group or other enrollment unit for the
673		-	4 period (and, for purposes of a refund or additional
674		-	5 premium, the profitable or unprofitable experience shall
675		-	6 be calculated taking into account a pro rata share of the
676		-	7 Health Maintenance Organization's administrative and
677		-	8 marketing expenses, but shall not include any refund to be
678		-	9 made or additional premium to be paid pursuant to this
679		-	10 subsection (f)). The Health Maintenance Organization and
680		-	11 the group or enrollment unit may agree that the profitable
681		-	12 or unprofitable experience may be calculated taking into
682		-	13 account the refund period and the immediately preceding 2
683		-	14 plan years.
684		-	15 The Health Maintenance Organization shall include a
685		-	16 statement in the evidence of coverage issued to each enrollee
686		-	17 describing the possibility of a refund or additional premium,
687		-	18 and upon request of any group or enrollment unit, provide to
688		-	19 the group or enrollment unit a description of the method used
689		-	20 to calculate (1) the Health Maintenance Organization's
690		-	21 profitable experience with respect to the group or enrollment
691		-	22 unit and the resulting refund to the group or enrollment unit
692		-	23 or (2) the Health Maintenance Organization's unprofitable
693		-	24 experience with respect to the group or enrollment unit and
694		-	25 the resulting additional premium to be paid by the group or
695		-	26 enrollment unit.
	651	+	HB1360- 18 -LRB104 07412 BAB 17453 b HB1360 - 18 - LRB104 07412 BAB 17453 b
	652	+	HB1360 - 18 - LRB104 07412 BAB 17453 b
	653	+	1 if any, is conditioned on the rules being adopted in
	654	+	2 accordance with all provisions of the Illinois Administrative
	655	+	3 Procedure Act and all rules and procedures of the Joint
	656	+	4 Committee on Administrative Rules; any purported rule not so
	657	+	5 adopted, for whatever reason, is unauthorized.
	658	+	6 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
	659	+	7 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
	660	+	8 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
	661	+	9 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
	662	+	10 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
	663	+	11 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
	664	+	12 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
	665	+	13 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
	666	+	14 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
	667	+	15 eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24;
	668	+	16 103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff.
	669	+	17 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751,
	670	+	18 eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25;
	671	+	19 103-777, eff. 8-2-24; 103-808, eff. 1-1-26; 103-914, eff.
	672	+	20 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; revised
	673	+	21 11-26-24.)
	674	+	22 Section 30. The Limited Health Service Organization Act is
	675	+	23 amended by changing Section 4003 as follows:
	676	+	24 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
696	677
697	678
698	679
699	680
700	681
701		-	HB1360 ~~Engrossed - 20~~ - LRB104 07412 BAB 17453 b
	682	+	HB1360 - 18 - LRB104 07412 BAB 17453 b
702	683
703	684
704		-	HB1360 ~~Engrossed- 21~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 21~~ - LRB104 07412 BAB 17453 b
705		-	HB1360 ~~Engrossed - 21~~ - LRB104 07412 BAB 17453 b
706		-	1 ~~In no event shall the~~ Illinois ~~Health Maintenance~~
707		-	2 ~~Organization Guaranty Association~~ be ~~liable~~ to ~~pay any~~
708		-	3 ~~contractual obligation~~ of ~~an insolvent organization to pay any~~
709		-	4 ~~refund authorized under this Section.~~
710		-	5 ~~(g) Rulemaking authority to implement Public Act 95-1045~~,
711		-	6 ~~if any~~, ~~is conditioned on the rules being adopted in~~
712		-	7 ~~accordance with all provisions of the Illinois Administrative~~
713		-	8 ~~Procedure Act and all rules and procedures of the Joint~~
714		-	9 ~~Committee on Administrative Rules;~~ ~~any purported rule not so~~
715		-	10 ~~adopted~~, ~~for whatever reason~~, ~~is unauthorized~~.
716		-	11 ~~(Source: P.A. 102-30~~, ~~eff. 1-1-22; 102-34~~, ~~eff~~. ~~6-25-21;~~
717		-	12 ~~102-203~~, ~~eff.~~ 1~~-1-22; 102-306~~, ~~eff.~~ 1~~-1-22; 102-443~~, ~~eff.~~
718		-	13 ~~1-1-22; 102-589, eff~~. ~~1-1-22; 102-642, eff.~~ ~~1-1-22; 102-665,~~
719		-	14 ~~eff. 10-8-21; 102-731, eff.~~ ~~1-1-23; 102-775, eff.~~ ~~5-13-22;~~
720		-	15 ~~102-804, eff~~. ~~1-1-23; 102-813, eff.~~ ~~5-13-22; 102-816, eff.~~
721		-	16 ~~1-1-23; 102-860~~, ~~eff~~. ~~1-1-23; 102-901, eff. 7-1-22; 102-1093,~~
722		-	17 ~~eff.~~ 1~~-1-23; 102-1117~~, ~~eff. 1-13-23; 103-84, eff. 1-1-24;~~
723		-	18 ~~103-91, eff.~~ ~~1-1-24; 103-123, eff.~~ ~~1-1-24; 103-154, eff.~~
724		-	19 ~~6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,~~
725		-	20 ~~eff. 1-1-24~~; ~~103-551, eff. 8-11-23; 103-605, eff. 7-1-24;~~
726		-	21 ~~103-618, eff.~~ ~~1-1-25; 103-649, eff.~~ ~~1-1-25; 103-656, eff.~~
727		-	22 ~~1-1-25; 103-700~~, ~~eff. 1-1-25; 103-718, eff.~~ ~~7-19-24; 103-751,~~
728		-	23 ~~eff. 8-2-24; 103-753~~, ~~eff. 8-2-24; 103-758, eff.~~ ~~1-1-25;~~
729		-	24 ~~103-777, eff.~~ ~~8-2-24; 103-808, eff.~~ ~~1-1-26; 103-914, eff.~~
730		-	25 ~~1-1-25; 103-918, eff.~~ ~~1-1-25; 103-1024, eff.~~ ~~1-1-25; revised~~
731		-	26 ~~11-26-24~~.)
	685	+	HB1360- 19 -LRB104 07412 BAB 17453 b HB1360 - 19 - LRB104 07412 BAB 17453 b
	686	+	HB1360 - 19 - LRB104 07412 BAB 17453 b
	687	+	1 Sec. 4003. Illinois Insurance Code provisions. Limited
	688	+	2 health service organizations shall be subject to the
	689	+	3 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
	690	+	4 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
	691	+	5 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
	692	+	6 355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
	693	+	7 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
	694	+	8 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
	695	+	9 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
	696	+	10 356z.73, 356z.74, 356z.75, 356z.80, 364.3, 368a, 401, 401.1,
	697	+	11 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and
	698	+	12 Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and
	699	+	13 XXVI of the Illinois Insurance Code. Nothing in this Section
	700	+	14 shall require a limited health care plan to cover any service
	701	+	15 that is not a limited health service. For purposes of the
	702	+	16 Illinois Insurance Code, except for Sections 444 and 444.1 and
	703	+	17 Articles XIII and XIII 1/2, limited health service
	704	+	18 organizations in the following categories are deemed to be
	705	+	19 domestic companies:
	706	+	20 (1) a corporation under the laws of this State; or
	707	+	21 (2) a corporation organized under the laws of another
	708	+	22 state, 30% or more of the enrollees of which are residents
	709	+	23 of this State, except a corporation subject to
	710	+	24 substantially the same requirements in its state of
	711	+	25 organization as is a domestic company under Article VIII
	712	+	26 1/2 of the Illinois Insurance Code.
732	713
733	714
734	715
735	716
736	717
737		-	HB1360 ~~Engrossed - 21~~ - LRB104 07412 BAB 17453 b
	718	+	HB1360 - 19 - LRB104 07412 BAB 17453 b
738	719
739	720
740		-	HB1360 ~~Engrossed- 22~~ -LRB104 07412 BAB 17453 b HB1360 ~~Engrossed - 22~~ - LRB104 07412 BAB 17453 b
741		-	HB1360 ~~Engrossed - 22~~ - LRB104 07412 BAB 17453 b
742		-	1 ~~Section 35~~. ~~The Limited Health Service Organization Act is~~
743		-	2 ~~amended by changing Section 4003 as follows:~~
744		-	3 ~~(215 ILCS 130/4003) (from Ch~~. 73, ~~par~~. ~~1504-3)~~
745		-	4 ~~Sec~~. ~~4003~~. ~~Illinois Insurance Code provisions~~. ~~Limited~~
746		-	5 ~~health service organizations shall be subject to the~~
747		-	6 ~~provisions of Sections 133~~, ~~134~~, ~~136~~, ~~137, 139, 140, 141.1,~~
748		-	7 ~~141~~.2, ~~141~~.3, ~~143, 143.31, 143c, 147, 148, 149, 151, 152, 153,~~
749		-	8 ~~154~~, ~~154~~.5, ~~154~~.6, ~~154~~.~~7, 154.8, 155.04, 155.37, 155.49, 352c,~~
750		-	9 ~~355.2~~, ~~355~~.3, ~~355b~~, ~~355d, 356m, 356q, 356v, 356z.4, 356z.4a,~~
751		-	10 ~~356z~~.10, ~~356z~~.~~21, 356z~~.~~22, 356z.25, 356z.26, 356z.29, 356z.32,~~
752		-	11 ~~356z~~.~~33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,~~
753		-	12 ~~356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,~~
754		-	13 ~~356z~~.73, ~~356z~~.~~74, 356z.75, 356z.80, 364.3, 368a, 401, 401.1,~~
755		-	14 ~~402, 403,~~ ~~403A, 408,~~ ~~408~~.~~2, 409, 412, 444, and 444.1 and~~
756		-	15 ~~Articles IIA,~~ ~~VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV,~~ and
757		-	16 ~~XXVI of~~ the ~~Illinois Insurance Code. Nothing in this Section~~
758		-	17 ~~shall require a limited health care plan to cover any service~~
759		-	18 ~~that is not a limited health service~~. ~~For purposes of the~~
760		-	19 ~~Illinois Insurance Code~~, ~~except for Sections 444 and 444.1 and~~
761		-	20 ~~Articles XIII and XIII~~ 1/2, ~~limited health service~~
762		-	21 ~~organizations in the following categories are deemed to be~~
763		-	22 ~~domestic companies:~~
764		-	23 ~~(1) a corporation under the laws of this State; or~~
765		-	24 ~~(2) a corporation organized under the laws of another~~
	721	+	HB1360- 20 -LRB104 07412 BAB 17453 b HB1360 - 20 - LRB104 07412 BAB 17453 b
	722	+	HB1360 - 20 - LRB104 07412 BAB 17453 b
	723	+	1 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
	724	+	2 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff.
	725	+	3 1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816,
	726	+	4 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
	727	+	5 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
	728	+	6 1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
	729	+	7 eff. 1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25;
	730	+	8 103-656, eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff.
	731	+	9 7-19-24; 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832,
	732	+	10 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
	733	+	11 Section 35. The Voluntary Health Services Plans Act is
	734	+	12 amended by changing Section 10 as follows:
	735	+	13 (215 ILCS 165/10) (from Ch. 32, par. 604)
	736	+	14 Sec. 10. Application of Insurance Code provisions. Health
	737	+	15 services plan corporations and all persons interested therein
	738	+	16 or dealing therewith shall be subject to the provisions of
	739	+	17 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
	740	+	18 143, 143.31, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3,
	741	+	19 355b, 355d, 356g, 356g.5, 356g.5-1, 356m, 356q, 356r, 356t,
	742	+	20 356u, 356u.10, 356v, 356w, 356x, 356y, 356z.1, 356z.2,
	743	+	21 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
	744	+	22 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18,
	745	+	23 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
	746	+	24 356z.32, 356z.32a, 356z.33, 356z.40, 356z.41, 356z.46,
766	747
767	748
768	749
769	750
770	751
771		-	HB1360 ~~Engrossed - 22~~ - LRB104 07412 BAB 17453 b
	752	+	HB1360 - 20 - LRB104 07412 BAB 17453 b
772	753
773	754
774		-	HB1360 Engrossed- 23 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 23 - LRB104 07412 BAB 17453 b
775		-	HB1360 Engrossed - 23 - LRB104 07412 BAB 17453 b
776		-	1 state, 30% or more of the enrollees of which are residents
777		-	2 of this State, except a corporation subject to
778		-	3 substantially the same requirements in its state of
779		-	4 organization as is a domestic company under Article VIII
780		-	5 1/2 of the Illinois Insurance Code.
781		-	6 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
782		-	7 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff.
783		-	8 1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816,
784		-	9 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
785		-	10 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
786		-	11 1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
787		-	12 eff. 1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25;
788		-	13 103-656, eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff.
789		-	14 7-19-24; 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832,
790		-	15 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
791		-	16 Section 40. The Voluntary Health Services Plans Act is
792		-	17 amended by changing Section 10 as follows:
793		-	18 (215 ILCS 165/10) (from Ch. 32, par. 604)
794		-	19 Sec. 10. Application of Insurance Code provisions. Health
795		-	20 services plan corporations and all persons interested therein
796		-	21 or dealing therewith shall be subject to the provisions of
797		-	22 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
798		-	23 143, 143.31, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3,
799		-	24 355b, 355d, 356g, 356g.5, 356g.5-1, 356m, 356q, 356r, 356t,
	755	+	HB1360- 21 -LRB104 07412 BAB 17453 b HB1360 - 21 - LRB104 07412 BAB 17453 b
	756	+	HB1360 - 21 - LRB104 07412 BAB 17453 b
	757	+	1 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59,
	758	+	2 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.71,
	759	+	3 356z.72, 356z.74, 356z.75, 356z.77, 356z.80, 364.01, 364.3,
	760	+	4 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
	761	+	5 and paragraphs (7) and (15) of Section 367 of the Illinois
	762	+	6 Insurance Code.
	763	+	7 Rulemaking authority to implement Public Act 95-1045, if
	764	+	8 any, is conditioned on the rules being adopted in accordance
	765	+	9 with all provisions of the Illinois Administrative Procedure
	766	+	10 Act and all rules and procedures of the Joint Committee on
	767	+	11 Administrative Rules; any purported rule not so adopted, for
	768	+	12 whatever reason, is unauthorized.
	769	+	13 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
	770	+	14 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff.
	771	+	15 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804,
	772	+	16 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
	773	+	17 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff.
	774	+	18 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
	775	+	19 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
	776	+	20 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-656, eff.
	777	+	21 1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
	778	+	22 eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. 1-1-25;
	779	+	23 103-914, eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff.
	780	+	24 1-1-25; revised 11-26-24.)
	781	+	25 Section 95. No acceleration or delay. Where this Act makes
800	782
801	783
802	784
803	785
804	786
805		-	HB1360 ~~Engrossed - 23~~ - LRB104 07412 BAB 17453 b
	787	+	HB1360 - 21 - LRB104 07412 BAB 17453 b
806	788
807	789
808		-	HB1360 Engrossed- 24 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 24 - LRB104 07412 BAB 17453 b
809		-	HB1360 Engrossed - 24 - LRB104 07412 BAB 17453 b
810		-	1 356u, 356u.10, 356v, 356w, 356x, 356y, 356z.1, 356z.2,
811		-	2 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
812		-	3 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18,
813		-	4 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
814		-	5 356z.32, 356z.32a, 356z.33, 356z.40, 356z.41, 356z.46,
815		-	6 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59,
816		-	7 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.71,
817		-	8 356z.72, 356z.74, 356z.75, 356z.77, 356z.80, 364.01, 364.3,
818		-	9 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
819		-	10 and paragraphs (7) and (15) of Section 367 of the Illinois
820		-	11 Insurance Code.
821		-	12 Rulemaking authority to implement Public Act 95-1045, if
822		-	13 any, is conditioned on the rules being adopted in accordance
823		-	14 with all provisions of the Illinois Administrative Procedure
824		-	15 Act and all rules and procedures of the Joint Committee on
825		-	16 Administrative Rules; any purported rule not so adopted, for
826		-	17 whatever reason, is unauthorized.
827		-	18 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
828		-	19 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff.
829		-	20 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804,
830		-	21 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
831		-	22 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff.
832		-	23 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
833		-	24 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
834		-	25 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-656, eff.
835		-	26 1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
	790	+	HB1360- 22 -LRB104 07412 BAB 17453 b HB1360 - 22 - LRB104 07412 BAB 17453 b
	791	+	HB1360 - 22 - LRB104 07412 BAB 17453 b
	792	+	1 changes in a statute that is represented in this Act by text
	793	+	2 that is not yet or no longer in effect (for example, a Section
	794	+	3 represented by multiple versions), the use of that text does
	795	+	4 not accelerate or delay the taking effect of (i) the changes
	796	+	5 made by this Act or (ii) provisions derived from any other
	797	+	6 Public Act.
836	798
837	799
838	800
839	801
840	802
841		-	HB1360 Engrossed - 24 - LRB104 07412 BAB 17453 b
842		-
843		-
844		-	HB1360 Engrossed- 25 -LRB104 07412 BAB 17453 b HB1360 Engrossed - 25 - LRB104 07412 BAB 17453 b
845		-	HB1360 Engrossed - 25 - LRB104 07412 BAB 17453 b
846		-	1 eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. 1-1-25;
847		-	2 103-914, eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff.
848		-	3 1-1-25; revised 11-26-24.)
849		-	4 Section 95. No acceleration or delay. Where this Act makes
850		-	5 changes in a statute that is represented in this Act by text
851		-	6 that is not yet or no longer in effect (for example, a Section
852		-	7 represented by multiple versions), the use of that text does
853		-	8 not accelerate or delay the taking effect of (i) the changes
854		-	9 made by this Act or (ii) provisions derived from any other
855		-	10 Public Act.
856		-	11 Section 99. Effective date. This Act takes effect upon
857		-	12 becoming law, except that the changes to Section 6.11 of the
858		-	13 State Employees Group Insurance Act of 1971 take effect on
859		-	14 July 1, 2027.
860		-
861		-
862		-
863		-
864		-
865		-	HB1360 Engrossed - 25 - LRB104 07412 BAB 17453 b
	803	+	HB1360 - 22 - LRB104 07412 BAB 17453 b