Illinois 2025-2026 Regular Session

Illinois House Bill HB3595 Compare Versions

Only one version of the bill is available at this time.
OldNewDifferences
11 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3595 Introduced , by Rep. Joyce Mason SYNOPSIS AS INTRODUCED: 215 ILCS 5/Art. XLVIII heading new215 ILCS 5/1800 new215 ILCS 5/1805 new215 ILCS 5/1810 new215 ILCS 5/1815 new215 ILCS 5/1820 new215 ILCS 5/1825 new Amends the Illinois Insurance Code. Creates the Pet Insurance Article of the Code. Defines terms. Requires a pet insurer to disclose coverage exclusions, limitations, waiting periods, and other information. Provides that pet insurance applicants shall have the right to examine and return the policy, certificate, or rider to the company or an agent or insurance producer of the company within 30 days of its receipt and to have the premium refunded if, after examination of the policy, certificate, or rider, the applicant is not satisfied for any reason. Provides that a pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. Provides that a pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident. Prohibits waiting periods for accidents. Provides that no pet insurer or insurance producer shall market a wellness program as pet insurance. Sets forth provisions concerning wellness programs sold by a pet insurer or insurance producer. LRB104 08153 BAB 18201 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3595 Introduced , by Rep. Joyce Mason SYNOPSIS AS INTRODUCED: 215 ILCS 5/Art. XLVIII heading new215 ILCS 5/1800 new215 ILCS 5/1805 new215 ILCS 5/1810 new215 ILCS 5/1815 new215 ILCS 5/1820 new215 ILCS 5/1825 new 215 ILCS 5/Art. XLVIII heading new 215 ILCS 5/1800 new 215 ILCS 5/1805 new 215 ILCS 5/1810 new 215 ILCS 5/1815 new 215 ILCS 5/1820 new 215 ILCS 5/1825 new Amends the Illinois Insurance Code. Creates the Pet Insurance Article of the Code. Defines terms. Requires a pet insurer to disclose coverage exclusions, limitations, waiting periods, and other information. Provides that pet insurance applicants shall have the right to examine and return the policy, certificate, or rider to the company or an agent or insurance producer of the company within 30 days of its receipt and to have the premium refunded if, after examination of the policy, certificate, or rider, the applicant is not satisfied for any reason. Provides that a pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. Provides that a pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident. Prohibits waiting periods for accidents. Provides that no pet insurer or insurance producer shall market a wellness program as pet insurance. Sets forth provisions concerning wellness programs sold by a pet insurer or insurance producer. LRB104 08153 BAB 18201 b LRB104 08153 BAB 18201 b A BILL FOR
22 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3595 Introduced , by Rep. Joyce Mason SYNOPSIS AS INTRODUCED:
33 215 ILCS 5/Art. XLVIII heading new215 ILCS 5/1800 new215 ILCS 5/1805 new215 ILCS 5/1810 new215 ILCS 5/1815 new215 ILCS 5/1820 new215 ILCS 5/1825 new 215 ILCS 5/Art. XLVIII heading new 215 ILCS 5/1800 new 215 ILCS 5/1805 new 215 ILCS 5/1810 new 215 ILCS 5/1815 new 215 ILCS 5/1820 new 215 ILCS 5/1825 new
44 215 ILCS 5/Art. XLVIII heading new
55 215 ILCS 5/1800 new
66 215 ILCS 5/1805 new
77 215 ILCS 5/1810 new
88 215 ILCS 5/1815 new
99 215 ILCS 5/1820 new
1010 215 ILCS 5/1825 new
1111 Amends the Illinois Insurance Code. Creates the Pet Insurance Article of the Code. Defines terms. Requires a pet insurer to disclose coverage exclusions, limitations, waiting periods, and other information. Provides that pet insurance applicants shall have the right to examine and return the policy, certificate, or rider to the company or an agent or insurance producer of the company within 30 days of its receipt and to have the premium refunded if, after examination of the policy, certificate, or rider, the applicant is not satisfied for any reason. Provides that a pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. Provides that a pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident. Prohibits waiting periods for accidents. Provides that no pet insurer or insurance producer shall market a wellness program as pet insurance. Sets forth provisions concerning wellness programs sold by a pet insurer or insurance producer.
1212 LRB104 08153 BAB 18201 b LRB104 08153 BAB 18201 b
1313 LRB104 08153 BAB 18201 b
1414 A BILL FOR
1515 HB3595LRB104 08153 BAB 18201 b HB3595 LRB104 08153 BAB 18201 b
1616 HB3595 LRB104 08153 BAB 18201 b
1717 1 AN ACT concerning regulation.
1818 2 Be it enacted by the People of the State of Illinois,
1919 3 represented in the General Assembly:
2020 4 Section 5. The Illinois Insurance Code is amended by
2121 5 adding Article XLVIII as follows:
2222 6 (215 ILCS 5/Art. XLVIII heading new)
2323 7 ARTICLE XLVIII. PET INSURANCE
2424 8 (215 ILCS 5/1800 new)
2525 9 Sec. 1800. Purpose and scope.
2626 10 (a) The purpose of this Article is to promote the public
2727 11 welfare by creating a comprehensive legal framework within
2828 12 which pet insurance may be sold in this State.
2929 13 (b) The requirements of this Article shall apply to pet
3030 14 insurance policies that are issued to any resident of this
3131 15 State; pet insurance policies that are sold, solicited,
3232 16 negotiated, or offered in this State; and pet insurance
3333 17 policies or certificates that are delivered or issued for
3434 18 delivery in this State.
3535 19 (c) All other applicable provisions of this State's
3636 20 insurance laws shall continue to apply to pet insurance,
3737 21 except that the specific provisions of this Article shall
3838 22 supersede any general provisions of law that would otherwise
3939
4040
4141
4242 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3595 Introduced , by Rep. Joyce Mason SYNOPSIS AS INTRODUCED:
4343 215 ILCS 5/Art. XLVIII heading new215 ILCS 5/1800 new215 ILCS 5/1805 new215 ILCS 5/1810 new215 ILCS 5/1815 new215 ILCS 5/1820 new215 ILCS 5/1825 new 215 ILCS 5/Art. XLVIII heading new 215 ILCS 5/1800 new 215 ILCS 5/1805 new 215 ILCS 5/1810 new 215 ILCS 5/1815 new 215 ILCS 5/1820 new 215 ILCS 5/1825 new
4444 215 ILCS 5/Art. XLVIII heading new
4545 215 ILCS 5/1800 new
4646 215 ILCS 5/1805 new
4747 215 ILCS 5/1810 new
4848 215 ILCS 5/1815 new
4949 215 ILCS 5/1820 new
5050 215 ILCS 5/1825 new
5151 Amends the Illinois Insurance Code. Creates the Pet Insurance Article of the Code. Defines terms. Requires a pet insurer to disclose coverage exclusions, limitations, waiting periods, and other information. Provides that pet insurance applicants shall have the right to examine and return the policy, certificate, or rider to the company or an agent or insurance producer of the company within 30 days of its receipt and to have the premium refunded if, after examination of the policy, certificate, or rider, the applicant is not satisfied for any reason. Provides that a pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. Provides that a pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident. Prohibits waiting periods for accidents. Provides that no pet insurer or insurance producer shall market a wellness program as pet insurance. Sets forth provisions concerning wellness programs sold by a pet insurer or insurance producer.
5252 LRB104 08153 BAB 18201 b LRB104 08153 BAB 18201 b
5353 LRB104 08153 BAB 18201 b
5454 A BILL FOR
5555
5656
5757
5858
5959
6060 215 ILCS 5/Art. XLVIII heading new
6161 215 ILCS 5/1800 new
6262 215 ILCS 5/1805 new
6363 215 ILCS 5/1810 new
6464 215 ILCS 5/1815 new
6565 215 ILCS 5/1820 new
6666 215 ILCS 5/1825 new
6767
6868
6969
7070 LRB104 08153 BAB 18201 b
7171
7272
7373
7474
7575
7676
7777
7878
7979
8080 HB3595 LRB104 08153 BAB 18201 b
8181
8282
8383 HB3595- 2 -LRB104 08153 BAB 18201 b HB3595 - 2 - LRB104 08153 BAB 18201 b
8484 HB3595 - 2 - LRB104 08153 BAB 18201 b
8585 1 be applicable to pet insurance.
8686 2 (d) Nothing in this Article shall in any way prohibit or
8787 3 limit the types of exclusions pet insurers may use in their
8888 4 policies or require pet insurers to have any of the
8989 5 limitations or exclusions described in this Article.
9090 6 (e) Any person licensed in a major line of authority as an
9191 7 insurance producer is authorized to sell, solicit, and
9292 8 negotiate pet insurance.
9393 9 (215 ILCS 5/1805 new)
9494 10 Sec. 1805. Definitions. In this Article:
9595 11 "Chronic condition" means a condition that can be treated
9696 12 or managed, but not cured.
9797 13 "Congenital anomaly or disorder" means a condition that is
9898 14 present from birth, whether inherited or caused by the
9999 15 environment, that may cause or contribute to illness or
100100 16 disease.
101101 17 "Department" means the Department of Insurance.
102102 18 "Hereditary disorder" means an abnormality that is
103103 19 genetically transmitted from parent to offspring and may cause
104104 20 illness or disease.
105105 21 "Pet insurance" means a property insurance policy that
106106 22 provides coverage for accidents and illnesses of pets.
107107 23 "Preexisting condition" means any condition for which any
108108 24 of the following are true prior to the effective date of a pet
109109 25 insurance policy or during any waiting period:
110110
111111
112112
113113
114114
115115 HB3595 - 2 - LRB104 08153 BAB 18201 b
116116
117117
118118 HB3595- 3 -LRB104 08153 BAB 18201 b HB3595 - 3 - LRB104 08153 BAB 18201 b
119119 HB3595 - 3 - LRB104 08153 BAB 18201 b
120120 1 (1) a veterinarian provided medical advice;
121121 2 (2) the pet received previous treatment; or
122122 3 (3) based on information from verifiable sources, the
123123 4 pet had signs or symptoms directly related to the
124124 5 condition for which a claim is being made.
125125 6 "Preexisting condition" does not include a condition that
126126 7 was covered under a preceding policy period prior to the
127127 8 renewal so long as there was no break in the superseding policy
128128 9 periods.
129129 10 "Renewal" means to issue and deliver at the end of an
130130 11 insurance policy period a policy that supersedes a policy
131131 12 previously issued and delivered by the same pet insurer or
132132 13 affiliated pet insurer and that provides types and limits of
133133 14 coverage substantially similar to those contained in the
134134 15 policy being superseded.
135135 16 "Orthopedic conditions" refers to conditions affecting the
136136 17 bones, skeletal muscle, cartilage, tendons, ligaments, and
137137 18 joints. "Orthopedic conditions" include, but are not limited
138138 19 to, elbow dysplasia, hip dysplasia, intervertebral disc
139139 20 degeneration, patellar luxation, and ruptured cranial cruciate
140140 21 ligaments. "Orthopedic conditions" do not include cancers or
141141 22 metabolic, hemopoietic, or autoimmune diseases.
142142 23 "Veterinarian" means an individual who holds a valid
143143 24 license to practice veterinary medicine from the appropriate
144144 25 licensing entity in the jurisdiction in which the individual
145145 26 practices.
146146
147147
148148
149149
150150
151151 HB3595 - 3 - LRB104 08153 BAB 18201 b
152152
153153
154154 HB3595- 4 -LRB104 08153 BAB 18201 b HB3595 - 4 - LRB104 08153 BAB 18201 b
155155 HB3595 - 4 - LRB104 08153 BAB 18201 b
156156 1 "Veterinary expenses" means the costs associated with
157157 2 medical advice, diagnosis, care, or treatment provided by a
158158 3 veterinarian, including, but not limited to, the cost of drugs
159159 4 prescribed by a veterinarian.
160160 5 "Waiting period" means the period of time specified in a
161161 6 pet insurance policy that is required to transpire before some
162162 7 or all of the coverage in the policy can begin.
163163 8 "Wellness program" means a subscription or
164164 9 reimbursement-based program that is separate from an insurance
165165 10 policy that provides goods and services to promote the general
166166 11 health, safety, or well-being of the pet.
167167 12 (215 ILCS 5/1810 new)
168168 13 Sec. 1810. Applicability of defined terms. If a pet
169169 14 insurer uses any of the defined terms in Section 1805 in a
170170 15 policy of pet insurance, the pet insurer shall use the
171171 16 definition of each of those terms as set forth in Section 1805
172172 17 and include the definition of the terms in the policy. The pet
173173 18 insurer shall also make the definition available through a
174174 19 clear and conspicuous link on the main page of the pet
175175 20 insurer's website or the pet insurer's program administrator's
176176 21 website.
177177 22 (215 ILCS 5/1815 new)
178178 23 Sec. 1815. Disclosures.
179179 24 (a) A pet insurer transacting pet insurance shall disclose
180180
181181
182182
183183
184184
185185 HB3595 - 4 - LRB104 08153 BAB 18201 b
186186
187187
188188 HB3595- 5 -LRB104 08153 BAB 18201 b HB3595 - 5 - LRB104 08153 BAB 18201 b
189189 HB3595 - 5 - LRB104 08153 BAB 18201 b
190190 1 the following to consumers:
191191 2 (1) If the policy excludes coverage due to any of the
192192 3 following:
193193 4 (A) a preexisting condition;
194194 5 (B) a hereditary disorder;
195195 6 (C) a congenital anomaly or disorder; or
196196 7 (D) a chronic condition.
197197 8 (2) If the policy includes any other exclusions, by
198198 9 including the following statement: "Other exclusions may
199199 10 apply. Please refer to the exclusions section of the
200200 11 policy for more information.".
201201 12 (3) Any policy provision that limits coverage through
202202 13 a waiting or affiliation period, a deductible,
203203 14 coinsurance, or an annual or lifetime policy limit.
204204 15 (4) Whether the pet insurer reduces coverage or
205205 16 increases premiums based on the insured's claim history,
206206 17 the age of the covered pet, or a change in the geographic
207207 18 location of the insured.
208208 19 (5) If the underwriting company differs from the brand
209209 20 name used to market and sell the product.
210210 21 (b) Unless the insured has filed a claim under the pet
211211 22 insurance policy, pet insurance applicants shall have the
212212 23 right to examine and return the policy, certificate, or rider
213213 24 to the company or an agent or insurance producer of the company
214214 25 within 30 days of its receipt and to have the premium refunded
215215 26 if, after examination of the policy, certificate, or rider,
216216
217217
218218
219219
220220
221221 HB3595 - 5 - LRB104 08153 BAB 18201 b
222222
223223
224224 HB3595- 6 -LRB104 08153 BAB 18201 b HB3595 - 6 - LRB104 08153 BAB 18201 b
225225 HB3595 - 6 - LRB104 08153 BAB 18201 b
226226 1 the applicant is not satisfied for any reason.
227227 2 Pet insurance policies, certificates, and riders shall
228228 3 have a notice prominently printed on the first page, or
229229 4 attached thereto, including specific instructions to
230230 5 accomplish a return. The following statement or language
231231 6 substantially similar shall be included:
232232 7 "You have 30 days from the day you receive this policy,
233233 8 certificate, or rider to review it and return it to the company
234234 9 if you decide not to keep it. You do not have to tell the
235235 10 company why you are returning it. If you decide not to keep it,
236236 11 simply return it to the company at its administrative office
237237 12 or you may return it to the agent/insurance producer that you
238238 13 bought it from as long as you have not filed a claim. You must
239239 14 return it within 30 days of the day you first received it. The
240240 15 company will refund the full amount of any premium paid within
241241 16 30 days after it receives the returned policy, certificate, or
242242 17 rider. The premium refund will be sent directly to the person
243243 18 who paid it. The policy, certificate, or rider will be void as
244244 19 if it had never been issued."
245245 20 This subsection (b) does not apply to renewals.
246246 21 (c) A pet insurer shall clearly disclose a summary
247247 22 description of the basis or formula on which the pet insurer
248248 23 determines claim payments under a pet insurance policy within
249249 24 the policy, both prior to policy issuance and through a clear
250250 25 and conspicuous link on the main page of the pet insurer's
251251 26 website or the pet insurer's program administrator's website.
252252
253253
254254
255255
256256
257257 HB3595 - 6 - LRB104 08153 BAB 18201 b
258258
259259
260260 HB3595- 7 -LRB104 08153 BAB 18201 b HB3595 - 7 - LRB104 08153 BAB 18201 b
261261 HB3595 - 7 - LRB104 08153 BAB 18201 b
262262 1 (d) A pet insurer that uses a benefit schedule to
263263 2 determine claim payment under a pet insurance policy shall:
264264 3 (1) clearly disclose the applicable benefit schedule
265265 4 in the policy; and
266266 5 (2) disclose all benefit schedules used by the pet
267267 6 insurer under its pet insurance policies through a clear
268268 7 and conspicuous link on the main page of the pet insurer's
269269 8 website or the pet insurer's program administrator's
270270 9 website.
271271 10 (e) A pet insurer that determines claim payments under a
272272 11 pet insurance policy based on usual and customary fees or any
273273 12 other reimbursement limitation based on prevailing veterinary
274274 13 service provider charges shall:
275275 14 (1) include a usual and customary fee limitation
276276 15 provision in the policy that clearly describes the pet
277277 16 insurer's basis for determining usual and customary fees
278278 17 and how that basis is applied in calculating claim
279279 18 payments; and
280280 19 (2) disclose the pet insurer's basis for determining
281281 20 usual and customary fees through a clear and conspicuous
282282 21 link on the main page of the pet insurer's website or the
283283 22 pet insurer's program administrator's website.
284284 23 (f) If any medical examination by a licensed veterinarian
285285 24 is required to effectuate coverage, the pet insurer shall
286286 25 clearly and conspicuously disclose the required aspects of the
287287 26 examination prior to purchase and disclose that examination
288288
289289
290290
291291
292292
293293 HB3595 - 7 - LRB104 08153 BAB 18201 b
294294
295295
296296 HB3595- 8 -LRB104 08153 BAB 18201 b HB3595 - 8 - LRB104 08153 BAB 18201 b
297297 HB3595 - 8 - LRB104 08153 BAB 18201 b
298298 1 documentation may result in a preexisting condition exclusion.
299299 2 (g) Waiting periods and the requirements applicable to the
300300 3 waiting periods shall be clearly and prominently disclosed to
301301 4 consumers prior to the policy purchase.
302302 5 (h) The pet insurer shall include a summary of all
303303 6 disclosures required by this Section in a separate document
304304 7 titled "Insurer Disclosure of Important Policy Provisions".
305305 8 The pet insurer shall post the document by way of a clear and
306306 9 conspicuous link on the main page of the pet insurer's website
307307 10 or the pet insurer's program administrator's website.
308308 11 In connection with the issuance of a new pet insurance
309309 12 policy, the pet insurer shall provide the consumer with a copy
310310 13 of the Insurer Disclosure of Important Policy Provisions
311311 14 document required under this subsection (h) in at least
312312 15 12-point type when it delivers the policy.
313313 16 (i) At the time a pet insurance policy is issued or
314314 17 delivered to a policyholder, the pet insurer shall include a
315315 18 written disclosure with the following information, printed in
316316 19 12-point boldface type:
317317 20 (1) The Department's mailing address, toll-free
318318 21 telephone number, and website address.
319319 22 (2) The address and customer service telephone number
320320 23 of the pet insurer or the agent or broker of record.
321321 24 (3) If the policy was issued or delivered by an agent
322322 25 or broker, a statement advising the policyholder to
323323 26 contact the broker or agent for assistance.
324324
325325
326326
327327
328328
329329 HB3595 - 8 - LRB104 08153 BAB 18201 b
330330
331331
332332 HB3595- 9 -LRB104 08153 BAB 18201 b HB3595 - 9 - LRB104 08153 BAB 18201 b
333333 HB3595 - 9 - LRB104 08153 BAB 18201 b
334334 1 (j) The disclosures required in this Section shall be in
335335 2 addition to any other disclosure requirements required by law
336336 3 or rule.
337337 4 (215 ILCS 5/1820 new)
338338 5 Sec. 1820. Policy conditions.
339339 6 (a) A pet insurer may issue policies that exclude coverage
340340 7 on the basis of one or more preexisting conditions with
341341 8 appropriate disclosure to the consumer. The pet insurer has
342342 9 the burden of proving that the preexisting condition exclusion
343343 10 applies to the condition for which a claim is being made.
344344 11 (b) A pet insurer may issue policies that impose waiting
345345 12 periods upon effectuation of the policy that do not exceed 30
346346 13 days for illnesses or orthopedic conditions not resulting from
347347 14 an accident. Waiting periods may not be applied to renewals of
348348 15 existing coverage. Waiting periods for accidents are
349349 16 prohibited.
350350 17 (1) A pet insurer using a waiting period shall include
351351 18 a provision in its contract that allows the waiting
352352 19 periods to be waived upon completion of a medical
353353 20 examination. Pet insurers may require the examination to
354354 21 be conducted by a licensed veterinarian after the purchase
355355 22 of the policy.
356356 23 (A) A medical examination shall be paid for by the
357357 24 policyholder, unless the policy specifies that the pet
358358 25 insurer will pay for the examination.
359359
360360
361361
362362
363363
364364 HB3595 - 9 - LRB104 08153 BAB 18201 b
365365
366366
367367 HB3595- 10 -LRB104 08153 BAB 18201 b HB3595 - 10 - LRB104 08153 BAB 18201 b
368368 HB3595 - 10 - LRB104 08153 BAB 18201 b
369369 1 (B) A pet insurer may specify elements to be
370370 2 included as part of the examination and require
371371 3 documentation thereof, provided the specifications do
372372 4 not unreasonably restrict a consumer's ability to
373373 5 waive the waiting periods by completing a medical
374374 6 examination.
375375 7 (2) Waiting periods and the requirements applicable to
376376 8 them shall be clearly and prominently disclosed to
377377 9 consumers prior to the policy purchase.
378378 10 (c) A pet insurer shall not require a veterinary
379379 11 examination of the covered pet for the insured to have the
380380 12 policy renewed.
381381 13 (d) If a pet insurer includes any prescriptive, wellness,
382382 14 or noninsurance benefits in the policy form, then such
383383 15 benefits are made part of the policy contract and shall follow
384384 16 all applicable laws and rules adopted under this Code.
385385 17 (e) An insured's eligibility to purchase a pet insurance
386386 18 policy shall not be based on participation or lack of
387387 19 participation in a separate wellness program.
388388 20 (215 ILCS 5/1825 new)
389389 21 Sec. 1825. Sales practices for wellness programs.
390390 22 (a) No pet insurer or insurance producer shall market a
391391 23 wellness program as pet insurance.
392392 24 (b) If a wellness program is sold by a pet insurer or
393393 25 insurance producer:
394394
395395
396396
397397
398398
399399 HB3595 - 10 - LRB104 08153 BAB 18201 b
400400
401401
402402 HB3595- 11 -LRB104 08153 BAB 18201 b HB3595 - 11 - LRB104 08153 BAB 18201 b
403403 HB3595 - 11 - LRB104 08153 BAB 18201 b
404404
405405
406406
407407
408408
409409 HB3595 - 11 - LRB104 08153 BAB 18201 b