104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1418 Introduced 1/31/2025, by Sen. Napoleon Harris, III SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.1155 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. 604305 ILCS 5/5-16.8 Amends the Illinois Insurance Code. Provides that a group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed after January 1, 2026 must provide coverage, no less than once every 12 months, for a peripheral artery disease screening test for any at-risk individual. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. LRB104 06136 BAB 16169 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1418 Introduced 1/31/2025, by Sen. Napoleon Harris, III SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.1155 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. 604305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.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. 604 305 ILCS 5/5-16.8 Amends the Illinois Insurance Code. Provides that a group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed after January 1, 2026 must provide coverage, no less than once every 12 months, for a peripheral artery disease screening test for any at-risk individual. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. LRB104 06136 BAB 16169 b LRB104 06136 BAB 16169 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1418 Introduced 1/31/2025, by Sen. Napoleon Harris, III SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.1155 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. 604305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.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. 604 305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.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. 604 305 ILCS 5/5-16.8 Amends the Illinois Insurance Code. Provides that a group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed after January 1, 2026 must provide coverage, no less than once every 12 months, for a peripheral artery disease screening test for any at-risk individual. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. LRB104 06136 BAB 16169 b LRB104 06136 BAB 16169 b LRB104 06136 BAB 16169 b A BILL FOR SB1418LRB104 06136 BAB 16169 b SB1418 LRB104 06136 BAB 16169 b SB1418 LRB104 06136 BAB 16169 b 1 AN ACT concerning regulation. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 1. Findings. The General Assembly finds that: 5 (1) Atherosclerosis occurs when blood flow is reduced 6 because arteries become narrowed or blocked with fatty 7 deposits. 8 (2) Atherosclerosis is responsible for more deaths in 9 the United States than any other condition, and heart 10 attacks resulting from clogged coronary arteries are the 11 leading cause of death in America. 12 (3) Atherosclerosis also occurs in the legs and is 13 known as peripheral artery disease (referred to as "PAD"), 14 and having PAD significantly increases the risk for heart 15 attack, stroke, amputation, and death. 16 (4) While most Americans are aware of atherosclerosis 17 in the heart, many Americans have never heard of PAD and 18 Americans with PAD are often unaware of the serious risks 19 of the disease. 20 (5) An estimated 21,000,000 Americans have PAD, and 21 about 200,000 of them, who are disproportionately 22 minorities, suffer avoidable amputations every year as a 23 result of such disease. 24 (6) Screening and arterial testing for PAD is cost 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1418 Introduced 1/31/2025, by Sen. Napoleon Harris, III SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.1155 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. 604305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.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. 604 305 ILCS 5/5-16.8 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.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. 604 305 ILCS 5/5-16.8 Amends the Illinois Insurance Code. Provides that a group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed after January 1, 2026 must provide coverage, no less than once every 12 months, for a peripheral artery disease screening test for any at-risk individual. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. LRB104 06136 BAB 16169 b LRB104 06136 BAB 16169 b LRB104 06136 BAB 16169 b A BILL FOR 5 ILCS 375/6.11 55 ILCS 5/5-1069.3 65 ILCS 5/10-4-2.3 105 ILCS 5/10-22.3f 215 ILCS 5/356z.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. 604 305 ILCS 5/5-16.8 LRB104 06136 BAB 16169 b SB1418 LRB104 06136 BAB 16169 b SB1418- 2 -LRB104 06136 BAB 16169 b SB1418 - 2 - LRB104 06136 BAB 16169 b SB1418 - 2 - LRB104 06136 BAB 16169 b 1 effective and should be part of routine medical care. 2 (7) Once PAD is detected, amputations and deaths can 3 be reduced through the use of national, evidence-based PAD 4 care guidelines. 5 Section 5. The State Employees Group Insurance Act of 1971 6 is amended by changing Section 6.11 as follows: 7 (5 ILCS 375/6.11) 8 Sec. 6.11. Required health benefits; Illinois Insurance 9 Code requirements. The program of health benefits shall 10 provide the post-mastectomy care benefits required to be 11 covered by a policy of accident and health insurance under 12 Section 356t of the Illinois Insurance Code. The program of 13 health benefits shall provide the coverage required under 14 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 15 356w, 356x, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 16 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 17 356z.17, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 18 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 19 356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, 20 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and 21 356z.70, and 356z.71, 356z.74, 356z.76, 356z.77, and 356z.80 22 of the Illinois Insurance Code. The program of health benefits 23 must comply with Sections 155.22a, 155.37, 355b, 356z.19, 24 370c, and 370c.1 and Article XXXIIB of the Illinois Insurance SB1418 - 2 - LRB104 06136 BAB 16169 b SB1418- 3 -LRB104 06136 BAB 16169 b SB1418 - 3 - LRB104 06136 BAB 16169 b SB1418 - 3 - LRB104 06136 BAB 16169 b 1 Code. The program of health benefits shall provide the 2 coverage required under Section 356m of the Illinois Insurance 3 Code and, for the employees of the State Employee Group 4 Insurance Program only, the coverage as also provided in 5 Section 6.11B of this Act. The Department of Insurance shall 6 enforce the requirements of this Section with respect to 7 Sections 370c and 370c.1 of the Illinois Insurance Code; all 8 other requirements of this Section shall be enforced by the 9 Department of Central Management Services. 10 Rulemaking authority to implement Public Act 95-1045, if 11 any, is conditioned on the rules being adopted in accordance 12 with all provisions of the Illinois Administrative Procedure 13 Act and all rules and procedures of the Joint Committee on 14 Administrative Rules; any purported rule not so adopted, for 15 whatever reason, is unauthorized. 16 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 17 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 18 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768, 19 eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 20 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 21 1-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84, 22 eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24; 23 103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff. 24 8-11-23; 103-605, eff. 7-1-24; 103-718, eff. 7-19-24; 103-751, 25 eff. 8-2-24; 103-870, eff. 1-1-25; 103-914, eff. 1-1-25; 26 103-918, eff. 1-1-25; 103-951, eff. 1-1-25; 103-1024, eff. SB1418 - 3 - LRB104 06136 BAB 16169 b SB1418- 4 -LRB104 06136 BAB 16169 b SB1418 - 4 - LRB104 06136 BAB 16169 b SB1418 - 4 - LRB104 06136 BAB 16169 b 1 1-1-25; revised 11-26-24.) 2 Section 10. The Counties Code is amended by changing 3 Section 5-1069.3 as follows: 4 (55 ILCS 5/5-1069.3) 5 Sec. 5-1069.3. Required health benefits. If a county, 6 including a home rule county, is a self-insurer for purposes 7 of providing health insurance coverage for its employees, the 8 coverage shall include coverage for the post-mastectomy care 9 benefits required to be covered by a policy of accident and 10 health insurance under Section 356t and the coverage required 11 under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 12 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 13 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 14 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 15 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 16 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 17 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and 356z.71, 18 356z.74, 356z.77, and 356z.80 of the Illinois Insurance Code. 19 The coverage shall comply with Sections 155.22a, 355b, 20 356z.19, and 370c of the Illinois Insurance Code. The 21 Department of Insurance shall enforce the requirements of this 22 Section. The requirement that health benefits be covered as 23 provided in this Section is an exclusive power and function of 24 the State and is a denial and limitation under Article VII, SB1418 - 4 - LRB104 06136 BAB 16169 b SB1418- 5 -LRB104 06136 BAB 16169 b SB1418 - 5 - LRB104 06136 BAB 16169 b SB1418 - 5 - LRB104 06136 BAB 16169 b 1 Section 6, subsection (h) of the Illinois Constitution. A home 2 rule county to which this Section applies must comply with 3 every provision of this Section. 4 Rulemaking authority to implement Public Act 95-1045, if 5 any, is conditioned on the rules being adopted in accordance 6 with all provisions of the Illinois Administrative Procedure 7 Act and all rules and procedures of the Joint Committee on 8 Administrative Rules; any purported rule not so adopted, for 9 whatever reason, is unauthorized. 10 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 11 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 12 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, 13 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 14 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 15 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, 16 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 17 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 18 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, 19 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 20 revised 11-26-24.) 21 Section 15. The Illinois Municipal Code is amended by 22 changing Section 10-4-2.3 as follows: 23 (65 ILCS 5/10-4-2.3) 24 Sec. 10-4-2.3. Required health benefits. If a SB1418 - 5 - LRB104 06136 BAB 16169 b SB1418- 6 -LRB104 06136 BAB 16169 b SB1418 - 6 - LRB104 06136 BAB 16169 b SB1418 - 6 - LRB104 06136 BAB 16169 b 1 municipality, including a home rule municipality, is a 2 self-insurer for purposes of providing health insurance 3 coverage for its employees, the coverage shall include 4 coverage for the post-mastectomy care benefits required to be 5 covered by a policy of accident and health insurance under 6 Section 356t and the coverage required under Sections 356g, 7 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, 8 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 9 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 10 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 11 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 12 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 13 356z.67, 356z.68, and 356z.70, and 356z.71, 356z.74, 356z.77, 14 and 356z.80 of the Illinois Insurance Code. The coverage shall 15 comply with Sections 155.22a, 355b, 356z.19, and 370c of the 16 Illinois Insurance Code. The Department of Insurance shall 17 enforce the requirements of this Section. The requirement that 18 health benefits be covered as provided in this is an exclusive 19 power and function of the State and is a denial and limitation 20 under Article VII, Section 6, subsection (h) of the Illinois 21 Constitution. A home rule municipality to which this Section 22 applies must comply with every provision of this Section. 23 Rulemaking authority to implement Public Act 95-1045, if 24 any, is conditioned on the rules being adopted in accordance 25 with all provisions of the Illinois Administrative Procedure 26 Act and all rules and procedures of the Joint Committee on SB1418 - 6 - LRB104 06136 BAB 16169 b SB1418- 7 -LRB104 06136 BAB 16169 b SB1418 - 7 - LRB104 06136 BAB 16169 b SB1418 - 7 - LRB104 06136 BAB 16169 b 1 Administrative Rules; any purported rule not so adopted, for 2 whatever reason, is unauthorized. 3 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 4 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 5 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, 6 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 7 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 8 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, 9 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 10 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 11 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, 12 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 13 revised 11-26-24.) 14 Section 20. The School Code is amended by changing Section 15 10-22.3f as follows: 16 (105 ILCS 5/10-22.3f) 17 Sec. 10-22.3f. Required health benefits. Insurance 18 protection and benefits for employees shall provide the 19 post-mastectomy care benefits required to be covered by a 20 policy of accident and health insurance under Section 356t and 21 the coverage required under Sections 356g, 356g.5, 356g.5-1, 22 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, 23 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 24 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, SB1418 - 7 - LRB104 06136 BAB 16169 b SB1418- 8 -LRB104 06136 BAB 16169 b SB1418 - 8 - LRB104 06136 BAB 16169 b SB1418 - 8 - LRB104 06136 BAB 16169 b 1 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 2 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 3 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and 4 356z.71, 356z.74, 356z.77, and 356z.80 of the Illinois 5 Insurance Code. Insurance policies shall comply with Section 6 356z.19 of the Illinois Insurance Code. The coverage shall 7 comply with Sections 155.22a, 355b, and 370c of the Illinois 8 Insurance Code. The Department of Insurance shall enforce the 9 requirements of this Section. 10 Rulemaking authority to implement Public Act 95-1045, if 11 any, is conditioned on the rules being adopted in accordance 12 with all provisions of the Illinois Administrative Procedure 13 Act and all rules and procedures of the Joint Committee on 14 Administrative Rules; any purported rule not so adopted, for 15 whatever reason, is unauthorized. 16 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 17 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 18 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, 19 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 20 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 21 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, 22 eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 23 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, eff. 24 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918, 25 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.) SB1418 - 8 - LRB104 06136 BAB 16169 b SB1418- 9 -LRB104 06136 BAB 16169 b SB1418 - 9 - LRB104 06136 BAB 16169 b SB1418 - 9 - LRB104 06136 BAB 16169 b 1 Section 22. The Illinois Insurance Code is amended by 2 adding Section 356z.80 as follows: 3 (215 ILCS 5/356z.80 new) 4 Sec. 356z.80. Coverage for peripheral artery disease 5 screening test. 6 (a) As used in this Section: 7 "At-risk individual" means an individual who: 8 (1) is 65 years of age or older; 9 (2) is at least 50 years of age but not older than 64 10 years of age with risk factors for atherosclerosis, such 11 as diabetes mellitus, a history of smoking, 12 hyperlipidemia, or hypertension, or a family history of 13 peripheral artery disease; 14 (3) is younger than 50 years of age with diabetes 15 mellitus and one additional risk factor for 16 atherosclerosis; or 17 (4) has a known atherosclerotic disease in another 18 vascular bed, such as coronary, carotid, subclavian, 19 renal, or mesenteric artery stenosis, or abdominal aortic 20 aneurysm. 21 "Peripheral artery disease screening test" means: 22 (1) noninvasive physiologic studies of extremity 23 arteries (commonly referred to as ankle-brachial index 24 testing); or 25 (2) ankle plethysmographic pulse volume recordings and SB1418 - 9 - LRB104 06136 BAB 16169 b SB1418- 10 -LRB104 06136 BAB 16169 b SB1418 - 10 - LRB104 06136 BAB 16169 b SB1418 - 10 - LRB104 06136 BAB 16169 b 1 Doppler waveforms. 2 (b) A group or individual plan of accident and health 3 insurance or managed care plan amended, delivered, issued, or 4 renewed after January 1, 2026 must provide coverage, no less 5 than once every 12 months, for a peripheral artery disease 6 screening test for any at-risk individual. 7 Section 25. The Health Maintenance Organization Act is 8 amended by changing Section 5-3 as follows: 9 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2) 10 (Text of Section before amendment by P.A. 103-808) 11 Sec. 5-3. Insurance Code provisions. 12 (a) Health Maintenance Organizations shall be subject to 13 the provisions of Sections 133, 134, 136, 137, 139, 140, 14 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 15 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 16 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g.5-1, 17 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 356z.3a, 18 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 19 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 20 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 356z.25, 21 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 356z.33, 22 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40, 23 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 356z.47, 24 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 356z.55, SB1418 - 10 - LRB104 06136 BAB 16169 b SB1418- 11 -LRB104 06136 BAB 16169 b SB1418 - 11 - LRB104 06136 BAB 16169 b SB1418 - 11 - LRB104 06136 BAB 16169 b 1 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 356z.62, 2 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 356z.69, 3 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 356z.77, 4 356z.80, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b, 5 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 6 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of 7 subsection (2) of Section 367, and Articles IIA, VIII 1/2, 8 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the 9 Illinois Insurance Code. 10 (b) For purposes of the Illinois Insurance Code, except 11 for Sections 444 and 444.1 and Articles XIII and XIII 1/2, 12 Health Maintenance Organizations in the following categories 13 are deemed to be "domestic companies": 14 (1) a corporation authorized under the Dental Service 15 Plan Act or the Voluntary Health Services Plans Act; 16 (2) a corporation organized under the laws of this 17 State; or 18 (3) a corporation organized under the laws of another 19 state, 30% or more of the enrollees of which are residents 20 of this State, except a corporation subject to 21 substantially the same requirements in its state of 22 organization as is a "domestic company" under Article VIII 23 1/2 of the Illinois Insurance Code. 24 (c) In considering the merger, consolidation, or other 25 acquisition of control of a Health Maintenance Organization 26 pursuant to Article VIII 1/2 of the Illinois Insurance Code, SB1418 - 11 - LRB104 06136 BAB 16169 b SB1418- 12 -LRB104 06136 BAB 16169 b SB1418 - 12 - LRB104 06136 BAB 16169 b SB1418 - 12 - LRB104 06136 BAB 16169 b 1 (1) the Director shall give primary consideration to 2 the continuation of benefits to enrollees and the 3 financial conditions of the acquired Health Maintenance 4 Organization after the merger, consolidation, or other 5 acquisition of control takes effect; 6 (2)(i) the criteria specified in subsection (1)(b) of 7 Section 131.8 of the Illinois Insurance Code shall not 8 apply and (ii) the Director, in making his determination 9 with respect to the merger, consolidation, or other 10 acquisition of control, need not take into account the 11 effect on competition of the merger, consolidation, or 12 other acquisition of control; 13 (3) the Director shall have the power to require the 14 following information: 15 (A) certification by an independent actuary of the 16 adequacy of the reserves of the Health Maintenance 17 Organization sought to be acquired; 18 (B) pro forma financial statements reflecting the 19 combined balance sheets of the acquiring company and 20 the Health Maintenance Organization sought to be 21 acquired as of the end of the preceding year and as of 22 a date 90 days prior to the acquisition, as well as pro 23 forma financial statements reflecting projected 24 combined operation for a period of 2 years; 25 (C) a pro forma business plan detailing an 26 acquiring party's plans with respect to the operation SB1418 - 12 - LRB104 06136 BAB 16169 b SB1418- 13 -LRB104 06136 BAB 16169 b SB1418 - 13 - LRB104 06136 BAB 16169 b SB1418 - 13 - LRB104 06136 BAB 16169 b 1 of the Health Maintenance Organization sought to be 2 acquired for a period of not less than 3 years; and 3 (D) such other information as the Director shall 4 require. 5 (d) The provisions of Article VIII 1/2 of the Illinois 6 Insurance Code and this Section 5-3 shall apply to the sale by 7 any health maintenance organization of greater than 10% of its 8 enrollee population (including, without limitation, the health 9 maintenance organization's right, title, and interest in and 10 to its health care certificates). 11 (e) In considering any management contract or service 12 agreement subject to Section 141.1 of the Illinois Insurance 13 Code, the Director (i) shall, in addition to the criteria 14 specified in Section 141.2 of the Illinois Insurance Code, 15 take into account the effect of the management contract or 16 service agreement on the continuation of benefits to enrollees 17 and the financial condition of the health maintenance 18 organization to be managed or serviced, and (ii) need not take 19 into account the effect of the management contract or service 20 agreement on competition. 21 (f) Except for small employer groups as defined in the 22 Small Employer Rating, Renewability and Portability Health 23 Insurance Act and except for medicare supplement policies as 24 defined in Section 363 of the Illinois Insurance Code, a 25 Health Maintenance Organization may by contract agree with a 26 group or other enrollment unit to effect refunds or charge SB1418 - 13 - LRB104 06136 BAB 16169 b SB1418- 14 -LRB104 06136 BAB 16169 b SB1418 - 14 - LRB104 06136 BAB 16169 b SB1418 - 14 - LRB104 06136 BAB 16169 b 1 additional premiums under the following terms and conditions: 2 (i) the amount of, and other terms and conditions with 3 respect to, the refund or additional premium are set forth 4 in the group or enrollment unit contract agreed in advance 5 of the period for which a refund is to be paid or 6 additional premium is to be charged (which period shall 7 not be less than one year); and 8 (ii) the amount of the refund or additional premium 9 shall not exceed 20% of the Health Maintenance 10 Organization's profitable or unprofitable experience with 11 respect to the group or other enrollment unit for the 12 period (and, for purposes of a refund or additional 13 premium, the profitable or unprofitable experience shall 14 be calculated taking into account a pro rata share of the 15 Health Maintenance Organization's administrative and 16 marketing expenses, but shall not include any refund to be 17 made or additional premium to be paid pursuant to this 18 subsection (f)). The Health Maintenance Organization and 19 the group or enrollment unit may agree that the profitable 20 or unprofitable experience may be calculated taking into 21 account the refund period and the immediately preceding 2 22 plan years. 23 The Health Maintenance Organization shall include a 24 statement in the evidence of coverage issued to each enrollee 25 describing the possibility of a refund or additional premium, 26 and upon request of any group or enrollment unit, provide to SB1418 - 14 - LRB104 06136 BAB 16169 b SB1418- 15 -LRB104 06136 BAB 16169 b SB1418 - 15 - LRB104 06136 BAB 16169 b SB1418 - 15 - LRB104 06136 BAB 16169 b 1 the group or enrollment unit a description of the method used 2 to calculate (1) the Health Maintenance Organization's 3 profitable experience with respect to the group or enrollment 4 unit and the resulting refund to the group or enrollment unit 5 or (2) the Health Maintenance Organization's unprofitable 6 experience with respect to the group or enrollment unit and 7 the resulting additional premium to be paid by the group or 8 enrollment unit. 9 In no event shall the Illinois Health Maintenance 10 Organization Guaranty Association be liable to pay any 11 contractual obligation of an insolvent organization to pay any 12 refund authorized under this Section. 13 (g) Rulemaking authority to implement Public Act 95-1045, 14 if any, is conditioned on the rules being adopted in 15 accordance with all provisions of the Illinois Administrative 16 Procedure Act and all rules and procedures of the Joint 17 Committee on Administrative Rules; any purported rule not so 18 adopted, for whatever reason, is unauthorized. 19 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; 20 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 21 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, 22 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 23 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 24 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, 25 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 26 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff. SB1418 - 15 - LRB104 06136 BAB 16169 b SB1418- 16 -LRB104 06136 BAB 16169 b SB1418 - 16 - LRB104 06136 BAB 16169 b SB1418 - 16 - LRB104 06136 BAB 16169 b 1 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, 2 eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 3 103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff. 4 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751, 5 eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25; 6 103-777, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918, eff. 7 1-1-25; 103-1024, eff. 1-1-25; revised 9-26-24.) 8 (Text of Section after amendment by P.A. 103-808) 9 Sec. 5-3. Insurance Code provisions. 10 (a) Health Maintenance Organizations shall be subject to 11 the provisions of Sections 133, 134, 136, 137, 139, 140, 12 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 13 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 14 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g, 15 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 16 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 17 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 18 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 19 356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 20 356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 21 356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 22 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 23 356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 24 356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 25 356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, SB1418 - 16 - LRB104 06136 BAB 16169 b SB1418- 17 -LRB104 06136 BAB 16169 b SB1418 - 17 - LRB104 06136 BAB 16169 b SB1418 - 17 - LRB104 06136 BAB 16169 b 1 356z.77, 356z.80, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 2 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 3 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) 4 of subsection (2) of Section 367, and Articles IIA, VIII 1/2, 5 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the 6 Illinois Insurance Code. 7 (b) For purposes of the Illinois Insurance Code, except 8 for Sections 444 and 444.1 and Articles XIII and XIII 1/2, 9 Health Maintenance Organizations in the following categories 10 are deemed to be "domestic companies": 11 (1) a corporation authorized under the Dental Service 12 Plan Act or the Voluntary Health Services Plans Act; 13 (2) a corporation organized under the laws of this 14 State; or 15 (3) a corporation organized under the laws of another 16 state, 30% or more of the enrollees of which are residents 17 of this State, except a corporation subject to 18 substantially the same requirements in its state of 19 organization as is a "domestic company" under Article VIII 20 1/2 of the Illinois Insurance Code. 21 (c) In considering the merger, consolidation, or other 22 acquisition of control of a Health Maintenance Organization 23 pursuant to Article VIII 1/2 of the Illinois Insurance Code, 24 (1) the Director shall give primary consideration to 25 the continuation of benefits to enrollees and the 26 financial conditions of the acquired Health Maintenance SB1418 - 17 - LRB104 06136 BAB 16169 b SB1418- 18 -LRB104 06136 BAB 16169 b SB1418 - 18 - LRB104 06136 BAB 16169 b SB1418 - 18 - LRB104 06136 BAB 16169 b 1 Organization after the merger, consolidation, or other 2 acquisition of control takes effect; 3 (2)(i) the criteria specified in subsection (1)(b) of 4 Section 131.8 of the Illinois Insurance Code shall not 5 apply and (ii) the Director, in making his determination 6 with respect to the merger, consolidation, or other 7 acquisition of control, need not take into account the 8 effect on competition of the merger, consolidation, or 9 other acquisition of control; 10 (3) the Director shall have the power to require the 11 following information: 12 (A) certification by an independent actuary of the 13 adequacy of the reserves of the Health Maintenance 14 Organization sought to be acquired; 15 (B) pro forma financial statements reflecting the 16 combined balance sheets of the acquiring company and 17 the Health Maintenance Organization sought to be 18 acquired as of the end of the preceding year and as of 19 a date 90 days prior to the acquisition, as well as pro 20 forma financial statements reflecting projected 21 combined operation for a period of 2 years; 22 (C) a pro forma business plan detailing an 23 acquiring party's plans with respect to the operation 24 of the Health Maintenance Organization sought to be 25 acquired for a period of not less than 3 years; and 26 (D) such other information as the Director shall SB1418 - 18 - LRB104 06136 BAB 16169 b SB1418- 19 -LRB104 06136 BAB 16169 b SB1418 - 19 - LRB104 06136 BAB 16169 b SB1418 - 19 - LRB104 06136 BAB 16169 b 1 require. 2 (d) The provisions of Article VIII 1/2 of the Illinois 3 Insurance Code and this Section 5-3 shall apply to the sale by 4 any health maintenance organization of greater than 10% of its 5 enrollee population (including, without limitation, the health 6 maintenance organization's right, title, and interest in and 7 to its health care certificates). 8 (e) In considering any management contract or service 9 agreement subject to Section 141.1 of the Illinois Insurance 10 Code, the Director (i) shall, in addition to the criteria 11 specified in Section 141.2 of the Illinois Insurance Code, 12 take into account the effect of the management contract or 13 service agreement on the continuation of benefits to enrollees 14 and the financial condition of the health maintenance 15 organization to be managed or serviced, and (ii) need not take 16 into account the effect of the management contract or service 17 agreement on competition. 18 (f) Except for small employer groups as defined in the 19 Small Employer Rating, Renewability and Portability Health 20 Insurance Act and except for medicare supplement policies as 21 defined in Section 363 of the Illinois Insurance Code, a 22 Health Maintenance Organization may by contract agree with a 23 group or other enrollment unit to effect refunds or charge 24 additional premiums under the following terms and conditions: 25 (i) the amount of, and other terms and conditions with 26 respect to, the refund or additional premium are set forth SB1418 - 19 - LRB104 06136 BAB 16169 b SB1418- 20 -LRB104 06136 BAB 16169 b SB1418 - 20 - LRB104 06136 BAB 16169 b SB1418 - 20 - LRB104 06136 BAB 16169 b 1 in the group or enrollment unit contract agreed in advance 2 of the period for which a refund is to be paid or 3 additional premium is to be charged (which period shall 4 not be less than one year); and 5 (ii) the amount of the refund or additional premium 6 shall not exceed 20% of the Health Maintenance 7 Organization's profitable or unprofitable experience with 8 respect to the group or other enrollment unit for the 9 period (and, for purposes of a refund or additional 10 premium, the profitable or unprofitable experience shall 11 be calculated taking into account a pro rata share of the 12 Health Maintenance Organization's administrative and 13 marketing expenses, but shall not include any refund to be 14 made or additional premium to be paid pursuant to this 15 subsection (f)). The Health Maintenance Organization and 16 the group or enrollment unit may agree that the profitable 17 or unprofitable experience may be calculated taking into 18 account the refund period and the immediately preceding 2 19 plan years. 20 The Health Maintenance Organization shall include a 21 statement in the evidence of coverage issued to each enrollee 22 describing the possibility of a refund or additional premium, 23 and upon request of any group or enrollment unit, provide to 24 the group or enrollment unit a description of the method used 25 to calculate (1) the Health Maintenance Organization's 26 profitable experience with respect to the group or enrollment SB1418 - 20 - LRB104 06136 BAB 16169 b SB1418- 21 -LRB104 06136 BAB 16169 b SB1418 - 21 - LRB104 06136 BAB 16169 b SB1418 - 21 - LRB104 06136 BAB 16169 b 1 unit and the resulting refund to the group or enrollment unit 2 or (2) the Health Maintenance Organization's unprofitable 3 experience with respect to the group or enrollment unit and 4 the resulting additional premium to be paid by the group or 5 enrollment unit. 6 In no event shall the Illinois Health Maintenance 7 Organization Guaranty Association be liable to pay any 8 contractual obligation of an insolvent organization to pay any 9 refund authorized under this Section. 10 (g) Rulemaking authority to implement Public Act 95-1045, 11 if any, is conditioned on the rules being adopted in 12 accordance with all provisions of the Illinois Administrative 13 Procedure Act and all rules and procedures of the Joint 14 Committee on Administrative Rules; any purported rule not so 15 adopted, for whatever reason, is unauthorized. 16 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; 17 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 18 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, 19 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 20 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 21 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, 22 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 23 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff. 24 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, 25 eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 26 103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff. SB1418 - 21 - LRB104 06136 BAB 16169 b SB1418- 22 -LRB104 06136 BAB 16169 b SB1418 - 22 - LRB104 06136 BAB 16169 b SB1418 - 22 - LRB104 06136 BAB 16169 b 1 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751, 2 eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25; 3 103-777, eff. 8-2-24; 103-808, eff. 1-1-26; 103-914, eff. 4 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; revised 5 11-26-24.) 6 Section 30. The Limited Health Service Organization Act is 7 amended by changing Section 4003 as follows: 8 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3) 9 Sec. 4003. Illinois Insurance Code provisions. Limited 10 health service organizations shall be subject to the 11 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, 12 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153, 13 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c, 14 355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a, 15 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32, 16 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 17 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71, 18 356z.73, 356z.74, 356z.75, 356z.80, 364.3, 368a, 401, 401.1, 19 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and 20 Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and 21 XXVI of the Illinois Insurance Code. Nothing in this Section 22 shall require a limited health care plan to cover any service 23 that is not a limited health service. For purposes of the 24 Illinois Insurance Code, except for Sections 444 and 444.1 and SB1418 - 22 - LRB104 06136 BAB 16169 b SB1418- 23 -LRB104 06136 BAB 16169 b SB1418 - 23 - LRB104 06136 BAB 16169 b SB1418 - 23 - LRB104 06136 BAB 16169 b 1 Articles XIII and XIII 1/2, limited health service 2 organizations in the following categories are deemed to be 3 domestic companies: 4 (1) a corporation under the laws of this State; or 5 (2) a corporation organized under the laws of another 6 state, 30% or more of the enrollees of which are residents 7 of this State, except a corporation subject to 8 substantially the same requirements in its state of 9 organization as is a domestic company under Article VIII 10 1/2 of the Illinois Insurance Code. 11 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 12 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff. 13 1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816, 14 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 15 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 16 1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, 17 eff. 1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 18 103-656, eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 19 7-19-24; 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, 20 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.) 21 Section 35. The Voluntary Health Services Plans Act is 22 amended by changing Section 10 as follows: 23 (215 ILCS 165/10) (from Ch. 32, par. 604) 24 Sec. 10. Application of Insurance Code provisions. Health SB1418 - 23 - LRB104 06136 BAB 16169 b SB1418- 24 -LRB104 06136 BAB 16169 b SB1418 - 24 - LRB104 06136 BAB 16169 b SB1418 - 24 - LRB104 06136 BAB 16169 b 1 services plan corporations and all persons interested therein 2 or dealing therewith shall be subject to the provisions of 3 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140, 4 143, 143.31, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 5 355b, 355d, 356g, 356g.5, 356g.5-1, 356m, 356q, 356r, 356t, 6 356u, 356u.10, 356v, 356w, 356x, 356y, 356z.1, 356z.2, 7 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 8 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18, 9 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 10 356z.32, 356z.32a, 356z.33, 356z.40, 356z.41, 356z.46, 11 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 12 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.71, 13 356z.72, 356z.74, 356z.75, 356z.77, 356z.80, 364.01, 364.3, 14 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, 15 and paragraphs (7) and (15) of Section 367 of the Illinois 16 Insurance Code. 17 Rulemaking authority to implement Public Act 95-1045, if 18 any, is conditioned on the rules being adopted in accordance 19 with all provisions of the Illinois Administrative Procedure 20 Act and all rules and procedures of the Joint Committee on 21 Administrative Rules; any purported rule not so adopted, for 22 whatever reason, is unauthorized. 23 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 24 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 25 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, 26 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; SB1418 - 24 - LRB104 06136 BAB 16169 b SB1418- 25 -LRB104 06136 BAB 16169 b SB1418 - 25 - LRB104 06136 BAB 16169 b SB1418 - 25 - LRB104 06136 BAB 16169 b 1 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 2 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, 3 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 4 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-656, eff. 5 1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, 6 eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 7 103-914, eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 8 1-1-25; revised 11-26-24.) 9 Section 40. The Illinois Public Aid Code is amended by 10 changing Section 5-16.8 as follows: 11 (305 ILCS 5/5-16.8) 12 Sec. 5-16.8. Required health benefits. The medical 13 assistance program shall (i) provide the post-mastectomy care 14 benefits required to be covered by a policy of accident and 15 health insurance under Section 356t and the coverage required 16 under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, 17 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46, 18 356z.47, 356z.51, 356z.53, 356z.59, 356z.60, 356z.61, 356z.64, 19 and 356z.67, and 356z.71, 356z.75, and 356z.80 of the Illinois 20 Insurance Code, (ii) be subject to the provisions of Sections 21 356z.19, 356z.44, 356z.49, 364.01, 370c, and 370c.1 of the 22 Illinois Insurance Code, and (iii) be subject to the 23 provisions of subsection (d-5) of Section 10 of the Network 24 Adequacy and Transparency Act. SB1418 - 25 - LRB104 06136 BAB 16169 b SB1418- 26 -LRB104 06136 BAB 16169 b SB1418 - 26 - LRB104 06136 BAB 16169 b SB1418 - 26 - LRB104 06136 BAB 16169 b 1 The Department, by rule, shall adopt a model similar to 2 the requirements of Section 356z.39 of the Illinois Insurance 3 Code. 4 On and after July 1, 2012, the Department shall reduce any 5 rate of reimbursement for services or other payments or alter 6 any methodologies authorized by this Code to reduce any rate 7 of reimbursement for services or other payments in accordance 8 with Section 5-5e. 9 To ensure full access to the benefits set forth in this 10 Section, on and after January 1, 2016, the Department shall 11 ensure that provider and hospital reimbursement for 12 post-mastectomy care benefits required under this Section are 13 no lower than the Medicare reimbursement rate. 14 (Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22; 15 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff. 16 1-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813, 17 eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23; 18 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 19 1-1-24; 103-420, eff. 1-1-24; 103-605, eff. 7-1-24; 103-703, 20 eff. 1-1-25; 103-758, eff. 1-1-25; 103-1024, eff. 1-1-25; 21 revised 11-26-24.) 22 Section 95. No acceleration or delay. Where this Act makes 23 changes in a statute that is represented in this Act by text 24 that is not yet or no longer in effect (for example, a Section 25 represented by multiple versions), the use of that text does SB1418 - 26 - LRB104 06136 BAB 16169 b SB1418- 27 -LRB104 06136 BAB 16169 b SB1418 - 27 - LRB104 06136 BAB 16169 b SB1418 - 27 - LRB104 06136 BAB 16169 b SB1418 - 27 - LRB104 06136 BAB 16169 b