Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1687 Compare Versions

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

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1687 Introduced 2/5/2025, by Sen. Christopher Belt 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.40b 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 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 one crib and one car seat for each postpartum individual covered under the policy. Provides that the postpartum individual must be covered by the insurance policy at the time of child birth and must submit a claim within 6 months after the birth. Provides that the insurer must either reimburse the postpartum individual for the purchase of an approved crib and car seat upon submission of a valid receipt or provide a car seat and crib to the postpartum individual that complies with all federal and State safety standards. 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 08886 BAB 18941 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1687 Introduced 2/5/2025, by Sen. Christopher Belt 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.40b 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.40b 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 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 one crib and one car seat for each postpartum individual covered under the policy. Provides that the postpartum individual must be covered by the insurance policy at the time of child birth and must submit a claim within 6 months after the birth. Provides that the insurer must either reimburse the postpartum individual for the purchase of an approved crib and car seat upon submission of a valid receipt or provide a car seat and crib to the postpartum individual that complies with all federal and State safety standards. 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 08886 BAB 18941 b LRB104 08886 BAB 18941 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1687 Introduced 2/5/2025, by Sen. Christopher Belt SYNOPSIS AS INTRODUCED:
3	3	5 ILCS 375/6.1155 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356z.40b 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.40b 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
4	4	5 ILCS 375/6.11
5	5	55 ILCS 5/5-1069.3
6	6	65 ILCS 5/10-4-2.3
7	7	105 ILCS 5/10-22.3f
8	8	215 ILCS 5/356z.40b new
9	9	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
10	10	215 ILCS 130/4003 from Ch. 73, par. 1504-3
11	11	215 ILCS 165/10 from Ch. 32, par. 604
12	12	305 ILCS 5/5-16.8
13	13	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 one crib and one car seat for each postpartum individual covered under the policy. Provides that the postpartum individual must be covered by the insurance policy at the time of child birth and must submit a claim within 6 months after the birth. Provides that the insurer must either reimburse the postpartum individual for the purchase of an approved crib and car seat upon submission of a valid receipt or provide a car seat and crib to the postpartum individual that complies with all federal and State safety standards. 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.
14	14	LRB104 08886 BAB 18941 b LRB104 08886 BAB 18941 b
15	15	LRB104 08886 BAB 18941 b
16	16	A BILL FOR
17	17	SB1687LRB104 08886 BAB 18941 b SB1687 LRB104 08886 BAB 18941 b
18	18	SB1687 LRB104 08886 BAB 18941 b
19	19	1 AN ACT concerning regulation.
20	20	2 Be it enacted by the People of the State of Illinois,
21	21	3 represented in the General Assembly:
22	22	4 Section 5. The State Employees Group Insurance Act of 1971
23	23	5 is amended by changing Section 6.11 as follows:
24	24	6 (5 ILCS 375/6.11)
25	25	7 Sec. 6.11. Required health benefits; Illinois Insurance
26	26	8 Code requirements. The program of health benefits shall
27	27	9 provide the post-mastectomy care benefits required to be
28	28	10 covered by a policy of accident and health insurance under
29	29	11 Section 356t of the Illinois Insurance Code. The program of
30	30	12 health benefits shall provide the coverage required under
31	31	13 Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10,
32	32	14 356w, 356x, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
33	33	15 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
34	34	16 356z.17, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
35	35	17 356z.33, 356z.36, 356z.40, 356z.40b, 356z.41, 356z.45,
36	36	18 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.55, 356z.56,
37	37	19 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67,
38	38	20 356z.68, and 356z.70, and 356z.71, 356z.74, 356z.76, and
39	39	21 356z.77 of the Illinois Insurance Code. The program of health
40	40	22 benefits must comply with Sections 155.22a, 155.37, 355b,
41	41	23 356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
42	42
43	43
44	44
45	45	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1687 Introduced 2/5/2025, by Sen. Christopher Belt SYNOPSIS AS INTRODUCED:
46	46	5 ILCS 375/6.1155 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356z.40b 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.40b 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
47	47	5 ILCS 375/6.11
48	48	55 ILCS 5/5-1069.3
49	49	65 ILCS 5/10-4-2.3
50	50	105 ILCS 5/10-22.3f
51	51	215 ILCS 5/356z.40b new
52	52	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
53	53	215 ILCS 130/4003 from Ch. 73, par. 1504-3
54	54	215 ILCS 165/10 from Ch. 32, par. 604
55	55	305 ILCS 5/5-16.8
56	56	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 one crib and one car seat for each postpartum individual covered under the policy. Provides that the postpartum individual must be covered by the insurance policy at the time of child birth and must submit a claim within 6 months after the birth. Provides that the insurer must either reimburse the postpartum individual for the purchase of an approved crib and car seat upon submission of a valid receipt or provide a car seat and crib to the postpartum individual that complies with all federal and State safety standards. 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.
57	57	LRB104 08886 BAB 18941 b LRB104 08886 BAB 18941 b
58	58	LRB104 08886 BAB 18941 b
59	59	A BILL FOR
60	60
61	61
62	62
63	63
64	64
65	65	5 ILCS 375/6.11
66	66	55 ILCS 5/5-1069.3
67	67	65 ILCS 5/10-4-2.3
68	68	105 ILCS 5/10-22.3f
69	69	215 ILCS 5/356z.40b new
70	70	215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
71	71	215 ILCS 130/4003 from Ch. 73, par. 1504-3
72	72	215 ILCS 165/10 from Ch. 32, par. 604
73	73	305 ILCS 5/5-16.8
74	74
75	75
76	76
77	77	LRB104 08886 BAB 18941 b
78	78
79	79
80	80
81	81
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86	86
87	87	SB1687 LRB104 08886 BAB 18941 b
88	88
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90	90	SB1687- 2 -LRB104 08886 BAB 18941 b SB1687 - 2 - LRB104 08886 BAB 18941 b
91	91	SB1687 - 2 - LRB104 08886 BAB 18941 b
92	92	1 Insurance Code. The program of health benefits shall provide
93	93	2 the coverage required under Section 356m of the Illinois
94	94	3 Insurance Code and, for the employees of the State Employee
95	95	4 Group Insurance Program only, the coverage as also provided in
96	96	5 Section 6.11B of this Act. The Department of Insurance shall
97	97	6 enforce the requirements of this Section with respect to
98	98	7 Sections 370c and 370c.1 of the Illinois Insurance Code; all
99	99	8 other requirements of this Section shall be enforced by the
100	100	9 Department of Central Management Services.
101	101	10 Rulemaking authority to implement Public Act 95-1045, if
102	102	11 any, is conditioned on the rules being adopted in accordance
103	103	12 with all provisions of the Illinois Administrative Procedure
104	104	13 Act and all rules and procedures of the Joint Committee on
105	105	14 Administrative Rules; any purported rule not so adopted, for
106	106	15 whatever reason, is unauthorized.
107	107	16 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
108	108	17 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
109	109	18 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768,
110	110	19 eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
111	111	20 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
112	112	21 1-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84,
113	113	22 eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24;
114	114	23 103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff.
115	115	24 8-11-23; 103-605, eff. 7-1-24; 103-718, eff. 7-19-24; 103-751,
116	116	25 eff. 8-2-24; 103-870, eff. 1-1-25; 103-914, eff. 1-1-25;
117	117	26 103-918, eff. 1-1-25; 103-951, eff. 1-1-25; 103-1024, eff.
118	118
119	119
120	120
121	121
122	122
123	123	SB1687 - 2 - LRB104 08886 BAB 18941 b
124	124
125	125
126	126	SB1687- 3 -LRB104 08886 BAB 18941 b SB1687 - 3 - LRB104 08886 BAB 18941 b
127	127	SB1687 - 3 - LRB104 08886 BAB 18941 b
128	128	1 1-1-25; revised 11-26-24.)
129	129	2 Section 10. The Counties Code is amended by changing
130	130	3 Section 5-1069.3 as follows:
131	131	4 (55 ILCS 5/5-1069.3)
132	132	5 Sec. 5-1069.3. Required health benefits. If a county,
133	133	6 including a home rule county, is a self-insurer for purposes
134	134	7 of providing health insurance coverage for its employees, the
135	135	8 coverage shall include coverage for the post-mastectomy care
136	136	9 benefits required to be covered by a policy of accident and
137	137	10 health insurance under Section 356t and the coverage required
138	138	11 under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
139	139	12 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
140	140	13 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
141	141	14 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
142	142	15 356z.40, 356z.40b, 356z.41, 356z.45, 356z.46, 356z.47,
143	143	16 356z.48, 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59,
144	144	17 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and
145	145	18 356z.70, and 356z.71, 356z.74, and 356z.77 of the Illinois
146	146	19 Insurance Code. The coverage shall comply with Sections
147	147	20 155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
148	148	21 Code. The Department of Insurance shall enforce the
149	149	22 requirements of this Section. The requirement that health
150	150	23 benefits be covered as provided in this Section is an
151	151	24 exclusive power and function of the State and is a denial and
152	152
153	153
154	154
155	155
156	156
157	157	SB1687 - 3 - LRB104 08886 BAB 18941 b
158	158
159	159
160	160	SB1687- 4 -LRB104 08886 BAB 18941 b SB1687 - 4 - LRB104 08886 BAB 18941 b
161	161	SB1687 - 4 - LRB104 08886 BAB 18941 b
162	162	1 limitation under Article VII, Section 6, subsection (h) of the
163	163	2 Illinois Constitution. A home rule county to which this
164	164	3 Section applies must comply with every provision of this
165	165	4 Section.
166	166	5 Rulemaking authority to implement Public Act 95-1045, if
167	167	6 any, is conditioned on the rules being adopted in accordance
168	168	7 with all provisions of the Illinois Administrative Procedure
169	169	8 Act and all rules and procedures of the Joint Committee on
170	170	9 Administrative Rules; any purported rule not so adopted, for
171	171	10 whatever reason, is unauthorized.
172	172	11 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
173	173	12 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
174	174	13 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
175	175	14 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
176	176	15 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
177	177	16 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
178	178	17 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
179	179	18 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
180	180	19 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914,
181	181	20 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25;
182	182	21 revised 11-26-24.)
183	183	22 Section 15. The Illinois Municipal Code is amended by
184	184	23 changing Section 10-4-2.3 as follows:
185	185	24 (65 ILCS 5/10-4-2.3)
186	186
187	187
188	188
189	189
190	190
191	191	SB1687 - 4 - LRB104 08886 BAB 18941 b
192	192
193	193
194	194	SB1687- 5 -LRB104 08886 BAB 18941 b SB1687 - 5 - LRB104 08886 BAB 18941 b
195	195	SB1687 - 5 - LRB104 08886 BAB 18941 b
196	196	1 Sec. 10-4-2.3. Required health benefits. If a
197	197	2 municipality, including a home rule municipality, is a
198	198	3 self-insurer for purposes of providing health insurance
199	199	4 coverage for its employees, the coverage shall include
200	200	5 coverage for the post-mastectomy care benefits required to be
201	201	6 covered by a policy of accident and health insurance under
202	202	7 Section 356t and the coverage required under Sections 356g,
203	203	8 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
204	204	9 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
205	205	10 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
206	206	11 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40,
207	207	12 356z.40b, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48,
208	208	13 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
209	209	14 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70, and
210	210	15 356z.71, 356z.74, and 356z.77 of the Illinois Insurance Code.
211	211	16 The coverage shall comply with Sections 155.22a, 355b,
212	212	17 356z.19, and 370c of the Illinois Insurance Code. The
213	213	18 Department of Insurance shall enforce the requirements of this
214	214	19 Section. The requirement that health benefits be covered as
215	215	20 provided in this is an exclusive power and function of the
216	216	21 State and is a denial and limitation under Article VII,
217	217	22 Section 6, subsection (h) of the Illinois Constitution. A home
218	218	23 rule municipality to which this Section applies must comply
219	219	24 with every provision of this Section.
220	220	25 Rulemaking authority to implement Public Act 95-1045, if
221	221	26 any, is conditioned on the rules being adopted in accordance
222	222
223	223
224	224
225	225
226	226
227	227	SB1687 - 5 - LRB104 08886 BAB 18941 b
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231	231	SB1687 - 6 - LRB104 08886 BAB 18941 b
232	232	1 with all provisions of the Illinois Administrative Procedure
233	233	2 Act and all rules and procedures of the Joint Committee on
234	234	3 Administrative Rules; any purported rule not so adopted, for
235	235	4 whatever reason, is unauthorized.
236	236	5 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
237	237	6 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
238	238	7 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
239	239	8 eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
240	240	9 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
241	241	10 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
242	242	11 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
243	243	12 103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
244	244	13 7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-914,
245	245	14 eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25;
246	246	15 revised 11-26-24.)
247	247	16 Section 20. The School Code is amended by changing Section
248	248	17 10-22.3f as follows:
249	249	18 (105 ILCS 5/10-22.3f)
250	250	19 Sec. 10-22.3f. Required health benefits. Insurance
251	251	20 protection and benefits for employees shall provide the
252	252	21 post-mastectomy care benefits required to be covered by a
253	253	22 policy of accident and health insurance under Section 356t and
254	254	23 the coverage required under Sections 356g, 356g.5, 356g.5-1,
255	255	24 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
256	256
257	257
258	258
259	259
260	260
261	261	SB1687 - 6 - LRB104 08886 BAB 18941 b
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266	266	1 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
267	267	2 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
268	268	3 356z.33, 356z.36, 356z.40, 356z.40b, 356z.41, 356z.45,
269	269	4 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 356z.57,
270	270	5 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68,
271	271	6 and 356z.70, and 356z.71, 356z.74, and 356z.77 of the Illinois
272	272	7 Insurance Code. Insurance policies shall comply with Section
273	273	8 356z.19 of the Illinois Insurance Code. The coverage shall
274	274	9 comply with Sections 155.22a, 355b, and 370c of the Illinois
275	275	10 Insurance Code. The Department of Insurance shall enforce the
276	276	11 requirements of this Section.
277	277	12 Rulemaking authority to implement Public Act 95-1045, if
278	278	13 any, is conditioned on the rules being adopted in accordance
279	279	14 with all provisions of the Illinois Administrative Procedure
280	280	15 Act and all rules and procedures of the Joint Committee on
281	281	16 Administrative Rules; any purported rule not so adopted, for
282	282	17 whatever reason, is unauthorized.
283	283	18 (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
284	284	19 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
285	285	20 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804,
286	286	21 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
287	287	22 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff.
288	288	23 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420,
289	289	24 eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 8-11-23;
290	290	25 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, eff.
291	291	26 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918,
292	292
293	293
294	294
295	295
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297	297	SB1687 - 7 - LRB104 08886 BAB 18941 b
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300	300	SB1687- 8 -LRB104 08886 BAB 18941 b SB1687 - 8 - LRB104 08886 BAB 18941 b
301	301	SB1687 - 8 - LRB104 08886 BAB 18941 b
302	302	1 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
303	303	2 Section 25. The Illinois Insurance Code is amended by
304	304	3 adding Section 356z.40b as follows:
305	305	4 (215 ILCS 5/356z.40b new)
306	306	5 Sec. 356z.40b. Coverage for crib and car seat. A group or
307	307	6 individual policy of accident and health insurance or a
308	308	7 managed care plan that is amended, delivered, issued, or
309	309	8 renewed on or after January 1, 2027 shall provide coverage for
310	310	9 one crib and one car seat for each postpartum individual
311	311	10 covered under the policy. The postpartum individual must be
312	312	11 covered by the insurance policy at the time of the child's
313	313	12 birth and must submit a claim within 6 months after the birth.
314	314	13 The insurer must either reimburse the postpartum individual
315	315	14 for the purchase of an approved crib and car seat upon
316	316	15 submission of a valid receipt or provide a car seat and crib to
317	317	16 the postpartum individual that complies with all federal and
318	318	17 State safety standards.
319	319	18 Section 30. The Health Maintenance Organization Act is
320	320	19 amended by changing Section 5-3 as follows:
321	321	20 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
322	322	21 (Text of Section before amendment by P.A. 103-808)
323	323	22 Sec. 5-3. Insurance Code provisions.
324	324
325	325
326	326
327	327
328	328
329	329	SB1687 - 8 - LRB104 08886 BAB 18941 b
330	330
331	331
332	332	SB1687- 9 -LRB104 08886 BAB 18941 b SB1687 - 9 - LRB104 08886 BAB 18941 b
333	333	SB1687 - 9 - LRB104 08886 BAB 18941 b
334	334	1 (a) Health Maintenance Organizations shall be subject to
335	335	2 the provisions of Sections 133, 134, 136, 137, 139, 140,
336	336	3 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
337	337	4 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
338	338	5 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g.5-1,
339	339	6 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 356z.3a,
340	340	7 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10,
341	341	8 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18,
342	342	9 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 356z.25,
343	343	10 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 356z.33,
344	344	11 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40,
345	345	12 356z.40a, 356z.40b, 356z.41, 356z.44, 356z.45, 356z.46,
346	346	13 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
347	347	14 356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
348	348	15 356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
349	349	16 356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
350	350	17 356z.77, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b,
351	351	18 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A,
352	352	19 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of
353	353	20 subsection (2) of Section 367, and Articles IIA, VIII 1/2,
354	354	21 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
355	355	22 Illinois Insurance Code.
356	356	23 (b) For purposes of the Illinois Insurance Code, except
357	357	24 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
358	358	25 Health Maintenance Organizations in the following categories
359	359	26 are deemed to be "domestic companies":
360	360
361	361
362	362
363	363
364	364
365	365	SB1687 - 9 - LRB104 08886 BAB 18941 b
366	366
367	367
368	368	SB1687- 10 -LRB104 08886 BAB 18941 b SB1687 - 10 - LRB104 08886 BAB 18941 b
369	369	SB1687 - 10 - LRB104 08886 BAB 18941 b
370	370	1 (1) a corporation authorized under the Dental Service
371	371	2 Plan Act or the Voluntary Health Services Plans Act;
372	372	3 (2) a corporation organized under the laws of this
373	373	4 State; or
374	374	5 (3) a corporation organized under the laws of another
375	375	6 state, 30% or more of the enrollees of which are residents
376	376	7 of this State, except a corporation subject to
377	377	8 substantially the same requirements in its state of
378	378	9 organization as is a "domestic company" under Article VIII
379	379	10 1/2 of the Illinois Insurance Code.
380	380	11 (c) In considering the merger, consolidation, or other
381	381	12 acquisition of control of a Health Maintenance Organization
382	382	13 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
383	383	14 (1) the Director shall give primary consideration to
384	384	15 the continuation of benefits to enrollees and the
385	385	16 financial conditions of the acquired Health Maintenance
386	386	17 Organization after the merger, consolidation, or other
387	387	18 acquisition of control takes effect;
388	388	19 (2)(i) the criteria specified in subsection (1)(b) of
389	389	20 Section 131.8 of the Illinois Insurance Code shall not
390	390	21 apply and (ii) the Director, in making his determination
391	391	22 with respect to the merger, consolidation, or other
392	392	23 acquisition of control, need not take into account the
393	393	24 effect on competition of the merger, consolidation, or
394	394	25 other acquisition of control;
395	395	26 (3) the Director shall have the power to require the
396	396
397	397
398	398
399	399
400	400
401	401	SB1687 - 10 - LRB104 08886 BAB 18941 b
402	402
403	403
404	404	SB1687- 11 -LRB104 08886 BAB 18941 b SB1687 - 11 - LRB104 08886 BAB 18941 b
405	405	SB1687 - 11 - LRB104 08886 BAB 18941 b
406	406	1 following information:
407	407	2 (A) certification by an independent actuary of the
408	408	3 adequacy of the reserves of the Health Maintenance
409	409	4 Organization sought to be acquired;
410	410	5 (B) pro forma financial statements reflecting the
411	411	6 combined balance sheets of the acquiring company and
412	412	7 the Health Maintenance Organization sought to be
413	413	8 acquired as of the end of the preceding year and as of
414	414	9 a date 90 days prior to the acquisition, as well as pro
415	415	10 forma financial statements reflecting projected
416	416	11 combined operation for a period of 2 years;
417	417	12 (C) a pro forma business plan detailing an
418	418	13 acquiring party's plans with respect to the operation
419	419	14 of the Health Maintenance Organization sought to be
420	420	15 acquired for a period of not less than 3 years; and
421	421	16 (D) such other information as the Director shall
422	422	17 require.
423	423	18 (d) The provisions of Article VIII 1/2 of the Illinois
424	424	19 Insurance Code and this Section 5-3 shall apply to the sale by
425	425	20 any health maintenance organization of greater than 10% of its
426	426	21 enrollee population (including, without limitation, the health
427	427	22 maintenance organization's right, title, and interest in and
428	428	23 to its health care certificates).
429	429	24 (e) In considering any management contract or service
430	430	25 agreement subject to Section 141.1 of the Illinois Insurance
431	431	26 Code, the Director (i) shall, in addition to the criteria
432	432
433	433
434	434
435	435
436	436
437	437	SB1687 - 11 - LRB104 08886 BAB 18941 b
438	438
439	439
440	440	SB1687- 12 -LRB104 08886 BAB 18941 b SB1687 - 12 - LRB104 08886 BAB 18941 b
441	441	SB1687 - 12 - LRB104 08886 BAB 18941 b
442	442	1 specified in Section 141.2 of the Illinois Insurance Code,
443	443	2 take into account the effect of the management contract or
444	444	3 service agreement on the continuation of benefits to enrollees
445	445	4 and the financial condition of the health maintenance
446	446	5 organization to be managed or serviced, and (ii) need not take
447	447	6 into account the effect of the management contract or service
448	448	7 agreement on competition.
449	449	8 (f) Except for small employer groups as defined in the
450	450	9 Small Employer Rating, Renewability and Portability Health
451	451	10 Insurance Act and except for medicare supplement policies as
452	452	11 defined in Section 363 of the Illinois Insurance Code, a
453	453	12 Health Maintenance Organization may by contract agree with a
454	454	13 group or other enrollment unit to effect refunds or charge
455	455	14 additional premiums under the following terms and conditions:
456	456	15 (i) the amount of, and other terms and conditions with
457	457	16 respect to, the refund or additional premium are set forth
458	458	17 in the group or enrollment unit contract agreed in advance
459	459	18 of the period for which a refund is to be paid or
460	460	19 additional premium is to be charged (which period shall
461	461	20 not be less than one year); and
462	462	21 (ii) the amount of the refund or additional premium
463	463	22 shall not exceed 20% of the Health Maintenance
464	464	23 Organization's profitable or unprofitable experience with
465	465	24 respect to the group or other enrollment unit for the
466	466	25 period (and, for purposes of a refund or additional
467	467	26 premium, the profitable or unprofitable experience shall
468	468
469	469
470	470
471	471
472	472
473	473	SB1687 - 12 - LRB104 08886 BAB 18941 b
474	474
475	475
476	476	SB1687- 13 -LRB104 08886 BAB 18941 b SB1687 - 13 - LRB104 08886 BAB 18941 b
477	477	SB1687 - 13 - LRB104 08886 BAB 18941 b
478	478	1 be calculated taking into account a pro rata share of the
479	479	2 Health Maintenance Organization's administrative and
480	480	3 marketing expenses, but shall not include any refund to be
481	481	4 made or additional premium to be paid pursuant to this
482	482	5 subsection (f)). The Health Maintenance Organization and
483	483	6 the group or enrollment unit may agree that the profitable
484	484	7 or unprofitable experience may be calculated taking into
485	485	8 account the refund period and the immediately preceding 2
486	486	9 plan years.
487	487	10 The Health Maintenance Organization shall include a
488	488	11 statement in the evidence of coverage issued to each enrollee
489	489	12 describing the possibility of a refund or additional premium,
490	490	13 and upon request of any group or enrollment unit, provide to
491	491	14 the group or enrollment unit a description of the method used
492	492	15 to calculate (1) the Health Maintenance Organization's
493	493	16 profitable experience with respect to the group or enrollment
494	494	17 unit and the resulting refund to the group or enrollment unit
495	495	18 or (2) the Health Maintenance Organization's unprofitable
496	496	19 experience with respect to the group or enrollment unit and
497	497	20 the resulting additional premium to be paid by the group or
498	498	21 enrollment unit.
499	499	22 In no event shall the Illinois Health Maintenance
500	500	23 Organization Guaranty Association be liable to pay any
501	501	24 contractual obligation of an insolvent organization to pay any
502	502	25 refund authorized under this Section.
503	503	26 (g) Rulemaking authority to implement Public Act 95-1045,
504	504
505	505
506	506
507	507
508	508
509	509	SB1687 - 13 - LRB104 08886 BAB 18941 b
510	510
511	511
512	512	SB1687- 14 -LRB104 08886 BAB 18941 b SB1687 - 14 - LRB104 08886 BAB 18941 b
513	513	SB1687 - 14 - LRB104 08886 BAB 18941 b
514	514	1 if any, is conditioned on the rules being adopted in
515	515	2 accordance with all provisions of the Illinois Administrative
516	516	3 Procedure Act and all rules and procedures of the Joint
517	517	4 Committee on Administrative Rules; any purported rule not so
518	518	5 adopted, for whatever reason, is unauthorized.
519	519	6 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
520	520	7 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
521	521	8 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
522	522	9 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
523	523	10 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
524	524	11 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
525	525	12 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
526	526	13 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
527	527	14 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
528	528	15 eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24;
529	529	16 103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff.
530	530	17 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751,
531	531	18 eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25;
532	532	19 103-777, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918, eff.
533	533	20 1-1-25; 103-1024, eff. 1-1-25; revised 9-26-24.)
534	534	21 (Text of Section after amendment by P.A. 103-808)
535	535	22 Sec. 5-3. Insurance Code provisions.
536	536	23 (a) Health Maintenance Organizations shall be subject to
537	537	24 the provisions of Sections 133, 134, 136, 137, 139, 140,
538	538	25 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
539	539
540	540
541	541
542	542
543	543
544	544	SB1687 - 14 - LRB104 08886 BAB 18941 b
545	545
546	546
547	547	SB1687- 15 -LRB104 08886 BAB 18941 b SB1687 - 15 - LRB104 08886 BAB 18941 b
548	548	SB1687 - 15 - LRB104 08886 BAB 18941 b
549	549	1 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
550	550	2 155.49, 352c, 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g,
551	551	3 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
552	552	4 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
553	553	5 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
554	554	6 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
555	555	7 356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
556	556	8 356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
557	557	9 356z.40, 356z.40a, 356z.40b, 356z.41, 356z.44, 356z.45,
558	558	10 356z.46, 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53,
559	559	11 356z.54, 356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60,
560	560	12 356z.61, 356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67,
561	561	13 356z.68, 356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74,
562	562	14 356z.75, 356z.77, 364, 364.01, 364.3, 367.2, 367.2-5, 367i,
563	563	15 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402,
564	564	16 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c)
565	565	17 of subsection (2) of Section 367, and Articles IIA, VIII 1/2,
566	566	18 XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the
567	567	19 Illinois Insurance Code.
568	568	20 (b) For purposes of the Illinois Insurance Code, except
569	569	21 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
570	570	22 Health Maintenance Organizations in the following categories
571	571	23 are deemed to be "domestic companies":
572	572	24 (1) a corporation authorized under the Dental Service
573	573	25 Plan Act or the Voluntary Health Services Plans Act;
574	574	26 (2) a corporation organized under the laws of this
575	575
576	576
577	577
578	578
579	579
580	580	SB1687 - 15 - LRB104 08886 BAB 18941 b
581	581
582	582
583	583	SB1687- 16 -LRB104 08886 BAB 18941 b SB1687 - 16 - LRB104 08886 BAB 18941 b
584	584	SB1687 - 16 - LRB104 08886 BAB 18941 b
585	585	1 State; or
586	586	2 (3) a corporation organized under the laws of another
587	587	3 state, 30% or more of the enrollees of which are residents
588	588	4 of this State, except a corporation subject to
589	589	5 substantially the same requirements in its state of
590	590	6 organization as is a "domestic company" under Article VIII
591	591	7 1/2 of the Illinois Insurance Code.
592	592	8 (c) In considering the merger, consolidation, or other
593	593	9 acquisition of control of a Health Maintenance Organization
594	594	10 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
595	595	11 (1) the Director shall give primary consideration to
596	596	12 the continuation of benefits to enrollees and the
597	597	13 financial conditions of the acquired Health Maintenance
598	598	14 Organization after the merger, consolidation, or other
599	599	15 acquisition of control takes effect;
600	600	16 (2)(i) the criteria specified in subsection (1)(b) of
601	601	17 Section 131.8 of the Illinois Insurance Code shall not
602	602	18 apply and (ii) the Director, in making his determination
603	603	19 with respect to the merger, consolidation, or other
604	604	20 acquisition of control, need not take into account the
605	605	21 effect on competition of the merger, consolidation, or
606	606	22 other acquisition of control;
607	607	23 (3) the Director shall have the power to require the
608	608	24 following information:
609	609	25 (A) certification by an independent actuary of the
610	610	26 adequacy of the reserves of the Health Maintenance
611	611
612	612
613	613
614	614
615	615
616	616	SB1687 - 16 - LRB104 08886 BAB 18941 b
617	617
618	618
619	619	SB1687- 17 -LRB104 08886 BAB 18941 b SB1687 - 17 - LRB104 08886 BAB 18941 b
620	620	SB1687 - 17 - LRB104 08886 BAB 18941 b
621	621	1 Organization sought to be acquired;
622	622	2 (B) pro forma financial statements reflecting the
623	623	3 combined balance sheets of the acquiring company and
624	624	4 the Health Maintenance Organization sought to be
625	625	5 acquired as of the end of the preceding year and as of
626	626	6 a date 90 days prior to the acquisition, as well as pro
627	627	7 forma financial statements reflecting projected
628	628	8 combined operation for a period of 2 years;
629	629	9 (C) a pro forma business plan detailing an
630	630	10 acquiring party's plans with respect to the operation
631	631	11 of the Health Maintenance Organization sought to be
632	632	12 acquired for a period of not less than 3 years; and
633	633	13 (D) such other information as the Director shall
634	634	14 require.
635	635	15 (d) The provisions of Article VIII 1/2 of the Illinois
636	636	16 Insurance Code and this Section 5-3 shall apply to the sale by
637	637	17 any health maintenance organization of greater than 10% of its
638	638	18 enrollee population (including, without limitation, the health
639	639	19 maintenance organization's right, title, and interest in and
640	640	20 to its health care certificates).
641	641	21 (e) In considering any management contract or service
642	642	22 agreement subject to Section 141.1 of the Illinois Insurance
643	643	23 Code, the Director (i) shall, in addition to the criteria
644	644	24 specified in Section 141.2 of the Illinois Insurance Code,
645	645	25 take into account the effect of the management contract or
646	646	26 service agreement on the continuation of benefits to enrollees
647	647
648	648
649	649
650	650
651	651
652	652	SB1687 - 17 - LRB104 08886 BAB 18941 b
653	653
654	654
655	655	SB1687- 18 -LRB104 08886 BAB 18941 b SB1687 - 18 - LRB104 08886 BAB 18941 b
656	656	SB1687 - 18 - LRB104 08886 BAB 18941 b
657	657	1 and the financial condition of the health maintenance
658	658	2 organization to be managed or serviced, and (ii) need not take
659	659	3 into account the effect of the management contract or service
660	660	4 agreement on competition.
661	661	5 (f) Except for small employer groups as defined in the
662	662	6 Small Employer Rating, Renewability and Portability Health
663	663	7 Insurance Act and except for medicare supplement policies as
664	664	8 defined in Section 363 of the Illinois Insurance Code, a
665	665	9 Health Maintenance Organization may by contract agree with a
666	666	10 group or other enrollment unit to effect refunds or charge
667	667	11 additional premiums under the following terms and conditions:
668	668	12 (i) the amount of, and other terms and conditions with
669	669	13 respect to, the refund or additional premium are set forth
670	670	14 in the group or enrollment unit contract agreed in advance
671	671	15 of the period for which a refund is to be paid or
672	672	16 additional premium is to be charged (which period shall
673	673	17 not be less than one year); and
674	674	18 (ii) the amount of the refund or additional premium
675	675	19 shall not exceed 20% of the Health Maintenance
676	676	20 Organization's profitable or unprofitable experience with
677	677	21 respect to the group or other enrollment unit for the
678	678	22 period (and, for purposes of a refund or additional
679	679	23 premium, the profitable or unprofitable experience shall
680	680	24 be calculated taking into account a pro rata share of the
681	681	25 Health Maintenance Organization's administrative and
682	682	26 marketing expenses, but shall not include any refund to be
683	683
684	684
685	685
686	686
687	687
688	688	SB1687 - 18 - LRB104 08886 BAB 18941 b
689	689
690	690
691	691	SB1687- 19 -LRB104 08886 BAB 18941 b SB1687 - 19 - LRB104 08886 BAB 18941 b
692	692	SB1687 - 19 - LRB104 08886 BAB 18941 b
693	693	1 made or additional premium to be paid pursuant to this
694	694	2 subsection (f)). The Health Maintenance Organization and
695	695	3 the group or enrollment unit may agree that the profitable
696	696	4 or unprofitable experience may be calculated taking into
697	697	5 account the refund period and the immediately preceding 2
698	698	6 plan years.
699	699	7 The Health Maintenance Organization shall include a
700	700	8 statement in the evidence of coverage issued to each enrollee
701	701	9 describing the possibility of a refund or additional premium,
702	702	10 and upon request of any group or enrollment unit, provide to
703	703	11 the group or enrollment unit a description of the method used
704	704	12 to calculate (1) the Health Maintenance Organization's
705	705	13 profitable experience with respect to the group or enrollment
706	706	14 unit and the resulting refund to the group or enrollment unit
707	707	15 or (2) the Health Maintenance Organization's unprofitable
708	708	16 experience with respect to the group or enrollment unit and
709	709	17 the resulting additional premium to be paid by the group or
710	710	18 enrollment unit.
711	711	19 In no event shall the Illinois Health Maintenance
712	712	20 Organization Guaranty Association be liable to pay any
713	713	21 contractual obligation of an insolvent organization to pay any
714	714	22 refund authorized under this Section.
715	715	23 (g) Rulemaking authority to implement Public Act 95-1045,
716	716	24 if any, is conditioned on the rules being adopted in
717	717	25 accordance with all provisions of the Illinois Administrative
718	718	26 Procedure Act and all rules and procedures of the Joint
719	719
720	720
721	721
722	722
723	723
724	724	SB1687 - 19 - LRB104 08886 BAB 18941 b
725	725
726	726
727	727	SB1687- 20 -LRB104 08886 BAB 18941 b SB1687 - 20 - LRB104 08886 BAB 18941 b
728	728	SB1687 - 20 - LRB104 08886 BAB 18941 b
729	729	1 Committee on Administrative Rules; any purported rule not so
730	730	2 adopted, for whatever reason, is unauthorized.
731	731	3 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
732	732	4 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
733	733	5 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
734	734	6 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
735	735	7 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
736	736	8 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
737	737	9 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
738	738	10 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
739	739	11 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
740	740	12 eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24;
741	741	13 103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff.
742	742	14 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751,
743	743	15 eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25;
744	744	16 103-777, eff. 8-2-24; 103-808, eff. 1-1-26; 103-914, eff.
745	745	17 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; revised
746	746	18 11-26-24.)
747	747	19 Section 35. The Limited Health Service Organization Act is
748	748	20 amended by changing Section 4003 as follows:
749	749	21 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
750	750	22 Sec. 4003. Illinois Insurance Code provisions. Limited
751	751	23 health service organizations shall be subject to the
752	752	24 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
753	753
754	754
755	755
756	756
757	757
758	758	SB1687 - 20 - LRB104 08886 BAB 18941 b
759	759
760	760
761	761	SB1687- 21 -LRB104 08886 BAB 18941 b SB1687 - 21 - LRB104 08886 BAB 18941 b
762	762	SB1687 - 21 - LRB104 08886 BAB 18941 b
763	763	1 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
764	764	2 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
765	765	3 355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
766	766	4 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
767	767	5 356z.33, 356z.40b, 356z.41, 356z.46, 356z.47, 356z.51,
768	768	6 356z.53, 356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67,
769	769	7 356z.68, 356z.71, 356z.73, 356z.74, 356z.75, 364.3, 368a, 401,
770	770	8 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and
771	771	9 Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and
772	772	10 XXVI of the Illinois Insurance Code. Nothing in this Section
773	773	11 shall require a limited health care plan to cover any service
774	774	12 that is not a limited health service. For purposes of the
775	775	13 Illinois Insurance Code, except for Sections 444 and 444.1 and
776	776	14 Articles XIII and XIII 1/2, limited health service
777	777	15 organizations in the following categories are deemed to be
778	778	16 domestic companies:
779	779	17 (1) a corporation under the laws of this State; or
780	780	18 (2) a corporation organized under the laws of another
781	781	19 state, 30% or more of the enrollees of which are residents
782	782	20 of this State, except a corporation subject to
783	783	21 substantially the same requirements in its state of
784	784	22 organization as is a domestic company under Article VIII
785	785	23 1/2 of the Illinois Insurance Code.
786	786	24 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
787	787	25 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff.
788	788	26 1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816,
789	789
790	790
791	791
792	792
793	793
794	794	SB1687 - 21 - LRB104 08886 BAB 18941 b
795	795
796	796
797	797	SB1687- 22 -LRB104 08886 BAB 18941 b SB1687 - 22 - LRB104 08886 BAB 18941 b
798	798	SB1687 - 22 - LRB104 08886 BAB 18941 b
799	799	1 eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
800	800	2 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
801	801	3 1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
802	802	4 eff. 1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25;
803	803	5 103-656, eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff.
804	804	6 7-19-24; 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832,
805	805	7 eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
806	806	8 Section 40. The Voluntary Health Services Plans Act is
807	807	9 amended by changing Section 10 as follows:
808	808	10 (215 ILCS 165/10) (from Ch. 32, par. 604)
809	809	11 Sec. 10. Application of Insurance Code provisions. Health
810	810	12 services plan corporations and all persons interested therein
811	811	13 or dealing therewith shall be subject to the provisions of
812	812	14 Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
813	813	15 143, 143.31, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3,
814	814	16 355b, 355d, 356g, 356g.5, 356g.5-1, 356m, 356q, 356r, 356t,
815	815	17 356u, 356u.10, 356v, 356w, 356x, 356y, 356z.1, 356z.2,
816	816	18 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
817	817	19 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.18,
818	818	20 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
819	819	21 356z.32, 356z.32a, 356z.33, 356z.40, 356z.40b, 356z.41,
820	820	22 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 356z.57,
821	821	23 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68,
822	822	24 356z.71, 356z.72, 356z.74, 356z.75, 356z.77, 364.01, 364.3,
823	823
824	824
825	825
826	826
827	827
828	828	SB1687 - 22 - LRB104 08886 BAB 18941 b
829	829
830	830
831	831	SB1687- 23 -LRB104 08886 BAB 18941 b SB1687 - 23 - LRB104 08886 BAB 18941 b
832	832	SB1687 - 23 - LRB104 08886 BAB 18941 b
833	833	1 367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
834	834	2 and paragraphs (7) and (15) of Section 367 of the Illinois
835	835	3 Insurance Code.
836	836	4 Rulemaking authority to implement Public Act 95-1045, if
837	837	5 any, is conditioned on the rules being adopted in accordance
838	838	6 with all provisions of the Illinois Administrative Procedure
839	839	7 Act and all rules and procedures of the Joint Committee on
840	840	8 Administrative Rules; any purported rule not so adopted, for
841	841	9 whatever reason, is unauthorized.
842	842	10 (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
843	843	11 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff.
844	844	12 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804,
845	845	13 eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
846	846	14 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff.
847	847	15 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
848	848	16 eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
849	849	17 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-656, eff.
850	850	18 1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
851	851	19 eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. 1-1-25;
852	852	20 103-914, eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff.
853	853	21 1-1-25; revised 11-26-24.)
854	854	22 Section 45. The Illinois Public Aid Code is amended by
855	855	23 changing Section 5-16.8 as follows:
856	856	24 (305 ILCS 5/5-16.8)
857	857
858	858
859	859
860	860
861	861
862	862	SB1687 - 23 - LRB104 08886 BAB 18941 b
863	863
864	864
865	865	SB1687- 24 -LRB104 08886 BAB 18941 b SB1687 - 24 - LRB104 08886 BAB 18941 b
866	866	SB1687 - 24 - LRB104 08886 BAB 18941 b
867	867	1 Sec. 5-16.8. Required health benefits. The medical
868	868	2 assistance program shall (i) provide the post-mastectomy care
869	869	3 benefits required to be covered by a policy of accident and
870	870	4 health insurance under Section 356t and the coverage required
871	871	5 under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
872	872	6 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35,
873	873	7 356z.40b, 356z.46, 356z.47, 356z.51, 356z.53, 356z.59,
874	874	8 356z.60, 356z.61, 356z.64, and 356z.67, and 356z.71, and
875	875	9 356z.75 of the Illinois Insurance Code, (ii) be subject to the
876	876	10 provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
877	877	11 370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
878	878	12 subject to the provisions of subsection (d-5) of Section 10 of
879	879	13 the Network Adequacy and Transparency Act.
880	880	14 The Department, by rule, shall adopt a model similar to
881	881	15 the requirements of Section 356z.39 of the Illinois Insurance
882	882	16 Code.
883	883	17 On and after July 1, 2012, the Department shall reduce any
884	884	18 rate of reimbursement for services or other payments or alter
885	885	19 any methodologies authorized by this Code to reduce any rate
886	886	20 of reimbursement for services or other payments in accordance
887	887	21 with Section 5-5e.
888	888	22 To ensure full access to the benefits set forth in this
889	889	23 Section, on and after January 1, 2016, the Department shall
890	890	24 ensure that provider and hospital reimbursement for
891	891	25 post-mastectomy care benefits required under this Section are
892	892	26 no lower than the Medicare reimbursement rate.
893	893
894	894
895	895
896	896
897	897
898	898	SB1687 - 24 - LRB104 08886 BAB 18941 b
899	899
900	900
901	901	SB1687- 25 -LRB104 08886 BAB 18941 b SB1687 - 25 - LRB104 08886 BAB 18941 b
902	902	SB1687 - 25 - LRB104 08886 BAB 18941 b
903	903	1 (Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22;
904	904	2 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff.
905	905	3 1-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813,
906	906	4 eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23;
907	907	5 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
908	908	6 1-1-24; 103-420, eff. 1-1-24; 103-605, eff. 7-1-24; 103-703,
909	909	7 eff. 1-1-25; 103-758, eff. 1-1-25; 103-1024, eff. 1-1-25;
910	910	8 revised 11-26-24.)
911	911
912	912
913	913
914	914
915	915
916	916	SB1687 - 25 - LRB104 08886 BAB 18941 b