Illinois 2025-2026 Regular Session

Illinois Senate Bill SB2353 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 SB2353 Introduced 2/7/2025, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED: 215 ILCS 5/370c.1 Amends the Illinois Insurance Code. In a provision concerning coverage for the treatment of mental, emotional, nervous, or substance use disorders or conditions, requires certain insurers to ensure, prior to policy issuance, that there is no limit on the number of visits per week for outpatient mental health treatment. LRB104 10556 BAB 20632 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB2353 Introduced 2/7/2025, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED: 215 ILCS 5/370c.1 215 ILCS 5/370c.1 Amends the Illinois Insurance Code. In a provision concerning coverage for the treatment of mental, emotional, nervous, or substance use disorders or conditions, requires certain insurers to ensure, prior to policy issuance, that there is no limit on the number of visits per week for outpatient mental health treatment. LRB104 10556 BAB 20632 b LRB104 10556 BAB 20632 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB2353 Introduced 2/7/2025, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED:
3	3	215 ILCS 5/370c.1 215 ILCS 5/370c.1
4	4	215 ILCS 5/370c.1
5	5	Amends the Illinois Insurance Code. In a provision concerning coverage for the treatment of mental, emotional, nervous, or substance use disorders or conditions, requires certain insurers to ensure, prior to policy issuance, that there is no limit on the number of visits per week for outpatient mental health treatment.
6	6	LRB104 10556 BAB 20632 b LRB104 10556 BAB 20632 b
7	7	LRB104 10556 BAB 20632 b
8	8	A BILL FOR
9	9	SB2353LRB104 10556 BAB 20632 b SB2353 LRB104 10556 BAB 20632 b
10	10	SB2353 LRB104 10556 BAB 20632 b
11	11	1 AN ACT concerning regulation.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Illinois Insurance Code is amended by
15	15	5 changing Section 370c.1 as follows:
16	16	6 (215 ILCS 5/370c.1)
17	17	7 Sec. 370c.1. Mental, emotional, nervous, or substance use
18	18	8 disorder or condition parity.
19	19	9 (a) On and after July 23, 2021 (the effective date of
20	20	10 Public Act 102-135), every insurer that amends, delivers,
21	21	11 issues, or renews a group or individual policy of accident and
22	22	12 health insurance or a qualified health plan offered through
23	23	13 the Health Insurance Marketplace in this State providing
24	24	14 coverage for hospital or medical treatment and for the
25	25	15 treatment of mental, emotional, nervous, or substance use
26	26	16 disorders or conditions shall ensure prior to policy issuance
27	27	17 that:
28	28	18 (1) the financial requirements applicable to such
29	29	19 mental, emotional, nervous, or substance use disorder or
30	30	20 condition benefits are no more restrictive than the
31	31	21 predominant financial requirements applied to
32	32	22 substantially all hospital and medical benefits covered by
33	33	23 the policy and that there are no separate cost-sharing
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37	37	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB2353 Introduced 2/7/2025, by Sen. Mike Simmons SYNOPSIS AS INTRODUCED:
38	38	215 ILCS 5/370c.1 215 ILCS 5/370c.1
39	39	215 ILCS 5/370c.1
40	40	Amends the Illinois Insurance Code. In a provision concerning coverage for the treatment of mental, emotional, nervous, or substance use disorders or conditions, requires certain insurers to ensure, prior to policy issuance, that there is no limit on the number of visits per week for outpatient mental health treatment.
41	41	LRB104 10556 BAB 20632 b LRB104 10556 BAB 20632 b
42	42	LRB104 10556 BAB 20632 b
43	43	A BILL FOR
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49	49	215 ILCS 5/370c.1
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68	68	1 requirements that are applicable only with respect to
69	69	2 mental, emotional, nervous, or substance use disorder or
70	70	3 condition benefits; and
71	71	4 (2) the treatment limitations applicable to such
72	72	5 mental, emotional, nervous, or substance use disorder or
73	73	6 condition benefits are no more restrictive than the
74	74	7 predominant treatment limitations applied to substantially
75	75	8 all hospital and medical benefits covered by the policy
76	76	9 and that there are no separate treatment limitations that
77	77	10 are applicable only with respect to mental, emotional,
78	78	11 nervous, or substance use disorder or condition benefits;
79	79	12 and .
80	80	13 (3) there is no limit on the number of visits per week
81	81	14 for outpatient mental health treatment.
82	82	15 (b) The following provisions shall apply concerning
83	83	16 aggregate lifetime limits:
84	84	17 (1) In the case of a group or individual policy of
85	85	18 accident and health insurance or a qualified health plan
86	86	19 offered through the Health Insurance Marketplace amended,
87	87	20 delivered, issued, or renewed in this State on or after
88	88	21 September 9, 2015 (the effective date of Public Act
89	89	22 99-480) that provides coverage for hospital or medical
90	90	23 treatment and for the treatment of mental, emotional,
91	91	24 nervous, or substance use disorders or conditions the
92	92	25 following provisions shall apply:
93	93	26 (A) if the policy does not include an aggregate
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104	104	1 lifetime limit on substantially all hospital and
105	105	2 medical benefits, then the policy may not impose any
106	106	3 aggregate lifetime limit on mental, emotional,
107	107	4 nervous, or substance use disorder or condition
108	108	5 benefits; or
109	109	6 (B) if the policy includes an aggregate lifetime
110	110	7 limit on substantially all hospital and medical
111	111	8 benefits (in this subsection referred to as the
112	112	9 "applicable lifetime limit"), then the policy shall
113	113	10 either:
114	114	11 (i) apply the applicable lifetime limit both
115	115	12 to the hospital and medical benefits to which it
116	116	13 otherwise would apply and to mental, emotional,
117	117	14 nervous, or substance use disorder or condition
118	118	15 benefits and not distinguish in the application of
119	119	16 the limit between the hospital and medical
120	120	17 benefits and mental, emotional, nervous, or
121	121	18 substance use disorder or condition benefits; or
122	122	19 (ii) not include any aggregate lifetime limit
123	123	20 on mental, emotional, nervous, or substance use
124	124	21 disorder or condition benefits that is less than
125	125	22 the applicable lifetime limit.
126	126	23 (2) In the case of a policy that is not described in
127	127	24 paragraph (1) of subsection (b) of this Section and that
128	128	25 includes no or different aggregate lifetime limits on
129	129	26 different categories of hospital and medical benefits, the
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140	140	1 Director shall establish rules under which subparagraph
141	141	2 (B) of paragraph (1) of subsection (b) of this Section is
142	142	3 applied to such policy with respect to mental, emotional,
143	143	4 nervous, or substance use disorder or condition benefits
144	144	5 by substituting for the applicable lifetime limit an
145	145	6 average aggregate lifetime limit that is computed taking
146	146	7 into account the weighted average of the aggregate
147	147	8 lifetime limits applicable to such categories.
148	148	9 (c) The following provisions shall apply concerning annual
149	149	10 limits:
150	150	11 (1) In the case of a group or individual policy of
151	151	12 accident and health insurance or a qualified health plan
152	152	13 offered through the Health Insurance Marketplace amended,
153	153	14 delivered, issued, or renewed in this State on or after
154	154	15 September 9, 2015 (the effective date of Public Act
155	155	16 99-480) that provides coverage for hospital or medical
156	156	17 treatment and for the treatment of mental, emotional,
157	157	18 nervous, or substance use disorders or conditions the
158	158	19 following provisions shall apply:
159	159	20 (A) if the policy does not include an annual limit
160	160	21 on substantially all hospital and medical benefits,
161	161	22 then the policy may not impose any annual limits on
162	162	23 mental, emotional, nervous, or substance use disorder
163	163	24 or condition benefits; or
164	164	25 (B) if the policy includes an annual limit on
165	165	26 substantially all hospital and medical benefits (in
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176	176	1 this subsection referred to as the "applicable annual
177	177	2 limit"), then the policy shall either:
178	178	3 (i) apply the applicable annual limit both to
179	179	4 the hospital and medical benefits to which it
180	180	5 otherwise would apply and to mental, emotional,
181	181	6 nervous, or substance use disorder or condition
182	182	7 benefits and not distinguish in the application of
183	183	8 the limit between the hospital and medical
184	184	9 benefits and mental, emotional, nervous, or
185	185	10 substance use disorder or condition benefits; or
186	186	11 (ii) not include any annual limit on mental,
187	187	12 emotional, nervous, or substance use disorder or
188	188	13 condition benefits that is less than the
189	189	14 applicable annual limit.
190	190	15 (2) In the case of a policy that is not described in
191	191	16 paragraph (1) of subsection (c) of this Section and that
192	192	17 includes no or different annual limits on different
193	193	18 categories of hospital and medical benefits, the Director
194	194	19 shall establish rules under which subparagraph (B) of
195	195	20 paragraph (1) of subsection (c) of this Section is applied
196	196	21 to such policy with respect to mental, emotional, nervous,
197	197	22 or substance use disorder or condition benefits by
198	198	23 substituting for the applicable annual limit an average
199	199	24 annual limit that is computed taking into account the
200	200	25 weighted average of the annual limits applicable to such
201	201	26 categories.
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212	212	1 (d) With respect to mental, emotional, nervous, or
213	213	2 substance use disorders or conditions, an insurer shall use
214	214	3 policies and procedures for the election and placement of
215	215	4 mental, emotional, nervous, or substance use disorder or
216	216	5 condition treatment drugs on their formulary that are no less
217	217	6 favorable to the insured as those policies and procedures the
218	218	7 insurer uses for the selection and placement of drugs for
219	219	8 medical or surgical conditions and shall follow the expedited
220	220	9 coverage determination requirements for substance abuse
221	221	10 treatment drugs set forth in Section 45.2 of the Managed Care
222	222	11 Reform and Patient Rights Act.
223	223	12 (e) This Section shall be interpreted in a manner
224	224	13 consistent with all applicable federal parity regulations
225	225	14 including, but not limited to, the Paul Wellstone and Pete
226	226	15 Domenici Mental Health Parity and Addiction Equity Act of
227	227	16 2008, final regulations issued under the Paul Wellstone and
228	228	17 Pete Domenici Mental Health Parity and Addiction Equity Act of
229	229	18 2008 and final regulations applying the Paul Wellstone and
230	230	19 Pete Domenici Mental Health Parity and Addiction Equity Act of
231	231	20 2008 to Medicaid managed care organizations, the Children's
232	232	21 Health Insurance Program, and alternative benefit plans.
233	233	22 (f) The provisions of subsections (b) and (c) of this
234	234	23 Section shall not be interpreted to allow the use of lifetime
235	235	24 or annual limits otherwise prohibited by State or federal law.
236	236	25 (g) As used in this Section:
237	237	26 "Financial requirement" includes deductibles, copayments,
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248	248	1 coinsurance, and out-of-pocket maximums, but does not include
249	249	2 an aggregate lifetime limit or an annual limit subject to
250	250	3 subsections (b) and (c).
251	251	4 "Mental, emotional, nervous, or substance use disorder or
252	252	5 condition" means a condition or disorder that involves a
253	253	6 mental health condition or substance use disorder that falls
254	254	7 under any of the diagnostic categories listed in the mental
255	255	8 and behavioral disorders chapter of the current edition of the
256	256	9 International Classification of Disease or that is listed in
257	257	10 the most recent version of the Diagnostic and Statistical
258	258	11 Manual of Mental Disorders.
259	259	12 "Treatment limitation" includes limits on benefits based
260	260	13 on the frequency of treatment, number of visits, days of
261	261	14 coverage, days in a waiting period, or other similar limits on
262	262	15 the scope or duration of treatment. "Treatment limitation"
263	263	16 includes both quantitative treatment limitations, which are
264	264	17 expressed numerically (such as 50 outpatient visits per year),
265	265	18 and nonquantitative treatment limitations, which otherwise
266	266	19 limit the scope or duration of treatment. A permanent
267	267	20 exclusion of all benefits for a particular condition or
268	268	21 disorder shall not be considered a treatment limitation.
269	269	22 "Nonquantitative treatment" means those limitations as
270	270	23 described under federal regulations (26 CFR 54.9812-1).
271	271	24 "Nonquantitative treatment limitations" include, but are not
272	272	25 limited to, those limitations described under federal
273	273	26 regulations 26 CFR 54.9812-1, 29 CFR 2590.712, and 45 CFR
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284	284	1 146.136.
285	285	2 (h) The Department of Insurance shall implement the
286	286	3 following education initiatives:
287	287	4 (1) By January 1, 2016, the Department shall develop a
288	288	5 plan for a Consumer Education Campaign on parity. The
289	289	6 Consumer Education Campaign shall focus its efforts
290	290	7 throughout the State and include trainings in the
291	291	8 northern, southern, and central regions of the State, as
292	292	9 defined by the Department, as well as each of the 5 managed
293	293	10 care regions of the State as identified by the Department
294	294	11 of Healthcare and Family Services. Under this Consumer
295	295	12 Education Campaign, the Department shall: (1) by January
296	296	13 1, 2017, provide at least one live training in each region
297	297	14 on parity for consumers and providers and one webinar
298	298	15 training to be posted on the Department website and (2)
299	299	16 establish a consumer hotline to assist consumers in
300	300	17 navigating the parity process by March 1, 2017. By January
301	301	18 1, 2018 the Department shall issue a report to the General
302	302	19 Assembly on the success of the Consumer Education
303	303	20 Campaign, which shall indicate whether additional training
304	304	21 is necessary or would be recommended.
305	305	22 (2) The Department, in coordination with the
306	306	23 Department of Human Services and the Department of
307	307	24 Healthcare and Family Services, shall convene a working
308	308	25 group of health care insurance carriers, mental health
309	309	26 advocacy groups, substance abuse patient advocacy groups,
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320	320	1 and mental health physician groups for the purpose of
321	321	2 discussing issues related to the treatment and coverage of
322	322	3 mental, emotional, nervous, or substance use disorders or
323	323	4 conditions and compliance with parity obligations under
324	324	5 State and federal law. Compliance shall be measured,
325	325	6 tracked, and shared during the meetings of the working
326	326	7 group. The working group shall meet once before January 1,
327	327	8 2016 and shall meet semiannually thereafter. The
328	328	9 Department shall issue an annual report to the General
329	329	10 Assembly that includes a list of the health care insurance
330	330	11 carriers, mental health advocacy groups, substance abuse
331	331	12 patient advocacy groups, and mental health physician
332	332	13 groups that participated in the working group meetings,
333	333	14 details on the issues and topics covered, and any
334	334	15 legislative recommendations developed by the working
335	335	16 group.
336	336	17 (3) Not later than January 1 of each year, the
337	337	18 Department, in conjunction with the Department of
338	338	19 Healthcare and Family Services, shall issue a joint report
339	339	20 to the General Assembly and provide an educational
340	340	21 presentation to the General Assembly. The report and
341	341	22 presentation shall:
342	342	23 (A) Cover the methodology the Departments use to
343	343	24 check for compliance with the federal Paul Wellstone
344	344	25 and Pete Domenici Mental Health Parity and Addiction
345	345	26 Equity Act of 2008, 42 U.S.C. 18031(j), and any
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356	356	1 federal regulations or guidance relating to the
357	357	2 compliance and oversight of the federal Paul Wellstone
358	358	3 and Pete Domenici Mental Health Parity and Addiction
359	359	4 Equity Act of 2008 and 42 U.S.C. 18031(j).
360	360	5 (B) Cover the methodology the Departments use to
361	361	6 check for compliance with this Section and Sections
362	362	7 356z.23 and 370c of this Code.
363	363	8 (C) Identify market conduct examinations or, in
364	364	9 the case of the Department of Healthcare and Family
365	365	10 Services, audits conducted or completed during the
366	366	11 preceding 12-month period regarding compliance with
367	367	12 parity in mental, emotional, nervous, and substance
368	368	13 use disorder or condition benefits under State and
369	369	14 federal laws and summarize the results of such market
370	370	15 conduct examinations and audits. This shall include:
371	371	16 (i) the number of market conduct examinations
372	372	17 and audits initiated and completed;
373	373	18 (ii) the benefit classifications examined by
374	374	19 each market conduct examination and audit;
375	375	20 (iii) the subject matter of each market
376	376	21 conduct examination and audit, including
377	377	22 quantitative and nonquantitative treatment
378	378	23 limitations; and
379	379	24 (iv) a summary of the basis for the final
380	380	25 decision rendered in each market conduct
381	381	26 examination and audit.
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392	392	1 Individually identifiable information shall be
393	393	2 excluded from the reports consistent with federal
394	394	3 privacy protections.
395	395	4 (D) Detail any educational or corrective actions
396	396	5 the Departments have taken to ensure compliance with
397	397	6 the federal Paul Wellstone and Pete Domenici Mental
398	398	7 Health Parity and Addiction Equity Act of 2008, 42
399	399	8 U.S.C. 18031(j), this Section, and Sections 356z.23
400	400	9 and 370c of this Code.
401	401	10 (E) The report must be written in non-technical,
402	402	11 readily understandable language and shall be made
403	403	12 available to the public by, among such other means as
404	404	13 the Departments find appropriate, posting the report
405	405	14 on the Departments' websites.
406	406	15 (i) The Parity Advancement Fund is created as a special
407	407	16 fund in the State treasury. Moneys from fines and penalties
408	408	17 collected from insurers for violations of this Section shall
409	409	18 be deposited into the Fund. Moneys deposited into the Fund for
410	410	19 appropriation by the General Assembly to the Department shall
411	411	20 be used for the purpose of providing financial support of the
412	412	21 Consumer Education Campaign, parity compliance advocacy, and
413	413	22 other initiatives that support parity implementation and
414	414	23 enforcement on behalf of consumers.
415	415	24 (j) (Blank).
416	416	25 (j-5) The Department of Insurance shall collect the
417	417	26 following information:
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428	428	1 (1) The number of employment disability insurance
429	429	2 plans offered in this State, including, but not limited
430	430	3 to:
431	431	4 (A) individual short-term policies;
432	432	5 (B) individual long-term policies;
433	433	6 (C) group short-term policies; and
434	434	7 (D) group long-term policies.
435	435	8 (2) The number of policies referenced in paragraph (1)
436	436	9 of this subsection that limit mental health and substance
437	437	10 use disorder benefits.
438	438	11 (3) The average defined benefit period for the
439	439	12 policies referenced in paragraph (1) of this subsection,
440	440	13 both for those policies that limit and those policies that
441	441	14 have no limitation on mental health and substance use
442	442	15 disorder benefits.
443	443	16 (4) Whether the policies referenced in paragraph (1)
444	444	17 of this subsection are purchased on a voluntary or
445	445	18 non-voluntary basis.
446	446	19 (5) The identities of the individuals, entities, or a
447	447	20 combination of the 2 that assume the cost associated with
448	448	21 covering the policies referenced in paragraph (1) of this
449	449	22 subsection.
450	450	23 (6) The average defined benefit period for plans that
451	451	24 cover physical disability and mental health and substance
452	452	25 abuse without limitation, including, but not limited to:
453	453	26 (A) individual short-term policies;
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464	464	1 (B) individual long-term policies;
465	465	2 (C) group short-term policies; and
466	466	3 (D) group long-term policies.
467	467	4 (7) The average premiums for disability income
468	468	5 insurance issued in this State for:
469	469	6 (A) individual short-term policies that limit
470	470	7 mental health and substance use disorder benefits;
471	471	8 (B) individual long-term policies that limit
472	472	9 mental health and substance use disorder benefits;
473	473	10 (C) group short-term policies that limit mental
474	474	11 health and substance use disorder benefits;
475	475	12 (D) group long-term policies that limit mental
476	476	13 health and substance use disorder benefits;
477	477	14 (E) individual short-term policies that include
478	478	15 mental health and substance use disorder benefits
479	479	16 without limitation;
480	480	17 (F) individual long-term policies that include
481	481	18 mental health and substance use disorder benefits
482	482	19 without limitation;
483	483	20 (G) group short-term policies that include mental
484	484	21 health and substance use disorder benefits without
485	485	22 limitation; and
486	486	23 (H) group long-term policies that include mental
487	487	24 health and substance use disorder benefits without
488	488	25 limitation.
489	489	26 The Department shall present its findings regarding
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500	500	1 information collected under this subsection (j-5) to the
501	501	2 General Assembly no later than April 30, 2024. Information
502	502	3 regarding a specific insurance provider's contributions to the
503	503	4 Department's report shall be exempt from disclosure under
504	504	5 paragraph (t) of subsection (1) of Section 7 of the Freedom of
505	505	6 Information Act. The aggregated information gathered by the
506	506	7 Department shall not be exempt from disclosure under paragraph
507	507	8 (t) of subsection (1) of Section 7 of the Freedom of
508	508	9 Information Act.
509	509	10 (k) An insurer that amends, delivers, issues, or renews a
510	510	11 group or individual policy of accident and health insurance or
511	511	12 a qualified health plan offered through the health insurance
512	512	13 marketplace in this State providing coverage for hospital or
513	513	14 medical treatment and for the treatment of mental, emotional,
514	514	15 nervous, or substance use disorders or conditions shall submit
515	515	16 an annual report, the format and definitions for which will be
516	516	17 determined by the Department and the Department of Healthcare
517	517	18 and Family Services and posted on their respective websites,
518	518	19 starting on September 1, 2023 and annually thereafter, that
519	519	20 contains the following information separately for inpatient
520	520	21 in-network benefits, inpatient out-of-network benefits,
521	521	22 outpatient in-network benefits, outpatient out-of-network
522	522	23 benefits, emergency care benefits, and prescription drug
523	523	24 benefits in the case of accident and health insurance or
524	524	25 qualified health plans, or inpatient, outpatient, emergency
525	525	26 care, and prescription drug benefits in the case of medical
526	526
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536	536	1 assistance:
537	537	2 (1) A summary of the plan's pharmacy management
538	538	3 processes for mental, emotional, nervous, or substance use
539	539	4 disorder or condition benefits compared to those for other
540	540	5 medical benefits.
541	541	6 (2) A summary of the internal processes of review for
542	542	7 experimental benefits and unproven technology for mental,
543	543	8 emotional, nervous, or substance use disorder or condition
544	544	9 benefits and those for other medical benefits.
545	545	10 (3) A summary of how the plan's policies and
546	546	11 procedures for utilization management for mental,
547	547	12 emotional, nervous, or substance use disorder or condition
548	548	13 benefits compare to those for other medical benefits.
549	549	14 (4) A description of the process used to develop or
550	550	15 select the medical necessity criteria for mental,
551	551	16 emotional, nervous, or substance use disorder or condition
552	552	17 benefits and the process used to develop or select the
553	553	18 medical necessity criteria for medical and surgical
554	554	19 benefits.
555	555	20 (5) Identification of all nonquantitative treatment
556	556	21 limitations that are applied to both mental, emotional,
557	557	22 nervous, or substance use disorder or condition benefits
558	558	23 and medical and surgical benefits within each
559	559	24 classification of benefits.
560	560	25 (6) The results of an analysis that demonstrates that
561	561	26 for the medical necessity criteria described in
562	562
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572	572	1 subparagraph (A) and for each nonquantitative treatment
573	573	2 limitation identified in subparagraph (B), as written and
574	574	3 in operation, the processes, strategies, evidentiary
575	575	4 standards, or other factors used in applying the medical
576	576	5 necessity criteria and each nonquantitative treatment
577	577	6 limitation to mental, emotional, nervous, or substance use
578	578	7 disorder or condition benefits within each classification
579	579	8 of benefits are comparable to, and are applied no more
580	580	9 stringently than, the processes, strategies, evidentiary
581	581	10 standards, or other factors used in applying the medical
582	582	11 necessity criteria and each nonquantitative treatment
583	583	12 limitation to medical and surgical benefits within the
584	584	13 corresponding classification of benefits; at a minimum,
585	585	14 the results of the analysis shall:
586	586	15 (A) identify the factors used to determine that a
587	587	16 nonquantitative treatment limitation applies to a
588	588	17 benefit, including factors that were considered but
589	589	18 rejected;
590	590	19 (B) identify and define the specific evidentiary
591	591	20 standards used to define the factors and any other
592	592	21 evidence relied upon in designing each nonquantitative
593	593	22 treatment limitation;
594	594	23 (C) provide the comparative analyses, including
595	595	24 the results of the analyses, performed to determine
596	596	25 that the processes and strategies used to design each
597	597	26 nonquantitative treatment limitation, as written, for
598	598
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602	602
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608	608	1 mental, emotional, nervous, or substance use disorder
609	609	2 or condition benefits are comparable to, and are
610	610	3 applied no more stringently than, the processes and
611	611	4 strategies used to design each nonquantitative
612	612	5 treatment limitation, as written, for medical and
613	613	6 surgical benefits;
614	614	7 (D) provide the comparative analyses, including
615	615	8 the results of the analyses, performed to determine
616	616	9 that the processes and strategies used to apply each
617	617	10 nonquantitative treatment limitation, in operation,
618	618	11 for mental, emotional, nervous, or substance use
619	619	12 disorder or condition benefits are comparable to, and
620	620	13 applied no more stringently than, the processes or
621	621	14 strategies used to apply each nonquantitative
622	622	15 treatment limitation, in operation, for medical and
623	623	16 surgical benefits; and
624	624	17 (E) disclose the specific findings and conclusions
625	625	18 reached by the insurer that the results of the
626	626	19 analyses described in subparagraphs (C) and (D)
627	627	20 indicate that the insurer is in compliance with this
628	628	21 Section and the Mental Health Parity and Addiction
629	629	22 Equity Act of 2008 and its implementing regulations,
630	630	23 which includes 42 CFR Parts 438, 440, and 457 and 45
631	631	24 CFR 146.136 and any other related federal regulations
632	632	25 found in the Code of Federal Regulations.
633	633	26 (7) Any other information necessary to clarify data
634	634
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644	644	1 provided in accordance with this Section requested by the
645	645	2 Director, including information that may be proprietary or
646	646	3 have commercial value, under the requirements of Section
647	647	4 30 of the Viatical Settlements Act of 2009.
648	648	5 (l) An insurer that amends, delivers, issues, or renews a
649	649	6 group or individual policy of accident and health insurance or
650	650	7 a qualified health plan offered through the health insurance
651	651	8 marketplace in this State providing coverage for hospital or
652	652	9 medical treatment and for the treatment of mental, emotional,
653	653	10 nervous, or substance use disorders or conditions on or after
654	654	11 January 1, 2019 (the effective date of Public Act 100-1024)
655	655	12 shall, in advance of the plan year, make available to the
656	656	13 Department or, with respect to medical assistance, the
657	657	14 Department of Healthcare and Family Services and to all plan
658	658	15 participants and beneficiaries the information required in
659	659	16 subparagraphs (C) through (E) of paragraph (6) of subsection
660	660	17 (k). For plan participants and medical assistance
661	661	18 beneficiaries, the information required in subparagraphs (C)
662	662	19 through (E) of paragraph (6) of subsection (k) shall be made
663	663	20 available on a publicly available website whose web address is
664	664	21 prominently displayed in plan and managed care organization
665	665	22 informational and marketing materials.
666	666	23 (m) In conjunction with its compliance examination program
667	667	24 conducted in accordance with the Illinois State Auditing Act,
668	668	25 the Auditor General shall undertake a review of compliance by
669	669	26 the Department and the Department of Healthcare and Family
670	670
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