093_SB1389

 
                                     LRB093 10830 JLS 11286 b

 1        AN ACT concerning public employee health benefits.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The State Employees Group  Insurance  Act  of
 5    1971 is amended by adding Section 6.15 as follows:

 6        (5 ILCS 375/6.15 new)
 7        Sec. 6.15.  Morbid obesity.
 8        (a)  Beginning  on January 1, 2004, the program of health
 9    benefits must  provide  benefits  for  the  expenses  of  the
10    surgical  treatment  of  morbid  obesity  for  the  following
11    individuals:
12             (1)  individuals  with a body-mass index equal to or
13        greater than 40 kilograms per meter squared;
14             (2)  individuals with a body-mass index equal to  or
15        greater   than  35  kilograms  per  meter  squared,  with
16        comorbidities or coexisting medical conditions,  such  as
17        hypertension, cardiopulmonary conditions, sleep apnea, or
18        diabetes; and
19             (3)  individuals  who  meet  the  guidelines for the
20        surgical treatment of morbid obesity as set forth by  the
21        national institutes of health.
22        (b)  The  benefits  provided  under  subsection (a) shall
23    include  benefits  for  examinations  and  laboratory   tests
24    performed  in  accordance with the guidelines of the national
25    institutes of health for the  surgical  treatment  of  morbid
26    obesity.
27        (c)  The  benefits provided under subsection (a) shall be
28    no less extensive than those provided for any other medically
29    necessary surgical procedure  under  the  program  of  health
30    benefits   and  shall  be  subject  to  the  same  terms  and
31    conditions, including copayment charges.
 
                            -2-      LRB093 10830 JLS 11286 b
 1        Section 10.  The  Counties  Code  is  amended  by  adding
 2    Section 5-1069.9 as follows:

 3        (55 ILCS 5/5-1069.9 new)
 4        Sec. 5-1069.9.  Morbid obesity.
 5        (a)  If  a  county,  including  a  home rule county, is a
 6    self-insurer  for  purposes  of  providing  health  insurance
 7    coverage  for  its  employees,  the  coverage  must   provide
 8    benefits for the expenses of the surgical treatment of morbid
 9    obesity for the following individuals:
10             (1)  individuals  with a body-mass index equal to or
11        greater than 40 kilograms per meter squared;
12             (2)  individuals with a body-mass index equal to  or
13        greater   than  35  kilograms  per  meter  squared,  with
14        comorbidities or coexisting medical conditions,  such  as
15        hypertension, cardiopulmonary conditions, sleep apnea, or
16        diabetes; and
17             (3)  individuals  who  meet  the  guidelines for the
18        surgical treatment of morbid obesity as set forth by  the
19        national institutes of health.
20        (b)  The  benefits  provided  under  subsection (a) shall
21    include  benefits  for  examinations  and  laboratory   tests
22    performed  in  accordance with the guidelines of the national
23    institutes of health for the  surgical  treatment  of  morbid
24    obesity.
25        (c)  The  benefits provided under subsection (a) shall be
26    no less extensive than those provided for any other medically
27    necessary surgical procedure under the coverage and shall  be
28    subject to the same terms and conditions, including copayment
29    charges.
30        (d)  The  requirement  that health benefits be covered as
31    provided in this Section is an exclusive power  and  function
32    of  the  State  and  is a denial and limitation under Article
33    VII, Section 6, subsection (h) of the Illinois  Constitution.
 
                            -3-      LRB093 10830 JLS 11286 b
 1    A  home rule county to which this Section applies must comply
 2    with every provision of this Section.

 3        Section 15. The Illinois Municipal  Code  is  amended  by
 4    adding Section 10-4-2.6 as follows:

 5        (65 ILCS 5/10-4-2.6 new)
 6        Sec. 10-4-2.6.  Morbid obesity.
 7        (a)  If   a   municipality,   including   a   home   rule
 8    municipality,  is  a  self-insurer  for purposes of providing
 9    health insurance coverage for  its  employees,  the  coverage
10    must  provide  benefits  for  the  expenses  of  the surgical
11    treatment of morbid obesity for the following individuals:
12             (1)  individuals with a body-mass index equal to  or
13        greater than 40 kilograms per meter squared;
14             (2)  individuals  with a body-mass index equal to or
15        greater  than  35  kilograms  per  meter  squared,   with
16        comorbidities  or  coexisting medical conditions, such as
17        hypertension, cardiopulmonary conditions, sleep apnea, or
18        diabetes; and
19             (3)  individuals who meet  the  guidelines  for  the
20        surgical  treatment of morbid obesity as set forth by the
21        national institutes of health.
22        (b)  The benefits provided  under  subsection  (a)  shall
23    include   benefits  for  examinations  and  laboratory  tests
24    performed in accordance with the guidelines of  the  national
25    institutes  of  health  for  the surgical treatment of morbid
26    obesity.
27        (c)  The benefits provided under subsection (a) shall  be
28    no less extensive than those provided for any other medically
29    necessary  surgical procedure under the coverage and shall be
30    subject to the same terms and conditions, including copayment
31    charges.
32        (d)  The requirement that health benefits be  covered  as
 
                            -4-      LRB093 10830 JLS 11286 b
 1    provided  in  this Section is an exclusive power and function
 2    of the State and is a denial  and  limitation  under  Article
 3    VII,  Section 6, subsection (h) of the Illinois Constitution.
 4    A home rule municipality to which this Section  applies  must
 5    comply with every provision of this Section.

 6        Section  95.  The State Mandates Act is amended by adding
 7    Section 8.27 as follows:

 8        (30 ILCS 805/8.27 new)
 9        Sec. 8.27. Exempt mandate.   Notwithstanding  Sections  6
10    and  8 of this Act, no reimbursement by the State is required
11    for  the  implementation  of  any  mandate  created  by  this
12    amendatory Act of the 93rd General Assembly.