(215 ILCS 109/50)
(a) If an employer who has 25 or more employees and contributes 25% or more
to the cost of the dental benefit plan coverage to employees and the
only dental plan coverage being offered requires enrollees to select a
primary care provider (dentist) and has no out-of-plan covered services
option, the managed care dental plan with which the employer is
contracting for the coverage shall offer a dental point-of-service
("POS") option to the employee.
(b) An employer may require an employee who accepts the POS option to be
responsible for the payment of a premium over the amount of the premium for
the coverage provided to employees under the dental benefit plan offered
which requires enrollees to select a primary care provider (dentist) and has
no out-of-plan covered services option. The enrollee may pay any additional
premium either directly or by payroll deduction in the same manner in which
the other premium is paid. The premium for the POS option shall be as
established by the managed care dental plan using its underwriting
guidelines for establishing rates to be charged for products which it
(c) Different cost-sharing provisions may be imposed for the POS
(d) An employer may charge an employee who accepts the POS option a
reasonable administrative fee for costs associated with the employer's
reasonable administration of the POS option.
(e) The POS option to be offered pursuant to this Section may be satisfied
by the plan by allowing prospective enrollees to elect the POS option during
employer's enrollment period, and remaining in the POS option until the next
open enrollment period, or any other basis reasonably determined by the plan to
satisfy the requirements of this Section.
(f) A managed care dental plan required to offer a POS option pursuant to
this Act shall be subject to those rules for POS products as
set by the Department.
(Source: P.A. 91-355, eff. 1-1-00.)