SB3508 - 104th General Assembly
| |||||||
| |||||||
| 1 | AN ACT concerning regulation. | ||||||
| 2 | Be it enacted by the People of the State of Illinois, | ||||||
| 3 | represented in the General Assembly: | ||||||
| 4 | Section 5. The Regulatory Sunset Act is amended by | ||||||
| 5 | changing Section 4.37 and by adding Section 4.47 as follows: | ||||||
| 6 | (5 ILCS 80/4.37) | ||||||
| 7 | Sec. 4.37. Acts and Articles repealed on January 1, 2027. | ||||||
| 8 | The following are repealed on January 1, 2027: | ||||||
| 9 | The Clinical Psychologist Licensing Act. | ||||||
| 10 | The Illinois Optometric Practice Act of 1987. | ||||||
| 11 | Articles II, III, IV, V, VI, VIIA, VIIC, XVII, XXXI, and | ||||||
| 12 | XXXI 1/4 of the Illinois Insurance Code. | ||||||
| 13 | The Boiler and Pressure Vessel Repairer Regulation Act. | ||||||
| 14 | The Marriage and Family Therapy Licensing Act. | ||||||
| 15 | The Boxing and Full-contact Martial Arts Act. | ||||||
| 16 | The Cemetery Oversight Act. | ||||||
| 17 | The Community Association Manager Licensing and | ||||||
| 18 | Disciplinary Act. | ||||||
| 19 | The Detection of Deception Examiners Act. | ||||||
| 20 | The Home Inspector License Act. | ||||||
| 21 | The Massage Licensing Act. | ||||||
| 22 | The Medical Practice Act of 1987. | ||||||
| 23 | The Petroleum Equipment Contractors Licensing Act. | ||||||
| |||||||
| |||||||
| 1 | The Radiation Protection Act of 1990. | ||||||
| 2 | The Real Estate Appraiser Licensing Act of 2002. | ||||||
| 3 | The Registered Interior Designers Act. | ||||||
| 4 | The Landscape Architecture Registration Act. | ||||||
| 5 | The Water Well and Pump Installation Contractor's License | ||||||
| 6 | Act. | ||||||
| 7 | The Licensed Certified Professional Midwife Practice Act. | ||||||
| 8 | (Source: P.A. 102-20, eff. 6-25-21; 102-284, eff. 8-6-21; | ||||||
| 9 | 102-437, eff. 8-20-21; 102-656, eff. 8-27-21; 102-683, eff. | ||||||
| 10 | 10-1-22; 102-813, eff. 5-13-22; 103-371, eff. 1-1-24; 103-823, | ||||||
| 11 | eff. 8-9-24.) | ||||||
| 12 | (5 ILCS 80/4.47 new) | ||||||
| 13 | Sec. 4.47. Articles repealed on January 1, 2037. The | ||||||
| 14 | following Articles are repealed on January 1, 2037: | ||||||
| 15 | Articles II, III, IV, V, VI, VIIA, VIIC, XVII, XXXI, and | ||||||
| 16 | XXXI 1/4 of the Illinois Insurance Code. | ||||||
| 17 | Section 10. The Illinois Administrative Procedure Act is | ||||||
| 18 | amended by changing Section 5-75 as follows: | ||||||
| 19 | (5 ILCS 100/5-75) (from Ch. 127, par. 1005-75) | ||||||
| 20 | Sec. 5-75. Incorporation by reference. | ||||||
| 21 | (a) An agency may incorporate by reference, in its rules | ||||||
| 22 | adopted under Section 5-35, rules, regulations, standards, and | ||||||
| 23 | guidelines of an agency of the United States or a nationally or | ||||||
| |||||||
| |||||||
| 1 | state recognized organization or association without | ||||||
| 2 | publishing the incorporated material in full. The reference in | ||||||
| 3 | the agency rules must fully identify the incorporated matter | ||||||
| 4 | by publisher address and date in order to specify how a copy of | ||||||
| 5 | the material may be obtained and must state that the rule, | ||||||
| 6 | regulation, standard, or guideline does not include any later | ||||||
| 7 | amendments or editions. An agency may incorporate by reference | ||||||
| 8 | these matters in its rules only if the agency, organization, | ||||||
| 9 | or association originally issuing the matter makes copies | ||||||
| 10 | readily available to the public. This Section does not apply | ||||||
| 11 | to any agency internal manual. | ||||||
| 12 | For any law imposing taxes on or measured by income, the | ||||||
| 13 | Department of Revenue may promulgate rules that include | ||||||
| 14 | incorporations by reference of federal rules or regulations | ||||||
| 15 | without identifying the incorporated matter by date and | ||||||
| 16 | without including a statement that the incorporation does not | ||||||
| 17 | include later amendments. | ||||||
| 18 | For any law implementing the federal Patient Protection | ||||||
| 19 | and Affordable Care Act (Pub. L. 111-148), the Department of | ||||||
| 20 | Insurance may adopt rules that include incorporations by | ||||||
| 21 | reference of federal rules and regulations without identifying | ||||||
| 22 | the incorporated matter by date and without including a | ||||||
| 23 | statement that the incorporation does not include later | ||||||
| 24 | amendments. | ||||||
| 25 | (b) Use of the incorporation by reference procedure under | ||||||
| 26 | this Section shall be reviewed by the Joint Committee on | ||||||
| |||||||
| |||||||
| 1 | Administrative Rules during the rulemaking process as set | ||||||
| 2 | forth in this Act. | ||||||
| 3 | (c) The agency adopting a rule, regulation, standard, or | ||||||
| 4 | guideline under this Section shall maintain a copy of the | ||||||
| 5 | referenced rule, regulation, standard, or guideline in at | ||||||
| 6 | least one of its principal offices and shall make it available | ||||||
| 7 | to the public upon request for inspection and copying at no | ||||||
| 8 | more than cost. Requests for copies of materials incorporated | ||||||
| 9 | by reference shall not be deemed Freedom of Information Act | ||||||
| 10 | requests unless so labeled by the requestor. The agency shall | ||||||
| 11 | designate by rule the agency location at which incorporated | ||||||
| 12 | materials are maintained and made available to the public for | ||||||
| 13 | inspection and copying. These rules may be adopted under the | ||||||
| 14 | procedures in Section 5-15. In addition, the agency may | ||||||
| 15 | include the designation of the agency location of incorporated | ||||||
| 16 | materials in a rulemaking under Section 5-35, but emergency | ||||||
| 17 | and peremptory rulemaking procedures may not be used solely | ||||||
| 18 | for this purpose. | ||||||
| 19 | (Source: P.A. 90-155, eff. 7-23-97.) | ||||||
| 20 | Section 15. The Illinois Insurance Code is amended by | ||||||
| 21 | changing Sections 155.49, 356z.73, 404, 500-35, and 513b1.1 as | ||||||
| 22 | follows: | ||||||
| 23 | (215 ILCS 5/155.49) | ||||||
| 24 | Sec. 155.49. Insurance company supplier diversity report. | ||||||
| |||||||
| |||||||
| 1 | (a) Every company authorized to do business in this State | ||||||
| 2 | or accredited by this State with assets of at least | ||||||
| 3 | $50,000,000 shall submit a 2-page report on its voluntary | ||||||
| 4 | supplier diversity program, or the company's procurement | ||||||
| 5 | program if there is no supplier diversity program, to the | ||||||
| 6 | Department. The report shall set forth all of the following: | ||||||
| 7 | (1) The name, address, phone number, and email address | ||||||
| 8 | of the point of contact for the supplier diversity program | ||||||
| 9 | for vendors to register with the program. | ||||||
| 10 | (2) Local and State certifications the company accepts | ||||||
| 11 | or recognizes for minority-owned, women-owned, LGBT-owned, | ||||||
| 12 | or veteran-owned business status. | ||||||
| 13 | (3) On the second page, a narrative explaining the | ||||||
| 14 | results of the program and the tactics to be employed to | ||||||
| 15 | achieve the goals of its voluntary supplier diversity | ||||||
| 16 | program. | ||||||
| 17 | (4) The voluntary goals for the calendar year for | ||||||
| 18 | which the report is made in each category for the entire | ||||||
| 19 | budget of the company and the commodity codes or a | ||||||
| 20 | description of particular goods and services for the area | ||||||
| 21 | of procurement in which the company expects most of those | ||||||
| 22 | goals to focus on in that year. | ||||||
| 23 | Each company is required to submit a searchable report, in | ||||||
| 24 | Portable Document Format (PDF), to the Department on or before | ||||||
| 25 | April 1, 2024 and on or before April 1 every year thereafter. | ||||||
| 26 | For reports due on or after April 1, 2027, the company shall | ||||||
| |||||||
| |||||||
| 1 | submit the report in the format designated by the Department. | ||||||
| 2 | (b) For each report submitted under subsection (a), the | ||||||
| 3 | Department shall publish the results on its Internet website | ||||||
| 4 | for 5 years after submission. The Department is not | ||||||
| 5 | responsible for collecting the reports or for the content of | ||||||
| 6 | the reports. | ||||||
| 7 | (c) The Department shall hold an annual insurance company | ||||||
| 8 | supplier diversity workshop in July of 2024 and every July | ||||||
| 9 | thereafter to discuss the reports with representatives of the | ||||||
| 10 | companies and vendors. | ||||||
| 11 | (d) The Department shall prepare a one-page template, not | ||||||
| 12 | including the narrative section, for the voluntary supplier | ||||||
| 13 | diversity reports. | ||||||
| 14 | (e) The Department may adopt such rules as it deems | ||||||
| 15 | necessary to implement this Section. | ||||||
| 16 | (Source: P.A. 103-426, eff. 8-4-23.) | ||||||
| 17 | (215 ILCS 5/356z.73) | ||||||
| 18 | Sec. 356z.73. Insurance coverage for dependent parents. | ||||||
| 19 | (a) A group or individual policy of accident and health | ||||||
| 20 | insurance issued, amended, delivered, or renewed on or after | ||||||
| 21 | January 1, 2026 that provides dependent coverage shall make | ||||||
| 22 | that dependent coverage available to the parent or stepparent | ||||||
| 23 | of the insured if the parent or stepparent meets the | ||||||
| 24 | definition of a qualifying relative under 26 U.S.C. 152(d) and | ||||||
| 25 | lives or resides within the accident and health insurance | ||||||
| |||||||
| |||||||
| 1 | policy's service area. | ||||||
| 2 | (b) This Section does not apply to specialized health care | ||||||
| 3 | service plans, including student health insurance coverage, | ||||||
| 4 | excepted benefits, or coverage under Article V of the Illinois | ||||||
| 5 | Public Aid Code or under the Children's Health Insurance | ||||||
| 6 | Program Act. However, this Section applies to stand-alone | ||||||
| 7 | dental plans available through the Illinois Health Benefits | ||||||
| 8 | Exchange, including when the same policy form is offered | ||||||
| 9 | outside the Exchange. ; Medicare supplement insurance; | ||||||
| 10 | hospital-only policies; accident-only policies; or specified | ||||||
| 11 | disease insurance policies that reimburse for hospital, | ||||||
| 12 | medical, or surgical expenses. | ||||||
| 13 | (Source: P.A. 103-700, eff. 1-1-25; 104-189, eff. 8-15-25; | ||||||
| 14 | 104-334, eff. 8-15-25; 104-417, eff. 8-15-25; revised | ||||||
| 15 | 9-12-25.) | ||||||
| 16 | (215 ILCS 5/404) (from Ch. 73, par. 1016) | ||||||
| 17 | Sec. 404. Office of Director; a public office; destruction | ||||||
| 18 | or disposal of records, papers, documents, and memoranda. | ||||||
| 19 | (1)(a) The office of the Director shall be a public office | ||||||
| 20 | and the records, books, and papers thereof on file therein, | ||||||
| 21 | except those records or documents containing or disclosing any | ||||||
| 22 | analysis, opinion, calculation, ratio, recommendation, advice, | ||||||
| 23 | viewpoint, or estimation by any Department staff regarding the | ||||||
| 24 | financial or market condition of an insurer not otherwise made | ||||||
| 25 | part of the public record by the Director, shall be accessible | ||||||
| |||||||
| |||||||
| 1 | to the inspection of the public, except as the Director, for | ||||||
| 2 | good reason, may decide otherwise, or except as may be | ||||||
| 3 | otherwise provided in this Code or as otherwise provided in | ||||||
| 4 | Section 7 of the Freedom of Information Act. | ||||||
| 5 | (b) Except where another provision of this Code expressly | ||||||
| 6 | prohibits a disclosure of confidential information to the | ||||||
| 7 | specific officials or organizations described in this | ||||||
| 8 | subsection, the Director may disclose or share any | ||||||
| 9 | confidential records or information in his custody and control | ||||||
| 10 | with any insurance regulatory officials of any state or | ||||||
| 11 | country, with the law enforcement officials of this State, any | ||||||
| 12 | other state, or the federal government, or with the National | ||||||
| 13 | Association of Insurance Commissioners, upon the written | ||||||
| 14 | agreement of the official or organization receiving the | ||||||
| 15 | information to hold the information or records confidential | ||||||
| 16 | and in a manner consistent with this Code. | ||||||
| 17 | (c) The Director shall maintain as confidential any | ||||||
| 18 | records or information received from the National Association | ||||||
| 19 | of Insurance Commissioners or other state, federal, or | ||||||
| 20 | international regulatory agencies insurance regulatory | ||||||
| 21 | officials of other states which that are is confidential in | ||||||
| 22 | that other jurisdiction. | ||||||
| 23 | (2) Upon the filing of the examination to which they | ||||||
| 24 | relate, the Director is authorized to destroy or otherwise | ||||||
| 25 | dispose of all working papers relative to any company which | ||||||
| 26 | has been examined at any time prior to that last examination by | ||||||
| |||||||
| |||||||
| 1 | the Department, so that in such circumstances only current | ||||||
| 2 | working papers of that last examination may be retained by the | ||||||
| 3 | Department. | ||||||
| 4 | (3) Five years after the conclusion of the transactions to | ||||||
| 5 | which they relate, the Director is authorized to destroy or | ||||||
| 6 | otherwise dispose of all books, records, papers, memoranda and | ||||||
| 7 | correspondence directly related to consumer complaints or | ||||||
| 8 | inquiries. | ||||||
| 9 | (4) Two years after the conclusion of the transactions to | ||||||
| 10 | which they relate, the Director is authorized to destroy or | ||||||
| 11 | otherwise dispose of all books, records, papers, memoranda, | ||||||
| 12 | and correspondence directly related to all void, obsolete, or | ||||||
| 13 | superseded rate filings and schedules required to be filed by | ||||||
| 14 | statute; and all individual company rating experience data and | ||||||
| 15 | all records, papers, documents and memoranda in the possession | ||||||
| 16 | of the Director relating thereto. | ||||||
| 17 | (5) Five years after the conclusion of the transactions to | ||||||
| 18 | which they relate, the Director is authorized to destroy or | ||||||
| 19 | otherwise dispose of all examination reports of companies made | ||||||
| 20 | by the insurance supervisory officials of states other than | ||||||
| 21 | Illinois; applications, requisitions, and requests for | ||||||
| 22 | licenses; all records of hearings; and all similar records, | ||||||
| 23 | papers, documents, and memoranda in the possession of the | ||||||
| 24 | Director. | ||||||
| 25 | (6) Ten years after the conclusion of the transactions to | ||||||
| 26 | which they relate, the Director is authorized to destroy or | ||||||
| |||||||
| |||||||
| 1 | otherwise dispose of all official correspondence of foreign | ||||||
| 2 | and alien companies, all foreign companies' and alien | ||||||
| 3 | companies' annual statements, valuation reports, tax reports, | ||||||
| 4 | and all similar records, papers, documents and memoranda in | ||||||
| 5 | the possession of the Director. | ||||||
| 6 | (7) Whenever any records, papers, documents or memoranda | ||||||
| 7 | are destroyed or otherwise disposed of pursuant to the | ||||||
| 8 | provisions of this section, the Director shall execute and | ||||||
| 9 | file in a separate, permanent office file a certificate | ||||||
| 10 | listing and setting forth by summary description the records, | ||||||
| 11 | papers, documents or memoranda so destroyed or otherwise | ||||||
| 12 | disposed of, and the Director may, in his discretion, preserve | ||||||
| 13 | copies of any such records, papers, documents or memoranda by | ||||||
| 14 | means of microfilming or photographing the same. | ||||||
| 15 | (8) This Section shall apply to records, papers, | ||||||
| 16 | documents, and memoranda presently in the possession of the | ||||||
| 17 | Director as well as to records, papers, documents, and | ||||||
| 18 | memoranda hereafter coming into his possession. | ||||||
| 19 | (Source: P.A. 97-1004, eff. 8-17-12.) | ||||||
| 20 | (215 ILCS 5/500-35) | ||||||
| 21 | (Section scheduled to be repealed on January 1, 2027) | ||||||
| 22 | Sec. 500-35. License. | ||||||
| 23 | (a) Unless denied a license pursuant to Section 500-70, | ||||||
| 24 | persons who have met the requirements of Sections 500-25 and | ||||||
| 25 | 500-30 shall be issued a 2-year insurance producer license. An | ||||||
| |||||||
| |||||||
| 1 | insurance producer may receive qualification for a license in | ||||||
| 2 | one or more of the following lines of authority: | ||||||
| 3 | (1) Life: insurance coverage on human lives including | ||||||
| 4 | benefits of endowment and annuities, and may include | ||||||
| 5 | benefits in the event of death or dismemberment by | ||||||
| 6 | accident and benefits for disability income. | ||||||
| 7 | (2) Variable life and variable annuity products: | ||||||
| 8 | insurance coverage provided under variable life insurance | ||||||
| 9 | contracts and variable annuities. | ||||||
| 10 | (3) Accident and health or sickness: insurance | ||||||
| 11 | coverage for sickness, bodily injury, or accidental death | ||||||
| 12 | and may include benefits for disability income. | ||||||
| 13 | (4) Property: insurance coverage for the direct or | ||||||
| 14 | consequential loss or damage to property of every kind. | ||||||
| 15 | (5) Casualty: insurance coverage against legal | ||||||
| 16 | liability, including that for death, injury, or disability | ||||||
| 17 | or damage to real or personal property. | ||||||
| 18 | (6) Personal lines: property and casualty insurance | ||||||
| 19 | coverage sold to individuals and families for primarily | ||||||
| 20 | noncommercial purposes. | ||||||
| 21 | (7) Any other line of insurance permitted under State | ||||||
| 22 | laws or rules. | ||||||
| 23 | (b) An insurance producer license shall remain in effect | ||||||
| 24 | unless revoked or suspended as long as the fee set forth in | ||||||
| 25 | Section 500-135 is paid and education requirements for | ||||||
| 26 | resident individual producers are met by the due date. | ||||||
| |||||||
| |||||||
| 1 | (1) Before each license renewal, an insurance producer | ||||||
| 2 | must satisfactorily complete at least 24 hours of course | ||||||
| 3 | study or participation in a professional insurance | ||||||
| 4 | association under paragraph (3) of this subsection in | ||||||
| 5 | accordance with rules prescribed by the Director. Three of | ||||||
| 6 | the 24 hours of course study must consist of classroom or | ||||||
| 7 | webinar ethics instruction. The Director may not approve a | ||||||
| 8 | course of study unless the course provides for classroom, | ||||||
| 9 | seminar, webinar, or self-study instruction methods. A | ||||||
| 10 | course given in a combination instruction method of | ||||||
| 11 | classroom, seminar, webinar, or self-study shall be deemed | ||||||
| 12 | to be a self-study course unless the number of classroom, | ||||||
| 13 | seminar, or webinar certified hours meets or exceeds | ||||||
| 14 | two-thirds of total hours certified for the course. The | ||||||
| 15 | self-study material used in the combination course must be | ||||||
| 16 | directly related to and complement the classroom portion | ||||||
| 17 | of the course in order to be considered for credit. An | ||||||
| 18 | instruction method other than classroom or seminar shall | ||||||
| 19 | be considered as self-study methodology. Self-study credit | ||||||
| 20 | hours require the successful completion of an examination | ||||||
| 21 | covering the self-study material. The examination may not | ||||||
| 22 | be self-evaluated. However, if the self-study material is | ||||||
| 23 | completed through the use of an approved computerized | ||||||
| 24 | interactive format whereby the computer validates the | ||||||
| 25 | successful completion of the self-study material, no | ||||||
| 26 | additional examination is required. The self-study credit | ||||||
| |||||||
| |||||||
| 1 | hours contained in a certified course shall be considered | ||||||
| 2 | classroom hours when at least two-thirds of the hours are | ||||||
| 3 | given as classroom or seminar instruction. | ||||||
| 4 | (2) An insurance producer license automatically | ||||||
| 5 | terminates when an insurance producer fails to | ||||||
| 6 | successfully meet the requirements of paragraph (1) of | ||||||
| 7 | this subsection. The producer must complete the course in | ||||||
| 8 | advance of the renewal date to allow the education | ||||||
| 9 | provider time to report the credit to the Department. | ||||||
| 10 | (3) An insurance producer's active participation in a | ||||||
| 11 | State or national professional insurance association may | ||||||
| 12 | be approved by the Director for up to 4 hours of continuing | ||||||
| 13 | education credit per biennial reporting period. Credit | ||||||
| 14 | shall be provided on an hour-for-hour basis. These hours | ||||||
| 15 | shall be verified and submitted by the association on | ||||||
| 16 | behalf of the insurance producer and credited upon timely | ||||||
| 17 | filing with the Director or his or her designee on a | ||||||
| 18 | biennial basis. Any association submitting continuing | ||||||
| 19 | education credit hours on behalf of insurance producers | ||||||
| 20 | must be registered as an education provider under Section | ||||||
| 21 | 500-135. Credit granted under these provisions shall not | ||||||
| 22 | be used to satisfy ethics education requirements. Active | ||||||
| 23 | participation in a State or national professional | ||||||
| 24 | insurance association is defined by one of the following | ||||||
| 25 | methods: | ||||||
| 26 | (A) service on a board of directors of a State or | ||||||
| |||||||
| |||||||
| 1 | national chapter of the association; | ||||||
| 2 | (B) service on a formal committee of a State or | ||||||
| 3 | national chapter of the association; or | ||||||
| 4 | (C) service on a formal subcommittee or task force | ||||||
| 5 | of a State or national chapter of the association. | ||||||
| 6 | (c) A provider of a pre-licensing or continuing education | ||||||
| 7 | course required by Section 500-30 and this Section must pay a | ||||||
| 8 | registration fee and a course certification fee for each | ||||||
| 9 | course being certified as provided by Section 500-135. The | ||||||
| 10 | Department may waive these fees if the pre-licensing or | ||||||
| 11 | continuing education course is provided by a government entity | ||||||
| 12 | free of charge. | ||||||
| 13 | (d) An individual insurance producer who allows his or her | ||||||
| 14 | license to lapse may, within 12 months after the due date of | ||||||
| 15 | the renewal fee, be issued a license without the necessity of | ||||||
| 16 | passing a written examination. However, a penalty in the | ||||||
| 17 | amount of double the unpaid renewal fee shall be required | ||||||
| 18 | after the due date. | ||||||
| 19 | (e) A licensed insurance producer who is unable to comply | ||||||
| 20 | with license renewal procedures due to military service may | ||||||
| 21 | request a waiver of those procedures. | ||||||
| 22 | (f) The license must contain the licensee's name, address, | ||||||
| 23 | and personal identification number, the date of issuance, the | ||||||
| 24 | lines of authority, the expiration date, and any other | ||||||
| 25 | information the Director deems necessary. | ||||||
| 26 | (g) Licensees must inform the Director by any means | ||||||
| |||||||
| |||||||
| 1 | acceptable to the Director of a change of address within 30 | ||||||
| 2 | days after the change. | ||||||
| 3 | (h) In order to assist in the performance of the | ||||||
| 4 | Director's duties, the Director may contract with a | ||||||
| 5 | non-governmental entity including the National Association of | ||||||
| 6 | Insurance Commissioners (NAIC), or any affiliates or | ||||||
| 7 | subsidiaries that the NAIC oversees, to perform any | ||||||
| 8 | ministerial functions, including collection of fees, related | ||||||
| 9 | to producer licensing that the Director and the | ||||||
| 10 | non-governmental entity may deem appropriate. | ||||||
| 11 | (Source: P.A. 104-417, eff. 8-15-25.) | ||||||
| 12 | (215 ILCS 5/513b1.1) | ||||||
| 13 | Sec. 513b1.1. Pharmacy benefit manager reporting | ||||||
| 14 | requirements. | ||||||
| 15 | (a) A pharmacy benefit manager that provides services for | ||||||
| 16 | a health benefit plan must submit an annual report no later | ||||||
| 17 | than September 1, to the Department, each health benefit plan | ||||||
| 18 | sponsor, and each insurer that includes the following: | ||||||
| 19 | (1) data on the health benefit plan including: | ||||||
| 20 | (A) a list of drugs including corresponding | ||||||
| 21 | information on therapeutic class, brand name, generic | ||||||
| 22 | name, or specialty drug name; | ||||||
| 23 | (B) the total number of covered individuals and | ||||||
| 24 | number of Illinois residents who are covered | ||||||
| 25 | individuals; | ||||||
| |||||||
| |||||||
| 1 | (C) number of drug-related claims; | ||||||
| 2 | (D) dosage units; | ||||||
| 3 | (E) dispensing channel used; | ||||||
| 4 | (F) average wholesale acquisition cost per drug; | ||||||
| 5 | and | ||||||
| 6 | (G) total out-of-pocket spending by deidentified | ||||||
| 7 | covered individual per drug, per transaction; | ||||||
| 8 | (2) amount received by the health benefit plan in | ||||||
| 9 | rebates, fees, or discounts related to drug utilization or | ||||||
| 10 | spending; | ||||||
| 11 | (3) total gross spending on drugs by the health | ||||||
| 12 | benefit plan; | ||||||
| 13 | (4) total net spending, gross spending less | ||||||
| 14 | administrative portion of the medical loss ratio, on drugs | ||||||
| 15 | by the health benefit plan; | ||||||
| 16 | (5) the amount paid by the health benefit plan to the | ||||||
| 17 | pharmacy benefit manager for reimbursement cost of a drug | ||||||
| 18 | and service per transaction; | ||||||
| 19 | (6) the amount a pharmacy benefit manager paid for | ||||||
| 20 | pharmacists' services and drugs rendered related to the | ||||||
| 21 | health benefit plan per transaction, including, but not | ||||||
| 22 | limited to, any dispensing fee; | ||||||
| 23 | (7) the specific rebate amount received by the | ||||||
| 24 | pharmacy benefit manager per transaction, the amount of | ||||||
| 25 | the rebates passed through to the health benefit plan per | ||||||
| 26 | transaction, and the amount of the rebates passed on to | ||||||
| |||||||
| |||||||
| 1 | covered individuals at the point of sale that reduced the | ||||||
| 2 | covered individuals' applicable deductible, copayment, | ||||||
| 3 | coinsurance, or other cost-sharing amount per transaction; | ||||||
| 4 | (8) any information collected from drug manufacturers | ||||||
| 5 | pertaining to copayment assistance to the extent such | ||||||
| 6 | information is collected; | ||||||
| 7 | (9) any compensation paid to brokers, consultants, | ||||||
| 8 | advisors, or any other individual or firm for referrals, | ||||||
| 9 | consideration, or retention by the health benefit plan; | ||||||
| 10 | (10) explanation of benefit design parameters | ||||||
| 11 | encouraging or requiring covered individuals to use | ||||||
| 12 | affiliated pharmacies, percentage of drugs charged by | ||||||
| 13 | these pharmacies, and a list of drugs dispensed by | ||||||
| 14 | affiliated pharmacies with their associated costs; and | ||||||
| 15 | (11) a complete copy of each unredacted contract the | ||||||
| 16 | pharmacy benefit manager has with the health benefit plan | ||||||
| 17 | sponsor or insurer. | ||||||
| 18 | (b) Annual reports pursuant to subsection (a): | ||||||
| 19 | (1) must be written in plain language to ensure ease | ||||||
| 20 | of reading and accessibility; | ||||||
| 21 | (2) must only contain summary health information to | ||||||
| 22 | ensure plan, coverage, or covered individual information | ||||||
| 23 | remains private and confidential; | ||||||
| 24 | (3) upon request by a covered individual, must be | ||||||
| 25 | available in summary format and provide aggregated | ||||||
| 26 | information to help covered individuals understand their | ||||||
| |||||||
| |||||||
| 1 | health benefit plan's drug coverage; and | ||||||
| 2 | (4) must be filed with the Department no later than | ||||||
| 3 | September 1 of each year in the format designated by the | ||||||
| 4 | Department via the Systems for Electronic Rates & Forms | ||||||
| 5 | Filing (SERFF). The filing shall include the summary | ||||||
| 6 | version of the report described in paragraph (3) of this | ||||||
| 7 | subsection, which the Department shall make available to | ||||||
| 8 | members of the public be marked for public access. | ||||||
| 9 | The Department may share all reports with an established | ||||||
| 10 | institution of higher education in this State for the creation | ||||||
| 11 | of a pharmacist dispensing cost report to be produced | ||||||
| 12 | annually. This annual pharmacist dispensing cost report shall | ||||||
| 13 | provide a survey of the average cost of dispensing a | ||||||
| 14 | prescription for pharmacists in Illinois. The institution of | ||||||
| 15 | higher education shall have the ability to request additional | ||||||
| 16 | information from pharmacists for its analysis. The institution | ||||||
| 17 | of higher education shall issue the report to the General | ||||||
| 18 | Assembly no later than December 31, 2026 and annually | ||||||
| 19 | thereafter. | ||||||
| 20 | (c) A pharmacy benefit manager may petition the Department | ||||||
| 21 | for a filing submission extension. The Director may grant or | ||||||
| 22 | deny the extension within 5 business days. | ||||||
| 23 | (d) Failure by a pharmacy benefit manager to submit all | ||||||
| 24 | required elements in an annual report to the Department may | ||||||
| 25 | result in a fine levied by the Director not to exceed $10,000 | ||||||
| 26 | per day, per offense. Funds derived from fines levied shall be | ||||||
| |||||||
| |||||||
| 1 | deposited into the Insurance Producer Administration Fund. | ||||||
| 2 | Fine information shall be posted on the Department's website. | ||||||
| 3 | (e) A pharmacy benefit manager found in violation of | ||||||
| 4 | subsection (a) or paragraph (4) of subsection (b) may request | ||||||
| 5 | a hearing from the Director within 10 days of receipt of the | ||||||
| 6 | Director's order, or, if the violation is found in a market | ||||||
| 7 | conduct examination, as provided in Section 132 of this Code. | ||||||
| 8 | (f) Except for the summary version, the annual reports | ||||||
| 9 | submitted by pharmacy benefit managers shall be considered | ||||||
| 10 | confidential and privileged for all purposes, including for | ||||||
| 11 | purposes of the Freedom of Information Act, shall not be | ||||||
| 12 | subject to subpoena from any private party, and shall not be | ||||||
| 13 | admissible as evidence in a civil action. | ||||||
| 14 | (g) A copy of an adverse decision against a pharmacy | ||||||
| 15 | benefit manager for failing to submit an annual report to the | ||||||
| 16 | Department must be posted to the Department's website. | ||||||
| 17 | (h) Nothing in this Section shall be construed as | ||||||
| 18 | permitting a pharmacy benefit manager to avoid or otherwise | ||||||
| 19 | fail to comply with the reporting requirements set forth in | ||||||
| 20 | Section 5-36 of the Illinois Public Aid Code. | ||||||
| 21 | (Source: P.A. 104-27, eff. 1-1-26; 104-439, eff. 12-2-25.) | ||||||
| 22 | (215 ILCS 123/Act rep.) | ||||||
| 23 | Section 20. The Health Care Purchasing Group Act is | ||||||
| 24 | repealed. | ||||||
| |||||||
| |||||||
| 1 | Section 25. The Network Adequacy and Transparency Act is | ||||||
| 2 | amended by changing Section 3 as follows: | ||||||
| 3 | (215 ILCS 124/3) | ||||||
| 4 | Sec. 3. Applicability of Act. This Act applies to an | ||||||
| 5 | individual or group policy of health insurance coverage with a | ||||||
| 6 | network plan amended, delivered, issued, or renewed in this | ||||||
| 7 | State on or after January 1, 2019. This Act does not apply to | ||||||
| 8 | an individual or group policy for excepted benefits or | ||||||
| 9 | short-term, limited-duration health insurance coverage with a | ||||||
| 10 | network plan. This Act does not apply to stand-alone dental | ||||||
| 11 | plans. If federal law establishes network adequacy and | ||||||
| 12 | transparency standards for stand-alone dental plans, the | ||||||
| 13 | Department shall enforce those applicable federal | ||||||
| 14 | requirements. | ||||||
| 15 | (Source: P.A. 103-650, eff. 1-1-25; 103-777, eff. 1-1-25; | ||||||
| 16 | 104-334, eff. 8-15-25; 104-417, eff. 8-15-25.) | ||||||
| 17 | Section 99. Effective date. This Act takes effect upon | ||||||
| 18 | becoming law. | ||||||
