Rep. Thaddeus Jones

Filed: 4/15/2021

 

 


 

 


 
10200HB0317ham001LRB102 09996 BMS 24699 a

1
AMENDMENT TO HOUSE BILL 317

2    AMENDMENT NO. ______. Amend House Bill 317 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Insurance Code is amended by
5changing Section 352 as follows:
 
6    (215 ILCS 5/352)  (from Ch. 73, par. 964)
7    Sec. 352. Scope of Article.
8    (a) Except as provided in subsections (b), (c), (d), and
9(e), this Article shall apply to all companies transacting in
10this State the kinds of business enumerated in clause (b) of
11Class 1 and clause (a) of Class 2 of Section 4. Nothing in this
12Article shall apply to, or in any way affect policies or
13contracts described in clause (a) of Class 1 of Section 4;
14however, this Article shall apply to policies and contracts
15which contain benefits providing reimbursement for the
16expenses of long term health care which are certified or

 

 

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1ordered by a physician including but not limited to
2professional nursing care, custodial nursing care, and
3non-nursing custodial care provided in a nursing home or at a
4residence of the insured.
5    (a-5) An air ambulance service or other entity that
6directly or indirectly, whether through an affiliated entity,
7agreement with a third-party entity, or otherwise, is engaging
8in the business of insurance as an insurer if the service or
9other entity, for the purpose of covering the copayments,
10deductibles, or cost-sharing amounts of a patient or
11post-service payments of costs to third parties, solicits air
12ambulance membership subscriptions, accepts membership
13applications, or charges membership fees. An air ambulance
14membership that covers the copayments, deductibles, or other
15cost-sharing amounts of a patient or provides for post-service
16payments of costs to third parties shall be considered
17insurance and an insurance product and may be considered
18secondary insurance coverage or a supplement to any insurance
19coverage and shall be regulated accordingly by the Department
20of Insurance.
21    (b) (Blank).
22    (c) A policy issued and delivered in this State that
23provides coverage under that policy for certificate holders
24who are neither residents of nor employed in this State does
25not need to provide to those nonresident certificate holders
26who are not employed in this State the coverages or services

 

 

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1mandated by this Article.
2    (d) Stop-loss insurance is exempt from all Sections of
3this Article, except this Section and Sections 353a, 354,
4357.30, and 370. For purposes of this exemption, stop-loss
5insurance is further defined as follows:
6        (1) The policy must be issued to and insure an
7    employer, trustee, or other sponsor of the plan, or the
8    plan itself, but not employees, members, or participants.
9        (2) Payments by the insurer must be made to the
10    employer, trustee, or other sponsors of the plan, or the
11    plan itself, but not to the employees, members,
12    participants, or health care providers.
13    (e) A policy issued or delivered in this State to the
14Department of Healthcare and Family Services (formerly
15Illinois Department of Public Aid) and providing coverage,
16under clause (b) of Class 1 or clause (a) of Class 2 as
17described in Section 4, to persons who are enrolled under
18Article V of the Illinois Public Aid Code or under the
19Children's Health Insurance Program Act is exempt from all
20restrictions, limitations, standards, rules, or regulations
21respecting benefits imposed by or under authority of this
22Code, except those specified by subsection (1) of Section 143,
23Section 370c, and Section 370c.1. Nothing in this subsection,
24however, affects the total medical services available to
25persons eligible for medical assistance under the Illinois
26Public Aid Code.

 

 

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1    (f) An in-office membership care agreement provided under
2the In-Office Membership Care Act is not insurance for the
3purposes of this Code.
4(Source: P.A. 101-190, eff. 8-2-19.)
 
5    Section 99. Effective date. This Act takes effect upon
6becoming law.".