103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB2445

 

Introduced 2/15/2023, by Rep. Natalie A. Manley

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
215 ILCS 5/356z.61 new
215 ILCS 125/5-3  from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003  from Ch. 73, par. 1504-3
215 ILCS 165/10  from Ch. 32, par. 604
305 ILCS 5/5-16.8

    Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act shall provide coverage for basic fitness center membership costs for individuals 65 years of age and older. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.


LRB103 30341 BMS 56771 b

STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT
MAY APPLY

 

 

A BILL FOR

 

HB2445LRB103 30341 BMS 56771 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    (Text of Section before amendment by P.A. 102-768)
8    Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall
10provide the post-mastectomy care benefits required to be
11covered by a policy of accident and health insurance under
12Section 356t of the Illinois Insurance Code. The program of
13health benefits shall provide the coverage required under
14Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
15356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
16356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
20the Illinois Insurance Code. The program of health benefits
21must comply with Sections 155.22a, 155.37, 355b, 356z.19,
22370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
23Code. The Department of Insurance shall enforce the

 

 

HB2445- 2 -LRB103 30341 BMS 56771 b

1requirements of this Section with respect to Sections 370c and
2370c.1 of the Illinois Insurance Code; all other requirements
3of this Section shall be enforced by the Department of Central
4Management Services.
5    Rulemaking authority to implement Public Act 95-1045, if
6any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
12101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
131-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
14eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
15102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
161-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
17eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
18revised 12-13-22.)
 
19    (Text of Section after amendment by P.A. 102-768)
20    Sec. 6.11. Required health benefits; Illinois Insurance
21Code requirements. The program of health benefits shall
22provide the post-mastectomy care benefits required to be
23covered by a policy of accident and health insurance under
24Section 356t of the Illinois Insurance Code. The program of
25health benefits shall provide the coverage required under

 

 

HB2445- 3 -LRB103 30341 BMS 56771 b

1Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
2356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
3356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
5356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
6356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
7356z.60, and 356z.61 of the Illinois Insurance Code. The
8program of health benefits must comply with Sections 155.22a,
9155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
10the Illinois Insurance Code. The Department of Insurance shall
11enforce the requirements of this Section with respect to
12Sections 370c and 370c.1 of the Illinois Insurance Code; all
13other requirements of this Section shall be enforced by the
14Department of Central Management Services.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
22101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
231-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
24eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
25102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
261-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,

 

 

HB2445- 4 -LRB103 30341 BMS 56771 b

1eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
2102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
3    Section 10. The Counties Code is amended by changing
4Section 5-1069.3 as follows:
 
5    (55 ILCS 5/5-1069.3)
6    Sec. 5-1069.3. Required health benefits. If a county,
7including a home rule county, is a self-insurer for purposes
8of providing health insurance coverage for its employees, the
9coverage shall include coverage for the post-mastectomy care
10benefits required to be covered by a policy of accident and
11health insurance under Section 356t and the coverage required
12under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
13356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
14356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
15356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
16356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
17356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
18of the Illinois Insurance Code. The coverage shall comply with
19Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
20Insurance Code. The Department of Insurance shall enforce the
21requirements of this Section. The requirement that health
22benefits be covered as provided in this Section is an
23exclusive power and function of the State and is a denial and
24limitation under Article VII, Section 6, subsection (h) of the

 

 

HB2445- 5 -LRB103 30341 BMS 56771 b

1Illinois Constitution. A home rule county to which this
2Section applies must comply with every provision of this
3Section.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
11101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
121-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
13eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
14102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
151-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
16eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
17102-1117, eff. 1-13-23.)
 
18    Section 15. The Illinois Municipal Code is amended by
19changing Section 10-4-2.3 as follows:
 
20    (65 ILCS 5/10-4-2.3)
21    Sec. 10-4-2.3. Required health benefits. If a
22municipality, including a home rule municipality, is a
23self-insurer for purposes of providing health insurance
24coverage for its employees, the coverage shall include

 

 

HB2445- 6 -LRB103 30341 BMS 56771 b

1coverage for the post-mastectomy care benefits required to be
2covered by a policy of accident and health insurance under
3Section 356t and the coverage required under Sections 356g,
4356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
5356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
6356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
7356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
8356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
9356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
10Illinois Insurance Code. The coverage shall comply with
11Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
12Insurance Code. The Department of Insurance shall enforce the
13requirements of this Section. The requirement that health
14benefits be covered as provided in this is an exclusive power
15and function of the State and is a denial and limitation under
16Article VII, Section 6, subsection (h) of the Illinois
17Constitution. A home rule municipality to which this Section
18applies must comply with every provision of this Section.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
26101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.

 

 

HB2445- 7 -LRB103 30341 BMS 56771 b

11-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
2eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
3102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
41-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
5eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
6102-1117, eff. 1-13-23.)
 
7    Section 20. The School Code is amended by changing Section
810-22.3f as follows:
 
9    (105 ILCS 5/10-22.3f)
10    Sec. 10-22.3f. Required health benefits. Insurance
11protection and benefits for employees shall provide the
12post-mastectomy care benefits required to be covered by a
13policy of accident and health insurance under Section 356t and
14the coverage required under Sections 356g, 356g.5, 356g.5-1,
15356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
16356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
20356z.61 of the Illinois Insurance Code. Insurance policies
21shall comply with Section 356z.19 of the Illinois Insurance
22Code. The coverage shall comply with Sections 155.22a, 355b,
23and 370c of the Illinois Insurance Code. The Department of
24Insurance shall enforce the requirements of this Section.

 

 

HB2445- 8 -LRB103 30341 BMS 56771 b

1    Rulemaking authority to implement Public Act 95-1045, if
2any, is conditioned on the rules being adopted in accordance
3with all provisions of the Illinois Administrative Procedure
4Act and all rules and procedures of the Joint Committee on
5Administrative Rules; any purported rule not so adopted, for
6whatever reason, is unauthorized.
7(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
8101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
91-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
10eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
11102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
121-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
13eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
14    Section 25. The Illinois Insurance Code is amended by
15adding Section 356z.61 as follows:
 
16    (215 ILCS 5/356z.61 new)
17    Sec. 356z.61. Senior fitness membership coverage. A group
18or individual policy of accident and health insurance or a
19managed care plan that is amended, delivered, issued, or
20renewed on or after the effective date of this amendatory Act
21of the 103rd General Assembly shall provide coverage for basic
22fitness center membership costs for individuals 65 years of
23age and older.
 

 

 

HB2445- 9 -LRB103 30341 BMS 56771 b

1    Section 30. The Health Maintenance Organization Act is
2amended by changing Section 5-3 as follows:
 
3    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
4    Sec. 5-3. Insurance Code provisions.
5    (a) Health Maintenance Organizations shall be subject to
6the provisions of Sections 133, 134, 136, 137, 139, 140,
7141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
8154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
9355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
10356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
11356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
12356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
13356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
14356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
15356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
16356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
17367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
18402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
19paragraph (c) of subsection (2) of Section 367, and Articles
20IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
21XXXIIB of the Illinois Insurance Code.
22    (b) For purposes of the Illinois Insurance Code, except
23for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
24Health Maintenance Organizations in the following categories
25are deemed to be "domestic companies":

 

 

HB2445- 10 -LRB103 30341 BMS 56771 b

1        (1) a corporation authorized under the Dental Service
2    Plan Act or the Voluntary Health Services Plans Act;
3        (2) a corporation organized under the laws of this
4    State; or
5        (3) a corporation organized under the laws of another
6    state, 30% or more of the enrollees of which are residents
7    of this State, except a corporation subject to
8    substantially the same requirements in its state of
9    organization as is a "domestic company" under Article VIII
10    1/2 of the Illinois Insurance Code.
11    (c) In considering the merger, consolidation, or other
12acquisition of control of a Health Maintenance Organization
13pursuant to Article VIII 1/2 of the Illinois Insurance Code,
14        (1) the Director shall give primary consideration to
15    the continuation of benefits to enrollees and the
16    financial conditions of the acquired Health Maintenance
17    Organization after the merger, consolidation, or other
18    acquisition of control takes effect;
19        (2)(i) the criteria specified in subsection (1)(b) of
20    Section 131.8 of the Illinois Insurance Code shall not
21    apply and (ii) the Director, in making his determination
22    with respect to the merger, consolidation, or other
23    acquisition of control, need not take into account the
24    effect on competition of the merger, consolidation, or
25    other acquisition of control;
26        (3) the Director shall have the power to require the

 

 

HB2445- 11 -LRB103 30341 BMS 56771 b

1    following information:
2            (A) certification by an independent actuary of the
3        adequacy of the reserves of the Health Maintenance
4        Organization sought to be acquired;
5            (B) pro forma financial statements reflecting the
6        combined balance sheets of the acquiring company and
7        the Health Maintenance Organization sought to be
8        acquired as of the end of the preceding year and as of
9        a date 90 days prior to the acquisition, as well as pro
10        forma financial statements reflecting projected
11        combined operation for a period of 2 years;
12            (C) a pro forma business plan detailing an
13        acquiring party's plans with respect to the operation
14        of the Health Maintenance Organization sought to be
15        acquired for a period of not less than 3 years; and
16            (D) such other information as the Director shall
17        require.
18    (d) The provisions of Article VIII 1/2 of the Illinois
19Insurance Code and this Section 5-3 shall apply to the sale by
20any health maintenance organization of greater than 10% of its
21enrollee population (including without limitation the health
22maintenance organization's right, title, and interest in and
23to its health care certificates).
24    (e) In considering any management contract or service
25agreement subject to Section 141.1 of the Illinois Insurance
26Code, the Director (i) shall, in addition to the criteria

 

 

HB2445- 12 -LRB103 30341 BMS 56771 b

1specified in Section 141.2 of the Illinois Insurance Code,
2take into account the effect of the management contract or
3service agreement on the continuation of benefits to enrollees
4and the financial condition of the health maintenance
5organization to be managed or serviced, and (ii) need not take
6into account the effect of the management contract or service
7agreement on competition.
8    (f) Except for small employer groups as defined in the
9Small Employer Rating, Renewability and Portability Health
10Insurance Act and except for medicare supplement policies as
11defined in Section 363 of the Illinois Insurance Code, a
12Health Maintenance Organization may by contract agree with a
13group or other enrollment unit to effect refunds or charge
14additional premiums under the following terms and conditions:
15        (i) the amount of, and other terms and conditions with
16    respect to, the refund or additional premium are set forth
17    in the group or enrollment unit contract agreed in advance
18    of the period for which a refund is to be paid or
19    additional premium is to be charged (which period shall
20    not be less than one year); and
21        (ii) the amount of the refund or additional premium
22    shall not exceed 20% of the Health Maintenance
23    Organization's profitable or unprofitable experience with
24    respect to the group or other enrollment unit for the
25    period (and, for purposes of a refund or additional
26    premium, the profitable or unprofitable experience shall

 

 

HB2445- 13 -LRB103 30341 BMS 56771 b

1    be calculated taking into account a pro rata share of the
2    Health Maintenance Organization's administrative and
3    marketing expenses, but shall not include any refund to be
4    made or additional premium to be paid pursuant to this
5    subsection (f)). The Health Maintenance Organization and
6    the group or enrollment unit may agree that the profitable
7    or unprofitable experience may be calculated taking into
8    account the refund period and the immediately preceding 2
9    plan years.
10    The Health Maintenance Organization shall include a
11statement in the evidence of coverage issued to each enrollee
12describing the possibility of a refund or additional premium,
13and upon request of any group or enrollment unit, provide to
14the group or enrollment unit a description of the method used
15to calculate (1) the Health Maintenance Organization's
16profitable experience with respect to the group or enrollment
17unit and the resulting refund to the group or enrollment unit
18or (2) the Health Maintenance Organization's unprofitable
19experience with respect to the group or enrollment unit and
20the resulting additional premium to be paid by the group or
21enrollment unit.
22    In no event shall the Illinois Health Maintenance
23Organization Guaranty Association be liable to pay any
24contractual obligation of an insolvent organization to pay any
25refund authorized under this Section.
26    (g) Rulemaking authority to implement Public Act 95-1045,

 

 

HB2445- 14 -LRB103 30341 BMS 56771 b

1if any, is conditioned on the rules being adopted in
2accordance with all provisions of the Illinois Administrative
3Procedure Act and all rules and procedures of the Joint
4Committee on Administrative Rules; any purported rule not so
5adopted, for whatever reason, is unauthorized.
6(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
7101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
81-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
9eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
10102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
111-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
12eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
13102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
141-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
15eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
16    Section 35. The Limited Health Service Organization Act is
17amended by changing Section 4003 as follows:
 
18    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
19    Sec. 4003. Illinois Insurance Code provisions. Limited
20health service organizations shall be subject to the
21provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
22141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
23154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
24355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,

 

 

HB2445- 15 -LRB103 30341 BMS 56771 b

1356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
2356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
3356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
4408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
51/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
6Illinois Insurance Code. Nothing in this Section shall require
7a limited health care plan to cover any service that is not a
8limited health service. For purposes of the Illinois Insurance
9Code, except for Sections 444 and 444.1 and Articles XIII and
10XIII 1/2, limited health service organizations in the
11following categories are deemed to be domestic companies:
12        (1) a corporation under the laws of this State; or
13        (2) a corporation organized under the laws of another
14    state, 30% or more of the enrollees of which are residents
15    of this State, except a corporation subject to
16    substantially the same requirements in its state of
17    organization as is a domestic company under Article VIII
18    1/2 of the Illinois Insurance Code.
19(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
20101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
211-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
22eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
23102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
241-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
25    Section 40. The Voluntary Health Services Plans Act is

 

 

HB2445- 16 -LRB103 30341 BMS 56771 b

1amended by changing Section 10 as follows:
 
2    (215 ILCS 165/10)  (from Ch. 32, par. 604)
3    Sec. 10. Application of Insurance Code provisions. Health
4services plan corporations and all persons interested therein
5or dealing therewith shall be subject to the provisions of
6Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
7143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
8356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
9356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
10356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
11356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
12356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
13356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
14356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
15367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
16and paragraphs (7) and (15) of Section 367 of the Illinois
17Insurance Code.
18    Rulemaking authority to implement Public Act 95-1045, if
19any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.
24(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
25101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.

 

 

HB2445- 17 -LRB103 30341 BMS 56771 b

11-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
2eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
3102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
41-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
5eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
6102-1117, eff. 1-13-23.)
 
7    Section 45. The Illinois Public Aid Code is amended by
8changing Section 5-16.8 as follows:
 
9    (305 ILCS 5/5-16.8)
10    Sec. 5-16.8. Required health benefits. The medical
11assistance program shall (i) provide the post-mastectomy care
12benefits required to be covered by a policy of accident and
13health insurance under Section 356t and the coverage required
14under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
15356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
16356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and
17356z.61 of the Illinois Insurance Code, (ii) be subject to the
18provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
19370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
20subject to the provisions of subsection (d-5) of Section 10 of
21the Network Adequacy and Transparency Act.
22    The Department, by rule, shall adopt a model similar to
23the requirements of Section 356z.39 of the Illinois Insurance
24Code.

 

 

HB2445- 18 -LRB103 30341 BMS 56771 b

1    On and after July 1, 2012, the Department shall reduce any
2rate of reimbursement for services or other payments or alter
3any methodologies authorized by this Code to reduce any rate
4of reimbursement for services or other payments in accordance
5with Section 5-5e.
6    To ensure full access to the benefits set forth in this
7Section, on and after January 1, 2016, the Department shall
8ensure that provider and hospital reimbursement for
9post-mastectomy care benefits required under this Section are
10no lower than the Medicare reimbursement rate.
11(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
12101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
131-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
14eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
15102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
161-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
17eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
18    Section 95. No acceleration or delay. Where this Act makes
19changes in a statute that is represented in this Act by text
20that is not yet or no longer in effect (for example, a Section
21represented by multiple versions), the use of that text does
22not accelerate or delay the taking effect of (i) the changes
23made by this Act or (ii) provisions derived from any other
24Public Act.