103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3202

 

Introduced 2/17/2023, by Rep. Jennifer Sanalitro

 

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 Accident and Health Article of the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2025 shall cover a medically necessary home saliva cancer screening every 24 months. 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 Medical Assistance Article of the Illinois Public Aid Code. Effective January 1, 2024.


LRB103 28677 BMS 55058 b

STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT
MAY APPLY

 

 

A BILL FOR

 

HB3202LRB103 28677 BMS 55058 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

 

 

HB3202- 2 -LRB103 28677 BMS 55058 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

 

 

HB3202- 3 -LRB103 28677 BMS 55058 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,

 

 

HB3202- 4 -LRB103 28677 BMS 55058 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

 

 

HB3202- 5 -LRB103 28677 BMS 55058 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

 

 

HB3202- 6 -LRB103 28677 BMS 55058 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.

 

 

HB3202- 7 -LRB103 28677 BMS 55058 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.

 

 

HB3202- 8 -LRB103 28677 BMS 55058 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. Home saliva cancer screening.
18    (a) As used in this Section, "home saliva cancer
19screening" means an outpatient test that utilizes an
20individual's saliva to detect biomarkers for early-stage
21cancer.
22    (b) An individual or group policy of accident and health
23insurance that is amended, delivered, issued, or renewed on or
24after January 1, 2025 shall cover a medically necessary home

 

 

HB3202- 9 -LRB103 28677 BMS 55058 b

1saliva cancer screening every 24 months.
 
2    Section 30. The Health Maintenance Organization Act is
3amended by changing Section 5-3 as follows:
 
4    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
5    Sec. 5-3. Insurance Code provisions.
6    (a) Health Maintenance Organizations shall be subject to
7the provisions of Sections 133, 134, 136, 137, 139, 140,
8141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
9154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
10355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
11356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
12356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
13356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
14356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
15356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
16356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
17356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
18367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
19402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
20paragraph (c) of subsection (2) of Section 367, and Articles
21IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
22XXXIIB of the Illinois Insurance Code.
23    (b) For purposes of the Illinois Insurance Code, except
24for Sections 444 and 444.1 and Articles XIII and XIII 1/2,

 

 

HB3202- 10 -LRB103 28677 BMS 55058 b

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

 

 

HB3202- 11 -LRB103 28677 BMS 55058 b

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

 

 

HB3202- 12 -LRB103 28677 BMS 55058 b

1agreement subject to Section 141.1 of the Illinois Insurance
2Code, the Director (i) shall, in addition to the criteria
3specified in Section 141.2 of the Illinois Insurance Code,
4take into account the effect of the management contract or
5service agreement on the continuation of benefits to enrollees
6and the financial condition of the health maintenance
7organization to be managed or serviced, and (ii) need not take
8into account the effect of the management contract or service
9agreement on competition.
10    (f) Except for small employer groups as defined in the
11Small Employer Rating, Renewability and Portability Health
12Insurance Act and except for medicare supplement policies as
13defined in Section 363 of the Illinois Insurance Code, a
14Health Maintenance Organization may by contract agree with a
15group or other enrollment unit to effect refunds or charge
16additional premiums under the following terms and conditions:
17        (i) the amount of, and other terms and conditions with
18    respect to, the refund or additional premium are set forth
19    in the group or enrollment unit contract agreed in advance
20    of the period for which a refund is to be paid or
21    additional premium is to be charged (which period shall
22    not be less than one year); and
23        (ii) the amount of the refund or additional premium
24    shall not exceed 20% of the Health Maintenance
25    Organization's profitable or unprofitable experience with
26    respect to the group or other enrollment unit for the

 

 

HB3202- 13 -LRB103 28677 BMS 55058 b

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

 

 

HB3202- 14 -LRB103 28677 BMS 55058 b

1refund authorized under this Section.
2    (g) Rulemaking authority to implement Public Act 95-1045,
3if any, is conditioned on the rules being adopted in
4accordance with all provisions of the Illinois Administrative
5Procedure Act and all rules and procedures of the Joint
6Committee on Administrative Rules; any purported rule not so
7adopted, for whatever reason, is unauthorized.
8(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
9101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
101-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
11eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
12102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
131-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
14eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
15102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
161-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
17eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
18    Section 35. The Limited Health Service Organization Act is
19amended by changing Section 4003 as follows:
 
20    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
21    Sec. 4003. Illinois Insurance Code provisions. Limited
22health service organizations shall be subject to the
23provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
24141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,

 

 

HB3202- 15 -LRB103 28677 BMS 55058 b

1154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
2355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
3356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
4356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
5356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
6408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
71/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
8Illinois Insurance Code. Nothing in this Section shall require
9a limited health care plan to cover any service that is not a
10limited health service. For purposes of the Illinois Insurance
11Code, except for Sections 444 and 444.1 and Articles XIII and
12XIII 1/2, limited health service organizations in the
13following categories are deemed to be domestic companies:
14        (1) a corporation under the laws of this State; or
15        (2) a corporation organized under the laws of another
16    state, 30% or more of the enrollees of which are residents
17    of this State, except a corporation subject to
18    substantially the same requirements in its state of
19    organization as is a domestic company under Article VIII
20    1/2 of the Illinois Insurance Code.
21(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
22101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
231-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
24eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
25102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
261-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 

 

 

HB3202- 16 -LRB103 28677 BMS 55058 b

1    Section 40. The Voluntary Health Services Plans Act is
2amended by changing Section 10 as follows:
 
3    (215 ILCS 165/10)  (from Ch. 32, par. 604)
4    Sec. 10. Application of Insurance Code provisions. Health
5services plan corporations and all persons interested therein
6or dealing therewith shall be subject to the provisions of
7Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
8143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
9356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
10356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
11356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
12356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
13356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
14356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
15356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
16367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
17and paragraphs (7) and (15) of Section 367 of the Illinois
18Insurance Code.
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.

 

 

HB3202- 17 -LRB103 28677 BMS 55058 b

1(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
2101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
31-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
4eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
5102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
61-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
7eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
8102-1117, eff. 1-13-23.)
 
9    Section 45. The Illinois Public Aid Code is amended by
10changing Section 5-16.8 as follows:
 
11    (305 ILCS 5/5-16.8)
12    Sec. 5-16.8. Required health benefits. The medical
13assistance program shall (i) provide the post-mastectomy care
14benefits required to be covered by a policy of accident and
15health insurance under Section 356t and the coverage required
16under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
17356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
18356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and
19356z.61 of the Illinois Insurance Code, (ii) be subject to the
20provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
21370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
22subject to the provisions of subsection (d-5) of Section 10 of
23the Network Adequacy and Transparency Act.
24    The Department, by rule, shall adopt a model similar to

 

 

HB3202- 18 -LRB103 28677 BMS 55058 b

1the requirements of Section 356z.39 of the Illinois Insurance
2Code.
3    On and after July 1, 2012, the Department shall reduce any
4rate of reimbursement for services or other payments or alter
5any methodologies authorized by this Code to reduce any rate
6of reimbursement for services or other payments in accordance
7with Section 5-5e.
8    To ensure full access to the benefits set forth in this
9Section, on and after January 1, 2016, the Department shall
10ensure that provider and hospital reimbursement for
11post-mastectomy care benefits required under this Section are
12no lower than the Medicare reimbursement rate.
13(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
14101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
151-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
16eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
17102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
181-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
19eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
20    Section 95. No acceleration or delay. Where this Act makes
21changes in a statute that is represented in this Act by text
22that is not yet or no longer in effect (for example, a Section
23represented by multiple versions), the use of that text does
24not accelerate or delay the taking effect of (i) the changes
25made by this Act or (ii) provisions derived from any other

 

 

HB3202- 19 -LRB103 28677 BMS 55058 b

1Public Act.
 
2    Section 99. Effective date. This Act takes effect January
31, 2024.