HB5643 EngrossedLRB103 39419 RPS 69602 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    Sec. 6.11. Required health benefits; Illinois Insurance
8Code requirements. The program of health benefits shall
9provide the post-mastectomy care benefits required to be
10covered by a policy of accident and health insurance under
11Section 356t of the Illinois Insurance Code. The program of
12health benefits shall provide the coverage required under
13Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
14356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
15356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
16356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
17356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
18356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, 356z.60,
19and 356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, 356z.70,
20and 356z.71 of the Illinois Insurance Code. The program of
21health benefits must comply with Sections 155.22a, 155.37,
22355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the
23Illinois Insurance Code. The program of health benefits shall

 

 

HB5643 Engrossed- 2 -LRB103 39419 RPS 69602 b

1provide the coverage required under Section 356m of the
2Illinois Insurance Code and, for the employees of the State
3Employee Group Insurance Program only, the coverage as also
4provided in Section 6.11B of this Act. The Department of
5Insurance shall enforce the requirements of this Section with
6respect to Sections 370c and 370c.1 of the Illinois Insurance
7Code; all other requirements of this Section shall be enforced
8by the Department of Central Management Services.
9    Rulemaking authority to implement Public Act 95-1045, if
10any, is conditioned on the rules being adopted in accordance
11with all provisions of the Illinois Administrative Procedure
12Act and all rules and procedures of the Joint Committee on
13Administrative Rules; any purported rule not so adopted, for
14whatever reason, is unauthorized.
15(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
16102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
171-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768,
18eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
19102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
201-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84,
21eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24;
22103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff.
238-11-23; revised 8-29-23.)
 
24    Section 10. The Illinois Insurance Code is amended by
25adding Section 356z.71 as follows:
 

 

 

HB5643 Engrossed- 3 -LRB103 39419 RPS 69602 b

1    (215 ILCS 5/356z.71 new)
2    Sec. 356z.71. Coverage for at-home pregnancy tests. A
3group or individual policy of accident and health insurance or
4a managed care plan that is amended, delivered, issued, or
5renewed on or after January 1, 2026 shall provide coverage for
6at-home, urine-based pregnancy tests that are prescribed to
7the covered person, regardless of whether the tests are
8otherwise available over-the-counter. The coverage required
9under this Section is limited to 2 at-home, urine-based
10pregnancy tests every 30 days.
 
11    Section 15. The Illinois Public Aid Code is amended by
12adding Section 5-5.24a as follows:
 
13    (305 ILCS 5/5-5.24a new)
14    Sec. 5-5.24a. Coverage for at-home pregnancy tests.
15Beginning January 1, 2025, the medical assistance program
16shall provide coverage for at-home, urine-based pregnancy
17tests that are ordered directly by a clinician or furnished
18through a standing order for patient use, regardless of
19whether the tests are otherwise available over the counter.
20The coverage required under this Section is limited to a
21multipack, as defined by the Department, of at-home,
22urine-based pregnancy tests every 30 days.
 
23    Section 99. Effective date. This Act takes effect January

 

 

HB5643 Engrossed- 4 -LRB103 39419 RPS 69602 b

11, 2025.