SB1282 EnrolledLRB103 27271 BMS 53642 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

 

 

SB1282 Enrolled- 2 -LRB103 27271 BMS 53642 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

 

 

SB1282 Enrolled- 3 -LRB103 27271 BMS 53642 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,

 

 

SB1282 Enrolled- 4 -LRB103 27271 BMS 53642 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

 

 

SB1282 Enrolled- 5 -LRB103 27271 BMS 53642 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

 

 

SB1282 Enrolled- 6 -LRB103 27271 BMS 53642 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.

 

 

SB1282 Enrolled- 7 -LRB103 27271 BMS 53642 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.

 

 

SB1282 Enrolled- 8 -LRB103 27271 BMS 53642 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. Coverage for liver disease screening. A
18group or individual policy of accident and health insurance or
19a managed care plan that is amended, delivered, issued, or
20renewed on or after January 1, 2025 shall provide coverage for
21preventative liver disease screenings for individuals 35 years
22of age or older and under the age of 65 at high risk for liver
23disease, including liver ultrasounds and alpha-fetoprotein
24blood tests every 6 months, without imposing a deductible,

 

 

SB1282 Enrolled- 9 -LRB103 27271 BMS 53642 b

1coinsurance, copayment, or any other cost-sharing requirement
2on the coverage provided; except that this Section does not
3apply to coverage of liver disease screenings to the extent
4such coverage would disqualify a high-deductible health plan
5from eligibility for a health savings account pursuant to
6Section 223 of the Internal Revenue Code.
 
7    Section 30. The Health Maintenance Organization Act is
8amended by changing Section 5-3 as follows:
 
9    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
10    Sec. 5-3. Insurance Code provisions.
11    (a) Health Maintenance Organizations shall be subject to
12the provisions of Sections 133, 134, 136, 137, 139, 140,
13141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
14154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
15355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
16356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
17356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
18356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
19356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
20356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
21356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
22356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
23367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
24402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,

 

 

SB1282 Enrolled- 10 -LRB103 27271 BMS 53642 b

1paragraph (c) of subsection (2) of Section 367, and Articles
2IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
3XXXIIB of the Illinois Insurance Code.
4    (b) For purposes of the Illinois Insurance Code, except
5for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
6Health Maintenance Organizations in the following categories
7are deemed to be "domestic companies":
8        (1) a corporation authorized under the Dental Service
9    Plan Act or the Voluntary Health Services Plans Act;
10        (2) a corporation organized under the laws of this
11    State; or
12        (3) a corporation organized under the laws of another
13    state, 30% or more of the enrollees of which are residents
14    of this State, except a corporation subject to
15    substantially the same requirements in its state of
16    organization as is a "domestic company" under Article VIII
17    1/2 of the Illinois Insurance Code.
18    (c) In considering the merger, consolidation, or other
19acquisition of control of a Health Maintenance Organization
20pursuant to Article VIII 1/2 of the Illinois Insurance Code,
21        (1) the Director shall give primary consideration to
22    the continuation of benefits to enrollees and the
23    financial conditions of the acquired Health Maintenance
24    Organization after the merger, consolidation, or other
25    acquisition of control takes effect;
26        (2)(i) the criteria specified in subsection (1)(b) of

 

 

SB1282 Enrolled- 11 -LRB103 27271 BMS 53642 b

1    Section 131.8 of the Illinois Insurance Code shall not
2    apply and (ii) the Director, in making his determination
3    with respect to the merger, consolidation, or other
4    acquisition of control, need not take into account the
5    effect on competition of the merger, consolidation, or
6    other acquisition of control;
7        (3) the Director shall have the power to require the
8    following information:
9            (A) certification by an independent actuary of the
10        adequacy of the reserves of the Health Maintenance
11        Organization sought to be acquired;
12            (B) pro forma financial statements reflecting the
13        combined balance sheets of the acquiring company and
14        the Health Maintenance Organization sought to be
15        acquired as of the end of the preceding year and as of
16        a date 90 days prior to the acquisition, as well as pro
17        forma financial statements reflecting projected
18        combined operation for a period of 2 years;
19            (C) a pro forma business plan detailing an
20        acquiring party's plans with respect to the operation
21        of the Health Maintenance Organization sought to be
22        acquired for a period of not less than 3 years; and
23            (D) such other information as the Director shall
24        require.
25    (d) The provisions of Article VIII 1/2 of the Illinois
26Insurance Code and this Section 5-3 shall apply to the sale by

 

 

SB1282 Enrolled- 12 -LRB103 27271 BMS 53642 b

1any health maintenance organization of greater than 10% of its
2enrollee population (including without limitation the health
3maintenance organization's right, title, and interest in and
4to its health care certificates).
5    (e) In considering any management contract or service
6agreement subject to Section 141.1 of the Illinois Insurance
7Code, the Director (i) shall, in addition to the criteria
8specified in Section 141.2 of the Illinois Insurance Code,
9take into account the effect of the management contract or
10service agreement on the continuation of benefits to enrollees
11and the financial condition of the health maintenance
12organization to be managed or serviced, and (ii) need not take
13into account the effect of the management contract or service
14agreement on competition.
15    (f) Except for small employer groups as defined in the
16Small Employer Rating, Renewability and Portability Health
17Insurance Act and except for medicare supplement policies as
18defined in Section 363 of the Illinois Insurance Code, a
19Health Maintenance Organization may by contract agree with a
20group or other enrollment unit to effect refunds or charge
21additional premiums under the following terms and conditions:
22        (i) the amount of, and other terms and conditions with
23    respect to, the refund or additional premium are set forth
24    in the group or enrollment unit contract agreed in advance
25    of the period for which a refund is to be paid or
26    additional premium is to be charged (which period shall

 

 

SB1282 Enrolled- 13 -LRB103 27271 BMS 53642 b

1    not be less than one year); and
2        (ii) the amount of the refund or additional premium
3    shall not exceed 20% of the Health Maintenance
4    Organization's profitable or unprofitable experience with
5    respect to the group or other enrollment unit for the
6    period (and, for purposes of a refund or additional
7    premium, the profitable or unprofitable experience shall
8    be calculated taking into account a pro rata share of the
9    Health Maintenance Organization's administrative and
10    marketing expenses, but shall not include any refund to be
11    made or additional premium to be paid pursuant to this
12    subsection (f)). The Health Maintenance Organization and
13    the group or enrollment unit may agree that the profitable
14    or unprofitable experience may be calculated taking into
15    account the refund period and the immediately preceding 2
16    plan years.
17    The Health Maintenance Organization shall include a
18statement in the evidence of coverage issued to each enrollee
19describing the possibility of a refund or additional premium,
20and upon request of any group or enrollment unit, provide to
21the group or enrollment unit a description of the method used
22to calculate (1) the Health Maintenance Organization's
23profitable experience with respect to the group or enrollment
24unit and the resulting refund to the group or enrollment unit
25or (2) the Health Maintenance Organization's unprofitable
26experience with respect to the group or enrollment unit and

 

 

SB1282 Enrolled- 14 -LRB103 27271 BMS 53642 b

1the resulting additional premium to be paid by the group or
2enrollment unit.
3    In no event shall the Illinois Health Maintenance
4Organization Guaranty Association be liable to pay any
5contractual obligation of an insolvent organization to pay any
6refund authorized under this Section.
7    (g) Rulemaking authority to implement Public Act 95-1045,
8if any, is conditioned on the rules being adopted in
9accordance with all provisions of the Illinois Administrative
10Procedure Act and all rules and procedures of the Joint
11Committee on Administrative Rules; any purported rule not so
12adopted, for whatever reason, is unauthorized.
13(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
14101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
151-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
16eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
17102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
181-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
19eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
20102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
211-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
22eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
23    Section 35. The Limited Health Service Organization Act is
24amended by changing Section 4003 as follows:
 

 

 

SB1282 Enrolled- 15 -LRB103 27271 BMS 53642 b

1    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
2    Sec. 4003. Illinois Insurance Code provisions. Limited
3health service organizations shall be subject to the
4provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
5141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
6154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
7355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
8356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
9356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,
10356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
11408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
121/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
13Illinois Insurance Code. Nothing in this Section shall require
14a limited health care plan to cover any service that is not a
15limited health service. For purposes of the Illinois Insurance
16Code, except for Sections 444 and 444.1 and Articles XIII and
17XIII 1/2, limited health service organizations in the
18following categories are deemed to be domestic companies:
19        (1) a corporation under the laws of this State; or
20        (2) a corporation organized under the laws of another
21    state, 30% or more of the enrollees of which are residents
22    of this State, except a corporation subject to
23    substantially the same requirements in its state of
24    organization as is a domestic company under Article VIII
25    1/2 of the Illinois Insurance Code.
26(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;

 

 

SB1282 Enrolled- 16 -LRB103 27271 BMS 53642 b

1101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
21-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
3eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
4102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
51-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
6    Section 40. The Voluntary Health Services Plans Act is
7amended by changing Section 10 as follows:
 
8    (215 ILCS 165/10)  (from Ch. 32, par. 604)
9    Sec. 10. Application of Insurance Code provisions. Health
10services plan corporations and all persons interested therein
11or dealing therewith shall be subject to the provisions of
12Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
13143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
14356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
15356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
16356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
17356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
18356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
19356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
20356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
21367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
22and paragraphs (7) and (15) of Section 367 of the Illinois
23Insurance Code.
24    Rulemaking authority to implement Public Act 95-1045, if

 

 

SB1282 Enrolled- 17 -LRB103 27271 BMS 53642 b

1any, is conditioned on the rules being adopted in accordance
2with all provisions of the Illinois Administrative Procedure
3Act and all rules and procedures of the Joint Committee on
4Administrative Rules; any purported rule not so adopted, for
5whatever 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; 101-393, eff. 1-1-20; 101-625, eff.
81-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
9eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
10102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
111-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
12eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
13102-1117, eff. 1-13-23.)
 
14    Section 45. The Illinois Public Aid Code is amended by
15changing Section 5-16.8 as follows:
 
16    (305 ILCS 5/5-16.8)
17    Sec. 5-16.8. Required health benefits. The medical
18assistance program shall (i) provide the post-mastectomy care
19benefits required to be covered by a policy of accident and
20health insurance under Section 356t and the coverage required
21under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
22356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
23356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and
24356z.61 of the Illinois Insurance Code, (ii) be subject to the

 

 

SB1282 Enrolled- 18 -LRB103 27271 BMS 53642 b

1provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
2370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
3subject to the provisions of subsection (d-5) of Section 10 of
4the Network Adequacy and Transparency Act.
5    The Department, by rule, shall adopt a model similar to
6the requirements of Section 356z.39 of the Illinois Insurance
7Code.
8    On and after July 1, 2012, the Department shall reduce any
9rate of reimbursement for services or other payments or alter
10any methodologies authorized by this Code to reduce any rate
11of reimbursement for services or other payments in accordance
12with Section 5-5e.
13    To ensure full access to the benefits set forth in this
14Section, on and after January 1, 2016, the Department shall
15ensure that provider and hospital reimbursement for
16post-mastectomy care benefits required under this Section are
17no lower than the Medicare reimbursement rate.
18(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
19101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
201-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
21eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
22102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
231-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
24eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
25    Section 95. No acceleration or delay. Where this Act makes

 

 

SB1282 Enrolled- 19 -LRB103 27271 BMS 53642 b

1changes in a statute that is represented in this Act by text
2that is not yet or no longer in effect (for example, a Section
3represented by multiple versions), the use of that text does
4not accelerate or delay the taking effect of (i) the changes
5made by this Act or (ii) provisions derived from any other
6Public Act.