Sen. Laura Fine

Filed: 3/20/2023





10300SB1288sam001LRB103 04626 BMS 59213 a


2    AMENDMENT NO. ______. Amend Senate Bill 1288 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Insurance Code is amended by
5changing Section 355.4 as follows:
6    (215 ILCS 5/355.4)
7    Sec. 355.4. Provider notification of network plan changes.
8    (a)In this Section:
9    "Contracting entity" means any person or company that
10enters into direct contracts with providers for the delivery
11of dental services in the ordinary course of business,
12including a third-party administrator and a dental carrier.
13    "Dental carrier" means a dental insurance company, dental
14service corporation, dental plan organization authorized to
15provide dental benefits, or a health insurance plan that
16includes coverage for dental services.



10300SB1288sam001- 2 -LRB103 04626 BMS 59213 a

1    (b) No dental carrier may automatically enroll a provider
2in a leased network without allowing any provider that is part
3of the dental carrier's provider network to choose to not
4participate by opting out.
5    (c) Any contract entered into or renewed on or after the
6effective date of this amendatory Act of the 103rd General
7Assembly this amendatory Act of the 99th General Assembly that
8allows the rights and obligations of the contract to be
9assigned or leased to another insurer shall provide for notice
10that informs each provider in writing via certified mail 60
11days before any scheduled assignment or lease of the network
12to which the provider is a contracted provider. To be in
13compliance with this Section, the notification must include
14all contract terms, a policy manual, a fee schedule, and a
15statement that the provider has the right to choose not to
16participate in third-party access of that assignment or lease
17within 30 days after the assignment or lease to the
18contracting dentist.
19    (d) A dental carrier that leases or assigns its network
20shall not cancel a network participating dentist's contractual
21relationship or otherwise penalize a network participating
22dentist in any way based on whether or not the dentist accepts
23the terms of the assignment or lease. Before accepting the
24terms of an assignment or lease agreement as described in this
25Section, any provider who receives notification of an
26impending assignment or lease must be given the option to



10300SB1288sam001- 3 -LRB103 04626 BMS 59213 a

1contract directly with the entities proposing to gain access
2to the provider's network.
3    (d) The provisions of this Section do not apply:
4        (1) if access to a provider network contract is
5    granted to a dental carrier or an entity operating in
6    accordance with the same brand licensee program as the
7    contracting entity; or
8        (2) to a provider network contract for dental services
9    provided to beneficiaries of the State employee group
10    health insurance program or the medical assistance program
11    under the Illinois Public Aid Code.
12(Source: P.A. 99-568, eff. 7-15-16.)".