93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
SB2748

 

Introduced 2/5/2004, by Mattie Hunter

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/6.16 new
55 ILCS 5/5-1069.9 new
65 ILCS 5/10-4-2.6 new
30 ILCS 805/8.28 new

    Amends the State Employees Group Insurance Act of 1971, the Counties Code, and the Illinois Municipal Code. Provides that health benefits provided to employees under those Acts must include coverage for surgical treatment for morbid obesity. Amends the State Mandates Act to require implementation without reimbursement.


LRB093 20228 RAS 45986 b

FISCAL NOTE ACT MAY APPLY
HOME RULE NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

 

 

A BILL FOR

 

SB2748 LRB093 20228 RAS 45986 b

1     AN ACT concerning public employee health benefits.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The State Employees Group Insurance Act of 1971
5 is amended by adding Section 6.16 as follows:
 
6     (5 ILCS 375/6.16 new)
7     Sec. 6.16. Morbid obesity.
8     (a) Beginning on January 1, 2005, the program of health
9 benefits must provide benefits for the expenses of the surgical
10 treatment of morbid obesity for the following individuals:
11         (1) individuals with a body-mass index equal to or
12     greater than 40 kilograms per meter squared;
13         (2) individuals with a body-mass index equal to or
14     greater than 35 kilograms per meter squared, with
15     comorbidities or coexisting medical conditions, such as
16     hypertension, cardiopulmonary conditions, sleep apnea, or
17     diabetes; and
18         (3) individuals who meet the guidelines for the
19     surgical treatment of morbid obesity as set forth by the
20     national institutes of health.
21     (b) The benefits provided under subsection (a) shall
22 include benefits for examinations and laboratory tests
23 performed in accordance with the guidelines of the national
24 institutes of health for the surgical treatment of morbid
25 obesity.
26     (c) The benefits provided under subsection (a) shall be no
27 less extensive than those provided for any other medically
28 necessary surgical procedure under the program of health
29 benefits and shall be subject to the same terms and conditions,
30 including copayment charges.
 
31     Section 10. The Counties Code is amended by adding Section

 

 

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1 5-1069.9 as follows:
 
2     (55 ILCS 5/5-1069.9 new)
3     Sec. 5-1069.9. Morbid obesity.
4     (a) If a county, including a home rule county, is a
5 self-insurer for purposes of providing health insurance
6 coverage for its employees, the coverage must provide benefits
7 for the expenses of the surgical treatment of morbid obesity
8 for the following individuals:
9         (1) individuals with a body-mass index equal to or
10     greater than 40 kilograms per meter squared;
11         (2) individuals with a body-mass index equal to or
12     greater than 35 kilograms per meter squared, with
13     comorbidities or coexisting medical conditions, such as
14     hypertension, cardiopulmonary conditions, sleep apnea, or
15     diabetes; and
16         (3) individuals who meet the guidelines for the
17     surgical treatment of morbid obesity as set forth by the
18     national institutes of health.
19     (b) The benefits provided under subsection (a) shall
20 include benefits for examinations and laboratory tests
21 performed in accordance with the guidelines of the national
22 institutes of health for the surgical treatment of morbid
23 obesity.
24     (c) The benefits provided under subsection (a) shall be no
25 less extensive than those provided for any other medically
26 necessary surgical procedure under the coverage and shall be
27 subject to the same terms and conditions, including copayment
28 charges.
29     (d) The requirement that health benefits be covered as
30 provided in this Section is an exclusive power and function of
31 the State and is a denial and limitation under Article VII,
32 Section 6, subsection (h) of the Illinois Constitution. A home
33 rule county to which this Section applies must comply with
34 every provision of this Section.
 

 

 

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1     Section 15. The Illinois Municipal Code is amended by
2 adding Section 10-4-2.6 as follows:
 
3     (65 ILCS 5/10-4-2.6 new)
4     Sec. 10-4-2.6. Morbid obesity.
5     (a) If a municipality, including a home rule municipality,
6 is a self-insurer for purposes of providing health insurance
7 coverage for its employees, the coverage must provide benefits
8 for the expenses of the surgical treatment of morbid obesity
9 for the following individuals:
10         (1) individuals with a body-mass index equal to or
11     greater than 40 kilograms per meter squared;
12         (2) individuals with a body-mass index equal to or
13     greater than 35 kilograms per meter squared, with
14     comorbidities or coexisting medical conditions, such as
15     hypertension, cardiopulmonary conditions, sleep apnea, or
16     diabetes; and
17         (3) individuals who meet the guidelines for the
18     surgical treatment of morbid obesity as set forth by the
19     national institutes of health.
20     (b) The benefits provided under subsection (a) shall
21 include benefits for examinations and laboratory tests
22 performed in accordance with the guidelines of the national
23 institutes of health for the surgical treatment of morbid
24 obesity.
25     (c) The benefits provided under subsection (a) shall be no
26 less extensive than those provided for any other medically
27 necessary surgical procedure under the coverage and shall be
28 subject to the same terms and conditions, including copayment
29 charges.
30     (d) The requirement that health benefits be covered as
31 provided in this Section is an exclusive power and function of
32 the State and is a denial and limitation under Article VII,
33 Section 6, subsection (h) of the Illinois Constitution. A home
34 rule municipality to which this Section applies must comply
35 with every provision of this Section.
 

 

 

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1     Section 90. The State Mandates Act is amended by adding
2 Section 8.28 as follows:
 
3     (30 ILCS 805/8.28 new)
4     Sec. 8.28. Exempt mandate. Notwithstanding Sections 6 and 8
5 of this Act, no reimbursement by the State is required for the
6 implementation of any mandate created by this amendatory Act of
7 the 93rd General Assembly.