99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB0235

 

Introduced , by Rep. Laura Fine

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356z.2

    Amends the Illinois Insurance Code. Provides that individual or group policies of accident and health insurance amended, delivered, issued, or renewed after the effective date of the Act shall cover charges incurred, and anesthetics provided, in conjunction with dental care that is provided to a covered individual in a dental office, oral surgeon's office, hospital, or ambulatory surgical treatment center if the individual is under age 26 and has been diagnosed with an autism spectrum disorder as defined in Section 10 of the Autism Spectrum Disorders Reporting Act.


LRB099 03691 MLM 23702 b

 

 

A BILL FOR

 

HB0235LRB099 03691 MLM 23702 b

1    AN ACT concerning insurance.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 356z.2 as follows:
 
6    (215 ILCS 5/356z.2)
7    Sec. 356z.2. Coverage for adjunctive services in dental
8care.
9    (a) An individual or group policy of accident and health
10insurance amended, delivered, issued, or renewed after the
11effective date of this amendatory Act of the 92nd General
12Assembly shall cover charges incurred, and anesthetics
13provided, in conjunction with dental care that is provided to a
14covered individual in a hospital or an ambulatory surgical
15treatment center if any of the following applies:
16        (1) the individual is a child age 6 or under;
17        (2) the individual has a medical condition that
18    requires hospitalization or general anesthesia for dental
19    care; or
20        (3) the individual is disabled.
21    (a-5) An individual or group policy of accident and health
22insurance amended, delivered, issued, or renewed after the
23effective date of this amendatory Act of the 99th General

 

 

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1Assembly shall cover charges incurred, and anesthetics
2provided, in conjunction with dental care that is provided to a
3covered individual in a dental office, oral surgeon's office,
4hospital, or ambulatory surgical treatment center if the
5individual is under age 26 and has been diagnosed with an
6autism spectrum disorder as defined in Section 10 of the Autism
7Spectrum Disorders Reporting Act.
8    (b) For purposes of this Section, "ambulatory surgical
9treatment center" has the meaning given to that term in Section
103 of the Ambulatory Surgical Treatment Center Act.
11    For purposes of this Section, "disabled" means a person,
12regardless of age, with a chronic disability if the chronic
13disability meets all of the following conditions:
14        (1) It is attributable to a mental or physical
15    impairment or     combination of mental and physical
16    impairments.
17        (2) It is likely to continue.
18        (3) It results in substantial functional limitations
19    in one or more of the following areas of major life
20    activity:
21            (A) self-care;
22            (B) receptive and expressive language;
23            (C) learning;
24            (D) mobility;
25            (E) capacity for independent living; or
26            (F) economic self-sufficiency.

 

 

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1    (c) The coverage required under this Section may be subject
2to any limitations, exclusions, or cost-sharing provisions
3that apply generally under the insurance policy.
4    (d) This Section does not apply to a policy that covers
5only dental care.
6    (e) Nothing in this Section requires that the dental
7services be covered.
8    (f) The provisions of this Section do not apply to
9short-term travel, accident-only, limited, or specified
10disease policies, nor to policies or contracts designed for
11issuance to persons eligible for coverage under Title XVIII of
12the Social Security Act, known as Medicare, or any other
13similar coverage under State or federal governmental plans.
14(Source: P.A. 95-331, eff. 8-21-07.)