093_HB1488

 
                                     LRB093 02149 JLS 02156 b

 1        AN ACT concerning health insurance coverage.

 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
 5    1971 is amended by changing Section 6.11 as follows:

 6        (5 ILCS 375/6.11)
 7        Sec. 6.11.  Required health benefits; Illinois  Insurance
 8    Code  requirements.   The  program  of  health benefits shall
 9    provide the post-mastectomy  care  benefits  required  to  be
10    covered  by  a  policy of accident and health insurance under
11    Section 356t of the Illinois Insurance Code.  The program  of
12    health  benefits  shall  provide  the coverage required under
13    Sections 356u, 356w, 356x, and  356z.2,  and  356z.4  of  the
14    Illinois  Insurance Code. The program of health benefits must
15    comply with Section 155.37 of the Illinois Insurance Code.
16    (Source: P.A. 92-440, eff. 8-17-01; 92-764, eff. 1-1-03.)

17        Section 10.  The Counties Code  is  amended  by  changing
18    Section 5-1069.3 as follows:

19        (55 ILCS 5/5-1069.3)
20        Sec.  5-1069.3.  Required  health benefits.  If a county,
21    including a home rule county, is a self-insurer for  purposes
22    of providing health insurance coverage for its employees, the
23    coverage  shall include coverage for the post-mastectomy care
24    benefits required to be covered by a policy of  accident  and
25    health insurance under Section 356t and the coverage required
26    under  Sections  356u,  356w,  and  356x,  and  356z.4 of the
27    Illinois  Insurance  Code.   The  requirement   that   health
28    benefits  be  covered  as  provided  in  this  Section  is an
29    exclusive power and function of the State and is a denial and
 
                            -2-      LRB093 02149 JLS 02156 b
 1    limitation under Article VII, Section 6,  subsection  (h)  of
 2    the  Illinois Constitution.  A home rule county to which this
 3    Section applies must comply  with  every  provision  of  this
 4    Section.
 5    (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.)

 6        Section  15.  The  Illinois  Municipal Code is amended by
 7    changing Section 10-4-2.3 as follows:

 8        (65 ILCS 5/10-4-2.3)
 9        Sec.  10-4-2.3.   Required   health   benefits.    If   a
10    municipality,  including  a  home  rule  municipality,  is  a
11    self-insurer  for  purposes  of  providing  health  insurance
12    coverage  for  its  employees,  the  coverage  shall  include
13    coverage for the post-mastectomy care benefits required to be
14    covered  by  a  policy of accident and health insurance under
15    Section 356t and the coverage required under  Sections  356u,
16    356w,  and  356x,  and 356z.4 of the Illinois Insurance Code.
17    The requirement that health benefits be covered  as  provided
18    in  this  is an exclusive power and function of the State and
19    is a denial and limitation  under  Article  VII,  Section  6,
20    subsection  (h)  of  the  Illinois Constitution.  A home rule
21    municipality to which this Section applies must  comply  with
22    every provision of this Section.
23    (Source: P.A. 90-7, eff. 6-10-97; 90-741, eff. 1-1-99.)

24        Section  20.  The  Illinois  Insurance Code is amended by
25    changing Section 351B-5 and adding Section 356z.4 as follows:

26        (215 ILCS 5/351B-5) (from Ch. 73, par. 963B-5)
27        Sec. 351B-5.  Applicability of other Code provisions. All
28    policies of accident and health insurance issued  under  this
29    Article  shall be subject to the provisions of Sections 356c,
30    subsection (a) of Section 356g,  356h,  356n,  356z.4,  367c,
 
                            -3-      LRB093 02149 JLS 02156 b
 1    367d, 370, 370a, and 370e of this Code.
 2    (Source: P.A. 86-1407; 87-792; 87-1066.)

 3        (215 ILCS 5/356z.4 new)
 4        Sec.  356z.4.  Coverage  for  certain benefits related to
 5    brain injury.
 6        (a)  A group or individual policy of accident and  health
 7    insurance,  a managed care plan, or multiple employer welfare
 8    arrangement, that is amended, delivered, issued,  or  renewed
 9    after  the  effective date of this amendatory Act of the 93rd
10    General Assembly  may  not  exclude  coverage  for  cognitive
11    rehabilitation   therapy,  cognitive  communication  therapy,
12    neurocognitive therapy and  rehabilitation,  neurobehavioral,
13    neurophysiological,          neuropsychological,          and
14    psychophysiological   testing   or  treatment,  neurofeedback
15    therapy,  remediation,  post-acute  transition  services,  or
16    community reintegration services necessary as a result of and
17    related to an acquired brain injury.
18        (b)  Coverage required under this Section may be  subject
19    to deductibles, copayments, coinsurance, or annual or maximum
20    payment   limits   that   are  consistent  with  deductibles,
21    copayments, coinsurance, and annual or maximum payment limits
22    applicable to other similar coverage under the policy.
23        (c)  The Department shall adopt  rules  as  necessary  to
24    implement this Section.

25        Section  25.  The  Health Maintenance Organization Act is
26    amended by changing Section 4-6.5 as follows:

27        (215 ILCS 125/4-6.5)
28        Sec. 4-6.5.  Required health benefits; Illinois Insurance
29    Code requirements.   A  health  maintenance  organization  is
30    subject to the provisions of Sections 155.37, 356t, 356u, and
31    356z.1, and 356z.4 of the Illinois Insurance Code.
 
                            -4-      LRB093 02149 JLS 02156 b
 1    (Source:  P.A.  92-130,  eff.  7-20-01; 92-440, eff. 8-17-01;
 2    92-651, eff. 7-11-02.)

 3        Section 30.  The Voluntary Health Services Plans  Act  is
 4    amended by changing Section 10 as follows:

 5        (215 ILCS 165/10) (from Ch. 32, par. 604)
 6        Sec.   10.  Application  of  Insurance  Code  provisions.
 7    Health services plan corporations and all persons  interested
 8    therein   or  dealing  therewith  shall  be  subject  to  the
 9    provisions of Articles IIA and XII 1/2 and Sections 3.1, 133,
10    140, 143, 143c, 149, 155.37, 354, 355.2,  356r,  356t,  356u,
11    356v,  356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 367.2, 368a,
12    401,  401.1,  402,  403,  403A,  408,  408.2,  and  412,  and
13    paragraphs (7) and  (15)  of  Section  367  of  the  Illinois
14    Insurance Code.
15    (Source: P.A.  91-406,  eff.  1-1-00;  91-549,  eff. 8-14-99;
16    91-605, eff. 12-14-99;  91-788,  eff.  6-9-00;  92-130,  eff.
17    7-20-01;  92-440, eff. 8-17-01; 92-651, eff. 7-11-02; 92-764,
18    eff. 1-1-03.)

19        Section 90.  The State Mandates Act is amended by  adding
20    Section 8.27 as follows:

21        (30 ILCS 805/8.27 new)
22        Sec.  8.27.  Exempt  mandate.  Notwithstanding Sections 6
23    and 8 of this Act, no reimbursement by the State is  required
24    for  the  implementation  of  any  mandate  created  by  this
25    amendatory Act of the 93rd General Assembly.