102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
Introduced 2/26/2021, by Sen. Laura M. Murphy
SYNOPSIS AS INTRODUCED:
215 ILCS 5/356z.43 new
305 ILCS 5/5-16.8
Amends the Illinois Insurance Code. Provides that no individual or
group policy of accident and health insurance or managed care organization
shall change an insured's eligibility or coverage during a contract
period. Provides that during a contract period, insureds shall have the
protection and continuity of their providers, medication, covered
benefits, and formulary during the contract period. Amends the Illinois
Public Aid Code making conforming changes.
A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
The Illinois Insurance Code is amended by
adding Section 356z.43 as follows:
(215 ILCS 5/356z.43 new)
Contract terms; coverage.
No individual or
group policy of accident and health insurance or managed care
organization shall amend, deliver, issue, or renew a policy in
a way that changes an insured's eligibility or coverage during
a contract period. During a contract period, an insured shall
have the protection and continuity of his or her providers,
his or her medication, his or her covered benefits, and the
formulary during the contract period.
The Illinois Public Aid Code is amended by
changing Section 5-16.8 as follows:
(305 ILCS 5/5-16.8)
Required health benefits.
(i) provide the post-mastectomy care
benefits required to be covered by a policy of
health insurance under Section 356t and the coverage required
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under Sections 356g.5, 356u, 356w, 356x, 356z.6, 356z.26,
356z.29, 356z.32, 356z.33, 356z.34,
, and 356z.43
of the Illinois
Insurance Code and (ii) be subject to the
provisions of Sections 356z.19, 364.01, 370c, and 370c.1 of
The Department, by rule, shall adopt a model similar to
the requirements of Section 356z.39 of the Illinois Insurance
On and after July 1, 2012, the Department shall reduce any
rate of reimbursement for services or other payments or alter
any methodologies authorized by this Code to reduce any rate
of reimbursement for services or other payments in accordance
with Section 5-5e.
To ensure full access to the benefits set forth in this
Section, on and after January 1, 2016, the Department shall
ensure that provider and hospital reimbursement for
post-mastectomy care benefits required under this Section are
no lower than the Medicare reimbursement rate.
(Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18;
100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff.
7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371,
eff. 1-1-20; 101-574, eff. 1-1-20; 101-649, eff. 7-7-20.)