State of Illinois
91st General Assembly
Legislation

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91_HB0814eng

 
HB0814 Engrossed                               LRB9102331JSpc

 1        AN  ACT  to amend the Illinois Insurance Code by changing
 2    Section 370c.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section  5.   The  Illinois  Insurance Code is amended by
 6    changing Section 370c as follows:

 7        (215 ILCS 5/370c) (from Ch. 73, par. 982c)
 8        Sec. 370c. Mental, emotional,  or  nervous  disorders  or
 9    conditions.
10        (1)  On  and  after  the  effective date of this Section,
11    every insurer which delivers, issues for delivery  or  renews
12    or   modifies  group  A&H  policies  providing  coverage  for
13    hospital or medical treatment or services for illness  on  an
14    expense-incurred  basis shall offer to the applicant or group
15    policyholder   subject   to   the   insurers   standards   of
16    insurability, coverage for reasonable and necessary treatment
17    and services for mental, emotional or  nervous  disorders  or
18    conditions  up to the limits provided in the policy for other
19    disorders or  conditions,  except  (i)  the  insured  may  be
20    required to pay up to 50% of expenses incurred as a result of
21    the  treatment or services, and (ii) the annual benefit limit
22    may be limited to  the  lesser  of  $10,000  or  25%  of  the
23    lifetime policy limit.
24        (2)  Each  insured  that is covered for mental, emotional
25    or nervous disorders or conditions shall be  free  to  select
26    the  physician  licensed  to  practice  medicine  in  all its
27    branches, licensed clinical psychologist,  licensed  clinical
28    professional counselor, or licensed clinical social worker of
29    his choice to treat such disorders, and the insurer shall pay
30    the  covered  charges  of such physician licensed to practice
31    medicine in all its branches, licensed clinical psychologist,
 
HB0814 Engrossed            -2-                LRB9102331JSpc
 1    licensed  clinical  professional   counselor,   or   licensed
 2    clinical social worker up to the limits of coverage, provided
 3    (i)  the  disorder  or  condition  treated  is covered by the
 4    policy,  and  (ii)  the  physician,  licensed   psychologist,
 5    licensed   clinical   professional   counselor,  or  licensed
 6    clinical social worker is authorized to provide said services
 7    under the statutes of  this  State  and  in  accordance  with
 8    accepted principles of his profession.
 9        Insofar  as  this  Section  applies  solely  to  licensed
10    clinical  social  workers  and licensed clinical professional
11    counselors,  those  persons  who  may  provide  services   to
12    individuals  shall  do  so after the licensed clinical social
13    worker  or  licensed  clinical  professional  counselor   has
14    informed  the  patient  of  the  desirability  of the patient
15    conferring with the patient's primary care physician and  the
16    licensed   clinical   social   worker  or  licensed  clinical
17    professional counselor has provided written  notification  to
18    the  patient's  primary care physician, if any, that services
19    are being provided to the patient.   That  notification  may,
20    however,  be  waived by the patient on a written form.  Those
21    forms shall be  retained  by  the  licensed  clinical  social
22    worker  or the licensed clinical professional counselor for a
23    period of not less than 5 years.
24    (Source: P.A. 86-1434.)

25        Section 99.  Effective date.  This Act takes effect  upon
26    becoming law.

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