State of Illinois
92nd General Assembly

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 1        AN ACT concerning the immunization of children.

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

 4        Section  1.  Short  title.  This  Act may be cited as the
 5    Childhood Immunization Insurance Act.

 6        Section 5. Definitions.  As used in this Act:
 7        "Child immunizations" means immunizations, including  the
 8    immunizing  agent  (reimbursement  for which shall not exceed
 9    150% of the average wholesale price) which, as determined  by
10    the  Department  of Public Health, conform with the standards
11    of the Advisory Committee on Immunization  Practices  of  the
12    Centers  for  Disease Control of the United States Department
13    of Health and Human Services.
14        "Health insurance policy" means any individual  or  group
15    accident  and  health  insurance  policy,  contract,  or plan
16    (other than a specified-disease policy) that provides medical
17    coverage on an expense-incurred, service,  or  prepaid  basis
18    and  provides  dependent  coverage  for  children.   The term
19    includes, but is not limited to, the following:
20             (1)  an accident and health insurance policy  issued
21        by  a  corporation  organized  under the Voluntary Health
22        Services Plans Act or by a company authorized to transact
23        business under the Illinois Insurance Code;
24             (2)  a health care plan operated  under  the  Health
25        Maintenance Organization Act; and
26             (3)  an  employee welfare benefit plan as defined in
27        Section 3  of  the  federal  Employee  Retirement  Income
28        Security Act of 1974 (ERISA).

29        Section  10.  Child immunizations.  Except as provided in
30    Section 25, a health  insurance  policy  that  is  delivered,
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 1    issued  for  delivery, renewed, extended, or modified in this
 2    State after the effective date of this Act must provide  that
 3    the  health  insurance  benefits  applicable under the policy
 4    include coverage for child immunizations.  A health insurance
 5    policy must provide  for  coverage  for  medically  necessary
 6    booster   doses  of  all  immunizing  agents  used  in  child
 7    immunizations.

 8        Section 15. Delivery of policy.  Except  as  provided  in
 9    Section 25, if a health insurance policy provides coverage or
10    benefits  to  a resident of this State, it shall be deemed to
11    be delivered in this State within the meaning  of  this  Act,
12    regardless  of  whether  the  health  care insurer issuing or
13    delivering the policy  is  located  within  or  outside  this
14    State.

15        Section 20. Copayments and deductibles.
16        (a)  Benefits for child immunization services are subject
17    to copayment and coinsurance provisions of a health insurance
18    policy  to  the extent that other medical services covered by
19    the policy are subject to those provisions.
20        (b)  Benefits for child immunization services are  exempt
21    from  deductible  or  dollar  limit  provisions  in  a health
22    insurance policy.  This exemption must be explicitly provided
23    for in the policy.

24        Section 25. Exemption.  Notwithstanding Sections  10  and
25    15,  this  Act  shall  not  be  construed to require a health
26    insurance policy to include coverage for child  immunizations
27    for  an individual who is a resident of this State if both of
28    the following apply:
29             (1)  The individual is employed outside this State.
30             (2)  The individual's employer  maintains  a  health
31        insurance  policy  for  the  individual  as an employment
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 1        benefit.

 2        Section 30.  Rules.  The Department of Public Health  and
 3    the  Department of Insurance shall promulgate rules necessary
 4    to implement this Act.

 5        Section 35.  Application of Act.  This Act applies to all
 6    group  and  individual  policies  of  accident   and   health
 7    insurance,   subscriber   contracts,   and   group  insurance
 8    certificates issued under any group master  policy  that  are
 9    amended,  delivered,  issued,  or renewed after the effective
10    date of this Act.

11        Section 99.  Effective date.  This Act takes effect  upon
12    becoming law.

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