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92_SB1742 LRB9215768JStm 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, -2- LRB9215768JStm 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 -3- LRB9215768JStm 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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