SB1288 103RD GENERAL ASSEMBLY

LRB103 04626 BMS 51013 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1288

Introduced 2/3/2023, by Sen. Laura Fine

SYNOPSIS AS INTRODUCED:

215 ILCS 5/355.4

Amends the Illinois Insurance Code. In provisions concerning provider notification of dental plan changes, provides that no insurer, service corporation, dental service plan corporation, insurance network leasing company, or any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act that provides dental insurance may automatically enroll a provider in a leased network without the provider's written consent. Provides that any contract entered into or renewed on or after the effective date of the amendatory Act that allows the rights and obligations of the contract to be assigned or leased to another insurer shall provide for notice that informs each provider in writing via certified mail 90 days before any scheduled assignment or lease of the network to which the provider is a contracted provider (rather than shall provide notice of that assignment or lease within 30 days after the assignment or lease to the contracting dentist). Provides that an insurer, service corporation, dental service plan corporation, insurance network leasing company, or any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act that provides dental insurance that leases or assigns its network shall not cancel a network participating dentist's contractual relationship or otherwise penalize a network participating dentist in any way based on whether or not the dentist accepts the terms of the assignment or lease.

A BILL FOR

AN ACT concerning regulation.

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

Section 5. The Illinois Insurance Code is amended by changing Section 355.4 as follows:

(215 ILCS 5/355.4)

Sec. 355.4. Provider notification of network plan changes.

(a) No insurer, service corporation, dental service plan corporation, insurance network leasing company, or any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of this amendatory Act of the 103rd General Assembly that provides dental insurance may automatically enroll a provider in a leased network without the provider's written consent.

(b) Any contract entered into or renewed on or after the effective date of this amendatory Act of the 103rd General Assembly this amendatory Act of the 99th General Assembly that allows the rights and obligations of the contract to be assigned or leased to another insurer shall provide for notice that informs each provider in writing via certified mail 90 days before any scheduled assignment or lease of the network to which the provider is a contracted provider. The notification must include all contract terms, a policy manual, a fee schedule, and a form whereby the provider must choose to opt in to the network of the insurer that gains access to the dentist's contractual relationship in order to be in compliance with this Section of that assignment or lease within 30 days after the assignment or lease to the contracting dentist.

(c) An insurer, service corporation, dental service plan corporation, insurance network leasing company, or any company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of this amendatory Act of the 103rd General Assembly that provides dental insurance that leases or assigns its network shall not cancel a network participating dentist's contractual relationship or otherwise penalize a network participating dentist in any way based on whether or not the dentist accepts the terms of the assignment or lease. Before accepting the terms of an assignment or lease agreement as described in this Section, any provider who receives notification of an impending assignment or lease must be given the option to contract directly with the entities proposing to gain access to the provider's network.

(Source: P.A. 99-568, eff. 7-15-16.)