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| | SB1289 Engrossed | | LRB103 05989 BMS 51011 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Insurance Code is amended by |
| 5 | | adding Section 355.5 as follows:
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| 6 | | (215 ILCS 5/355.5 new) |
| 7 | | Sec. 355.5. Dental coverage reimbursement; prohibitions. |
| 8 | | No insurer, dental service plan corporation, professional |
| 9 | | service corporation, insurance network leasing company, or any |
| 10 | | company that amends, delivers, issues, or renews an individual |
| 11 | | or group policy of accident and health insurance on or after |
| 12 | | the effective date of this amendatory Act of the 103rd General |
| 13 | | Assembly shall require a dental care provider to incur a fee to |
| 14 | | access and obtain payment or reimbursement for services |
| 15 | | provided. A dental plan carrier shall provide a dental care |
| 16 | | provider with 100% of the contracted amount of the payment or |
| 17 | | reimbursement. Fees incurred directly by a dental care |
| 18 | | provider from third parties related to transmitting an |
| 19 | | automated clearing house network claim, transaction |
| 20 | | management, data management, or portal services and other fees |
| 21 | | charged by third parties that are not in the control of the |
| 22 | | dental plan carrier shall not be prohibited by this Section.
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