HB3476 104TH GENERAL ASSEMBLY

LRB104 08938 BAB 18993 b

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB3476

Introduced 2/18/2025, by Rep. Jennifer Gong-Gershowitz

SYNOPSIS AS INTRODUCED:

215 ILCS 5/355.5

Amends the Illinois Insurance Code. Removes provision stating that fees incurred directly by a dental care provider from third parties related to transmitting an automated clearing house network claim, transaction management, data management, or portal services and other fees charged by third parties that are not in the control of the dental plan carrier shall not be prohibited. Effective immediately.

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 355.5 as follows:

(215 ILCS 5/355.5)

Sec. 355.5. Dental coverage reimbursement; prohibitions. No insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any company that amends, delivers, issues, 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 shall require a dental care provider to incur a fee to access and obtain payment or reimbursement for services provided. A dental plan carrier shall provide a dental care provider with 100% of the contracted amount of the payment or reimbursement. Fees incurred directly by a dental care provider from third parties related to transmitting an automated clearing house network claim, transaction management, data management, or portal services and other fees charged by third parties that are not in the control of the dental plan carrier shall not be prohibited by this Section.

(Source: P.A. 103-24, eff. 1-1-24.)

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