SB2762 EnrolledLRB104 16499 BAB 29895 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:
 
4    Section 5. The Counties Code is amended by changing 
5Section 5-1069.3 as follows:
 
6    (55 ILCS 5/5-1069.3)
7    (Text of Section before amendment by P.A. 104-446)
8    Sec. 5-1069.3. Required health benefits. If a county, 
9including a home rule county, is a self-insurer for purposes 
10of providing health insurance coverage for its employees, the 
11coverage shall include coverage for the post-mastectomy care 
12benefits required to be covered by a policy of accident and 
13health insurance under Section 356t and the coverage required 
14under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 
15356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 
16356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 
17356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 
18356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 
20356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, 
21and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, 
22356z.84, 356z.85, 356z.88, and 356z.89 of the Illinois 
23Insurance Code. The coverage shall comply with Sections 
 
 
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1155.22a, 355b, 356z.19, and 370c of the Illinois Insurance 
2Code. The Department of Insurance shall enforce the 
3requirements of this Section. The requirement that health 
4benefits be covered as provided in this Section is an 
5exclusive power and function of the State and is a denial and 
6limitation under Article VII, Section 6, subsection (h) of the 
7Illinois Constitution. A home rule county to which this 
8Section applies must comply with every provision of this 
9Section. 
10    Rulemaking authority to implement Public Act 95-1045, if 
11any, is conditioned on the rules being adopted in accordance 
12with all provisions of the Illinois Administrative Procedure 
13Act and all rules and procedures of the Joint Committee on 
14Administrative Rules; any purported rule not so adopted, for 
15whatever reason, is unauthorized. 
16(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
17103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 
188-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 
19eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 
20103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 
216-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 
221-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 
23eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-7-26.)
 
24    (Text of Section after amendment by P.A. 104-446)
25    Sec. 5-1069.3. Required health benefits. If a county, 
 
 
SB2762 Enrolled- 3 -LRB104 16499 BAB 29895 b

1including a home rule county, is a self-insurer for purposes 
2of providing health insurance coverage for its employees, the 
3coverage shall include coverage for the post-mastectomy care 
4benefits required to be covered by a policy of accident and 
5health insurance under Section 356t and the coverage required 
6under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 
7356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 
8356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 
9356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 
10356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 
11356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 
12356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, 
13and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, 
14356z.84, 356z.85, 356z.88, and 356z.89 of the Illinois 
15Insurance Code. The coverage shall comply with Sections 
16155.22a, 355b, 356z.19, 370c, and 370c.4 of the Illinois 
17Insurance Code. The Department of Insurance shall enforce the 
18requirements of this Section. The requirement that health 
19benefits be covered as provided in this Section is an 
20exclusive power and function of the State and is a denial and 
21limitation under Article VII, Section 6, subsection (h) of the 
22Illinois Constitution. A home rule county to which this 
23Section applies must comply with every provision of this 
24Section. 
25    Rulemaking authority to implement Public Act 95-1045, if 
26any, is conditioned on the rules being adopted in accordance 
 
 
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1with all provisions of the Illinois Administrative Procedure 
2Act and all rules and procedures of the Joint Committee on 
3Administrative Rules; any purported rule not so adopted, for 
4whatever reason, is unauthorized. 
5(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
6103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 
78-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 
8eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 
9103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 
106-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 
111-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 
12eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26; 
13revised 1-7-26.)
 
14    Section 10. The Illinois Municipal Code is amended by 
15changing Section 10-4-2.3 as follows:
 
16    (65 ILCS 5/10-4-2.3)
17    (Text of Section before amendment by P.A. 104-446)
18    Sec. 10-4-2.3. Required health benefits. If a 
19municipality, including a home rule municipality, is a 
20self-insurer for purposes of providing health insurance 
21coverage for its employees, the coverage shall include 
22coverage for the post-mastectomy care benefits required to be 
23covered by a policy of accident and health insurance under 
24Section 356t and the coverage required under Sections 356g, 
 
 
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1356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, 
2356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 
3356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 
4356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 
5356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 
6356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 
7356z.67, 356z.68, 356z.70, 356z.71, 356z.74, and 356z.77, 
8356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, 356z.84, 
9356z.85, 356z.88, and 356z.89 of the Illinois Insurance Code. 
10The coverage shall comply with Sections 155.22a, 355b, 
11356z.19, and 370c of the Illinois Insurance Code. The 
12Department of Insurance shall enforce the requirements of this 
13Section. The requirement that health benefits be covered as 
14provided in this Section is an exclusive power and function of 
15the State and is a denial and limitation under Article VII, 
16Section 6, subsection (h) of the Illinois Constitution. A home 
17rule municipality to which this Section applies must comply 
18with every provision of this Section. 
19    Rulemaking authority to implement Public Act 95-1045, if 
20any, is conditioned on the rules being adopted in accordance 
21with all provisions of the Illinois Administrative Procedure 
22Act and all rules and procedures of the Joint Committee on 
23Administrative Rules; any purported rule not so adopted, for 
24whatever reason, is unauthorized. 
25(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
26103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 
 
 
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18-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 
2eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 
3103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 
46-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 
51-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 
6eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-8-26.)
 
7    (Text of Section after amendment by P.A. 104-446)
8    Sec. 10-4-2.3. Required health benefits. If a 
9municipality, including a home rule municipality, is a 
10self-insurer for purposes of providing health insurance 
11coverage for its employees, the coverage shall include 
12coverage for the post-mastectomy care benefits required to be 
13covered by a policy of accident and health insurance under 
14Section 356t and the coverage required under Sections 356g, 
15356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, 
16356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 
17356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 
18356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 
19356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 
20356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 
21356z.67, 356z.68, 356z.70, 356z.71, 356z.74, and 356z.77, 
22356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, 356z.84, 
23356z.85, 356z.88, and 356z.89 of the Illinois Insurance Code. 
24The coverage shall comply with Sections 155.22a, 355b, 
25356z.19, 370c, and 370c.4 of the Illinois Insurance Code. The 
 
 
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1Department of Insurance shall enforce the requirements of this 
2Section. The requirement that health benefits be covered as 
3provided in this Section is an exclusive power and function of 
4the State and is a denial and limitation under Article VII, 
5Section 6, subsection (h) of the Illinois Constitution. A home 
6rule municipality to which this Section applies must comply 
7with every provision of this Section. 
8    Rulemaking authority to implement Public Act 95-1045, if 
9any, is conditioned on the rules being adopted in accordance 
10with all provisions of the Illinois Administrative Procedure 
11Act and all rules and procedures of the Joint Committee on 
12Administrative Rules; any purported rule not so adopted, for 
13whatever reason, is unauthorized. 
14(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
15103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 
168-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 
17eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 
18103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 
196-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 
201-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 
21eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26; 
22revised 1-8-26.)
 
23    Section 15. The School Code is amended by changing Section 
2410-22.3f as follows:
 
 
 
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1    (105 ILCS 5/10-22.3f)
2    (Text of Section before amendment by P.A. 104-446)
3    Sec. 10-22.3f. Required health benefits. Insurance 
4protection and benefits for employees shall provide the 
5post-mastectomy care benefits required to be covered by a 
6policy of accident and health insurance under Section 356t and 
7the coverage required under Sections 356g, 356g.5, 356g.5-1, 
8356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, 
9356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 
10356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 
11356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 
12356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 
13356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 
14356z.74, and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, 
15356z.83, 356z.84, 356z.85, 356z.88, and 356z.89 of the 
16Illinois Insurance Code. Insurance policies shall comply with 
17Section 356z.19 of the Illinois Insurance Code. The coverage 
18shall comply with Sections 155.22a, 355b, and 370c and Article 
19XXXIIB of the Illinois Insurance Code. The Department of 
20Insurance shall enforce the requirements of this Section. 
21    Rulemaking authority to implement Public Act 95-1045, if 
22any, is conditioned on the rules being adopted in accordance 
23with all provisions of the Illinois Administrative Procedure 
24Act and all rules and procedures of the Joint Committee on 
25Administrative Rules; any purported rule not so adopted, for 
26whatever reason, is unauthorized. 
 
 
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1(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
2103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 
38-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 
4eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 
5103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 
66-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 
71-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324, 
8eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; 
9revised 1-8-26.)
 
10    (Text of Section after amendment by P.A. 104-446)
11    Sec. 10-22.3f. Required health benefits. Insurance 
12protection and benefits for employees shall provide the 
13post-mastectomy care benefits required to be covered by a 
14policy of accident and health insurance under Section 356t and 
15the coverage required under Sections 356g, 356g.5, 356g.5-1, 
16356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, 
17356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 
18356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 
19356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 
20356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 
21356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 
22356z.74, and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, 
23356z.83, 356z.84, 356z.85, 356z.88, and 356z.89 of the 
24Illinois Insurance Code. Insurance policies shall comply with 
25Section 356z.19 of the Illinois Insurance Code. The coverage 
 
 
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1shall comply with Sections 155.22a, 355b, 370c, and 370c.4 and 
2Article XXXIIB of the Illinois Insurance Code. The Department 
3of Insurance shall enforce the requirements of this Section. 
4    Rulemaking authority to implement Public Act 95-1045, if 
5any, is conditioned on the rules being adopted in accordance 
6with all provisions of the Illinois Administrative Procedure 
7Act and all rules and procedures of the Joint Committee on 
8Administrative Rules; any purported rule not so adopted, for 
9whatever reason, is unauthorized. 
10(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
11103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 
128-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 
13eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 
14103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 
156-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 
161-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324, 
17eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; 
18104-446, eff. 6-1-26; revised 1-8-26.)
 
19    Section 20. The Illinois Insurance Code is amended by 
20adding Sections 356z.88 and 356z.89 as follows:
 
21    (215 ILCS 5/356z.88 new)
22    Sec. 356z.88. Coverage for seizure detection devices.
23    (a) For the purposes of this Section, "seizure detection 
24device" means a monitoring device cleared by the United States 
 
 
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1Food and Drug Administration, and any related technology, 
2application, service, or subscription supporting the 
3prescribed use of the device, that provides the following:
4        (1) individual monitoring and alert services relating 
5    to seizure activity;
6        (2) detection or prediction of seizure activity and 
7    transmission of notification of the seizure activity to 
8    the individual or a caregiver for appropriate medical 
9    response; or
10        (3) collection of data of the seizure activity of the 
11    individual that can be used by a health care provider to 
12    diagnose or appropriately treat a health care condition 
13    that causes the seizure activity.
14    (b) A group or individual plan of accident and health 
15insurance or managed care plan amended, delivered, issued, or 
16renewed on or after January 1, 2029 shall provide coverage for 
17medically prescribed seizure detection devices.
18    (c) All seizure detection devices covered under this 
19Section shall be approved for use by individuals, and the 
20choice of device shall be made based upon the individual's 
21circumstances and medical needs in consultation with the 
22individual's medical provider.
23    (d) Any individual who has been prescribed a seizure 
24detection device shall not be required to obtain prior 
25authorization for coverage for a seizure detection device, and 
26coverage shall be continuous once the seizure detection device 
 
 
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1is prescribed.
2    (e) A group or individual policy of accident and health 
3insurance or a managed care plan that is amended, delivered, 
4issued, or renewed on or after January 1, 2029 shall not impose 
5a deductible, coinsurance, copayment, or any other 
6cost-sharing requirement of more than $50 on the coverage of a 
7seizure detection device per plan year. The provisions of this 
8subsection do not apply to coverage under this Section to the 
9extent that the coverage would disqualify a high-deductible 
10health plan from eligibility for a health savings account.
 
11    (215 ILCS 5/356z.89 new)
12    Sec. 356z.89. Coverage for preeclampsia biomarker testing. 
13Any group or individual policy of accident and health 
14insurance or managed care plan amended, delivered, issued, or 
15renewed on or after January 1, 2028 shall cover, without 
16imposing a deductible, coinsurance, copayment, or any other 
17cost-sharing requirement upon the insured, preeclampsia 
18biomarker testing for predictive screening in asymptomatic 
19individuals, or for diagnosis and management when symptoms are 
20present.
 
21    Section 25. The Health Maintenance Organization Act is 
22amended by changing Section 5-3 as follows:
 
23    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
 
 
SB2762 Enrolled- 13 -LRB104 16499 BAB 29895 b

1    Sec. 5-3. Illinois Insurance Code provisions. 
2    (a) Health Maintenance Organizations shall be subject to 
3the provisions of Sections 133, 134, 136, 137, 139, 140, 
4141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 
5152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 
6155.49, 352c, 355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f, 
7356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 
8356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 
9356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 
10356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 
11356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 
12356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 
13356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 
14356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 
15356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 
16356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 
17356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 
18356z.76, 356z.77, 356z.78, 356z.79, 356z.80, 356z.81, 356z.82, 
19356z.83, 356z.84, 356z.85, 356z.88, 356z.89, 364, 364.01, 
20364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 
21370a, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 
22409, 412, 444, and 444.1, paragraph (c) of subsection (2) of 
23Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, 
24XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance 
25Code.
26    (b) For purposes of the Illinois Insurance Code, except 
 
 
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1for Sections 444 and 444.1 and Articles XIII and XIII 1/2, 
2Health Maintenance Organizations in the following categories 
3are deemed to be "domestic companies":
4        (1) a corporation authorized under the Dental Service 
5    Plan Act or the Voluntary Health Services Plans Act;
6        (2) a corporation organized under the laws of this 
7    State; or
8        (3) a corporation organized under the laws of another 
9    state, 30% or more of the enrollees of which are residents 
10    of this State, except a corporation subject to 
11    substantially the same requirements in its state of 
12    organization as is a "domestic company" under Article VIII 
13    1/2 of the Illinois Insurance Code.
14    (c) In considering the merger, consolidation, or other 
15acquisition of control of a Health Maintenance Organization 
16pursuant to Article VIII 1/2 of the Illinois Insurance Code,
17        (1) the Director shall give primary consideration to 
18    the continuation of benefits to enrollees and the 
19    financial conditions of the acquired Health Maintenance 
20    Organization after the merger, consolidation, or other 
21    acquisition of control takes effect;
22        (2)(i) the criteria specified in subsection (1)(b) of 
23    Section 131.8 of the Illinois Insurance Code shall not 
24    apply and (ii) the Director, in making his determination 
25    with respect to the merger, consolidation, or other 
26    acquisition of control, need not take into account the 
 
 
SB2762 Enrolled- 15 -LRB104 16499 BAB 29895 b

1    effect on competition of the merger, consolidation, or 
2    other acquisition of control;
3        (3) the Director shall have the power to require the 
4    following information:
5            (A) certification by an independent actuary of the 
6        adequacy of the reserves of the Health Maintenance 
7        Organization sought to be acquired;
8            (B) pro forma financial statements reflecting the 
9        combined balance sheets of the acquiring company and 
10        the Health Maintenance Organization sought to be 
11        acquired as of the end of the preceding year and as of 
12        a date 90 days prior to the acquisition, as well as pro 
13        forma financial statements reflecting projected 
14        combined operation for a period of 2 years;
15            (C) a pro forma business plan detailing an 
16        acquiring party's plans with respect to the operation 
17        of the Health Maintenance Organization sought to be 
18        acquired for a period of not less than 3 years; and
19            (D) such other information as the Director shall 
20        require.
21    (d) The provisions of Article VIII 1/2 of the Illinois 
22Insurance Code and this Section 5-3 shall apply to the sale by 
23any health maintenance organization of greater than 10% of its 
24enrollee population (including, without limitation, the health 
25maintenance organization's right, title, and interest in and 
26to its health care certificates).
 
 
SB2762 Enrolled- 16 -LRB104 16499 BAB 29895 b

1    (e) In considering any management contract or service 
2agreement subject to Section 141.1 of the Illinois Insurance 
3Code, the Director (i) shall, in addition to the criteria 
4specified in Section 141.2 of the Illinois Insurance Code, 
5take into account the effect of the management contract or 
6service agreement on the continuation of benefits to enrollees 
7and the financial condition of the health maintenance 
8organization to be managed or serviced, and (ii) need not take 
9into account the effect of the management contract or service 
10agreement on competition.
11    (f) Except for small employer groups as defined in the 
12Small Employer Rating, Renewability and Portability Health 
13Insurance Act and except for medicare supplement policies as 
14defined in Section 363 of the Illinois Insurance Code, a 
15Health Maintenance Organization may by contract agree with a 
16group or other enrollment unit to effect refunds or charge 
17additional premiums under the following terms and conditions:
18        (i) the amount of, and other terms and conditions with 
19    respect to, the refund or additional premium are set forth 
20    in the group or enrollment unit contract agreed in advance 
21    of the period for which a refund is to be paid or 
22    additional premium is to be charged (which period shall 
23    not be less than one year); and
24        (ii) the amount of the refund or additional premium 
25    shall not exceed 20% of the Health Maintenance 
26    Organization's profitable or unprofitable experience with 
 
 
SB2762 Enrolled- 17 -LRB104 16499 BAB 29895 b

1    respect to the group or other enrollment unit for the 
2    period (and, for purposes of a refund or additional 
3    premium, the profitable or unprofitable experience shall 
4    be calculated taking into account a pro rata share of the 
5    Health Maintenance Organization's administrative and 
6    marketing expenses, but shall not include any refund to be 
7    made or additional premium to be paid pursuant to this 
8    subsection (f)). The Health Maintenance Organization and 
9    the group or enrollment unit may agree that the profitable 
10    or unprofitable experience may be calculated taking into 
11    account the refund period and the immediately preceding 2 
12    plan years.
13    The Health Maintenance Organization shall include a 
14statement in the evidence of coverage issued to each enrollee 
15describing the possibility of a refund or additional premium, 
16and upon request of any group or enrollment unit, provide to 
17the group or enrollment unit a description of the method used 
18to calculate (1) the Health Maintenance Organization's 
19profitable experience with respect to the group or enrollment 
20unit and the resulting refund to the group or enrollment unit 
21or (2) the Health Maintenance Organization's unprofitable 
22experience with respect to the group or enrollment unit and 
23the resulting additional premium to be paid by the group or 
24enrollment unit.
25    In no event shall the Illinois Health Maintenance 
26Organization Guaranty Association be liable to pay any 
 
 
SB2762 Enrolled- 18 -LRB104 16499 BAB 29895 b

1contractual obligation of an insolvent organization to pay any 
2refund authorized under this Section.
3    (g) Rulemaking authority to implement Public Act 95-1045, 
4if any, is conditioned on the rules being adopted in 
5accordance with all provisions of the Illinois Administrative 
6Procedure Act and all rules and procedures of the Joint 
7Committee on Administrative Rules; any purported rule not so 
8adopted, for whatever reason, is unauthorized. 
9(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
10103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff. 
111-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551, 
12eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25; 
13103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff. 
141-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, 
15eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24; 
16103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff. 
171-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28, 
18eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, 
19eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26; 
20104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff. 
211-1-26; 104-417, eff. 8-15-25; revised 11-21-25.)
 
22    Section 30. The Limited Health Service Organization Act is 
23amended by changing Section 4003 as follows:
 
24    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
 
 
SB2762 Enrolled- 19 -LRB104 16499 BAB 29895 b

1    Sec. 4003. Illinois Insurance Code provisions. Limited 
2health service organizations shall be subject to the 
3provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, 
4141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153, 
5154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c, 
6355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a, 
7356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32, 
8356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 
9356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71, 
10356z.73, 356z.74, 356z.75, 356z.79, 356z.80, 356z.81, 356z.83, 
11356z.84, 356z.85, 356z.88, 356z.89, 364.3, 368a, 370a, 401, 
12401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and 
13Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, 
14XXVI, and XXXIIB of the Illinois Insurance Code. Nothing in 
15this Section shall require a limited health care plan to cover 
16any service that is not a limited health service. For purposes 
17of the Illinois Insurance Code, except for Sections 444 and 
18444.1 and Articles XIII and XIII 1/2, limited health service 
19organizations in the following categories are deemed to be 
20domestic companies:
21        (1) a corporation under the laws of this State; or
22        (2) a corporation organized under the laws of another 
23    state, 30% or more of the enrollees of which are residents 
24    of this State, except a corporation subject to 
25    substantially the same requirements in its state of 
26    organization as is a domestic company under Article VIII 
 
 
SB2762 Enrolled- 20 -LRB104 16499 BAB 29895 b

1    1/2 of the Illinois Insurance Code.
2(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
3103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 
41-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656, 
5eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 
6103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. 
71-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42, 
8eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26; 
9104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff. 
108-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised 
1111-21-25.)
 
12    Section 35. The Voluntary Health Services Plans Act is 
13amended by changing Section 10 as follows:
 
14    (215 ILCS 165/10)  (from Ch. 32, par. 604)
15    Sec. 10. Application of Illinois Insurance Code 
16provisions. Health services plan corporations and all persons 
17interested therein or dealing therewith shall be subject to 
18the provisions of Articles IIA and XII 1/2 and Sections 3.1, 
19133, 136, 139, 140, 143, 143.31, 143c, 149, 155.22a, 155.37, 
20354, 355.2, 355.3, 355.7, 355b, 355d, 356g, 356g.5, 356g.5-1, 
21356m, 356q, 356r, 356t, 356u, 356u.10, 356v, 356w, 356x, 356y, 
22356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 
23356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 
24356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 
 
 
SB2762 Enrolled- 21 -LRB104 16499 BAB 29895 b

1356z.29, 356z.30, 356z.32, 356z.32a, 356z.33, 356z.40, 
2356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 
3356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 
4356z.68, 356z.71, 356z.72, 356z.74, 356z.75, 356z.77, 356z.79, 
5356z.80, 356z.81, 356z.83, 356z.84, 356z.85, 356z.88, 356z.89, 
6364.01, 364.3, 367.2, 368a, 370a, 401, 401.1, 402, 403, 403A, 
7408, 408.2, and 412, and paragraphs (7) and (15) of Section 367 
8of the Illinois Insurance Code.
9    Rulemaking authority to implement Public Act 95-1045, if 
10any, is conditioned on the rules being adopted in accordance 
11with all provisions of the Illinois Administrative Procedure 
12Act and all rules and procedures of the Joint Committee on 
13Administrative Rules; any purported rule not so adopted, for 
14whatever reason, is unauthorized. 
15(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 
16103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-551, eff. 
178-11-23; 103-605, eff. 7-1-24; 103-656, eff. 1-1-25; 103-718, 
18eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, eff. 8-2-24; 
19103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 103-914, eff. 
201-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, 
21eff. 6-9-25; 104-28, eff. 1-1-26; 104-42, eff. 8-1-25; 104-73, 
22eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26; 
23104-324, eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 
248-15-25; revised 11-21-25.)
 
25    Section 95. No acceleration or delay. Where this Act makes 
 
 
SB2762 Enrolled- 22 -LRB104 16499 BAB 29895 b

1changes in a statute that is represented in this Act by text 
2that is not yet or no longer in effect (for example, a Section 
3represented by multiple versions), the use of that text does 
4not accelerate or delay the taking effect of (i) the changes 
5made by this Act or (ii) provisions derived from any other 
6Public Act.
 
7    Section 99. Effective date. This Act takes effect upon 
8becoming law.