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Sen. Julie A. Morrison
Filed: 2/25/2026
| | 10400SB2762sam002 | | LRB104 16499 BAB 34891 a |
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| 1 | | AMENDMENT TO SENATE BILL 2762
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| 2 | | AMENDMENT NO. ______. Amend Senate Bill 2762 by replacing |
| 3 | | everything after the enacting clause with the following: |
| 4 | | "Section 5. The Counties Code is amended by changing |
| 5 | | Section 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, |
| 9 | | including a home rule county, is a self-insurer for purposes |
| 10 | | of providing health insurance coverage for its employees, the |
| 11 | | coverage shall include coverage for the post-mastectomy care |
| 12 | | benefits required to be covered by a policy of accident and |
| 13 | | health insurance under Section 356t and the coverage required |
| 14 | | under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, |
| 15 | | 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, |
| 16 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, |
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| 1 | | 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, |
| 2 | | 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, |
| 3 | | 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, |
| 4 | | 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, |
| 5 | | and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, |
| 6 | | 356z.84, 356z.85, and 356z.88 of the Illinois Insurance Code. |
| 7 | | The coverage shall comply with Sections 155.22a, 355b, |
| 8 | | 356z.19, and 370c of the Illinois Insurance Code. The |
| 9 | | Department of Insurance shall enforce the requirements of this |
| 10 | | Section. The requirement that health benefits be covered as |
| 11 | | provided in this Section is an exclusive power and function of |
| 12 | | the State and is a denial and limitation under Article VII, |
| 13 | | Section 6, subsection (h) of the Illinois Constitution. A home |
| 14 | | rule county to which this Section applies must comply with |
| 15 | | every provision of this Section. |
| 16 | | Rulemaking authority to implement Public Act 95-1045, if |
| 17 | | any, is conditioned on the rules being adopted in accordance |
| 18 | | with all provisions of the Illinois Administrative Procedure |
| 19 | | Act and all rules and procedures of the Joint Committee on |
| 20 | | Administrative Rules; any purported rule not so adopted, for |
| 21 | | whatever reason, is unauthorized. |
| 22 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 23 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. |
| 24 | | 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, |
| 25 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; |
| 26 | | 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. |
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| 1 | | 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. |
| 2 | | 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, |
| 3 | | eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-7-26.) |
| 4 | | (Text of Section after amendment by P.A. 104-446) |
| 5 | | Sec. 5-1069.3. Required health benefits. If a county, |
| 6 | | including a home rule county, is a self-insurer for purposes |
| 7 | | of providing health insurance coverage for its employees, the |
| 8 | | coverage shall include coverage for the post-mastectomy care |
| 9 | | benefits required to be covered by a policy of accident and |
| 10 | | health insurance under Section 356t and the coverage required |
| 11 | | under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, |
| 12 | | 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, |
| 13 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, |
| 14 | | 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, |
| 15 | | 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, |
| 16 | | 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, |
| 17 | | 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, |
| 18 | | and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, |
| 19 | | 356z.84, 356z.85, and 356z.88 of the Illinois Insurance Code. |
| 20 | | The coverage shall comply with Sections 155.22a, 355b, |
| 21 | | 356z.19, 370c, and 370c.4 of the Illinois Insurance Code. The |
| 22 | | Department of Insurance shall enforce the requirements of this |
| 23 | | Section. The requirement that health benefits be covered as |
| 24 | | provided in this Section is an exclusive power and function of |
| 25 | | the State and is a denial and limitation under Article VII, |
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| 1 | | Section 6, subsection (h) of the Illinois Constitution. A home |
| 2 | | rule county to which this Section applies must comply with |
| 3 | | every provision of this Section. |
| 4 | | Rulemaking authority to implement Public Act 95-1045, if |
| 5 | | any, is conditioned on the rules being adopted in accordance |
| 6 | | with all provisions of the Illinois Administrative Procedure |
| 7 | | Act and all rules and procedures of the Joint Committee on |
| 8 | | Administrative Rules; any purported rule not so adopted, for |
| 9 | | whatever reason, is unauthorized. |
| 10 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 11 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. |
| 12 | | 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, |
| 13 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; |
| 14 | | 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. |
| 15 | | 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. |
| 16 | | 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, |
| 17 | | eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26; |
| 18 | | revised 1-7-26.) |
| 19 | | Section 10. The Illinois Municipal Code is amended by |
| 20 | | changing Section 10-4-2.3 as follows: |
| 21 | | (65 ILCS 5/10-4-2.3) |
| 22 | | (Text of Section before amendment by P.A. 104-446) |
| 23 | | Sec. 10-4-2.3. Required health benefits. If a |
| 24 | | municipality, including a home rule municipality, is a |
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| 1 | | self-insurer for purposes of providing health insurance |
| 2 | | coverage for its employees, the coverage shall include |
| 3 | | coverage for the post-mastectomy care benefits required to be |
| 4 | | covered by a policy of accident and health insurance under |
| 5 | | Section 356t and the coverage required under Sections 356g, |
| 6 | | 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, |
| 7 | | 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, |
| 8 | | 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, |
| 9 | | 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, |
| 10 | | 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, |
| 11 | | 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, |
| 12 | | 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, and 356z.77, |
| 13 | | 356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, 356z.84, |
| 14 | | 356z.85, and 356z.88 of the Illinois Insurance Code. The |
| 15 | | coverage shall comply with Sections 155.22a, 355b, 356z.19, |
| 16 | | and 370c of the Illinois Insurance Code. The Department of |
| 17 | | Insurance shall enforce the requirements of this Section. The |
| 18 | | requirement that health benefits be covered as provided in |
| 19 | | this Section is an exclusive power and function of the State |
| 20 | | and is a denial and limitation under Article VII, Section 6, |
| 21 | | subsection (h) of the Illinois Constitution. A home rule |
| 22 | | municipality to which this Section applies must comply with |
| 23 | | every provision of this Section. |
| 24 | | Rulemaking authority to implement Public Act 95-1045, if |
| 25 | | any, is conditioned on the rules being adopted in accordance |
| 26 | | with all provisions of the Illinois Administrative Procedure |
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| 1 | | Act and all rules and procedures of the Joint Committee on |
| 2 | | Administrative Rules; any purported rule not so adopted, for |
| 3 | | whatever reason, is unauthorized. |
| 4 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 5 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. |
| 6 | | 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, |
| 7 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; |
| 8 | | 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. |
| 9 | | 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. |
| 10 | | 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, |
| 11 | | eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-8-26.) |
| 12 | | (Text of Section after amendment by P.A. 104-446) |
| 13 | | Sec. 10-4-2.3. Required health benefits. If a |
| 14 | | municipality, including a home rule municipality, is a |
| 15 | | self-insurer for purposes of providing health insurance |
| 16 | | coverage for its employees, the coverage shall include |
| 17 | | coverage for the post-mastectomy care benefits required to be |
| 18 | | covered by a policy of accident and health insurance under |
| 19 | | Section 356t and the coverage required under Sections 356g, |
| 20 | | 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, |
| 21 | | 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, |
| 22 | | 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, |
| 23 | | 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, |
| 24 | | 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, |
| 25 | | 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, |
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| 1 | | 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, and 356z.77, |
| 2 | | 356z.79, and 356z.80, 356z.81, 356z.82, 356z.83, 356z.84, |
| 3 | | 356z.85, and 356z.88 of the Illinois Insurance Code. The |
| 4 | | coverage shall comply with Sections 155.22a, 355b, 356z.19, |
| 5 | | 370c, and 370c.4 of the Illinois Insurance Code. The |
| 6 | | Department of Insurance shall enforce the requirements of this |
| 7 | | Section. The requirement that health benefits be covered as |
| 8 | | provided in this Section is an exclusive power and function of |
| 9 | | the State and is a denial and limitation under Article VII, |
| 10 | | Section 6, subsection (h) of the Illinois Constitution. A home |
| 11 | | rule municipality to which this Section applies must comply |
| 12 | | with every provision of this Section. |
| 13 | | Rulemaking authority to implement Public Act 95-1045, if |
| 14 | | any, is conditioned on the rules being adopted in accordance |
| 15 | | with all provisions of the Illinois Administrative Procedure |
| 16 | | Act and all rules and procedures of the Joint Committee on |
| 17 | | Administrative Rules; any purported rule not so adopted, for |
| 18 | | whatever reason, is unauthorized. |
| 19 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 20 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. |
| 21 | | 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, |
| 22 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; |
| 23 | | 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. |
| 24 | | 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. |
| 25 | | 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, |
| 26 | | eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26; |
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| 1 | | revised 1-8-26.) |
| 2 | | Section 15. The School Code is amended by changing Section |
| 3 | | 10-22.3f as follows: |
| 4 | | (105 ILCS 5/10-22.3f) |
| 5 | | (Text of Section before amendment by P.A. 104-446) |
| 6 | | Sec. 10-22.3f. Required health benefits. Insurance |
| 7 | | protection and benefits for employees shall provide the |
| 8 | | post-mastectomy care benefits required to be covered by a |
| 9 | | policy of accident and health insurance under Section 356t and |
| 10 | | the coverage required under Sections 356g, 356g.5, 356g.5-1, |
| 11 | | 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, |
| 12 | | 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, |
| 13 | | 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, |
| 14 | | 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, |
| 15 | | 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, |
| 16 | | 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, |
| 17 | | 356z.74, and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, |
| 18 | | 356z.83, 356z.84, 356z.85, and 356z.88 of the Illinois |
| 19 | | Insurance Code. Insurance policies shall comply with Section |
| 20 | | 356z.19 of the Illinois Insurance Code. The coverage shall |
| 21 | | comply with Sections 155.22a, 355b, and 370c and Article |
| 22 | | XXXIIB of the Illinois Insurance Code. The Department of |
| 23 | | Insurance shall enforce the requirements of this Section. |
| 24 | | Rulemaking authority to implement Public Act 95-1045, if |
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| | 10400SB2762sam002 | - 9 - | LRB104 16499 BAB 34891 a |
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| 1 | | any, is conditioned on the rules being adopted in accordance |
| 2 | | with all provisions of the Illinois Administrative Procedure |
| 3 | | Act and all rules and procedures of the Joint Committee on |
| 4 | | Administrative Rules; any purported rule not so adopted, for |
| 5 | | whatever reason, is unauthorized. |
| 6 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 7 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. |
| 8 | | 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, |
| 9 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; |
| 10 | | 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. |
| 11 | | 6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. |
| 12 | | 1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324, |
| 13 | | eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; |
| 14 | | revised 1-8-26.) |
| 15 | | (Text of Section after amendment by P.A. 104-446) |
| 16 | | Sec. 10-22.3f. Required health benefits. Insurance |
| 17 | | protection and benefits for employees shall provide the |
| 18 | | post-mastectomy care benefits required to be covered by a |
| 19 | | policy of accident and health insurance under Section 356t and |
| 20 | | the coverage required under Sections 356g, 356g.5, 356g.5-1, |
| 21 | | 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, |
| 22 | | 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, |
| 23 | | 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, |
| 24 | | 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, |
| 25 | | 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, |
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| 1 | | 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, |
| 2 | | 356z.74, and 356z.77, 356z.79, and 356z.80, 356z.81, 356z.82, |
| 3 | | 356z.83, 356z.84, 356z.85, and 356z.88 of the Illinois |
| 4 | | Insurance Code. Insurance policies shall comply with Section |
| 5 | | 356z.19 of the Illinois Insurance Code. The coverage shall |
| 6 | | comply with Sections 155.22a, 355b, 370c, and 370c.4 and |
| 7 | | Article XXXIIB of the Illinois Insurance Code. The Department |
| 8 | | of Insurance shall enforce the requirements of this Section. |
| 9 | | Rulemaking authority to implement Public Act 95-1045, if |
| 10 | | any, is conditioned on the rules being adopted in accordance |
| 11 | | with all provisions of the Illinois Administrative Procedure |
| 12 | | Act and all rules and procedures of the Joint Committee on |
| 13 | | Administrative Rules; any purported rule not so adopted, for |
| 14 | | whatever reason, is unauthorized. |
| 15 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 16 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. |
| 17 | | 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, |
| 18 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; |
| 19 | | 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. |
| 20 | | 6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. |
| 21 | | 1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324, |
| 22 | | eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; |
| 23 | | 104-446, eff. 6-1-26; revised 1-8-26.) |
| 24 | | Section 20. The Illinois Insurance Code is amended by |
| 25 | | adding Section 356z.88 as follows: |
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| 1 | | (215 ILCS 5/356z.88 new) |
| 2 | | Sec. 356z.88. Coverage for seizure detection devices. |
| 3 | | (a) For the purposes of this Section, "seizure detection |
| 4 | | device" means a monitoring device cleared by the United States |
| 5 | | Food and Drug Administration, and any related technology, |
| 6 | | application, service, or subscription supporting the |
| 7 | | prescribed use of the device, that provides the following: |
| 8 | | (1) individual monitoring and alert services relating |
| 9 | | to seizure activity; |
| 10 | | (2) detection or prediction of seizure activity and |
| 11 | | transmission of notification of the seizure activity to |
| 12 | | the individual or a caregiver for appropriate medical |
| 13 | | response; or |
| 14 | | (3) collection of data of the seizure activity of the |
| 15 | | individual that can be used by a health care provider to |
| 16 | | diagnose or appropriately treat a health care condition |
| 17 | | that causes the seizure activity. |
| 18 | | (b) A group or individual plan of accident and health |
| 19 | | insurance or managed care plan amended, delivered, issued, or |
| 20 | | renewed on or after January 1, 2028 shall provide coverage for |
| 21 | | medically prescribed seizure detection devices. |
| 22 | | (c) All seizure detection devices covered under this |
| 23 | | Section shall be approved for use by individuals, and the |
| 24 | | choice of device shall be made based upon the individual's |
| 25 | | circumstances and medical needs in consultation with the |
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| 1 | | individual's medical provider. |
| 2 | | (d) Any individual who has been prescribed a seizure |
| 3 | | detection device shall not be required to obtain prior |
| 4 | | authorization for coverage for a seizure detection device, and |
| 5 | | coverage shall be continuous once the seizure detection device |
| 6 | | is prescribed. |
| 7 | | (e) A group or individual policy of accident and health |
| 8 | | insurance or a managed care plan that is amended, delivered, |
| 9 | | issued, or renewed on or after January 1, 2028 shall not impose |
| 10 | | a deductible, coinsurance, copayment, or any other |
| 11 | | cost-sharing requirement of more than $50 on the coverage of a |
| 12 | | seizure detection device per plan year. The provisions of this |
| 13 | | subsection do not apply to coverage under this Section to the |
| 14 | | extent that the coverage would disqualify a high-deductible |
| 15 | | health plan from eligibility for a health savings account. |
| 16 | | Section 25. The Limited Health Service Organization Act is |
| 17 | | amended by changing Section 4003 as follows: |
| 18 | | (215 ILCS 130/4003) (from Ch. 73, par. 1504-3) |
| 19 | | Sec. 4003. Illinois Insurance Code provisions. Limited |
| 20 | | health service organizations shall be subject to the |
| 21 | | provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, |
| 22 | | 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153, |
| 23 | | 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c, |
| 24 | | 355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a, |
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| 1 | | 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32, |
| 2 | | 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, |
| 3 | | 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71, |
| 4 | | 356z.73, 356z.74, 356z.75, 356z.79, 356z.80, 356z.81, 356z.83, |
| 5 | | 356z.84, 356z.85, 356z.88, 364.3, 368a, 370a, 401, 401.1, 402, |
| 6 | | 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles |
| 7 | | IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and |
| 8 | | XXXIIB of the Illinois Insurance Code. Nothing in this Section |
| 9 | | shall require a limited health care plan to cover any service |
| 10 | | that is not a limited health service. For purposes of the |
| 11 | | Illinois Insurance Code, except for Sections 444 and 444.1 and |
| 12 | | Articles XIII and XIII 1/2, limited health service |
| 13 | | organizations in the following categories are deemed to be |
| 14 | | domestic companies: |
| 15 | | (1) a corporation under the laws of this State; or |
| 16 | | (2) a corporation organized under the laws of another |
| 17 | | state, 30% or more of the enrollees of which are residents |
| 18 | | of this State, except a corporation subject to |
| 19 | | substantially the same requirements in its state of |
| 20 | | organization as is a domestic company under Article VIII |
| 21 | | 1/2 of the Illinois Insurance Code. |
| 22 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 23 | | 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff. |
| 24 | | 1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656, |
| 25 | | eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; |
| 26 | | 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. |
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| 1 | | 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42, |
| 2 | | eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26; |
| 3 | | 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff. |
| 4 | | 8-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised |
| 5 | | 11-21-25.) |
| 6 | | Section 30. The Voluntary Health Services Plans Act is |
| 7 | | amended by changing Section 10 as follows: |
| 8 | | (215 ILCS 165/10) (from Ch. 32, par. 604) |
| 9 | | Sec. 10. Application of Illinois Insurance Code |
| 10 | | provisions. Health services plan corporations and all persons |
| 11 | | interested therein or dealing therewith shall be subject to |
| 12 | | the provisions of Articles IIA and XII 1/2 and Sections 3.1, |
| 13 | | 133, 136, 139, 140, 143, 143.31, 143c, 149, 155.22a, 155.37, |
| 14 | | 354, 355.2, 355.3, 355.7, 355b, 355d, 356g, 356g.5, 356g.5-1, |
| 15 | | 356m, 356q, 356r, 356t, 356u, 356u.10, 356v, 356w, 356x, 356y, |
| 16 | | 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, |
| 17 | | 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, |
| 18 | | 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, |
| 19 | | 356z.29, 356z.30, 356z.32, 356z.32a, 356z.33, 356z.40, |
| 20 | | 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, |
| 21 | | 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, |
| 22 | | 356z.68, 356z.71, 356z.72, 356z.74, 356z.75, 356z.77, 356z.79, |
| 23 | | 356z.80, 356z.81, 356z.83, 356z.84, 356z.85, 356z.88, 364.01, |
| 24 | | 364.3, 367.2, 368a, 370a, 401, 401.1, 402, 403, 403A, 408, |
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| 1 | | 408.2, and 412, and paragraphs (7) and (15) of Section 367 of |
| 2 | | the Illinois Insurance Code. |
| 3 | | Rulemaking authority to implement Public Act 95-1045, if |
| 4 | | any, is conditioned on the rules being adopted in accordance |
| 5 | | with all provisions of the Illinois Administrative Procedure |
| 6 | | Act and all rules and procedures of the Joint Committee on |
| 7 | | Administrative Rules; any purported rule not so adopted, for |
| 8 | | whatever reason, is unauthorized. |
| 9 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 10 | | 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-551, eff. |
| 11 | | 8-11-23; 103-605, eff. 7-1-24; 103-656, eff. 1-1-25; 103-718, |
| 12 | | eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, eff. 8-2-24; |
| 13 | | 103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 103-914, eff. |
| 14 | | 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, |
| 15 | | eff. 6-9-25; 104-28, eff. 1-1-26; 104-42, eff. 8-1-25; 104-73, |
| 16 | | eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26; |
| 17 | | 104-324, eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. |
| 18 | | 8-15-25; revised 11-21-25.) |
| 19 | | Section 35. The Illinois Public Aid Code is amended by |
| 20 | | changing Section 5-16.8 as follows: |
| 21 | | (305 ILCS 5/5-16.8) |
| 22 | | Sec. 5-16.8. Required health benefits. The medical |
| 23 | | assistance program shall (i) provide the post-mastectomy care |
| 24 | | benefits required to be covered by a policy of accident and |
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| 1 | | health insurance under Section 356t and the coverage required |
| 2 | | under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, |
| 3 | | 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46, |
| 4 | | 356z.47, 356z.51, 356z.53, 356z.59, 356z.60, 356z.61, 356z.64, |
| 5 | | 356z.67, 356z.71, and 356z.75, and 356z.80, 356z.84, 356z.85, |
| 6 | | and 356z.88 of the Illinois Insurance Code, (ii) be subject to |
| 7 | | the provisions of Sections 356z.19, 356z.44, 356z.49, 364.01, |
| 8 | | 370c, and 370c.1 of the Illinois Insurance Code, and (iii) be |
| 9 | | subject to the provisions of subsection (d-5) of Section 10 of |
| 10 | | the Network Adequacy and Transparency Act. |
| 11 | | The Department, by rule, shall adopt a model similar to |
| 12 | | the requirements of Section 356z.39 of the Illinois Insurance |
| 13 | | Code. |
| 14 | | On and after July 1, 2012, the Department shall reduce any |
| 15 | | rate of reimbursement for services or other payments or alter |
| 16 | | any methodologies authorized by this Code to reduce any rate |
| 17 | | of reimbursement for services or other payments in accordance |
| 18 | | with Section 5-5e. |
| 19 | | To ensure full access to the benefits set forth in this |
| 20 | | Section, on and after January 1, 2016, the Department shall |
| 21 | | ensure that provider and hospital reimbursement for |
| 22 | | post-mastectomy care benefits required under this Section are |
| 23 | | no lower than the Medicare reimbursement rate. |
| 24 | | (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; |
| 25 | | 103-420, eff. 1-1-24; 103-605, eff. 7-1-24; 103-703, eff. |
| 26 | | 1-1-25; 103-758, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-73, |