SB3707 104TH GENERAL ASSEMBLY

LRB104 20689 JDS 34188 b

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB3707

Introduced 2/5/2026, by Sen. Cristina Castro

SYNOPSIS AS INTRODUCED:

See Index

Amends the Illinois Insurance Code. Creates the Vision Benefit Managers Article. Beginning on July 1, 2026, requires a vision benefit manager to be registered with the Department of Insurance, as specified, to conduct business in the State. Requires amounts collected under provisions concerning vision benefit manager registration requirements to be deposited into the Low-Income Student Vision Examination Fund, which is created as a special fund in the State treasury. Grants the Director or the Director's designee the authority to examine a registered vision benefit manager related to all of its lines of business. Amends the Vision Care Plan Regulation Act. Changes the name of the Act to the Vision Benefit Manager Regulation Act. Establishes the legislative intent of the Act. Makes changes to defined terms. Throughout the Act, replaces references to vision care plans with vision benefit plans and vision benefit discount plans and vision care organizations with vision benefit managers. Sets forth provisions concerning required actions for noncovered services; fee schedules for eye care providers; reimbursement paid by a vision benefit manager to an eye care provider; application of the Act to a specified limited health service organization; an eye care provider's choice of vendors and affiliations; the modification of a plan; audits of an eye care provider; prohibited conduct impacting patient access and choice; credentialing; termination of agreements; prohibition on security interests; arbitration costs; nonretaliation; and private rights of action. Amends the Consumer Fraud and Deceptive Business Practices Act and the State Finance Act to make conforming changes. Effective January 1, 2027.

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 State Finance Act is amended by adding Section 5.1038 as follows:

(30 ILCS 105/5.1038 new)

Sec. 5.1038. The Low-Income Student Vision Examination Fund.

Section 10. The Illinois Insurance Code is amended by adding Article XXXIIC as follows:

(215 ILCS 5/Art. XXXIIC heading new)

ARTICLE XXXIIC. VISION BENEFIT MANAGERS

(215 ILCS 5/513c1 new)

Sec. 513c1. Vision benefit manager registration requirements.

(a) Beginning on July 1, 2027, to conduct business in this State, a vision benefit manager must register with the Director. To initially register or renew a registration, a vision benefit manager shall submit:

(1) a nonrefundable fee not to exceed $500;

(2) a copy of the registrant's corporate charter, articles of incorporation, or other charter document; and

(3) a completed registration form adopted by the Director containing:

(A) the name and address of the registrant; and

(B) the name, address, and official position of each officer and director of the registrant.

(b) The registrant shall report any change in information required under this Section to the Director in writing within 60 days after the change occurs.

(c) Upon receipt of a completed registration form, the required documents, and the registration fee, the Director shall issue a registration certificate. The certificate may be in paper or an electronic form and shall clearly indicate the expiration date of the registration. Registration certificates are nontransferable.

(d) A registration certificate is valid for 2 years after its date of issue. The Director shall adopt by rule an initial registration fee not to exceed $500 and a registration renewal fee not to exceed $500, both of which shall be nonrefundable. Total fees may not exceed the cost of administering this Section.

(e) The Department shall adopt any rules necessary to implement this Section.

(f) On or before August 1, 2027, the vision benefit manager shall submit a report to the Department that lists the name of each vision benefit plan and vision benefit discount plan it administers, provides the number of covered individuals for each vision benefit plan and vision benefit discount plan as of the date of submission, and provides the total number of covered individuals across all vision benefit plans and vision benefit discount plans the vision benefit manager administers. On or before September 1, 2027, a registered vision benefit manager, as a condition of its authority to transact business in this State, must submit to the Department an amount equal to $15 or an alternate amount as determined by the Director by rule per covered individual enrolled by the vision benefit manager in this State, as detailed in the report submitted to the Department under this subsection, during the preceding calendar year. On or before September 1, 2028 and each September 1 thereafter, payments submitted under this subsection shall be based on the number of covered individuals reported to the Department in this Section.

(g) All amounts collected under this Section shall be deposited into the Low-Income Student Vision Examination Fund, which is hereby created as a special fund in the State treasury. The moneys collected under this Section shall be transferred to the Illinois State Board of Education for grants to school districts to provide vision examinations for low-income students.

(215 ILCS 5/513c2 new)

Sec. 513c2. Examination.

(a) The Director, or the Director's designee, may examine a registered vision benefit manager related to all of its lines of business, including government programs, under the Director's jurisdiction in accordance with Sections 132 through 132.7. If the Director or the examiners find that the vision benefit manager has violated this Article or any other insurance-related or health benefits-related laws, rules, or regulations under the Director's jurisdiction because of the manner in which the vision benefit manager has conducted business on behalf of a vision benefit plan or a vision benefit discount plan, then, unless the vision benefit manager is included in the examination and has been afforded the same opportunity to request or participate in a hearing on the examination report, the examination report shall not allege a violation by the vision benefit manager and the Director's order based on the report shall not impose any requirements, prohibitions, or penalties on the vision benefit manager. Nothing in this Section shall prevent the Director from using any information obtained during the examination of a vision benefit manager to examine, investigate, or take other appropriate regulatory or legal action with respect to a vision benefit plan or a vision benefit discount plan.

(b) The examination requirement for the vision benefit manager to provide convenient and free access to all books and records under Sections 132 and 132.4 of this Code includes, at the Director's discretion, unredacted copies furnished electronically to the Director's market conduct surveillance personnel or examiners. Access must include information related to third-party entities affiliated or contracted with the vision benefit manager.

(c) The Department may examine any vision benefit manager as often as the Department deems appropriate, but shall, at a minimum, conduct an examination of the 3 largest vision benefit managers with the most covered individuals not less frequently than once every 5 years beginning in 2027, or following the conclusion of any market conduct exams already in progress for the 3 largest vision benefit managers. In determining the market share of a vision benefit plan or a vision benefit discount plan, the Department may consider, but is not limited to, the following:

(1) the number of covered individuals;

(2) the Illinois Market share;

(3) the number of claims;

(4) the previous violations; and

(5) the complaints received.

Section 15. The Vision Care Plan Regulation Act is amended by changing Sections 1, 5, 10, 15, 20, 25, 30, 35, and 40 and by adding Sections 1.5, 45, 50, 55, 60, 65, 70, 75, and 80 as follows:

(215 ILCS 161/1)

Sec. 1. Short title. This Act may be cited as the Vision Benefit Manager Care Plan Regulation Act.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/1.5 new)

Sec. 1.5. Legislative intent. It is the intent of the General Assembly to ensure that enrollees in vision benefit plans and vision benefit discount plans have the freedom to choose among in-network eye care providers without undue interference from vision benefit managers. This Act promotes transparency, protects the patient-provider relationship, and prevents practices that may coerce or limit patient choice through financial incentives, penalties, or differential reimbursements. The provisions of this Act are designed to regulate conduct rather than speech and safeguard the public interest in fair and equitable access to vision care services.

(215 ILCS 161/5)

Sec. 5. Definitions. As used in this Act:

"Covered materials" means materials for which reimbursement from a the vision benefit manager care plan is provided to an eye care provider that are eligible for reimbursement under by an enrollee's vision benefit plan or vision benefit discount plan contract or for which a reimbursement would be available but for the application of the enrollee's contractual limitation of deductibles, copayments, or coinsurance, regardless of how the benefits are listed in an enrollee's benefit plan's definition of benefits . "Covered materials" includes lens treatment or coatings added to a spectacle lens if the base spectacle lens is a covered material.

"Covered services" means services for which reimbursement from a the vision benefit manager care plan is provided to an eye care provider that are eligible for reimbursement under by an enrollee's vision benefit plan or vision benefit discount plan contract or for which a reimbursement would be available but for the application of the enrollee's contractual plan limitation of deductibles, copayments, or coinsurance regardless of how the benefits are listed in an enrollee's benefit plan's definition of benefits.

"Enrollee" means any individual enrolled in a vision benefit plan or vision benefit discount care plan provided by a group, employer, or other entity that purchases or supplies coverage for a vision benefit plan or vision benefit discount care plan.

"Extrapolation" means a mathematical formula, process, or technique used by a vision benefit manager or vision benefit manager's agent when performing an audit of an eye care provider to estimate audit results or findings for a larger batch or group of claims not reviewed by the vision benefit manager.

"Eye care provider" means a doctor of optometry licensed pursuant to the Illinois Optometric Practice Act of 1987 or a physician licensed to practice medicine in all of its branches pursuant to the Medical Practice Act of 1987.

"Fee schedule" means the document or system that lists the predetermined payment rates or allowed amounts for covered services or covered materials and determines the amount of reimbursement paid to eye care providers by the vision benefit manager and the amounts charged to an enrollee by the vision benefit manager or eye care provider.

"Materials" means ophthalmic devices, including, but not limited to:

(i) lenses, devices containing lenses, ophthalmic frames, and other lens mounting apparatus, prisms, lens treatments, and coatings;

(ii) contact lenses and prosthetic devices that correct, relieve, or treat defects or abnormal conditions of the human eye or adnexa; and

(iii) any devices that deliver medication or other therapeutic treatment to the human eye or adnexa.

"Services" means the professional work performed by an eye care provider.

"Subcontractor" means any company, group, affiliate, or third-party entity, including agents, servants, partially owned or wholly owned subsidiaries and controlled organizations, or any person or entity that directly or indirectly, through one or more intermediaries, controls or is controlled by or is under common control with the person or entity that the vision benefit manager care plan contracts with to supply services or materials for another vision benefit manager or an eye care provider or enrollee to execute or fulfill the benefit plan of a vision benefit plan or a vision benefit discount care plan. The location of the person or entity's domicile, whether in Illinois or a foreign or alien jurisdiction, does not affect the person or entity's status as a subcontractor.

"Vision benefit discount plan" means a policy, contract, or agreement offered by a vision benefit manager to an enrollee that solely provides for a discount for vision care services or materials.

"Vision benefit manager" "Vision care organization" means an entity formed under the laws of this State or another state that issues a vision benefit plan or a vision benefit discount care plan. "Vision benefit manager" includes an individual, company, organization, group, or other entity, including, without limitation, a third-party administrator, affiliate, or subcontractor, that creates, promotes, sells, provides, advertises, or administers an integrated or stand-alone vision benefit plan or a vision benefit discount plan or other insurance policy or contract that provides vision benefits or discounts to an enrollee pertaining to the provision of covered services or covered materials. "Vision benefit manager" does not include an eye care provider who offers an in-office membership plan to the provider's patients.

"Vision benefit care plan" means a policy, contract, or agreement offered by a vision benefit manager to an enrollee to pay for, reimburse, or offset health and vision care costs plan that creates, promotes, sells, provides, advertises, or administers an integrated or stand-alone plan that provides coverage for covered services and covered materials.

(Source: P.A. 103-482, eff. 8-4-23; 104-417, eff. 8-15-25.)

(215 ILCS 161/10)

Sec. 10. Noncovered services.

(a) No vision benefit manager care organization that issues, delivers, amends, or renews a vision benefit plan or a vision benefit discount care plan on or after the effective date of this amendatory Act of the 104th General Assembly shall issue a contract that requires an eye care provider, as a condition of participation in the vision care plan, to provide services or materials to an enrollee at a fee set by the vision benefit plan or the vision benefit discount care plan unless the services or materials are covered services or covered materials under the vision benefit plan or the vision benefit discount care plan. De minimis reimbursements shall not qualify a service or material as a covered service or a covered material under this Act.

(b) An eye care provider shall not charge an enrollee a fee for noncovered services or noncovered materials that is more than the eye care provider's customary fee for the services or materials. An eye care provider who chooses not to accept as payment an amount set by a vision care plan for services or materials that are not covered services or covered materials shall post, in a conspicuous place, a notice stating the following: "IMPORTANT: This eye care provider does not accept the fee schedule set by your insurer for vision care services and vision care materials that are not covered benefits under your plan and instead charges his or her normal fee for those services and materials. This eye care provider will provide you with an estimated cost for each noncovered service or noncovered material upon your request."

(c) A vision benefit manager may not require an eye care provider to discount charges for noncovered services or noncovered materials provided to an enrollee who is covered by the vision benefit plan or the vision benefit discount plan.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/15)

Sec. 15. Fees and reimbursement for covered services and covered materials.

(a) Fees paid under a vision benefit plan or a vision benefit discount care plan for covered services and covered materials, regardless of the supplier or optical lab used to obtain materials, shall be reasonable and shall be clearly and individually listed on a fee schedule that has been provided by the vision benefit manager to the eye care provider separately from the vision benefit plan, the vision benefit discount plan, provider manuals, or other documents related to the vision benefit plan or the vision benefit discount plan: before entering into a contract with the vision care organization. Fees paid for materials supplied by a non-network lab are not required to be identical to fees paid for materials ordered through a network lab, but non-network lab fees shall be reasonable.

(1) within 10 business days after the date that an eye care provider applies to become an eye care provider under the vision benefit plan or the vision benefit discount plan;

(2) at the time that the vision benefit manager offers participation in a vision benefit plan or a vision benefit discount plan to the eye care provider; and

(3) at all times by electronic means.

(b) A vision benefit manager shall only use standardized codes, names, descriptions, and definitions published in the Healthcare Common Procedure Coding System (HCPCS), including Current Procedural Terminology codes published by the American Medical Association and Level II codes published by the Centers for Medicare and Medicaid Services, to identify and describe covered services of the vision benefit plan to purchasers, enrollees, and eye care providers of the vision benefit plan.

(c) Beginning January 1, 2027, reimbursement paid by a vision benefit manager to an eye care provider for covered services, including nonmedical eye exams, medical eye exams, and services within the scope of the practice of optometry as defined in Section 3 of the Illinois Optometric Practice Act of 1987 shall be the greater of:

(1) the reimbursement rates set forth in the vision benefit plan or the vision benefit discount plan; or

(2) an amount equal to the Illinois Medicaid reimbursement rates that were in effect on January 1, 2026 for the covered service provided to the enrollee. Reimbursement paid to an eye care provider for covered services identified in the Level II Healthcare Common Procedure Coding System, including nonmedical eye examinations, medical eye examinations, and services that are within the scope of practice of optometry, may not be less than the reimbursement rates established in this paragraph (2). References to Medicaid in this subsection (c) are solely for purposes of establishing minimum reimbursement levels. On January 1, 2027 and on January 1 of each subsequent year, the reimbursement rates in this subsection (c) shall be increased by an amount equal to the percentage increase, if any, in the Consumer Price Index for All Urban Consumers for all items published by the United States Department of Labor for the 12 months ending in September of the preceding year.

(d) A vision benefit plan or a vision benefit discount plan shall not contain a provision requiring the eye care provider to provide a covered material or covered service at a loss.

(e) A vision benefit plan or a vision benefit discount plan shall not prohibit an eye care provider from offering a cash payment option to the enrollee if the cash payment option is less costly to the enrollee than the total out-of-pocket cost of the service or material.

(f) An eye care provider shall not be subject to an audit solely because the provider offers enrollees a cash price option to pay for services or materials.

(g) A vision benefit manager may not prohibit an eye care provider from being reimbursed through an automated clearing house electronic funds transfer.

(h) A vision benefit plan or a vision benefit discount plan shall not contain a provision that requires the eye care provider to accept a reimbursement payment in the form of a virtual credit card or any other payment method where a processing fee, administrative fee, percentage amount, or dollar amount is assessed to receive the reimbursement payment, except in the case of a nominal fee assessed by the eye care provider's financial institution to receive an electronic funds transfer.

(i) A vision benefit manager shall not retroactively reverse reimbursement paid to an eye care provider for covered materials or covered services provided to an enrollee for which the vision benefit manager later determined that the enrollee was ineligible to receive if the eye care provider:

(1) relied in good faith on coverage materials presented by the enrollee; or

(2) performed customary verification methods required by the vision benefit manager.

(j) A vision benefit plan or a vision benefit discount plan shall be accompanied by a fee schedule that individually identifies each covered service and covered material and its corresponding allowed amount, the reimbursement amount paid to the eye care provider, and the amount of any cost-sharing paid by the enrollee to the eye care provider.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/20)

Sec. 20. Misrepresentation; application of the Act.

(a) A vision benefit manager care organization and its officers, directors, agents, and employees are subject to the provisions of Sections 149 and 154.6 of the Illinois Insurance Code.

(a-5) The provisions of this Act shall apply to any limited health service organization certified under the Limited Health Service Organization Act that is a vision benefit manager or provides, administers, or manages vision care services, vision benefit plans, or vision care discount plans.

(b) Incorporation by reference in this Act to specific laws of this State shall not be construed to exempt a vision benefit manager, a vision benefit plan, or a care organization or vision care benefit plan from otherwise applicable laws that are not specifically referenced in this Act.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/25)

Sec. 25. Subcontractors. The provisions of this Act apply to any subcontractors used by a vision benefit manager care organization to supply materials or services to an eye care provider or an enrollee under a vision benefit plan or a vision care discount care plan.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/30)

Sec. 30. Suppliers; optical labs; vendors; affiliations.

(a) A vision benefit manager care organization may not restrict or limit an eye care provider's choice of suppliers of services, covered materials, or the use of an optical lab.

(b) A vision benefit manager care organization may not require an eye care provider or patient to order or purchase covered materials, including, but not limited to, ophthalmic lenses, from any source owned by, controlled by, or in a common ownership scheme with the entity that issued the vision benefit plan or the vision benefit discount care plan.

(c) A vision benefit plan or a vision benefit discount plan may not restrict or limit, either directly or indirectly, the eye care provider's choice or use of sources and suppliers of covered or noncovered services or materials, including the choice or use of optical laboratories provided by the eye care provider to an enrollee. A vision benefit manager shall not reimburse an eye care provider a different amount for covered services or covered materials because of the eye care provider's choice or use of any of the following: At the request of an enrollee, an eye care provider recommending an out-of-network source or supplier of vision care materials to an enrollee shall provide written notice to the enrollee stating:

(1) an optical laboratory; that the source or supplier is an out-of-network laboratory or supplier of vision care materials; and

(2) a source of supplier for: any business interest that the eye care provider has in the out-of-network source or supplier recommended to the enrollee.

(A) contact lenses;

(B) ophthalmic lenses;

(C) ophthalmic glasses frames; or

(D) covered services, covered materials, noncovered services, or noncovered materials;

(3) equipment used for patient care;

(4) retail optical affiliation;

(5) vision support organization;

(6) group purchasing organization;

(7) doctor alliance;

(8) professional trade association membership;

(9) electronic health record software, electronic medical record software, or practice management software; or

(10) third-party claim filing service, billing service, or electronic data interchange clearing house company.

(d) A vision benefit manager or subcontractor may not require an eye care provider to opt out of or opt in to any provision of this Section, including opting in or out on a patient-by-patient basis. An eye care provider is required to offer an enrollee in-network sources or suppliers of vision care materials at the enrollee's request.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/35)

Sec. 35. Modification of plan.

(a) The terms, fees, discounts, policies, provider manuals, fee schedules, or reimbursement rates in a vision benefit plan or a vision benefit discount care plan may not be changed during the term of a plan the contract unless mutually agreed to in writing by the eye care provider and the vision benefit manager care organization that issued the vision benefit plan or the vision benefit discount care plan. However, a change proposed to a vision benefit plan or a vision benefit discount care plan by the vision benefit manager care organization shall become effective if the eye care provider fails to respond to the vision benefit manager care organization within 90 60 days after receipt of notice of the proposed changes.

(b) The terms of a vision benefit plan or a vision benefit discount care plan contract that is amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 104th General Assembly this Act shall comply with the provisions of this Act.

(c) The details of any proposed changes to the vision benefit plan or the vision benefit discount plan must be sent to the eye care provider by certified letter or by an electronic communication that requires an electronic signature proving receipt.

(d) A vision benefit manager shall include a copy of the current plan provider manual referred to in a vision benefit plan or a vision benefit discount plan at the time a plan, amendment, or addendum is delivered to any eye care provider and any policies referenced in the plan, amendment, or addendum, including, but not limited to, dispute resolution policies.

(e) The term of a vision benefit plan or a vision benefit discount plan may not exceed 2 years unless mutually agreed to in writing by all parties.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/40)

Sec. 40. Prohibitions; medical plan preconditions.

(a) No vision benefit manager care organization that issues, delivers, amends, or renews a vision benefit care plan, vision benefit discount plan, provider manual, or its policies on or after the effective date of this amendatory Act of the 104th General Assembly the effective date of this Act shall issue a vision benefit plan or a vision benefit discount care plan contract that requires:

(1) an eye care provider to either provide services under a government health plan or contract with a plan that offers supplemental or specialty health care services as a condition of contracting with a plan that offers basic health services; or

(2) an eye care provider to contract with a vision benefit plan or a vision benefit discount care plan as a condition to participation in a medical plan or in-network.

(b) A vision benefit plan or a vision benefit discount care plan may enter into an agreement with a health care plan to deliver routine vision care services that are covered under the enrollee's plan.

(c) A vision benefit plan or a vision benefit discount care plan may act as a network regarding routine vision care services offered by a health care plan.

(Source: P.A. 103-482, eff. 8-4-23.)

(215 ILCS 161/45 new)

Sec. 45. Audits; extrapolation. A vision benefit manager shall not use extrapolation to conduct an audit of an eye care provider. Any additional payment due to an eye care provider or any refund due to the vision benefit manager shall not be based on extrapolation, but shall be based on the actual overpayment or underpayment as determined after an investigation by the vision benefit manager, and the eye care provider has been afforded and has exhausted all opportunities to appeal the vision benefit manager's findings as set forth in the vision benefit plan or the vision benefit discount plan. The cost of the audit shall be borne exclusively by the vision benefit manager.

(215 ILCS 161/50 new)

Sec. 50. Prohibited conduct impacting patient access and choice. A vision benefit manager may not solicit patients or referrals for supplies on behalf of the vision benefit manager or its affiliates by identifying participating eye care providers in an inaccurate or otherwise misleading manner in any list of participating providers or in any communications to purchasers or enrollees. All communications that distinguish between participating eye care providers, or that otherwise claim professional superiority or the performance of a professional service in a superior manner, based on the following characteristics shall be subject to verification by the Department of Insurance:

(1) a discount or incentive offered by the participating eye care provider on services and materials that are not covered by the vision benefit manager;

(2) the dollar amount, volume amount, or percent usage amount of any material, product, or good purchased by the participating eye care provider;

(3) the brand, source, manufacturer, or supplier of a covered service or covered material used by the participating eye care provider.

This Section does not prohibit advertising if the advertising is: (i) not false, misleading, or deceptive; or (ii) readily subject to verification.

(215 ILCS 161/55 new)

Sec. 55. Credentialing.

(a) A vision benefit manager shall complete the credentialing process and notify the eye care provider of approval, denial, or a request for additional information within 30 calendar days after receiving a completed credentialing application. Credentialing decisions shall not be delayed, denied, or conditioned upon the eye care provider's materials sourcing, group affiliation, or the prior exercise of rights under this Act. If a determination is not made within 30 calendar days, the application shall be deemed approved and the eye care provider shall be permitted to participate under the terms of the vision benefit plan or the vision benefit discount plan.

(b) No later than the 10th business day after receiving a completed application, the vision benefit manager shall make available electronically to the eye care provider a vision benefit plan or the vision benefit discount plan, including applicable fee schedules, policies, and provider manuals.

(c) No later than the 20th business day after the eye care provider has accepted the vision benefit plan or the vision benefit discount plan and is credentialed, the vision benefit manager shall include the provider as a participating provider under the vision benefit plan or the vision benefit discount plan.

(d) A vision benefit manager shall not discriminate with respect to participation, including reimbursement, against any eye care provider who is acting within the scope of the eye care provider's license under State law.

(e) A vision benefit manager shall not exclude an eye care provider from participating in the vision benefit plan or the vision benefit discount plan on the basis of:

(1) the number of eye care providers participating in the vision benefit plan or the vision benefit discount plan, including those participating within a specific geographic service area; or

(2) the time, distance, or appointment availability for a patient to access an eye care provider.

(215 ILCS 161/60 new)

Sec. 60. Termination of agreements. Termination of any vision benefit plan or vision benefit discount plan by a vision benefit manager shall be permissible only in the event of a material breach wherein the eye care provider fails to remedy the alleged breach to the reasonable satisfaction of the vision benefit manager within 30 days after receipt of written notice. The written notice must detail the alleged breach and shall be delivered by either certified letter or by electronic communication that requires an electronic signature confirming receipt.

(215 ILCS 161/65 new)

Sec. 65. Prohibition on security interests. A vision benefit manager may not require an eye care provider to establish a security interest in all or any part of the vision benefit manager's property and assets, including assets pertaining to the vision benefit manager's practice, in a sum equivalent to the funds owed to the vision benefit manager at termination.

(215 ILCS 161/70 new)

Sec. 70. Arbitration costs. A vision benefit plan or a vision benefit discount plan may not contain a provision obligating the eye care provider to share equally in expenses related to arbitration.

(215 ILCS 161/75 new)

Sec. 75. Nonretaliation. A vision benefit manager may not retaliate against an eye care provider for exercising any rights under this Act. Retaliation includes, but is not limited to:

(1) terminating a contract or reducing reimbursement;

(2) subjecting the eye care provider to increased audits or administrative burdens;

(3) refusing to offer or renew a vision benefit plan or vision benefit discount plan with the eye care provider;

(4) denying the eye care provider's participation on a provider panel or network without cause;

(5) imposing penalties or sanctions without cause; or

(6) taking any other adverse action without cause based on the eye care provider's:

(A) filing of a complaint or report;

(B) refusal to accept contract terms that violate this Act; or

(C) communication with regulatory personnel, legislators, or professional associations regarding the enforcement or interpretation of this Act.

(215 ILCS 161/80 new)

Sec. 80. Private right of action.

(a) In addition to any other remedies available under State or federal law, an eye care provider adversely affected by a violation of this Act may bring a civil action in a court of competent jurisdiction in the State of Illinois against a vision benefit manager, a vision benefit plan, or a vision benefit discount plan for injunctive relief, monetary damages, and any other appropriate legal or equitable relief.

(b) Upon prevailing in such an action, the eye care provider shall be entitled to:

(1) injunctive relief;

(2) monetary damages not to exceed $1,000 for each day the violation is found to have occurred;

(3) in cases involving retaliation as defined in Section 75 of this Act:

(A) an additional penalty of up to $10,000 per retaliatory act;

(B) reinstatement of network participation, if applicable; and

(C) any lost compensation directly attributable to the retaliatory action;

(4) reasonable attorney's fees and court costs.

(c) A cause of action under this Section may be brought by one or more eye care providers on behalf of themselves and others similarly situated as a class action, subject to the Code of Civil Procedure and applicable rules of civil procedure.

(d) Any action brought under this Section shall be commenced within 2 years after the date on which the violation or retaliatory act occurred or within 2 years from the date the eye care provider knew or reasonably should have known of the violation, whichever is later.

(e) The remedies under this Section are cumulative of, and not exclusive to, any administrative enforcement action or penalty imposed by the Department of Insurance or the Office of the Attorney General.

Section 20. The Consumer Fraud and Deceptive Business Practices Act is amended by changing Section 2CCCC as follows:

(815 ILCS 505/2CCCC)

Sec. 2CCCC. Violations of the Vision Benefit Manager Care Plan Regulation Act. Any person who violates the Vision Benefit Manager Care Plan Regulation Act commits an unlawful practice within the meaning of this Act.

(Source: P.A. 103-482, eff. 8-4-23; 103-605, eff. 7-1-24.)

Section 97. Severability. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes.

Section 99. Effective date. This Act takes effect January 1, 2027.