HB0790sam001 93RD GENERAL ASSEMBLY

Sen. Iris Y. Martinez

Filed: 5/28/2004

09300HB0790sam001 LRB093 05462 AMC 51863 a

AMENDMENT TO HOUSE BILL 790

AMENDMENT NO. ______. Amend House Bill 790 by replacing everything after the enacting clause with the following:

"Section 5. The Illinois Insurance Code is amended by changing Section 356z.4 as follows:

(215 ILCS 5/356z.4)

Sec. 356z.4. Coverage for contraceptives.

(a) An individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State after the effective date of this amendatory Act of the 93rd General Assembly that provides coverage for outpatient services and outpatient prescription drugs or devices must provide coverage for the insured and any dependent of the insured covered by the policy for all outpatient contraceptive services and all outpatient contraceptive drugs and devices approved by the Food and Drug Administration. Coverage required under this Section may not impose any deductible, coinsurance, waiting period, or other cost-sharing or limitation that is greater than that required for any outpatient service or outpatient prescription drug or device otherwise covered by the policy.

(b) As used in this Section, "outpatient contraceptive service" means consultations, examinations, procedures, and medical services, provided on an outpatient basis and related to the use of contraceptive methods (including natural family planning) to prevent an unintended pregnancy.

(c) Nothing in this Section shall be construed to require an insurance company to cover services related to an abortion as the term "abortion" is defined in the Illinois Abortion Law of 1975.

(d) Nothing in this Section shall be construed to require an insurance company to cover services related to permanent sterilization that requires a surgical procedure.

(e) Notwithstanding any other provision of this Section, a religious employer may request a policy or plan without coverage for outpatient contraceptive services and outpatient prescription contraceptive drugs and devices that are contrary to the documented tenets of the religious employer's religion. If so requested, a plan or policy may be issued without coverage for outpatient contraceptive services and outpatient prescription contraceptive drugs or devices. This subsection shall not be construed to deny an enrollee coverage of, and timely access to, contraceptive methods.

Every religious employer that invokes the exemption provided under this subsection shall provide written notice to prospective enrollees prior to enrollment with the plan listing the contraceptive health care services the employer refuses to cover for religious reasons.

Nothing in this subsection shall be construed to exclude coverage for prescription contraceptive drugs or devices prescribed by a health care provider for reasons other than contraceptive purposes, including but not limited to decreasing the risk of ovarian cancer or eliminating the symptoms of menopause, or for prescription contraception that is necessary to preserve the life or health of an enrollee.

For the purposes of this subsection, a "religious employer" is an entity for which each of the following is true:

(1) The inculcation of religious values is the purpose of the entity.

(2) The entity primarily employs persons who share the religious tenets of the entity.

(3) The entity serves primarily persons who share the religious tenets of the entity.

(4) The entity is a nonprofit organization as described in Section 6033(a)(2)(A)(i) or (iii) of the Internal Revenue Code of 1986, as amended.

(Source: P.A. 93-102, eff. 1-1-04.)

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