94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB0494


 
Introduced 1/27/2005, by Rep. Linda Chapa LaVia
 
SYNOPSIS AS INTRODUCED:
 		














215 ILCS 5/356z.2









    Amends the Illinois Insurance Code.  Requires certain insurers to cover dental care provided in hospitals, ambulatory surgical treatment centers, and dental offices.
















LRB094 05501 LJB 35548 b

















 


 


A BILL FOR









 











HB0494

LRB094 05501 LJB 35548 b






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    AN ACT concerning insurance.

 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:


 
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    Section 5. The Illinois Insurance Code is amended  by 
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changing Section 356z.2 as follows:
 



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    (215 ILCS 5/356z.2)


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    Sec. 356z.2. Coverage for adjunctive services in dental 
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care. 

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    (a) An individual or group policy of accident and health 
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insurance
amended, delivered, issued, or renewed after the 
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effective date of this
amendatory Act of the 94th
92nd General 
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Assembly shall cover
charges incurred, and anesthetics 
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provided, in
conjunction with dental care that is provided to a 
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covered individual in a
hospital,
or
an ambulatory surgical 
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treatment center, or a dental office.
if any of the
following

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applies:


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        (1) the individual is a child age 6 or under;


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        (2) the individual has a medical condition that 
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    requires
hospitalization or general anesthesia for dental 
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    care; or


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        (3) the individual is disabled.

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    (b) For purposes of this Section, "ambulatory surgical 
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treatment center"
has the meaning given to that term in Section 
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3 of the Ambulatory
Surgical Treatment Center Act.

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    For purposes of this Section, "disabled" means a person, 
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regardless of age,
with a chronic
disability if the chronic 
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disability meets all of the following conditions:


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        (1) It is attributable to a mental or physical 
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    impairment or
    combination of mental and physical 
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    impairments.


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        (2) It is likely to continue.


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        (3) It results in substantial functional limitations 
 


 






HB0494
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LRB094 05501 LJB 35548 b




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    in one or more of
the following areas of major life 
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    activity:


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            (A) self-care;


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            (B) receptive and expressive language;


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            (C) learning;


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            (D) mobility;


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            (E) capacity for independent living; or


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            (F) economic self-sufficiency.

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    (c) The coverage required under this Section may be subject 
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to any
limitations, exclusions, or cost-sharing provisions 
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that apply generally under
the insurance policy.

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    (d) (Blank).
This Section does not apply to a policy that 
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covers only dental care.

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    (e) (Blank).
Nothing in this Section requires that the 
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dental services be
covered.

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    (f) The provisions of this Section do not apply to 
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short-term travel,
accident-only, limited, or specified 
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disease policies, nor to policies or
contracts designed for 
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issuance to persons eligible for coverage under Title
XVIII of 
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the Social Security Act, known as Medicare, or any other 
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similar
coverage under State or federal governmental plans.

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(Source: P.A. 92-764, eff. 1-1-03.)