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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 Uniform Health Care Service Benefits
5Information Card Act is amended by changing Sections 10 and 15
6as follows:
7    (215 ILCS 139/10)
8    Sec. 10. Definitions. As used in this Act, the following
9terms have the meanings given in this Section.
10    "Department" means the Department of Insurance.
11    "Director" means the Director of Insurance.
12    "Health benefit plan" means an accident and health
13insurance policy or certificate subject to the Illinois
14Insurance Code, a voluntary health services plan subject to the
15Voluntary Health Services Plans Act, a health maintenance
16organization subscriber contract subject to the Health
17Maintenance Organization Act, a plan provided by a multiple
18employer welfare arrangement, a dental service plan subject to
19the Dental Service Plan Act, or a plan provided by another
20benefit arrangement. Without limitation, "health benefit plan"
21does not mean any of the following types of insurance:
22        (1) accident;
23        (2) credit;



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1        (3) disability income;
2        (4) long-term or nursing home care;
3        (5) specified disease;
4        (6) dental or vision;
5        (7) coverage issued as a supplement to liability
6    insurance;
7        (8) medical payments under automobile or homeowners;
8        (9) insurance under which benefits are payable with or
9    without regard to fault as statutorily required to be
10    contained in any liability policy or equivalent
11    self-insurance;
12        (10) hospital income or indemnity; and
13        (11) self-insured health benefit plans under the
14    federal Employee Retirement Income Security Act of 1974.
15(Source: P.A. 92-106, eff. 1-1-02.)
16    (215 ILCS 139/15)
17    Sec. 15. Uniform health care benefit information cards
19    (a) A health benefit plan that issues a card or other
20technology and provides coverage for health care services
21including prescription drugs or devices also referred to as
22health care benefits and an administrator of such a plan
23including, but not limited to, third-party administrators for
24self-insured plans and state-administered plans shall issue to
25its insureds a card or other technology containing uniform



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1health care benefit information. The health care benefit
2information card or other technology shall specifically
3identify and display the following mandatory data elements on
4the card:
5        (1) processor control number, if required for claims
6    adjudication;
7        (2) group number;
8        (3) card issuer identifier;
9        (4) cardholder ID number; and
10        (5) cardholder name.
11    (b) The uniform health care benefit information card or
12other technology shall specifically identify and display the
13following mandatory data elements on the back of the card:
14        (1) claims submission names and addresses; and
15        (2) help desk telephone numbers and names.
16    (b-5) A uniform health care benefit information card or
17other technology for a health benefit plan offering dental
18coverage shall include a statement indicating whether the
19health benefit plan offering dental coverage is subject to
20regulation by the Department of Insurance.
21    (c) A new uniform health care benefit information card or
22other technology shall be issued by a health benefit plan upon
23enrollment and reissued upon any change in the insured's
24coverage that affects mandatory data elements contained on the
26    (d) Notwithstanding subsections (a), (b), and (c) of this



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1Section, a discounted health care services plan administrator
2shall issue to its beneficiaries a card containing the
3following mandatory data elements:
4        (1) an Internet website for beneficiaries to access
5    up-to-date lists of preferred providers;
6        (2) a toll-free help desk number for beneficiaries and
7    providers to access up-to-date lists of preferred
8    providers and additional information about the discounted
9    health care services plan;
10        (3) the name or logo of the provider network;
11        (4) a group number, if necessary for the processing of
12    benefits;
13        (5) a cardholder ID number;
14        (6) the cardholder's name or a space to permit the
15    cardholder to print his or her name, if the cardholder pays
16    a periodic charge for use of the card;
17        (7) a processor control number, if required for claims
18    adjudication; and
19        (8) a statement that the plan is not insurance.
20    (e) As used in this Section, "discounted health care
21services plan administrator" means any person, partnership, or
22corporation, other than an insurer, health service
23corporation, limited health service organization holding a
24certificate of authority under the Limited Health Service
25Organization Act, or health maintenance organization holding a
26certificate of authority under the Health Maintenance



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1Organization Act that arranges, contracts with, or administers
2contracts with a provider whereby insureds or beneficiaries are
3provided an incentive to use health care services provided by
4health care services providers under a discounted health care
5services plan in which there are no other incentives, such as
6copayment, coinsurance, or any other reimbursement
7differential, for beneficiaries to utilize the provider.
8"Discounted health care services plan administrator" also
9includes any person, partnership, or corporation, other than an
10insurer, health service corporation, limited health service
11organization holding a certificate of authority under the
12Limited Health Service Organization Act, or health maintenance
13organization holding a certificate of authority under the
14Health Maintenance Organization Act that enters into a contract
15with another administrator to enroll beneficiaries or insureds
16in a preferred provider program marketed as an independently
17identifiable program based on marketing materials or member
18benefit identification cards.
19(Source: P.A. 96-1326, eff. 1-1-11.)