101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB5484

 

Introduced , by Rep. Bradley Stephens

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
215 ILCS 5/356w
215 ILCS 5/356z.43 new
215 ILCS 125/5-3  from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003  from Ch. 73, par. 1504-3
215 ILCS 165/10  from Ch. 32, par. 604

    Amends the Illinois Insurance Code. Provides that insurers that provide coverage for diabetic self-management supplies must limit the total amount an insured is required to pay for diabetic self-management supplies to $100 per 30-day supply of diabetic self-management supplies required by an insured with diabetes for diabetic self-management. Provides that the limitation on diabetic self-management supplies costs also applies to provisions requiring coverage of certain diabetes items to be subject to the same coverage, deductible, co-payment, and co-insurance provisions under a policy. Defines "diabetic self-management supplies". Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. Effective January 1, 2021.


LRB101 18246 BMS 67688 b

FISCAL NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

 

 

A BILL FOR

 

HB5484LRB101 18246 BMS 67688 b

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 State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
 
6    (5 ILCS 375/6.11)
7    (Text of Section before amendment by P.A. 101-625)
8    Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall provide
10the post-mastectomy care benefits required to be covered by a
11policy of accident and health insurance under Section 356t of
12the Illinois Insurance Code. The program of health benefits
13shall provide the coverage required under Sections 356g,
14356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
15356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
16356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26,
17356z.29, 356z.30a, 356z.32, and 356z.33, 356z.36, and 356z.43
18of the Illinois Insurance Code. The program of health benefits
19must comply with Sections 155.22a, 155.37, 355b, 356z.19, 370c,
20and 370c.1, and Article XXXIIB of the Illinois Insurance Code.
21The Department of Insurance shall enforce the requirements of
22this Section with respect to Sections 370c and 370c.1 of the
23Illinois Insurance Code; all other requirements of this Section

 

 

HB5484- 2 -LRB101 18246 BMS 67688 b

1shall be enforced by the Department of Central Management
2Services.
3    Rulemaking authority to implement Public Act 95-1045, if
4any, is conditioned on the rules being adopted in accordance
5with all provisions of the Illinois Administrative Procedure
6Act and all rules and procedures of the Joint Committee on
7Administrative Rules; any purported rule not so adopted, for
8whatever reason, is unauthorized.
9(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
10100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
111-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
12eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
13101-452, eff. 1-1-20; 101-461, eff. 1-1-20; revised 10-16-19.)
 
14    (Text of Section after amendment by P.A. 101-625)
15    Sec. 6.11. Required health benefits; Illinois Insurance
16Code requirements. The program of health benefits shall provide
17the post-mastectomy care benefits required to be covered by a
18policy of accident and health insurance under Section 356t of
19the Illinois Insurance Code. The program of health benefits
20shall provide the coverage required under Sections 356g,
21356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4,
22356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
23356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26,
24356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and
25356z.43 of the Illinois Insurance Code. The program of health

 

 

HB5484- 3 -LRB101 18246 BMS 67688 b

1benefits must comply with Sections 155.22a, 155.37, 355b,
2356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
3Insurance Code. The Department of Insurance shall enforce the
4requirements of this Section with respect to Sections 370c and
5370c.1 of the Illinois Insurance Code; all other requirements
6of this Section shall be enforced by the Department of Central
7Management Services.
8    Rulemaking authority to implement Public Act 95-1045, if
9any, is conditioned on the rules being adopted in accordance
10with all provisions of the Illinois Administrative Procedure
11Act and all rules and procedures of the Joint Committee on
12Administrative Rules; any purported rule not so adopted, for
13whatever reason, is unauthorized.
14(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
15100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
161-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19; 101-13,
17eff. 6-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
18101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
191-1-21.)
 
20    Section 10. The Counties Code is amended by changing
21Section 5-1069.3 as follows:
 
22    (55 ILCS 5/5-1069.3)
23    (Text of Section before amendment by P.A. 101-625)
24    Sec. 5-1069.3. Required health benefits. If a county,

 

 

HB5484- 4 -LRB101 18246 BMS 67688 b

1including a home rule county, is a self-insurer for purposes of
2providing health insurance coverage for its employees, the
3coverage shall include coverage for the post-mastectomy care
4benefits required to be covered by a policy of accident and
5health insurance under Section 356t and the coverage required
6under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
7356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
8356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
9356z.30a, and 356z.32, and 356z.33, 356z.36, and 356z.43 of the
10Illinois Insurance Code. The coverage shall comply with
11Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
12Insurance Code. The Department of Insurance shall enforce the
13requirements of this Section. The requirement that health
14benefits be covered as provided in this Section is an exclusive
15power and function of the State and is a denial and limitation
16under Article VII, Section 6, subsection (h) of the Illinois
17Constitution. A home rule county to which this Section applies
18must comply with every provision of this Section.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
26100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.

 

 

HB5484- 5 -LRB101 18246 BMS 67688 b

11-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
2eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
3revised 10-16-19.)
 
4    (Text of Section after amendment by P.A. 101-625)
5    Sec. 5-1069.3. Required health benefits. If a county,
6including a home rule county, is a self-insurer for purposes of
7providing health insurance coverage for its employees, the
8coverage shall include coverage for the post-mastectomy care
9benefits required to be covered by a policy of accident and
10health insurance under Section 356t and the coverage required
11under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x,
12356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
13356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
14356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
15of the Illinois Insurance Code. The coverage shall comply with
16Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
17Insurance Code. The Department of Insurance shall enforce the
18requirements of this Section. The requirement that health
19benefits be covered as provided in this Section is an exclusive
20power and function of the State and is a denial and limitation
21under Article VII, Section 6, subsection (h) of the Illinois
22Constitution. A home rule county to which this Section applies
23must comply with every provision of this Section.
24    Rulemaking authority to implement Public Act 95-1045, if
25any, is conditioned on the rules being adopted in accordance

 

 

HB5484- 6 -LRB101 18246 BMS 67688 b

1with all provisions of the Illinois Administrative Procedure
2Act and all rules and procedures of the Joint Committee on
3Administrative Rules; any purported rule not so adopted, for
4whatever reason, is unauthorized.
5(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
6100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
71-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
8eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
9101-625, eff. 1-1-21.)
 
10    Section 15. The Illinois Municipal Code is amended by
11changing Section 10-4-2.3 as follows:
 
12    (65 ILCS 5/10-4-2.3)
13    (Text of Section before amendment by P.A. 101-625)
14    Sec. 10-4-2.3. Required health benefits. If a
15municipality, including a home rule municipality, is a
16self-insurer for purposes of providing health insurance
17coverage for its employees, the coverage shall include coverage
18for the post-mastectomy care benefits required to be covered by
19a policy of accident and health insurance under Section 356t
20and the coverage required under Sections 356g, 356g.5,
21356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
22356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25,
23356z.26, 356z.29, 356z.30a, and 356z.32, and 356z.33, 356z.36,
24and 356z.43 of the Illinois Insurance Code. The coverage shall

 

 

HB5484- 7 -LRB101 18246 BMS 67688 b

1comply with Sections 155.22a, 355b, 356z.19, and 370c of the
2Illinois Insurance Code. The Department of Insurance shall
3enforce the requirements of this Section. The requirement that
4health benefits be covered as provided in this is an exclusive
5power and function of the State and is a denial and limitation
6under Article VII, Section 6, subsection (h) of the Illinois
7Constitution. A home rule municipality to which this Section
8applies must comply with every provision of this Section.
9    Rulemaking authority to implement Public Act 95-1045, if
10any, is conditioned on the rules being adopted in accordance
11with all provisions of the Illinois Administrative Procedure
12Act and all rules and procedures of the Joint Committee on
13Administrative Rules; any purported rule not so adopted, for
14whatever reason, is unauthorized.
15(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
16100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
171-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
18eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
19revised 10-16-19.)
 
20    (Text of Section after amendment by P.A. 101-625)
21    Sec. 10-4-2.3. Required health benefits. If a
22municipality, including a home rule municipality, is a
23self-insurer for purposes of providing health insurance
24coverage for its employees, the coverage shall include coverage
25for the post-mastectomy care benefits required to be covered by

 

 

HB5484- 8 -LRB101 18246 BMS 67688 b

1a policy of accident and health insurance under Section 356t
2and the coverage required under Sections 356g, 356g.5,
3356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10,
4356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25,
5356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, and
6356z.41, and 356z.43 of the Illinois Insurance Code. The
7coverage shall comply with Sections 155.22a, 355b, 356z.19, and
8370c of the Illinois Insurance Code. The Department of
9Insurance shall enforce the requirements of this Section. The
10requirement that health benefits be covered as provided in this
11is an exclusive power and function of the State and is a denial
12and limitation under Article VII, Section 6, subsection (h) of
13the Illinois Constitution. A home rule municipality to which
14this Section applies must comply with every provision of this
15Section.
16    Rulemaking authority to implement Public Act 95-1045, if
17any, is conditioned on the rules being adopted in accordance
18with all provisions of the Illinois Administrative Procedure
19Act and all rules and procedures of the Joint Committee on
20Administrative Rules; any purported rule not so adopted, for
21whatever reason, is unauthorized.
22(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
23100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
241-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
25eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
26101-625, eff. 1-1-21.)
 

 

 

HB5484- 9 -LRB101 18246 BMS 67688 b

1    Section 20. The School Code is amended by changing Section
210-22.3f as follows:
 
3    (105 ILCS 5/10-22.3f)
4    (Text of Section before amendment by P.A. 101-625)
5    Sec. 10-22.3f. Required health benefits. Insurance
6protection and benefits for employees shall provide the
7post-mastectomy care benefits required to be covered by a
8policy of accident and health insurance under Section 356t and
9the coverage required under Sections 356g, 356g.5, 356g.5-1,
10356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
11356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
12356z.30a, and 356z.32, and 356z.33, 356z.36, and 356z.43 of the
13Illinois Insurance Code. Insurance policies shall comply with
14Section 356z.19 of the Illinois Insurance Code. The coverage
15shall comply with Sections 155.22a, 355b, and 370c of the
16Illinois Insurance Code. The Department of Insurance shall
17enforce the requirements of this Section.
18    Rulemaking authority to implement Public Act 95-1045, if
19any, is conditioned on the rules being adopted in accordance
20with all provisions of the Illinois Administrative Procedure
21Act and all rules and procedures of the Joint Committee on
22Administrative Rules; any purported rule not so adopted, for
23whatever reason, is unauthorized.
24(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;

 

 

HB5484- 10 -LRB101 18246 BMS 67688 b

1100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
21-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
3eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
4revised 10-16-19.)
 
5    (Text of Section after amendment by P.A. 101-625)
6    Sec. 10-22.3f. Required health benefits. Insurance
7protection and benefits for employees shall provide the
8post-mastectomy care benefits required to be covered by a
9policy of accident and health insurance under Section 356t and
10the coverage required under Sections 356g, 356g.5, 356g.5-1,
11356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12,
12356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
13356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41, and 356z.43
14of the Illinois Insurance Code. Insurance policies shall comply
15with Section 356z.19 of the Illinois Insurance Code. The
16coverage shall comply with Sections 155.22a, 355b, and 370c of
17the Illinois Insurance Code. The Department of Insurance shall
18enforce the requirements of this Section.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;

 

 

HB5484- 11 -LRB101 18246 BMS 67688 b

1100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff.
21-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
3eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20;
4101-625, eff. 1-1-21.)
 
5    Section 25. The Illinois Insurance Code is amended by
6changing Section 356w and by adding Section 356z.43 as follows:
 
7    (215 ILCS 5/356w)
8    (Text of Section before amendment by P.A. 101-625)
9    Sec. 356w. Diabetes self-management training and
10education.
11    (a) A group policy of accident and health insurance that is
12amended, delivered, issued, or renewed after the effective date
13of this amendatory Act of 1998 shall provide coverage for
14outpatient self-management training and education, equipment,
15and supplies, as set forth in this Section, for the treatment
16of type 1 diabetes, type 2 diabetes, and gestational diabetes
17mellitus.
18    (b) As used in this Section:
19    "Diabetes self-management training" means instruction in
20an outpatient setting which enables a diabetic patient to
21understand the diabetic management process and daily
22management of diabetic therapy as a means of avoiding frequent
23hospitalization and complications. Diabetes self-management
24training shall include the content areas listed in the National

 

 

HB5484- 12 -LRB101 18246 BMS 67688 b

1Standards for Diabetes Self-Management Education Programs as
2published by the American Diabetes Association, including
3medical nutrition therapy and education programs, as defined by
4the contract of insurance, that allow the patient to maintain
5an A1c level within the range identified in nationally
6recognized standards of care.
7    "Medical nutrition therapy" shall have the meaning
8ascribed to that term in the Dietitian Nutritionist Practice
9Act.
10    "Physician" means a physician licensed to practice
11medicine in all of its branches providing care to the
12individual.
13    "Qualified provider" for an individual that is enrolled in:
14        (1) a health maintenance organization that uses a
15    primary care physician to control access to specialty care
16    means (A) the individual's primary care physician licensed
17    to practice medicine in all of its branches, (B) a
18    physician licensed to practice medicine in all of its
19    branches to whom the individual has been referred by the
20    primary care physician, or (C) a certified, registered, or
21    licensed network health care professional with expertise
22    in diabetes management to whom the individual has been
23    referred by the primary care physician.
24        (2) an insurance plan means (A) a physician licensed to
25    practice medicine in all of its branches or (B) a
26    certified, registered, or licensed health care

 

 

HB5484- 13 -LRB101 18246 BMS 67688 b

1    professional with expertise in diabetes management to whom
2    the individual has been referred by a physician.
3    (c) Coverage under this Section for diabetes
4self-management training, including medical nutrition
5education, shall be limited to the following:
6        (1) Up to 3 medically necessary visits to a qualified
7    provider upon initial diagnosis of diabetes by the
8    patient's physician or, if diagnosis of diabetes was made
9    within one year prior to the effective date of this
10    amendatory Act of 1998 where the insured was a covered
11    individual, up to 3 medically necessary visits to a
12    qualified provider within one year after that effective
13    date.
14        (2) Up to 2 medically necessary visits to a qualified
15    provider upon a determination by a patient's physician that
16    a significant change in the patient's symptoms or medical
17    condition has occurred. A "significant change" in
18    condition means symptomatic hyperglycemia (greater than
19    250 mg/dl on repeated occasions), severe hypoglycemia
20    (requiring the assistance of another person), onset or
21    progression of diabetes, or a significant change in medical
22    condition that would require a significantly different
23    treatment regimen.
24    Payment by the insurer or health maintenance organization
25for the coverage required for diabetes self-management
26training pursuant to the provisions of this Section is only

 

 

HB5484- 14 -LRB101 18246 BMS 67688 b

1required to be made for services provided. No coverage is
2required for additional visits beyond those specified in items
3(1) and (2) of this subsection.
4    Coverage under this subsection (c) for diabetes
5self-management training shall be subject to the same
6deductible, co-payment, and co-insurance provisions that apply
7to coverage under the policy for other services provided by the
8same type of provider.
9    (d) Coverage shall be provided for the following equipment
10when medically necessary and prescribed by a physician licensed
11to practice medicine in all of its branches. Coverage for the
12following items shall be subject to deductible, co-payment and
13co-insurance provisions provided for under the policy or a
14durable medical equipment rider to the policy:
15        (1) blood glucose monitors;
16        (2) blood glucose monitors for the legally blind;
17        (3) cartridges for the legally blind; and
18        (4) lancets and lancing devices.
19    This subsection does not apply to a group policy of
20accident and health insurance that does not provide a durable
21medical equipment benefit.
22    (e) Coverage shall be provided for the following
23pharmaceuticals and supplies when medically necessary and
24prescribed by a physician licensed to practice medicine in all
25of its branches. Coverage for the following items shall be
26subject to the same coverage, deductible, co-payment, and

 

 

HB5484- 15 -LRB101 18246 BMS 67688 b

1co-insurance provisions under the policy or a drug rider to the
2policy:
3        (1) insulin;
4        (2) syringes and needles;
5        (3) test strips for glucose monitors;
6        (4) FDA approved oral agents used to control blood
7    sugar; and
8        (5) glucagon emergency kits.
9    This subsection does not apply to a group policy of
10accident and health insurance that does not provide a drug
11benefit.
12    (f) Coverage shall be provided for regular foot care exams
13by a physician or by a physician to whom a physician has
14referred the patient. Coverage for regular foot care exams
15shall be subject to the same deductible, co-payment, and
16co-insurance provisions that apply under the policy for other
17services provided by the same type of provider.
18    (g) If authorized by a physician, diabetes self-management
19training may be provided as a part of an office visit, group
20setting, or home visit.
21    (h) This Section shall not apply to agreements, contracts,
22or policies that provide coverage for a specified diagnosis or
23other limited benefit coverage.
24(Source: P.A. 97-281, eff. 1-1-12; 97-1141, eff. 12-28-12.)
 
25    (Text of Section after amendment by P.A. 101-625)

 

 

HB5484- 16 -LRB101 18246 BMS 67688 b

1    Sec. 356w. Diabetes self-management training and
2education.
3    (a) A group policy of accident and health insurance that is
4amended, delivered, issued, or renewed after the effective date
5of this amendatory Act of 1998 shall provide coverage for
6outpatient self-management training and education, equipment,
7and supplies, as set forth in this Section, for the treatment
8of type 1 diabetes, type 2 diabetes, and gestational diabetes
9mellitus.
10    (b) As used in this Section:
11    "Diabetes self-management training" means instruction in
12an outpatient setting which enables a diabetic patient to
13understand the diabetic management process and daily
14management of diabetic therapy as a means of avoiding frequent
15hospitalization and complications. Diabetes self-management
16training shall include the content areas listed in the National
17Standards for Diabetes Self-Management Education Programs as
18published by the American Diabetes Association, including
19medical nutrition therapy and education programs, as defined by
20the contract of insurance, that allow the patient to maintain
21an A1c level within the range identified in nationally
22recognized standards of care.
23    "Medical nutrition therapy" shall have the meaning
24ascribed to that term in the Dietitian Nutritionist Practice
25Act.
26    "Physician" means a physician licensed to practice

 

 

HB5484- 17 -LRB101 18246 BMS 67688 b

1medicine in all of its branches providing care to the
2individual.
3    "Qualified provider" for an individual that is enrolled in:
4        (1) a health maintenance organization that uses a
5    primary care physician to control access to specialty care
6    means (A) the individual's primary care physician licensed
7    to practice medicine in all of its branches, (B) a
8    physician licensed to practice medicine in all of its
9    branches to whom the individual has been referred by the
10    primary care physician, or (C) a certified, registered, or
11    licensed network health care professional with expertise
12    in diabetes management to whom the individual has been
13    referred by the primary care physician.
14        (2) an insurance plan means (A) a physician licensed to
15    practice medicine in all of its branches or (B) a
16    certified, registered, or licensed health care
17    professional with expertise in diabetes management to whom
18    the individual has been referred by a physician.
19    (c) Coverage under this Section for diabetes
20self-management training, including medical nutrition
21education, shall be limited to the following:
22        (1) Up to 3 medically necessary visits to a qualified
23    provider upon initial diagnosis of diabetes by the
24    patient's physician or, if diagnosis of diabetes was made
25    within one year prior to the effective date of this
26    amendatory Act of 1998 where the insured was a covered

 

 

HB5484- 18 -LRB101 18246 BMS 67688 b

1    individual, up to 3 medically necessary visits to a
2    qualified provider within one year after that effective
3    date.
4        (2) Up to 2 medically necessary visits to a qualified
5    provider upon a determination by a patient's physician that
6    a significant change in the patient's symptoms or medical
7    condition has occurred. A "significant change" in
8    condition means symptomatic hyperglycemia (greater than
9    250 mg/dl on repeated occasions), severe hypoglycemia
10    (requiring the assistance of another person), onset or
11    progression of diabetes, or a significant change in medical
12    condition that would require a significantly different
13    treatment regimen.
14    Payment by the insurer or health maintenance organization
15for the coverage required for diabetes self-management
16training pursuant to the provisions of this Section is only
17required to be made for services provided. No coverage is
18required for additional visits beyond those specified in items
19(1) and (2) of this subsection.
20    Coverage under this subsection (c) for diabetes
21self-management training shall be subject to the same
22deductible, co-payment, and co-insurance provisions that apply
23to coverage under the policy for other services provided by the
24same type of provider.
25    (d) Coverage shall be provided for the following equipment
26when medically necessary and prescribed by a physician licensed

 

 

HB5484- 19 -LRB101 18246 BMS 67688 b

1to practice medicine in all of its branches. Coverage for the
2following items shall be subject to deductible, co-payment and
3co-insurance provisions provided for under the policy or a
4durable medical equipment rider to the policy:
5        (1) blood glucose monitors;
6        (2) blood glucose monitors for the legally blind;
7        (3) cartridges for the legally blind; and
8        (4) lancets and lancing devices.
9    This subsection does not apply to a group policy of
10accident and health insurance that does not provide a durable
11medical equipment benefit.
12    (e) Coverage shall be provided for the following
13pharmaceuticals and supplies when medically necessary and
14prescribed by a physician licensed to practice medicine in all
15of its branches. Coverage for the following items shall be
16subject to the same coverage, deductible, co-payment, and
17co-insurance provisions under the policy or a drug rider to the
18policy, except as otherwise provided for under Sections Section
19356z.41 and 356z.43:
20        (1) insulin;
21        (2) syringes and needles;
22        (3) test strips for glucose monitors;
23        (4) FDA approved oral agents used to control blood
24    sugar; and
25        (5) glucagon emergency kits.
26    This subsection does not apply to a group policy of

 

 

HB5484- 20 -LRB101 18246 BMS 67688 b

1accident and health insurance that does not provide a drug
2benefit.
3    (f) Coverage shall be provided for regular foot care exams
4by a physician or by a physician to whom a physician has
5referred the patient. Coverage for regular foot care exams
6shall be subject to the same deductible, co-payment, and
7co-insurance provisions that apply under the policy for other
8services provided by the same type of provider.
9    (g) If authorized by a physician, diabetes self-management
10training may be provided as a part of an office visit, group
11setting, or home visit.
12    (h) This Section shall not apply to agreements, contracts,
13or policies that provide coverage for a specified diagnosis or
14other limited benefit coverage.
15(Source: P.A. 101-625, eff. 1-1-21.)
 
16    (215 ILCS 5/356z.43 new)
17    Sec. 356z.43. Cost sharing in diabetic self-management
18supplies; limits; confidentiality of rebate information.
19    (a) As used in this Section, "diabetic self-management
20supplies" means items determined to be medically necessary for
21a person with diabetes for diabetic self-management, including
22blood test strips for glucose monitors and the monthly lease of
23an insulin pump. "Diabetic self-management supplies" do not
24include insulin drugs.
25    (b) This Section applies to a group or individual policy of

 

 

HB5484- 21 -LRB101 18246 BMS 67688 b

1accident and health insurance amended, delivered, issued, or
2renewed on or after the effective date of this amendatory Act
3of the 101st General Assembly.
4    (c) An insurer that provides coverage for diabetic
5self-management supplies pursuant to the terms of a health
6coverage plan the insurer offers shall limit the total amount
7that an insured is required to pay for a 30-day supply of
8diabetic self-management supplies at an amount not to exceed
9$100, regardless of the quantity or type of diabetic
10self-management supplies required by an insured with diabetes
11for diabetic self-management.
12    (d) Nothing in this Section prevents an insurer from
13reducing an insured's cost sharing by an amount greater than
14the amount specified in subsection (c).
15    (e) The Director may use any of the Director's enforcement
16powers to obtain an insurer's compliance with this Section.
17    (f) The Department may adopt rules as necessary to
18implement and administer this Section and to align it with
19federal requirements.
20    (g) On January 1 of each year, the limit on the amount that
21an insured is required to pay for a 30-day supply of diabetic
22self-management supplies shall increase by a percentage equal
23to the percentage change from the preceding year in the medical
24care component of the Consumer Price Index of the Bureau of
25Labor Statistics of the United States Department of Labor.
 

 

 

HB5484- 22 -LRB101 18246 BMS 67688 b

1    Section 30. The Health Maintenance Organization Act is
2amended by changing Section 5-3 as follows:
 
3    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
4    (Text of Section before amendment by P.A. 101-625)
5    Sec. 5-3. Insurance Code provisions.
6    (a) Health Maintenance Organizations shall be subject to
7the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
8141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
9154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3,
10355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4,
11356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
12356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19,
13356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
14356z.30a, 356z.32, 356z.33, 356z.35, 356z.36, 356z.43, 364,
15364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e,
16370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412,
17444, and 444.1, paragraph (c) of subsection (2) of Section 367,
18and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV,
19XXVI, and XXXIIB of the Illinois Insurance Code.
20    (b) For purposes of the Illinois Insurance Code, except for
21Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
22Maintenance Organizations in the following categories are
23deemed to be "domestic companies":
24        (1) a corporation authorized under the Dental Service
25    Plan Act or the Voluntary Health Services Plans Act;

 

 

HB5484- 23 -LRB101 18246 BMS 67688 b

1        (2) a corporation organized under the laws of this
2    State; or
3        (3) a corporation organized under the laws of another
4    state, 30% or more of the enrollees of which are residents
5    of this State, except a corporation subject to
6    substantially the same requirements in its state of
7    organization as is a "domestic company" under Article VIII
8    1/2 of the Illinois Insurance Code.
9    (c) In considering the merger, consolidation, or other
10acquisition of control of a Health Maintenance Organization
11pursuant to Article VIII 1/2 of the Illinois Insurance Code,
12        (1) the Director shall give primary consideration to
13    the continuation of benefits to enrollees and the financial
14    conditions of the acquired Health Maintenance Organization
15    after the merger, consolidation, or other acquisition of
16    control takes effect;
17        (2)(i) the criteria specified in subsection (1)(b) of
18    Section 131.8 of the Illinois Insurance Code shall not
19    apply and (ii) the Director, in making his determination
20    with respect to the merger, consolidation, or other
21    acquisition of control, need not take into account the
22    effect on competition of the merger, consolidation, or
23    other acquisition of control;
24        (3) the Director shall have the power to require the
25    following information:
26            (A) certification by an independent actuary of the

 

 

HB5484- 24 -LRB101 18246 BMS 67688 b

1        adequacy of the reserves of the Health Maintenance
2        Organization sought to be acquired;
3            (B) pro forma financial statements reflecting the
4        combined balance sheets of the acquiring company and
5        the Health Maintenance Organization sought to be
6        acquired as of the end of the preceding year and as of
7        a date 90 days prior to the acquisition, as well as pro
8        forma financial statements reflecting projected
9        combined operation for a period of 2 years;
10            (C) a pro forma business plan detailing an
11        acquiring party's plans with respect to the operation
12        of the Health Maintenance Organization sought to be
13        acquired for a period of not less than 3 years; and
14            (D) such other information as the Director shall
15        require.
16    (d) The provisions of Article VIII 1/2 of the Illinois
17Insurance Code and this Section 5-3 shall apply to the sale by
18any health maintenance organization of greater than 10% of its
19enrollee population (including without limitation the health
20maintenance organization's right, title, and interest in and to
21its health care certificates).
22    (e) In considering any management contract or service
23agreement subject to Section 141.1 of the Illinois Insurance
24Code, the Director (i) shall, in addition to the criteria
25specified in Section 141.2 of the Illinois Insurance Code, take
26into account the effect of the management contract or service

 

 

HB5484- 25 -LRB101 18246 BMS 67688 b

1agreement on the continuation of benefits to enrollees and the
2financial condition of the health maintenance organization to
3be managed or serviced, and (ii) need not take into account the
4effect of the management contract or service agreement on
5competition.
6    (f) Except for small employer groups as defined in the
7Small Employer Rating, Renewability and Portability Health
8Insurance Act and except for medicare supplement policies as
9defined in Section 363 of the Illinois Insurance Code, a Health
10Maintenance Organization may by contract agree with a group or
11other enrollment unit to effect refunds or charge additional
12premiums under the following terms and conditions:
13        (i) the amount of, and other terms and conditions with
14    respect to, the refund or additional premium are set forth
15    in the group or enrollment unit contract agreed in advance
16    of the period for which a refund is to be paid or
17    additional premium is to be charged (which period shall not
18    be less than one year); and
19        (ii) the amount of the refund or additional premium
20    shall not exceed 20% of the Health Maintenance
21    Organization's profitable or unprofitable experience with
22    respect to the group or other enrollment unit for the
23    period (and, for purposes of a refund or additional
24    premium, the profitable or unprofitable experience shall
25    be calculated taking into account a pro rata share of the
26    Health Maintenance Organization's administrative and

 

 

HB5484- 26 -LRB101 18246 BMS 67688 b

1    marketing expenses, but shall not include any refund to be
2    made or additional premium to be paid pursuant to this
3    subsection (f)). The Health Maintenance Organization and
4    the group or enrollment unit may agree that the profitable
5    or unprofitable experience may be calculated taking into
6    account the refund period and the immediately preceding 2
7    plan years.
8    The Health Maintenance Organization shall include a
9statement in the evidence of coverage issued to each enrollee
10describing the possibility of a refund or additional premium,
11and upon request of any group or enrollment unit, provide to
12the group or enrollment unit a description of the method used
13to calculate (1) the Health Maintenance Organization's
14profitable experience with respect to the group or enrollment
15unit and the resulting refund to the group or enrollment unit
16or (2) the Health Maintenance Organization's unprofitable
17experience with respect to the group or enrollment unit and the
18resulting additional premium to be paid by the group or
19enrollment unit.
20    In no event shall the Illinois Health Maintenance
21Organization Guaranty Association be liable to pay any
22contractual obligation of an insolvent organization to pay any
23refund authorized under this Section.
24    (g) Rulemaking authority to implement Public Act 95-1045,
25if any, is conditioned on the rules being adopted in accordance
26with all provisions of the Illinois Administrative Procedure

 

 

HB5484- 27 -LRB101 18246 BMS 67688 b

1Act and all rules and procedures of the Joint Committee on
2Administrative Rules; any purported rule not so adopted, for
3whatever reason, is unauthorized.
4(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
5100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
61-1-19; 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19; 101-81,
7eff. 7-12-19; 101-281, eff. 1-1-20; 101-371, eff. 1-1-20;
8101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
91-1-20; revised 10-16-19.)
 
10    (Text of Section after amendment by P.A. 101-625)
11    Sec. 5-3. Insurance Code provisions.
12    (a) Health Maintenance Organizations shall be subject to
13the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
14141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
15154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3,
16355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4,
17356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
18356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19,
19356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30,
20356z.30a, 356z.32, 356z.33, 356z.35, 356z.36, 356z.41,
21356z.43, 364, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c,
22368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408,
23408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection
24(2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2,
25XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance

 

 

HB5484- 28 -LRB101 18246 BMS 67688 b

1Code.
2    (b) For purposes of the Illinois Insurance Code, except for
3Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health
4Maintenance Organizations in the following categories are
5deemed to be "domestic companies":
6        (1) a corporation authorized under the Dental Service
7    Plan Act or the Voluntary Health Services Plans Act;
8        (2) a corporation organized under the laws of this
9    State; or
10        (3) a corporation organized under the laws of another
11    state, 30% or more of the enrollees of which are residents
12    of this State, except a corporation subject to
13    substantially the same requirements in its state of
14    organization as is a "domestic company" under Article VIII
15    1/2 of the Illinois Insurance Code.
16    (c) In considering the merger, consolidation, or other
17acquisition of control of a Health Maintenance Organization
18pursuant to Article VIII 1/2 of the Illinois Insurance Code,
19        (1) the Director shall give primary consideration to
20    the continuation of benefits to enrollees and the financial
21    conditions of the acquired Health Maintenance Organization
22    after the merger, consolidation, or other acquisition of
23    control takes effect;
24        (2)(i) the criteria specified in subsection (1)(b) of
25    Section 131.8 of the Illinois Insurance Code shall not
26    apply and (ii) the Director, in making his determination

 

 

HB5484- 29 -LRB101 18246 BMS 67688 b

1    with respect to the merger, consolidation, or other
2    acquisition of control, need not take into account the
3    effect on competition of the merger, consolidation, or
4    other acquisition of control;
5        (3) the Director shall have the power to require the
6    following information:
7            (A) certification by an independent actuary of the
8        adequacy of the reserves of the Health Maintenance
9        Organization sought to be acquired;
10            (B) pro forma financial statements reflecting the
11        combined balance sheets of the acquiring company and
12        the Health Maintenance Organization sought to be
13        acquired as of the end of the preceding year and as of
14        a date 90 days prior to the acquisition, as well as pro
15        forma financial statements reflecting projected
16        combined operation for a period of 2 years;
17            (C) a pro forma business plan detailing an
18        acquiring party's plans with respect to the operation
19        of the Health Maintenance Organization sought to be
20        acquired for a period of not less than 3 years; and
21            (D) such other information as the Director shall
22        require.
23    (d) The provisions of Article VIII 1/2 of the Illinois
24Insurance Code and this Section 5-3 shall apply to the sale by
25any health maintenance organization of greater than 10% of its
26enrollee population (including without limitation the health

 

 

HB5484- 30 -LRB101 18246 BMS 67688 b

1maintenance organization's right, title, and interest in and to
2its health care certificates).
3    (e) In considering any management contract or service
4agreement subject to Section 141.1 of the Illinois Insurance
5Code, the Director (i) shall, in addition to the criteria
6specified in Section 141.2 of the Illinois Insurance Code, take
7into account the effect of the management contract or service
8agreement on the continuation of benefits to enrollees and the
9financial condition of the health maintenance organization to
10be managed or serviced, and (ii) need not take into account the
11effect of the management contract or service agreement on
12competition.
13    (f) Except for small employer groups as defined in the
14Small Employer Rating, Renewability and Portability Health
15Insurance Act and except for medicare supplement policies as
16defined in Section 363 of the Illinois Insurance Code, a Health
17Maintenance Organization may by contract agree with a group or
18other enrollment unit to effect refunds or charge additional
19premiums under the following terms and conditions:
20        (i) the amount of, and other terms and conditions with
21    respect to, the refund or additional premium are set forth
22    in the group or enrollment unit contract agreed in advance
23    of the period for which a refund is to be paid or
24    additional premium is to be charged (which period shall not
25    be less than one year); and
26        (ii) the amount of the refund or additional premium

 

 

HB5484- 31 -LRB101 18246 BMS 67688 b

1    shall not exceed 20% of the Health Maintenance
2    Organization's profitable or unprofitable experience with
3    respect to the group or other enrollment unit for the
4    period (and, for purposes of a refund or additional
5    premium, the profitable or unprofitable experience shall
6    be calculated taking into account a pro rata share of the
7    Health Maintenance Organization's administrative and
8    marketing expenses, but shall not include any refund to be
9    made or additional premium to be paid pursuant to this
10    subsection (f)). The Health Maintenance Organization and
11    the group or enrollment unit may agree that the profitable
12    or unprofitable experience may be calculated taking into
13    account the refund period and the immediately preceding 2
14    plan years.
15    The Health Maintenance Organization shall include a
16statement in the evidence of coverage issued to each enrollee
17describing the possibility of a refund or additional premium,
18and upon request of any group or enrollment unit, provide to
19the group or enrollment unit a description of the method used
20to calculate (1) the Health Maintenance Organization's
21profitable experience with respect to the group or enrollment
22unit and the resulting refund to the group or enrollment unit
23or (2) the Health Maintenance Organization's unprofitable
24experience with respect to the group or enrollment unit and the
25resulting additional premium to be paid by the group or
26enrollment unit.

 

 

HB5484- 32 -LRB101 18246 BMS 67688 b

1    In no event shall the Illinois Health Maintenance
2Organization Guaranty Association be liable to pay any
3contractual obligation of an insolvent organization to pay any
4refund authorized under this Section.
5    (g) Rulemaking authority to implement Public Act 95-1045,
6if any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
12100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
131-1-19; 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19; 101-81,
14eff. 7-12-19; 101-281, eff. 1-1-20; 101-371, eff. 1-1-20;
15101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
161-1-20; 101-625, eff. 1-1-21.)
 
17    Section 35. The Limited Health Service Organization Act is
18amended by changing Section 4003 as follows:
 
19    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
20    (Text of Section before amendment by P.A. 101-625)
21    Sec. 4003. Illinois Insurance Code provisions. Limited
22health service organizations shall be subject to the provisions
23of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
24143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,

 

 

HB5484- 33 -LRB101 18246 BMS 67688 b

1154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v,
2356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
3356z.30a, 356z.32, 356z.33, 356z.43, 368a, 401, 401.1, 402,
4403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles
5IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of
6the Illinois Insurance Code. For purposes of the Illinois
7Insurance Code, except for Sections 444 and 444.1 and Articles
8XIII and XIII 1/2, limited health service organizations in the
9following categories are deemed to be domestic companies:
10        (1) a corporation under the laws of this State; or
11        (2) a corporation organized under the laws of another
12    state, 30% or more of the enrollees of which are residents
13    of this State, except a corporation subject to
14    substantially the same requirements in its state of
15    organization as is a domestic company under Article VIII
16    1/2 of the Illinois Insurance Code.
17(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
18100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff.
191-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
20eff. 1-1-20; 101-393, eff. 1-1-20; revised 10-16-19.)
 
21    (Text of Section after amendment by P.A. 101-625)
22    Sec. 4003. Illinois Insurance Code provisions. Limited
23health service organizations shall be subject to the provisions
24of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3,
25143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6,

 

 

HB5484- 34 -LRB101 18246 BMS 67688 b

1154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v,
2356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
3356z.30a, 356z.32, 356z.33, 356z.41, 356z.43, 368a, 401,
4401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and
5Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and
6XXVI of the Illinois Insurance Code. For purposes of the
7Illinois Insurance Code, except for Sections 444 and 444.1 and
8Articles XIII and XIII 1/2, limited health service
9organizations in the following categories are deemed to be
10domestic companies:
11        (1) a corporation under the laws of this State; or
12        (2) a corporation organized under the laws of another
13    state, 30% or more of the enrollees of which are residents
14    of this State, except a corporation subject to
15    substantially the same requirements in its state of
16    organization as is a domestic company under Article VIII
17    1/2 of the Illinois Insurance Code.
18(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
19100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff.
201-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281,
21eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. 1-1-21.)
 
22    Section 40. The Voluntary Health Services Plans Act is
23amended by changing Section 10 as follows:
 
24    (215 ILCS 165/10)  (from Ch. 32, par. 604)

 

 

HB5484- 35 -LRB101 18246 BMS 67688 b

1    (Text of Section before amendment by P.A. 101-625)
2    Sec. 10. Application of Insurance Code provisions. Health
3services plan corporations and all persons interested therein
4or dealing therewith shall be subject to the provisions of
5Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
6143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g,
7356g.5, 356g.5-1, 356r, 356t, 356u, 356v, 356w, 356x, 356y,
8356z.1, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
9356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
10356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
11356z.30, 356z.30a, 356z.32, 356z.33, 356z.43, 364.01, 367.2,
12368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412, and
13paragraphs (7) and (15) of Section 367 of the Illinois
14Insurance Code.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
22100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
231-1-19; 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19; 101-81,
24eff. 7-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
25revised 10-16-19.)
 

 

 

HB5484- 36 -LRB101 18246 BMS 67688 b

1    (Text of Section after amendment by P.A. 101-625)
2    Sec. 10. Application of Insurance Code provisions. Health
3services plan corporations and all persons interested therein
4or dealing therewith shall be subject to the provisions of
5Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
6143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 356g,
7356g.5, 356g.5-1, 356r, 356t, 356u, 356v, 356w, 356x, 356y,
8356z.1, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
9356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
10356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29,
11356z.30, 356z.30a, 356z.32, 356z.33, 356z.41, 356z.43, 364.01,
12367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
13and paragraphs (7) and (15) of Section 367 of the Illinois
14Insurance Code.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17;
22100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff.
231-1-19; 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19; 101-81,
24eff. 7-12-19; 101-281, eff. 1-1-20; 101-393, eff. 1-1-20;
25101-625, eff. 1-1-21.)
 

 

 

HB5484- 37 -LRB101 18246 BMS 67688 b

1    Section 95. No acceleration or delay. Where this Act makes
2changes in a statute that is represented in this Act by text
3that is not yet or no longer in effect (for example, a Section
4represented by multiple versions), the use of that text does
5not accelerate or delay the taking effect of (i) the changes
6made by this Act or (ii) provisions derived from any other
7Public Act.
 
8    Section 99. Effective date. This Act takes effect January
91, 2021.