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| 1 | AN ACT concerning regulation. | ||||||
| 2 | Be it enacted by the People of the State of Illinois, | ||||||
| 3 | represented in the General Assembly: | ||||||
| 4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||
| 5 | is amended by changing Section 6.11 as follows: | ||||||
| 6 | (5 ILCS 375/6.11) | ||||||
| 7 | Sec. 6.11. Required health benefits; Illinois Insurance | ||||||
| 8 | Code requirements. The program of health benefits shall | ||||||
| 9 | provide the post-mastectomy care benefits required to be | ||||||
| 10 | covered by a policy of accident and health insurance under | ||||||
| 11 | Section 356t of the Illinois Insurance Code. The program of | ||||||
| 12 | health benefits shall provide the coverage required under | ||||||
| 13 | Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x, | ||||||
| 14 | 356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, | ||||||
| 15 | 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, | ||||||
| 16 | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | ||||||
| 17 | 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, | ||||||
| 18 | 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, 356z.60, | ||||||
| 19 | and 356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, | ||||||
| 20 | and 356z.71 of the Illinois Insurance Code. The program of | ||||||
| 21 | health benefits must comply with Sections 155.22a, 155.37, | ||||||
| 22 | 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the | ||||||
| 23 | Illinois Insurance Code. The program of health benefits shall | ||||||
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| 1 | provide the coverage required under Section 356m of the | ||||||
| 2 | Illinois Insurance Code and, for the employees of the State | ||||||
| 3 | Employee Group Insurance Program only, the coverage as also | ||||||
| 4 | provided in Section 6.11B of this Act. The Department of | ||||||
| 5 | Insurance shall enforce the requirements of this Section with | ||||||
| 6 | respect to Sections 370c and 370c.1 of the Illinois Insurance | ||||||
| 7 | Code; all other requirements of this Section shall be enforced | ||||||
| 8 | by the Department of Central Management Services. | ||||||
| 9 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
| 10 | any, is conditioned on the rules being adopted in accordance | ||||||
| 11 | with all provisions of the Illinois Administrative Procedure | ||||||
| 12 | Act and all rules and procedures of the Joint Committee on | ||||||
| 13 | Administrative Rules; any purported rule not so adopted, for | ||||||
| 14 | whatever reason, is unauthorized. | ||||||
| 15 | (Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; | ||||||
| 16 | 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. | ||||||
| 17 | 1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768, | ||||||
| 18 | eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; | ||||||
| 19 | 102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. | ||||||
| 20 | 1-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84, | ||||||
| 21 | eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24; | ||||||
| 22 | 103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff. | ||||||
| 23 | 8-11-23; revised 8-29-23.) | ||||||
| 24 | Section 10. The Illinois Insurance Code is amended by | ||||||
| 25 | adding Section 356z.71 as follows: | ||||||
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| 1 | (215 ILCS 5/356z.71 new) | ||||||
| 2 | Sec. 356z.71. Coverage for at-home pregnancy tests. A | ||||||
| 3 | group or individual policy of accident and health insurance or | ||||||
| 4 | a managed care plan that is amended, delivered, issued, or | ||||||
| 5 | renewed on or after January 1, 2026 shall provide coverage for | ||||||
| 6 | at-home, urine-based pregnancy tests that are prescribed to | ||||||
| 7 | the covered person, regardless of whether the tests are | ||||||
| 8 | otherwise available over-the-counter. The coverage required | ||||||
| 9 | under this Section is limited to 2 at-home, urine-based | ||||||
| 10 | pregnancy tests every 30 days. | ||||||
| 11 | Section 15. The Illinois Public Aid Code is amended by | ||||||
| 12 | adding Section 5-5.24a as follows: | ||||||
| 13 | (305 ILCS 5/5-5.24a new) | ||||||
| 14 | Sec. 5-5.24a. Coverage for at-home pregnancy tests. | ||||||
| 15 | Beginning January 1, 2025, the medical assistance program | ||||||
| 16 | shall provide coverage for at-home, urine-based pregnancy | ||||||
| 17 | tests that are ordered directly by a clinician or furnished | ||||||
| 18 | through a standing order for patient use, regardless of | ||||||
| 19 | whether the tests are otherwise available over the counter. | ||||||
| 20 | The coverage required under this Section is limited to a | ||||||
| 21 | multipack, as defined by the Department, of at-home, | ||||||
| 22 | urine-based pregnancy tests every 30 days. | ||||||
| 23 | Section 99. Effective date. This Act takes effect January | ||||||
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| 1 | 1, 2025. | ||||||