Illinois General Assembly - Full Text of HB5363
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Full Text of HB5363  102nd General Assembly

HB5363 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5363

 

Introduced 1/31/2022, by Rep. Brad Halbrook

 

SYNOPSIS AS INTRODUCED:
 
55 ILCS 5/5-1069  from Ch. 34, par. 5-1069

    Amends the Counties Code. Provides that, on and after January 1, 2023, group life, health, accident, hospital, and medical insurance may not be provided to part-time county board members unless the same benefits are provided or offered to part-time employees of the county. Effective immediately.


LRB102 25367 AWJ 34647 b

 

 

A BILL FOR

 

HB5363LRB102 25367 AWJ 34647 b

1    AN ACT concerning local government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Counties Code is amended by changing
5Section 5-1069 as follows:
 
6    (55 ILCS 5/5-1069)  (from Ch. 34, par. 5-1069)
7    Sec. 5-1069. Group life, health, accident, hospital, and
8medical insurance.
9    (a) The county board of any county may arrange to provide,
10for the benefit of employees of the county, group life,
11health, accident, hospital, and medical insurance, or any one
12or any combination of those types of insurance, or the county
13board may self-insure, for the benefit of its employees, all
14or a portion of the employees' group life, health, accident,
15hospital, and medical insurance, or any one or any combination
16of those types of insurance, including a combination of
17self-insurance and other types of insurance authorized by this
18Section, provided that the county board complies with all
19other requirements of this Section. The insurance may include
20provision for employees who rely on treatment by prayer or
21spiritual means alone for healing in accordance with the
22tenets and practice of a well recognized religious
23denomination. The county board may provide for payment by the

 

 

HB5363- 2 -LRB102 25367 AWJ 34647 b

1county of a portion or all of the premium or charge for the
2insurance with the employee paying the balance of the premium
3or charge, if any. If the county board undertakes a plan under
4which the county pays only a portion of the premium or charge,
5the county board shall provide for withholding and deducting
6from the compensation of those employees who consent to join
7the plan the balance of the premium or charge for the
8insurance.
9    (b) If the county board does not provide for
10self-insurance or for a plan under which the county pays a
11portion or all of the premium or charge for a group insurance
12plan, the county board may provide for withholding and
13deducting from the compensation of those employees who consent
14thereto the total premium or charge for any group life,
15health, accident, hospital, and medical insurance.
16    (c) The county board may exercise the powers granted in
17this Section only if it provides for self-insurance or, where
18it makes arrangements to provide group insurance through an
19insurance carrier, if the kinds of group insurance are
20obtained from an insurance company authorized to do business
21in the State of Illinois. The county board may enact an
22ordinance prescribing the method of operation of the insurance
23program.
24    (c-5) On and after January 1, 2023, benefits under this
25Section may not be provided to part-time county board members
26unless the same benefits are provided or offered to part-time

 

 

HB5363- 3 -LRB102 25367 AWJ 34647 b

1employees of the county.
2    (d) If a county, including a home rule county, is a
3self-insurer for purposes of providing health insurance
4coverage for its employees, the insurance coverage shall
5include screening by low-dose mammography for all women 35
6years of age or older for the presence of occult breast cancer
7unless the county elects to provide mammograms itself under
8Section 5-1069.1. The coverage shall be as follows:
9        (1) A baseline mammogram for women 35 to 39 years of
10    age.
11        (2) An annual mammogram for women 40 years of age or
12    older.
13        (3) A mammogram at the age and intervals considered
14    medically necessary by the woman's health care provider
15    for women under 40 years of age and having a family history
16    of breast cancer, prior personal history of breast cancer,
17    positive genetic testing, or other risk factors.
18        (4) For a group policy of accident and health
19    insurance that is amended, delivered, issued, or renewed
20    on or after the effective date of this amendatory Act of
21    the 101st General Assembly, a comprehensive ultrasound
22    screening of an entire breast or breasts if a mammogram
23    demonstrates heterogeneous or dense breast tissue or when
24    medically necessary as determined by a physician licensed
25    to practice medicine in all of its branches, advanced
26    practice registered nurse, or physician assistant.

 

 

HB5363- 4 -LRB102 25367 AWJ 34647 b

1        (5) For a group policy of accident and health
2    insurance that is amended, delivered, issued, or renewed
3    on or after the effective date of this amendatory Act of
4    the 101st General Assembly, a diagnostic mammogram when
5    medically necessary, as determined by a physician licensed
6    to practice medicine in all its branches, advanced
7    practice registered nurse, or physician assistant.
8    A policy subject to this subsection shall not impose a
9deductible, coinsurance, copayment, or any other cost-sharing
10requirement on the coverage provided; except that this
11sentence does not apply to coverage of diagnostic mammograms
12to the extent such coverage would disqualify a high-deductible
13health plan from eligibility for a health savings account
14pursuant to Section 223 of the Internal Revenue Code (26
15U.S.C. 223).
16    For purposes of this subsection:
17    "Diagnostic mammogram" means a mammogram obtained using
18diagnostic mammography.
19    "Diagnostic mammography" means a method of screening that
20is designed to evaluate an abnormality in a breast, including
21an abnormality seen or suspected on a screening mammogram or a
22subjective or objective abnormality otherwise detected in the
23breast.
24    "Low-dose mammography" means the x-ray examination of the
25breast using equipment dedicated specifically for mammography,
26including the x-ray tube, filter, compression device, and

 

 

HB5363- 5 -LRB102 25367 AWJ 34647 b

1image receptor, with an average radiation exposure delivery of
2less than one rad per breast for 2 views of an average size
3breast. The term also includes digital mammography.
4    (d-5) Coverage as described by subsection (d) shall be
5provided at no cost to the insured and shall not be applied to
6an annual or lifetime maximum benefit.
7    (d-10) When health care services are available through
8contracted providers and a person does not comply with plan
9provisions specific to the use of contracted providers, the
10requirements of subsection (d-5) are not applicable. When a
11person does not comply with plan provisions specific to the
12use of contracted providers, plan provisions specific to the
13use of non-contracted providers must be applied without
14distinction for coverage required by this Section and shall be
15at least as favorable as for other radiological examinations
16covered by the policy or contract.
17    (d-15) If a county, including a home rule county, is a
18self-insurer for purposes of providing health insurance
19coverage for its employees, the insurance coverage shall
20include mastectomy coverage, which includes coverage for
21prosthetic devices or reconstructive surgery incident to the
22mastectomy. Coverage for breast reconstruction in connection
23with a mastectomy shall include:
24        (1) reconstruction of the breast upon which the
25    mastectomy has been performed;
26        (2) surgery and reconstruction of the other breast to

 

 

HB5363- 6 -LRB102 25367 AWJ 34647 b

1    produce a symmetrical appearance; and
2        (3) prostheses and treatment for physical
3    complications at all stages of mastectomy, including
4    lymphedemas.
5Care shall be determined in consultation with the attending
6physician and the patient. The offered coverage for prosthetic
7devices and reconstructive surgery shall be subject to the
8deductible and coinsurance conditions applied to the
9mastectomy, and all other terms and conditions applicable to
10other benefits. When a mastectomy is performed and there is no
11evidence of malignancy then the offered coverage may be
12limited to the provision of prosthetic devices and
13reconstructive surgery to within 2 years after the date of the
14mastectomy. As used in this Section, "mastectomy" means the
15removal of all or part of the breast for medically necessary
16reasons, as determined by a licensed physician.
17    A county, including a home rule county, that is a
18self-insurer for purposes of providing health insurance
19coverage for its employees, may not penalize or reduce or
20limit the reimbursement of an attending provider or provide
21incentives (monetary or otherwise) to an attending provider to
22induce the provider to provide care to an insured in a manner
23inconsistent with this Section.
24    (d-20) The requirement that mammograms be included in
25health insurance coverage as provided in subsections (d)
26through (d-15) is an exclusive power and function of the State

 

 

HB5363- 7 -LRB102 25367 AWJ 34647 b

1and is a denial and limitation under Article VII, Section 6,
2subsection (h) of the Illinois Constitution of home rule
3county powers. A home rule county to which subsections (d)
4through (d-15) apply must comply with every provision of those
5subsections.
6    (e) The term "employees" as used in this Section includes
7elected or appointed officials but does not include temporary
8employees.
9    (f) The county board may, by ordinance, arrange to provide
10group life, health, accident, hospital, and medical insurance,
11or any one or a combination of those types of insurance, under
12this Section to retired former employees and retired former
13elected or appointed officials of the county.
14    (g) Rulemaking authority to implement this amendatory Act
15of the 95th General Assembly, if any, is conditioned on the
16rules being adopted in accordance with all provisions of the
17Illinois Administrative Procedure Act and all rules and
18procedures of the Joint Committee on Administrative Rules; any
19purported rule not so adopted, for whatever reason, is
20unauthorized.
21(Source: P.A. 100-513, eff. 1-1-18; 101-580, eff. 1-1-20.)
 
22    Section 99. Effective date. This Act takes effect upon
23becoming law.