Full Text of HB5656 101st General Assembly
HB5656 101ST GENERAL ASSEMBLY |
| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020 HB5656 Introduced , by Rep. Jonathan Pizer SYNOPSIS AS INTRODUCED: |
| 55 ILCS 5/5-1069.3 | | 65 ILCS 5/10-4-2.3 | | 105 ILCS 5/10-22.3f | | 215 ILCS 5/356z.4a | | 215 ILCS 130/4003 | from Ch. 73, par. 1504-3 | 305 ILCS 5/5-16.8 | |
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Amends the Illinois Insurance Code. In provisions requiring that no individual or group policy of accident and health insurance be issued unless it provides a covered person with coverage for abortion care, removes the condition that it applies to a policy that provides pregnancy-related benefits. Makes conforming changes in the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, and the Illinois Public Aid Code.
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| | FISCAL NOTE ACT MAY APPLY | | STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT |
| | A BILL FOR |
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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 Counties Code is amended by changing Section | 5 | | 5-1069.3 as follows: | 6 | | (55 ILCS 5/5-1069.3)
| 7 | | (Text of Section before amendment by P.A. 101-625 ) | 8 | | Sec. 5-1069.3. Required health benefits. If a county, | 9 | | including a home
rule
county, is a self-insurer for purposes of | 10 | | providing health insurance coverage
for its employees, the | 11 | | coverage shall include coverage for the post-mastectomy
care | 12 | | benefits required to be covered by a policy of accident and | 13 | | health
insurance under Section 356t and the coverage required | 14 | | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, | 15 | | 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, | 16 | | 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, | 17 | | 356z.30a, and 356z.32, and 356z.33 , and 356z.36 of
the Illinois | 18 | | Insurance Code. The coverage shall comply with Sections | 19 | | 155.22a, 355b, 356z.19, and 370c of
the Illinois Insurance | 20 | | Code. The Department of Insurance shall enforce the | 21 | | requirements of this Section. The requirement that health | 22 | | benefits be covered
as provided in this Section is an
exclusive | 23 | | power and function of the State and is a denial and limitation |
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| 1 | | under
Article VII, Section 6, subsection (h) of the Illinois | 2 | | Constitution. A home
rule county to which this Section applies | 3 | | must comply with every provision of
this Section.
| 4 | | Rulemaking authority to implement Public Act 95-1045, if | 5 | | any, is conditioned on the rules being adopted in accordance | 6 | | with all provisions of the Illinois Administrative Procedure | 7 | | Act and all rules and procedures of the Joint Committee on | 8 | | Administrative Rules; any purported rule not so adopted, for | 9 | | whatever reason, is unauthorized. | 10 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 11 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 12 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 13 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 14 | | revised 10-16-19.) | 15 | | (Text of Section after amendment by P.A. 101-625 ) | 16 | | Sec. 5-1069.3. Required health benefits. If a county, | 17 | | including a home
rule
county, is a self-insurer for purposes of | 18 | | providing health insurance coverage
for its employees, the | 19 | | coverage shall include coverage for the post-mastectomy
care | 20 | | benefits required to be covered by a policy of accident and | 21 | | health
insurance under Section 356t and the coverage required | 22 | | under Sections 356g, 356g.5, 356g.5-1, 356u,
356w, 356x, | 23 | | 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, | 24 | | 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, | 25 | | 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 of
the |
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| 1 | | Illinois Insurance Code. The coverage shall comply with | 2 | | Sections 155.22a, 355b, 356z.19, and 370c of
the Illinois | 3 | | Insurance Code. The Department of Insurance shall enforce the | 4 | | requirements of this Section. The requirement that health | 5 | | benefits be covered
as provided in this Section is an
exclusive | 6 | | power and function of the State and is a denial and limitation | 7 | | under
Article VII, Section 6, subsection (h) of the Illinois | 8 | | Constitution. A home
rule county to which this Section applies | 9 | | must comply with every provision of
this Section.
| 10 | | Rulemaking authority to implement Public Act 95-1045, if | 11 | | any, is conditioned on the rules being adopted in accordance | 12 | | with all provisions of the Illinois Administrative Procedure | 13 | | Act and all rules and procedures of the Joint Committee on | 14 | | Administrative Rules; any purported rule not so adopted, for | 15 | | whatever reason, is unauthorized. | 16 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 17 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 18 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 19 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 20 | | 101-625, eff. 1-1-21.) | 21 | | Section 10. The Illinois Municipal Code is amended by | 22 | | changing Section 10-4-2.3 as follows: | 23 | | (65 ILCS 5/10-4-2.3)
| 24 | | (Text of Section before amendment by P.A. 101-625 ) |
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| 1 | | Sec. 10-4-2.3. Required health benefits. If a | 2 | | municipality, including a
home rule municipality, is a | 3 | | self-insurer for purposes of providing health
insurance | 4 | | coverage for its employees, the coverage shall include coverage | 5 | | for
the post-mastectomy care benefits required to be covered by | 6 | | a policy of
accident and health insurance under Section 356t | 7 | | and the coverage required
under Sections 356g, 356g.5, | 8 | | 356g.5-1, 356u, 356w, 356x, 356z.4a, 356z.6, 356z.8, 356z.9, | 9 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, | 10 | | 356z.25, 356z.26, 356z.29, 356z.30a, and 356z.32, and 356z.33 , | 11 | | and 356z.36 of the Illinois
Insurance
Code. The coverage shall | 12 | | comply with Sections 155.22a, 355b, 356z.19, and 370c of
the | 13 | | Illinois Insurance Code. The Department of Insurance shall | 14 | | enforce the requirements of this Section. The requirement that | 15 | | health
benefits be covered as provided in this is an exclusive | 16 | | power and function of
the State and is a denial and limitation | 17 | | under Article VII, Section 6,
subsection (h) of the Illinois | 18 | | Constitution. A home rule municipality to which
this Section | 19 | | applies must comply with every provision of this Section.
| 20 | | Rulemaking authority to implement Public Act 95-1045, if | 21 | | any, is conditioned on the rules being adopted in accordance | 22 | | with all provisions of the Illinois Administrative Procedure | 23 | | Act and all rules and procedures of the Joint Committee on | 24 | | Administrative Rules; any purported rule not so adopted, for | 25 | | whatever reason, is unauthorized. | 26 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; |
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| 1 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 2 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 3 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 4 | | revised 10-16-19.) | 5 | | (Text of Section after amendment by P.A. 101-625 ) | 6 | | Sec. 10-4-2.3. Required health benefits. If a | 7 | | municipality, including a
home rule municipality, is a | 8 | | self-insurer for purposes of providing health
insurance | 9 | | coverage for its employees, the coverage shall include coverage | 10 | | for
the post-mastectomy care benefits required to be covered by | 11 | | a policy of
accident and health insurance under Section 356t | 12 | | and the coverage required
under Sections 356g, 356g.5, | 13 | | 356g.5-1, 356u, 356w, 356x, 356z.4a, 356z.6, 356z.8, 356z.9, | 14 | | 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, | 15 | | 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, | 16 | | 356z.36, and 356z.41 of the Illinois
Insurance
Code. The | 17 | | coverage shall comply with Sections 155.22a, 355b, 356z.19, and | 18 | | 370c of
the Illinois Insurance Code. The Department of | 19 | | Insurance shall enforce the requirements of this Section. The | 20 | | requirement that health
benefits be covered as provided in this | 21 | | is an exclusive power and function of
the State and is a denial | 22 | | and limitation under Article VII, Section 6,
subsection (h) of | 23 | | the Illinois Constitution. A home rule municipality to which
| 24 | | this Section applies must comply with every provision of this | 25 | | Section.
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| 1 | | Rulemaking authority to implement Public Act 95-1045, if | 2 | | any, is conditioned on the rules being adopted in accordance | 3 | | with all provisions of the Illinois Administrative Procedure | 4 | | Act and all rules and procedures of the Joint Committee on | 5 | | Administrative Rules; any purported rule not so adopted, for | 6 | | whatever reason, is unauthorized. | 7 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 8 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 9 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 10 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 11 | | 101-625, eff. 1-1-21.) | 12 | | Section 15. The School Code is amended by changing Section | 13 | | 10-22.3f as follows: | 14 | | (105 ILCS 5/10-22.3f)
| 15 | | (Text of Section before amendment by P.A. 101-625 ) | 16 | | Sec. 10-22.3f. Required health benefits. Insurance | 17 | | protection and
benefits
for employees shall provide the | 18 | | post-mastectomy care benefits required to be
covered by a | 19 | | policy of accident and health insurance under Section 356t and | 20 | | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | 21 | | 356u, 356w, 356x, 356z.4a,
356z.6, 356z.8, 356z.9, 356z.11, | 22 | | 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, | 23 | | 356z.29, 356z.30a, and 356z.32, and 356z.33 , and 356z.36 of
the
| 24 | | Illinois Insurance Code.
Insurance policies shall comply with |
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| 1 | | Section 356z.19 of the Illinois Insurance Code. The coverage | 2 | | shall comply with Sections 155.22a, 355b, and 370c of
the | 3 | | Illinois Insurance Code. The Department of Insurance shall | 4 | | enforce the requirements of this Section.
| 5 | | Rulemaking authority to implement Public Act 95-1045, if | 6 | | any, is conditioned on the rules being adopted in accordance | 7 | | with all provisions of the Illinois Administrative Procedure | 8 | | Act and all rules and procedures of the Joint Committee on | 9 | | Administrative Rules; any purported rule not so adopted, for | 10 | | whatever reason, is unauthorized. | 11 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 12 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 13 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 14 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 15 | | revised 10-16-19.) | 16 | | (Text of Section after amendment by P.A. 101-625 ) | 17 | | Sec. 10-22.3f. Required health benefits. Insurance | 18 | | protection and
benefits
for employees shall provide the | 19 | | post-mastectomy care benefits required to be
covered by a | 20 | | policy of accident and health insurance under Section 356t and | 21 | | the
coverage required under Sections 356g, 356g.5, 356g.5-1, | 22 | | 356u, 356w, 356x, 356z.4a,
356z.6, 356z.8, 356z.9, 356z.11, | 23 | | 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, | 24 | | 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, and 356z.41 of
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Illinois Insurance Code.
Insurance policies shall comply |
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| 1 | | with Section 356z.19 of the Illinois Insurance Code. The | 2 | | coverage shall comply with Sections 155.22a, 355b, and 370c of
| 3 | | the Illinois Insurance Code. The Department of Insurance shall | 4 | | enforce the requirements of this Section.
| 5 | | Rulemaking authority to implement Public Act 95-1045, if | 6 | | any, is conditioned on the rules being adopted in accordance | 7 | | with all provisions of the Illinois Administrative Procedure | 8 | | Act and all rules and procedures of the Joint Committee on | 9 | | Administrative Rules; any purported rule not so adopted, for | 10 | | whatever reason, is unauthorized. | 11 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 12 | | 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. | 13 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 14 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-461, eff. 1-1-20; | 15 | | 101-625, eff. 1-1-21.) | 16 | | Section 20. The Illinois Insurance Code is amended by | 17 | | changing Section 356z.4a as follows: | 18 | | (215 ILCS 5/356z.4a) | 19 | | Sec. 356z.4a. Coverage for abortion. | 20 | | (a) Except as otherwise provided in this Section, no | 21 | | individual or group policy of accident and health insurance | 22 | | that provides pregnancy-related benefits may be issued, | 23 | | amended, delivered, or renewed in this State after the | 24 | | effective date of this amendatory Act of the 101st General |
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| 1 | | Assembly the effective date of this amendatory Act of the 101st | 2 | | General Assembly unless the policy provides a covered person | 3 | | with coverage for abortion care. | 4 | | (b) Coverage for abortion care may not impose any | 5 | | deductible, coinsurance, waiting period, or other cost-sharing | 6 | | limitation that is greater than that required for other | 7 | | pregnancy-related benefits covered by the policy. | 8 | | (c) Except as otherwise authorized under this Section, a | 9 | | policy shall not impose any restrictions or delays on the | 10 | | coverage required under this Section. | 11 | | (d) This Section does not, pursuant to 42 U.S.C. | 12 | | 18054(a)(6), apply to a multistate plan that does not provide | 13 | | coverage for abortion. | 14 | | (e) If the Department concludes that enforcement of this | 15 | | Section may adversely affect the allocation of federal funds to | 16 | | this State, the Department may grant an exemption to the | 17 | | requirements, but only to the minimum extent necessary to | 18 | | ensure the continued receipt of federal funds.
| 19 | | (Source: P.A. 101-13, eff. 6-12-19.) | 20 | | Section 25. The Limited Health Service Organization Act is | 21 | | amended by changing Section 4003 as follows:
| 22 | | (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
| 23 | | (Text of Section before amendment by P.A. 101-625 )
| 24 | | Sec. 4003. Illinois Insurance Code provisions. Limited |
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| 1 | | health service
organizations shall be subject to the provisions | 2 | | of Sections 133, 134, 136, 137, 139,
140, 141.1, 141.2, 141.3, | 3 | | 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, | 4 | | 154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v, | 5 | | 356z.4a, 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, | 6 | | 356z.30a, 356z.32, 356z.33, 368a, 401, 401.1,
402,
403, 403A, | 7 | | 408,
408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII | 8 | | 1/2, XII, XII 1/2,
XIII,
XIII 1/2, XXV, and XXVI of the | 9 | | Illinois Insurance Code. For purposes of the
Illinois Insurance | 10 | | Code, except for Sections 444 and 444.1 and Articles XIII
and | 11 | | XIII 1/2, limited health service organizations in the following | 12 | | categories
are deemed to be domestic companies:
| 13 | | (1) a corporation under the laws of this State; or
| 14 | | (2) a corporation organized under the laws of another | 15 | | state, 30% or more
of the enrollees of which are residents | 16 | | of this State, except a corporation
subject to | 17 | | substantially the same requirements in its state of | 18 | | organization as
is a domestic company under Article VIII | 19 | | 1/2 of the Illinois Insurance Code.
| 20 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 21 | | 100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff. | 22 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 23 | | eff. 1-1-20; 101-393, eff. 1-1-20; revised 10-16-19.) | 24 | | (Text of Section after amendment by P.A. 101-625 )
| 25 | | Sec. 4003. Illinois Insurance Code provisions. Limited |
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| 1 | | health service
organizations shall be subject to the provisions | 2 | | of Sections 133, 134, 136, 137, 139,
140, 141.1, 141.2, 141.3, | 3 | | 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, | 4 | | 154.7, 154.8, 155.04, 155.37, 355.2, 355.3, 355b, 356v, | 5 | | 356z.4a, 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, | 6 | | 356z.30a, 356z.32, 356z.33, 356z.41, 368a, 401, 401.1,
402,
| 7 | | 403, 403A, 408,
408.2, 409, 412, 444, and 444.1 and Articles | 8 | | IIA, VIII 1/2, XII, XII 1/2,
XIII,
XIII 1/2, XXV, and XXVI of | 9 | | the Illinois Insurance Code. For purposes of the
Illinois | 10 | | Insurance Code, except for Sections 444 and 444.1 and Articles | 11 | | XIII
and XIII 1/2, limited health service organizations in the | 12 | | following categories
are deemed to be domestic companies:
| 13 | | (1) a corporation under the laws of this State; or
| 14 | | (2) a corporation organized under the laws of another | 15 | | state, 30% or more
of the enrollees of which are residents | 16 | | of this State, except a corporation
subject to | 17 | | substantially the same requirements in its state of | 18 | | organization as
is a domestic company under Article VIII | 19 | | 1/2 of the Illinois Insurance Code.
| 20 | | (Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; | 21 | | 100-201, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1057, eff. | 22 | | 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. 7-12-19; 101-281, | 23 | | eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. 1-1-21.) | 24 | | Section 30. The Illinois Public Aid Code is amended by | 25 | | changing Section 5-16.8 as follows:
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| 1 | | (305 ILCS 5/5-16.8)
| 2 | | Sec. 5-16.8. Required health benefits. The medical | 3 | | assistance program
shall
(i) provide the post-mastectomy care | 4 | | benefits required to be covered by a policy of
accident and | 5 | | health insurance under Section 356t and the coverage required
| 6 | | under Sections 356g.5, 356u, 356w, 356x, 356z.4a, 356z.6, | 7 | | 356z.26, 356z.29, and 356z.32, and 356z.33 , 356z.34, 356z.35, | 8 | | and 356z.39 of the Illinois
Insurance Code and (ii) be subject | 9 | | to the provisions of Sections 356z.19, 364.01, 370c, and 370c.1 | 10 | | of the Illinois
Insurance Code.
| 11 | | On and after July 1, 2012, the Department shall reduce any | 12 | | rate of reimbursement for services or other payments or alter | 13 | | any methodologies authorized by this Code to reduce any rate of | 14 | | reimbursement for services or other payments in accordance with | 15 | | Section 5-5e. | 16 | | To ensure full access to the benefits set forth in this | 17 | | Section, on and after January 1, 2016, the Department shall | 18 | | ensure that provider and hospital reimbursement for | 19 | | post-mastectomy care benefits required under this Section are | 20 | | no lower than the Medicare reimbursement rate. | 21 | | (Source: P.A. 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; | 22 | | 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 101-81, eff. | 23 | | 7-12-19; 101-218, eff. 1-1-20; 101-281, eff. 1-1-20; 101-371, | 24 | | eff. 1-1-20; 101-574, eff. 1-1-20; revised 10-16-19.)
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| 1 | | Section 95. No acceleration or delay. Where this Act makes | 2 | | changes in a statute that is represented in this Act by text | 3 | | that is not yet or no longer in effect (for example, a Section | 4 | | represented by multiple versions), the use of that text does | 5 | | not accelerate or delay the taking effect of (i) the changes | 6 | | made by this Act or (ii) provisions derived from any other | 7 | | Public Act.
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