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90_HB3427enr
215 ILCS 5/356r
Amends the Illinois Insurance Code regarding women's
health care providers. Requires insurers to notify insureds
of the right to designate a woman's principal health care
provider and to provide a list of participating women's
health care providers within 30 days after a request for the
list is made. Effective immediately.
LRB9008922JSgcB
HB3427 Enrolled LRB9008922JSgcB
1 AN ACT concerning insurance coverages, amending named
2 Acts.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The State Employees Group Insurance Act of
6 1971 is amended by changing and renumbering Section 6.9 added
7 by Public Act 90-7 as follows:
8 (5 ILCS 375/6.11)
9 Sec. 6.11. 6.9. Required health benefits. The program
10 of health benefits shall provide the post-mastectomy care
11 benefits required to be covered by a policy of accident and
12 health insurance under Section 356t of the Illinois Insurance
13 Code. The program of health benefits shall provide the
14 coverage required under Sections Section 356u, 356w, and 356x
15 of the Illinois Insurance Code.
16 (Source: P.A. 90-7, eff. 6-10-97; revised 11-10-97.)
17 Section 10. The State Mandates Act is amended by adding
18 Section 8.22 as follows:
19 (30 ILCS 805/8.22 new)
20 Sec. 8.22. Exempt mandate. Notwithstanding Sections 6
21 and 8 of this Act, no reimbursement by the State is required
22 for the implementation of any mandate created by this
23 amendatory Act of 1998.
24 Section 15. The Counties Code is amended by changing
25 Section 5-1069.3 as follows:
26 (55 ILCS 5/5-1069.3)
27 Sec. 5-1069.3. Required health benefits. If a county,
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1 including a home rule county, is a self-insurer for purposes
2 of providing health insurance coverage for its employees, the
3 coverage shall include coverage for 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 Section 356u, 356w, and 356x of the Illinois
7 Insurance Code. The requirement that health benefits be
8 covered as provided in this Section is an exclusive power and
9 function of the State and is a denial and limitation under
10 Article VII, Section 6, subsection (h) of the Illinois
11 Constitution. A home rule county to which this Section
12 applies must comply with every provision of this Section.
13 (Source: P.A. 90-7, eff. 6-10-97.)
14 Section 20. The Illinois Municipal Code is amended by
15 changing Section 10-4-2.3 as follows:
16 (65 ILCS 5/10-4-2.3)
17 Sec. 10-4-2.3. Required health benefits. If a
18 municipality, including a home rule municipality, is a
19 self-insurer for purposes of providing health insurance
20 coverage for its employees, the coverage shall include
21 coverage for the post-mastectomy care benefits required to be
22 covered by a policy of accident and health insurance under
23 Section 356t and the coverage required under Sections Section
24 356u, 356w, and 356x of the Illinois Insurance Code. The
25 requirement that health benefits be covered as provided in
26 this is an exclusive power and function of the State and is a
27 denial and limitation under Article VII, Section 6,
28 subsection (h) of the Illinois Constitution. A home rule
29 municipality to which this Section applies must comply with
30 every provision of this Section.
31 (Source: P.A. 90-7, eff. 6-10-97.)
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1 Section 25. The School Code is amended by changing
2 Section 10-22.3f as follows:
3 (105 ILCS 5/10-22.3f)
4 Sec. 10-22.3f. Required health benefits. Insurance
5 protection and benefits for employees shall provide the
6 post-mastectomy care benefits required to be covered by a
7 policy of accident and health insurance under Section 356t
8 and the coverage required under Sections Section 356u, 356w,
9 and 356x of the Illinois Insurance Code.
10 (Source: P.A. 90-7, eff. 6-10-97.)
11 Section 30. The Illinois Insurance Code is amended by
12 changing Sections 4 and 356r and adding Sections 356w and
13 356x as follows:
14 (215 ILCS 5/4) (from Ch. 73, par. 616)
15 Sec. 4. Classes of insurance. Insurance and insurance
16 business shall be classified as follows:
17 Class 1. Life, Accident and Health.
18 (a) Life. Insurance on the lives of persons and every
19 insurance appertaining thereto or connected therewith and
20 granting, purchasing or disposing of annuities. Policies of
21 life or endowment insurance or annuity contracts or contracts
22 supplemental thereto which contain provisions for additional
23 benefits in case of death by accidental means and provisions
24 operating to safeguard such policies or contracts against
25 lapse, to give a special surrender value, or special benefit,
26 or an annuity, in the event, that the insured or annuitant
27 shall become totally and permanently disabled as defined by
28 the policy or contract, or which contain benefits providing
29 acceleration of life or endowment or annuity benefits in
30 advance of the time they would otherwise be payable, as an
31 indemnity for long term care which is certified or ordered by
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1 a physician, including but not limited to, professional
2 nursing care, medical care expenses, custodial nursing care,
3 non-nursing custodial care provided in a nursing home or at a
4 residence of the insured, or which contain benefits providing
5 acceleration of life or endowment or annuity benefits in
6 advance of the time they would otherwise be payable, at any
7 time during the insured's lifetime, as an indemnity for a
8 terminal illness shall be deemed to be policies of life or
9 endowment insurance or annuity contracts within the intent of
10 this clause.
11 Also to be deemed as policies of life or endowment
12 insurance or annuity contracts within the intent of this
13 clause shall be those policies or riders that provide for the
14 payment of up to 75% 25% of the face amount of benefits in
15 advance of the time they would otherwise be payable upon a
16 diagnosis by a physician licensed to practice medicine in all
17 of its branches that the insured has incurred a one of the
18 covered condition conditions listed in the policy or rider.
19 Every such policy or rider shall contain a majority of
20 the following "Covered condition", as used in this clause,
21 means conditions: heart attack,; stroke,; coronary artery
22 surgery,; life threatening cancer,; renal failure,;
23 alzheimer's disease,; paraplegia,; major organ
24 transplantation, total and permanent disability, and any
25 other medical condition that the Department may approve for
26 any particular filing.
27 The Director may issue rules that specify prohibited
28 policy provisions, not otherwise specifically prohibited by
29 law, which in the opinion of the Director are unjust, unfair,
30 or unfairly discriminatory to the policyholder, any person
31 insured under the policy, or beneficiary.
32 (b) Accident and health. Insurance against bodily
33 injury, disablement or death by accident and against
34 disablement resulting from sickness or old age and every
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1 insurance appertaining thereto, including stop-loss
2 insurance. Stop-loss insurance is insurance against the risk
3 of economic loss issued to a single employer self-funded
4 employee disability benefit plan or an employee welfare
5 benefit plan as described in 29 U.S.C. 100 et seq.
6 (c) Legal Expense Insurance. Insurance which involves
7 the assumption of a contractual obligation to reimburse the
8 beneficiary against or pay on behalf of the beneficiary, all
9 or a portion of his fees, costs, or expenses related to or
10 arising out of services performed by or under the supervision
11 of an attorney licensed to practice in the jurisdiction
12 wherein the services are performed, regardless of whether the
13 payment is made by the beneficiaries individually or by a
14 third person for them, but does not include the provision of
15 or reimbursement for legal services incidental to other
16 insurance coverages. The insurance laws of this State,
17 including this Act do not apply to:
18 (i) Retainer contracts made by attorneys at law
19 with individual clients with fees based on estimates of
20 the nature and amount of services to be provided to the
21 specific client, and similar contracts made with a group
22 of clients involved in the same or closely related legal
23 matters;
24 (ii) Plans owned or operated by attorneys who are
25 the providers of legal services to the plan;
26 (iii) Plans providing legal service benefits to
27 groups where such plans are owned or operated by
28 authority of a state, county, local or other bar
29 association;
30 (iv) Any lawyer referral service authorized or
31 operated by a state, county, local or other bar
32 association;
33 (v) The furnishing of legal assistance by labor
34 unions and other employee organizations to their members
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1 in matters relating to employment or occupation;
2 (vi) The furnishing of legal assistance to members
3 or dependents, by churches, consumer organizations,
4 cooperatives, educational institutions, credit unions, or
5 organizations of employees, where such organizations
6 contract directly with lawyers or law firms for the
7 provision of legal services, and the administration and
8 marketing of such legal services is wholly conducted by
9 the organization or its subsidiary;
10 (vii) Legal services provided by an employee
11 welfare benefit plan defined by the Employee Retirement
12 Income Security Act of 1974;
13 (viii) Any collectively bargained plan for legal
14 services between a labor union and an employer negotiated
15 pursuant to Section 302 of the Labor Management Relations
16 Act as now or hereafter amended, under which plan legal
17 services will be provided for employees of the employer
18 whether or not payments for such services are funded to
19 or through an insurance company.
20 Class 2. Casualty, Fidelity and Surety.
21 (a) Accident and health. Insurance against bodily
22 injury, disablement or death by accident and against
23 disablement resulting from sickness or old age and every
24 insurance appertaining thereto, including stop-loss
25 insurance. Stop-loss insurance is insurance against the risk
26 of economic loss issued to a single employer self-funded
27 employee disability benefit plan or an employee welfare
28 benefit plan as described in 29 U.S.C. 1001 et seq.
29 (b) Vehicle. Insurance against any loss or liability
30 resulting from or incident to the ownership, maintenance or
31 use of any vehicle (motor or otherwise), draft animal or
32 aircraft. Any policy insuring against any loss or liability
33 on account of the bodily injury or death of any person may
34 contain a provision for payment of disability benefits to
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1 injured persons and death benefits to dependents,
2 beneficiaries or personal representatives of persons who are
3 killed, including the named insured, irrespective of legal
4 liability of the insured, if the injury or death for which
5 benefits are provided is caused by accident and sustained
6 while in or upon or while entering into or alighting from or
7 through being struck by a vehicle (motor or otherwise), draft
8 animal or aircraft, and such provision shall not be deemed to
9 be accident insurance.
10 (c) Liability. Insurance against the liability of the
11 insured for the death, injury or disability of an employee or
12 other person, and insurance against the liability of the
13 insured for damage to or destruction of another person's
14 property.
15 (d) Workers' compensation. Insurance of the obligations
16 accepted by or imposed upon employers under laws for workers'
17 compensation.
18 (e) Burglary and forgery. Insurance against loss or
19 damage by burglary, theft, larceny, robbery, forgery, fraud
20 or otherwise; including all householders' personal property
21 floater risks.
22 (f) Glass. Insurance against loss or damage to glass
23 including lettering, ornamentation and fittings from any
24 cause.
25 (g) Fidelity and surety. Become surety or guarantor for
26 any person, copartnership or corporation in any position or
27 place of trust or as custodian of money or property, public
28 or private; or, becoming a surety or guarantor for the
29 performance of any person, copartnership or corporation of
30 any lawful obligation, undertaking, agreement or contract of
31 any kind, except contracts or policies of insurance; and
32 underwriting blanket bonds. Such obligations shall be known
33 and treated as suretyship obligations and such business shall
34 be known as surety business.
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1 (h) Miscellaneous. Insurance against loss or damage to
2 property and any liability of the insured caused by accidents
3 to boilers, pipes, pressure containers, machinery and
4 apparatus of any kind and any apparatus connected thereto, or
5 used for creating, transmitting or applying power, light,
6 heat, steam or refrigeration, making inspection of and
7 issuing certificates of inspection upon elevators, boilers,
8 machinery and apparatus of any kind and all mechanical
9 apparatus and appliances appertaining thereto; insurance
10 against loss or damage by water entering through leaks or
11 openings in buildings, or from the breakage or leakage of a
12 sprinkler, pumps, water pipes, plumbing and all tanks,
13 apparatus, conduits and containers designed to bring water
14 into buildings or for its storage or utilization therein, or
15 caused by the falling of a tank, tank platform or supports,
16 or against loss or damage from any cause (other than causes
17 specifically enumerated under Class 3 of this Section) to
18 such sprinkler, pumps, water pipes, plumbing, tanks,
19 apparatus, conduits or containers; insurance against loss or
20 damage which may result from the failure of debtors to pay
21 their obligations to the insured; and insurance of the
22 payment of money for personal services under contracts of
23 hiring.
24 (i) Other casualty risks. Insurance against any other
25 casualty risk not otherwise specified under Classes 1 or 3,
26 which may lawfully be the subject of insurance and may
27 properly be classified under Class 2.
28 (j) Contingent losses. Contingent, consequential and
29 indirect coverages wherein the proximate cause of the loss is
30 attributable to any one of the causes enumerated under Class
31 2. Such coverages shall, for the purpose of classification,
32 be included in the specific grouping of the kinds of
33 insurance wherein such cause is specified.
34 (k) Livestock and domestic animals. Insurance against
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1 mortality, accident and health of livestock and domestic
2 animals.
3 (l) Legal expense insurance. Insurance against risk
4 resulting from the cost of legal services as defined under
5 Class 1(c).
6 Class 3. Fire and Marine, etc.
7 (a) Fire. Insurance against loss or damage by fire,
8 smoke and smudge, lightning or other electrical disturbances.
9 (b) Elements. Insurance against loss or damage by
10 earthquake, windstorms, cyclone, tornado, tempests, hail,
11 frost, snow, ice, sleet, flood, rain, drought or other
12 weather or climatic conditions including excess or deficiency
13 of moisture, rising of the waters of the ocean or its
14 tributaries.
15 (c) War, riot and explosion. Insurance against loss or
16 damage by bombardment, invasion, insurrection, riot, strikes,
17 civil war or commotion, military or usurped power, or
18 explosion (other than explosion of steam boilers and the
19 breaking of fly wheels on premises owned, controlled,
20 managed, or maintained by the insured.)
21 (d) Marine and transportation. Insurance against loss or
22 damage to vessels, craft, aircraft, vehicles of every kind,
23 (excluding vehicles operating under their own power or while
24 in storage not incidental to transportation) as well as all
25 goods, freights, cargoes, merchandise, effects,
26 disbursements, profits, moneys, bullion, precious stones,
27 securities, chooses in action, evidences of debt, valuable
28 papers, bottomry and respondentia interests and all other
29 kinds of property and interests therein, in respect to,
30 appertaining to or in connection with any or all risks or
31 perils of navigation, transit, or transportation, including
32 war risks, on or under any seas or other waters, on land or
33 in the air, or while being assembled, packed, crated, baled,
34 compressed or similarly prepared for shipment or while
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1 awaiting the same or during any delays, storage,
2 transshipment, or reshipment incident thereto, including
3 marine builder's risks and all personal property floater
4 risks; and for loss or damage to persons or property in
5 connection with or appertaining to marine, inland marine,
6 transit or transportation insurance, including liability for
7 loss of or damage to either arising out of or in connection
8 with the construction, repair, operation, maintenance, or use
9 of the subject matter of such insurance, (but not including
10 life insurance or surety bonds); but, except as herein
11 specified, shall not mean insurances against loss by reason
12 of bodily injury to the person; and insurance against loss or
13 damage to precious stones, jewels, jewelry, gold, silver and
14 other precious metals whether used in business or trade or
15 otherwise and whether the same be in course of transportation
16 or otherwise, which shall include jewelers' block insurance;
17 and insurance against loss or damage to bridges, tunnels and
18 other instrumentalities of transportation and communication
19 (excluding buildings, their furniture and furnishings, fixed
20 contents and supplies held in storage) unless fire, tornado,
21 sprinkler leakage, hail, explosion, earthquake, riot and
22 civil commotion are the only hazards to be covered; and to
23 piers, wharves, docks and slips, excluding the risks of fire,
24 tornado, sprinkler leakage, hail, explosion, earthquake, riot
25 and civil commotion; and to other aids to navigation and
26 transportation, including dry docks and marine railways,
27 against all risk.
28 (e) Vehicle. Insurance against loss or liability
29 resulting from or incident to the ownership, maintenance or
30 use of any vehicle (motor or otherwise), draft animal or
31 aircraft, excluding the liability of the insured for the
32 death, injury or disability of another person.
33 (f) Property damage, sprinkler leakage and crop.
34 Insurance against the liability of the insured for loss or
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1 damage to another person's property or property interests
2 from any cause enumerated in this class; insurance against
3 loss or damage by water entering through leaks or openings in
4 buildings, or from the breakage or leakage of a sprinkler,
5 pumps, water pipes, plumbing and all tanks, apparatus,
6 conduits and containers designed to bring water into
7 buildings or for its storage or utilization therein, or
8 caused by the falling of a tank, tank platform or supports or
9 against loss or damage from any cause to such sprinklers,
10 pumps, water pipes, plumbing, tanks, apparatus, conduits or
11 containers; insurance against loss or damage from insects,
12 diseases or other causes to trees, crops or other products of
13 the soil.
14 (g) Other fire and marine risks. Insurance against any
15 other property risk not otherwise specified under Classes 1
16 or 2, which may lawfully be the subject of insurance and may
17 properly be classified under Class 3.
18 (h) Contingent losses. Contingent, consequential and
19 indirect coverages wherein the proximate cause of the loss is
20 attributable to any of the causes enumerated under Class 3.
21 Such coverages shall, for the purpose of classification, be
22 included in the specific grouping of the kinds of insurance
23 wherein such cause is specified.
24 (i) Legal expense insurance. Insurance against risk
25 resulting from the cost of legal services as defined under
26 Class 1(c).
27 (Source: P.A. 88-364.)
28 (215 ILCS 5/356r)
29 Sec. 356r. Woman's principal health care provider.
30 (a) An individual or group policy of accident and health
31 insurance or a managed care plan amended, delivered, issued,
32 or renewed in this State after November 14, 1996 that
33 requires an insured or enrollee to designate an individual to
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1 coordinate care or to control access to health care services
2 shall also permit a female insured or enrollee to designate a
3 participating woman's principal health care provider, and the
4 insurer or managed care plan shall provide the following
5 written notice to all female insureds or enrollees no later
6 than 120 days after the effective date of this amendatory Act
7 of 1998; to all new enrollees at the time of enrollment; and
8 thereafter to all existing enrollees at least annually, as a
9 part of a regular publication or informational mailing:
10 "NOTICE TO ALL FEMALE PLAN MEMBERS:
11 YOUR RIGHT TO SELECT A WOMAN'S PRINCIPAL
12 HEALTH CARE PROVIDER.
13 Illinois law allows you to select "a woman's
14 principal health care provider" in addition to your
15 selection of a primary care physician. A woman's
16 principal health care provider is a physician licensed to
17 practice medicine in all its branches specializing in
18 obstetrics or gynecology or specializing in family
19 practice. A woman's principal health care provider may
20 be seen for care without referrals from your primary care
21 physician. If you have not already selected a woman's
22 principal health care provider, you may do so now or at
23 any other time. You are not required to have or to
24 select a woman's principal health care provider.
25 Your woman's principal health care provider must be
26 a part of your plan. You may get the list of
27 participating obstetricians, gynecologists, and family
28 practice specialists from your employer's employee
29 benefits coordinator, or for your own copy of the current
30 list, you may call [insert plan's toll free number]. The
31 list will be sent to you within 10 days after your call.
32 To designate a woman's principal health care provider
33 from the list, call [insert plan's toll free number] and
34 tell our staff the name of the physician you have
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1 selected.".
2 If the insurer or managed care plan exercises the option set
3 forth in subsection (a-5), the notice shall also state:
4 "Your plan requires that your primary care physician
5 and your woman's principal health care provider have a
6 referral arrangement with one another. If the woman's
7 principal health care provider that you select does not
8 have a referral arrangement with your primary care
9 physician, you will have to select a new primary care
10 physician who has a referral arrangement with your
11 woman's principal health care provider or you may select
12 a woman's principal health care provider who has a
13 referral arrangement with your primary care physician.
14 The list of woman's principal health care providers will
15 also have the names of the primary care physicians and
16 their referral arrangements.".
17 No later than 120 days after the effective date of this
18 amendatory Act of 1998, the insurer or managed care plan
19 shall provide each employer who has a policy of insurance or
20 a managed care plan with the insurer or managed care plan
21 with a list of physicians licensed to practice medicine in
22 all its branches specializing in obstetrics or gynecology or
23 specializing in family practice who have contracted with the
24 plan. At the time of enrollment and thereafter within 10 days
25 after a request by an insured or enrollee, the insurer or
26 managed care plan also shall provide this list directly to
27 the insured or enrollee. The list shall include each
28 physician's address, telephone number, and specialty. No
29 insurer or plan formal or informal policy may restrict a
30 female insured's or enrollee's right to designate a woman's
31 principal health care provider, except as set forth in
32 subsection (a-5). If the female enrollee is an enrollee of a
33 managed care plan under contract with the Department of
34 Public Aid, the physician chosen by the enrollee as her
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1 woman's principal health care provider must be a
2 Medicaid-enrolled provider. This requirement does not require
3 a female insured or enrollee to make a selection of a woman's
4 principal health care provider. The female insured or
5 enrollee may designate a physician licensed to practice
6 medicine in all its branches specializing in family practice
7 as her woman's principal health care provider.
8 (a-5) The insured or enrollee may be required by the
9 insurer or managed care plan to select a woman's principal
10 health care provider who has a referral arrangement with the
11 insured's or enrollee's individual who coordinates care or
12 controls access to health care services if such referral
13 arrangement exists or to select a new individual to
14 coordinate care or to control access to health care services
15 who has a referral arrangement with the woman's principal
16 health care provider chosen by the insured or enrollee, if
17 such referral arrangement exists. If an insurer or a managed
18 care plan requires an insured or enrollee to select a new
19 physician under this subsection (a-5), the insurer or managed
20 care plan must provide the insured or enrollee with both
21 options to select a new physician provided in this subsection
22 (a-5).
23 Notwithstanding a plan's restrictions of the frequency or
24 timing of making designations of primary care providers, a
25 female enrollee or insured who is subject to the selection
26 requirements of this subsection, may, at any time, effect a
27 change in primary care physicians in order to make a
28 selection of a woman's principal health care provider.
29 (a-6) If an insurer or managed care plan exercises the
30 option in subsection (a-5), the list to be provided under
31 subsection (a) shall identify the referral arrangements that
32 exist between the individual who coordinates care or controls
33 access to health care services and the woman's principal
34 health care provider in order to assist the female insured or
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1 enrollee to make a selection within the insurer's or managed
2 care plan's requirement.
3 (b) If a female insured or enrollee has designated a
4 woman's principal health care provider, then the insured or
5 enrollee must be given direct access to the woman's principal
6 health care provider for services covered by the policy or
7 plan without the need for a referral or prior approval.
8 Nothing shall prohibit the insurer or managed care plan from
9 requiring prior authorization or approval from either a
10 primary care provider or the woman's principal health care
11 provider for referrals for additional care or services.
12 (c) For the purposes of this Section the following terms
13 are defined:
14 (1) "Woman's principal health care provider" means
15 a physician licensed to practice medicine in all of its
16 branches specializing in obstetrics or gynecology or
17 specializing in family practice.
18 (2) "Managed care entity" means any entity
19 including a licensed insurance company, hospital or
20 medical service plan, health maintenance organization,
21 limited health service organization, preferred provider
22 organization, third party administrator, an employer or
23 employee organization, or any person or entity that
24 establishes, operates, or maintains a network of
25 participating providers.
26 (3) "Managed care plan" means a plan operated by a
27 managed care entity that provides for the financing of
28 health care services to persons enrolled in the plan
29 through:
30 (A) organizational arrangements for ongoing
31 quality assurance, utilization review programs, or
32 dispute resolution; or
33 (B) financial incentives for persons enrolled
34 in the plan to use the participating providers and
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1 procedures covered by the plan.
2 (4) "Participating provider" means a physician who
3 has contracted with an insurer or managed care plan to
4 provide services to insureds or enrollees as defined by
5 the contract.
6 (d) The original provisions of this Section became law
7 on July 17, 1996 and took effect November 14, 1996, which is
8 120 days after becoming law.
9 (Source: P.A. 89-514; 90-14, eff. 7-1-97.)
10 (215 ILCS 5/356w new)
11 Sec. 356w. Diabetes self-management training and
12 education.
13 (a) A group policy of accident and health insurance that
14 is amended, delivered, issued, or renewed after the effective
15 date of this amendatory Act of 1998 shall provide coverage
16 for outpatient self-management training and education,
17 equipment, and supplies, as set forth in this Section, for
18 the treatment of type 1 diabetes, type 2 diabetes, and
19 gestational diabetes mellitus.
20 (b) As used in this Section:
21 "Diabetes self-management training" means instruction in
22 an outpatient setting which enables a diabetic patient to
23 understand the diabetic management process and daily
24 management of diabetic therapy as a means of avoiding
25 frequent hospitalization and complications. Diabetes
26 self-management training shall include the content areas
27 listed in the National Standards for Diabetes Self-Management
28 Education Programs as published by the American Diabetes
29 Association, including medical nutrition therapy.
30 "Medical nutrition therapy" shall have the meaning
31 ascribed to "medical nutrition care" in the Dietetic and
32 Nutrition Services Practice Act.
33 "Physician" means a physician licensed to practice
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1 medicine in all of its branches providing care to the
2 individual.
3 "Qualified provider" for an individual that is enrolled
4 in:
5 (1) a health maintenance organization that uses a
6 primary care physician to control access to specialty
7 care means (A) the individual's primary care physician
8 licensed to practice medicine in all of its branches, (B)
9 a physician licensed to practice medicine in all of its
10 branches to whom the individual has been referred by the
11 primary care physician, or (C) a certified, registered,
12 or licensed network health care professional with
13 expertise in diabetes management to whom the individual
14 has been referred by the primary care physician.
15 (2) an insurance plan means (A) a physician
16 licensed to practice medicine in all of its branches or
17 (B) a certified, registered, or licensed health care
18 professional with expertise in diabetes management to
19 whom the individual has been referred by a physician.
20 (c) Coverage under this Section for diabetes
21 self-management training, including medical nutrition
22 education, shall be limited to the following:
23 (1) Up to 3 medically necessary visits to a
24 qualified provider upon initial diagnosis of diabetes by
25 the patient's physician or, if diagnosis of diabetes was
26 made within one year prior to the effective date of this
27 amendatory Act of 1998 where the insured was a covered
28 individual, up to 3 medically necessary visits to a
29 qualified provider within one year after that effective
30 date.
31 (2) Up to 2 medically necessary visits to a
32 qualified provider upon a determination by a patient's
33 physician that a significant change in the patient's
34 symptoms or medical condition has occurred. A
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1 "significant change" in condition means symptomatic
2 hyperglycemia (greater than 250 mg/dl on repeated
3 occasions), severe hypoglycemia (requiring the assistance
4 of another person), onset or progression of diabetes, or
5 a significant change in medical condition that would
6 require a significantly different treatment regimen.
7 Payment by the insurer or health maintenance
8 organization for the coverage required for diabetes
9 self-management training pursuant to the provisions of this
10 Section is only required to be made for services provided. No
11 coverage is required for additional visits beyond those
12 specified in items (1) and (2) of this subsection.
13 Coverage under this subsection (c) for diabetes
14 self-management training shall be subject to the same
15 deductible, co-payment, and co-insurance provisions that
16 apply to coverage under the policy for other services
17 provided by the same type of provider.
18 (d) Coverage shall be provided for the following
19 equipment when medically necessary and prescribed by a
20 physician licensed to practice medicine in all of its
21 branches. Coverage for the following items shall be subject
22 to deductible, co-payment and co-insurance provisions
23 provided for under the policy or a durable medical equipment
24 rider to the policy:
25 (1) blood glucose monitors;
26 (2) blood glucose monitors for the legally blind;
27 (3) cartridges for the legally blind; and
28 (4) lancets and lancing devices.
29 This subsection does not apply to a group policy of
30 accident and health insurance that does not provide a durable
31 medical equipment benefit.
32 (e) Coverage shall be provided for the following
33 pharmaceuticals and supplies when medically necessary and
34 prescribed by a physician licensed to practice medicine in
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1 all of its branches. Coverage for the following items shall
2 be subject to the same coverage, deductible, co-payment, and
3 co-insurance provisions under the policy or a drug rider to
4 the policy:
5 (1) insulin;
6 (2) syringes and needles;
7 (3) test strips for glucose monitors;
8 (4) FDA approved oral agents used to control blood
9 sugar; and
10 (5) glucagon emergency kits.
11 This subsection does not apply to a group policy of
12 accident and health insurance that does not provide a drug
13 benefit.
14 (f) Coverage shall be provided for regular foot care
15 exams by a physician or by a physician to whom a physician
16 has referred the patient. Coverage for regular foot care
17 exams shall be subject to the same deductible, co-payment,
18 and co-insurance provisions that apply under the policy for
19 other services provided by the same type of provider.
20 (g) If authorized by a physician, diabetes
21 self-management training may be provided as a part of an
22 office visit, group setting, or home visit.
23 (h) This Section shall not apply to agreements,
24 contracts, or policies that provide coverage for a specified
25 diagnosis or other limited benefit coverage.
26 (215 ILCS 5/356x new)
27 Sec. 356x. Coverage for colorectal cancer screening.
28 (a) An insurer shall provide in each group policy,
29 contract, or certificate of accident and health insurance
30 amended, delivered, issued, or renewed covering persons who
31 are residents of this State coverage for colorectal cancer
32 screening with sigmoidoscopy or fecal occult blood testing
33 once every 3 years for persons who are at least 50 years old.
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1 (b) For persons who may be classified as high risk for
2 colorectal cancer because the person or a first degree family
3 member of the person has a history of colorectal cancer, the
4 coverage required under subsection (a) shall apply to persons
5 who have attained at least 30 years of age.
6 (c) This Section does not apply to agreements,
7 contracts, or policies that provide coverage for a specified
8 disease or other limited benefit coverage.
9 Section 35. The Health Maintenance Organization Act is
10 amended by changing Section 5-3 as follows:
11 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
12 (Text of Section before amendment by P.A. 90-372)
13 Sec. 5-3. Insurance Code provisions.
14 (a) Health Maintenance Organizations shall be subject to
15 the provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
16 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
17 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356v, 356w, 356x,
18 356t, 367i, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
19 paragraph (c) of subsection (2) of Section 367, and Articles
20 VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, and XXVI of the
21 Illinois Insurance Code.
22 (b) For purposes of the Illinois Insurance Code, except
23 for Articles XIII and XIII 1/2, Health Maintenance
24 Organizations in the following categories are deemed to be
25 "domestic companies":
26 (1) a corporation authorized under the Medical
27 Service Plan Act, the Dental Service Plan Act, the
28 Pharmaceutical Service Plan Act, or the Voluntary Health
29 Services Plans Plan Act, or the Nonprofit Health Care
30 Service Plan Act;
31 (2) a corporation organized under the laws of this
32 State; or
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1 (3) a corporation organized under the laws of
2 another state, 30% or more of the enrollees of which are
3 residents of this State, except a corporation subject to
4 substantially the same requirements in its state of
5 organization as is a "domestic company" under Article
6 VIII 1/2 of the Illinois Insurance Code.
7 (c) In considering the merger, consolidation, or other
8 acquisition of control of a Health Maintenance Organization
9 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
10 (1) the Director shall give primary consideration
11 to the continuation of benefits to enrollees and the
12 financial conditions of the acquired Health Maintenance
13 Organization after the merger, consolidation, or other
14 acquisition of control takes effect;
15 (2)(i) the criteria specified in subsection (1)(b)
16 of Section 131.8 of the Illinois Insurance Code shall not
17 apply and (ii) the Director, in making his determination
18 with respect to the merger, consolidation, or other
19 acquisition of control, need not take into account the
20 effect on competition of the merger, consolidation, or
21 other acquisition of control;
22 (3) the Director shall have the power to require
23 the following information:
24 (A) certification by an independent actuary of
25 the adequacy of the reserves of the Health
26 Maintenance Organization sought to be acquired;
27 (B) pro forma financial statements reflecting
28 the combined balance sheets of the acquiring company
29 and the Health Maintenance Organization sought to be
30 acquired as of the end of the preceding year and as
31 of a date 90 days prior to the acquisition, as well
32 as pro forma financial statements reflecting
33 projected combined operation for a period of 2
34 years;
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1 (C) a pro forma business plan detailing an
2 acquiring party's plans with respect to the
3 operation of the Health Maintenance Organization
4 sought to be acquired for a period of not less than
5 3 years; and
6 (D) such other information as the Director
7 shall require.
8 (d) The provisions of Article VIII 1/2 of the Illinois
9 Insurance Code and this Section 5-3 shall apply to the sale
10 by any health maintenance organization of greater than 10% of
11 its enrollee population (including without limitation the
12 health maintenance organization's right, title, and interest
13 in and to its health care certificates).
14 (e) In considering any management contract or service
15 agreement subject to Section 141.1 of the Illinois Insurance
16 Code, the Director (i) shall, in addition to the criteria
17 specified in Section 141.2 of the Illinois Insurance Code,
18 take into account the effect of the management contract or
19 service agreement on the continuation of benefits to
20 enrollees and the financial condition of the health
21 maintenance organization to be managed or serviced, and (ii)
22 need not take into account the effect of the management
23 contract or service agreement on competition.
24 (f) Except for small employer groups as defined in the
25 Small Employer Rating, Renewability and Portability Health
26 Insurance Act and except for medicare supplement policies as
27 defined in Section 363 of the Illinois Insurance Code, a
28 Health Maintenance Organization may by contract agree with a
29 group or other enrollment unit to effect refunds or charge
30 additional premiums under the following terms and conditions:
31 (i) the amount of, and other terms and conditions
32 with respect to, the refund or additional premium are set
33 forth in the group or enrollment unit contract agreed in
34 advance of the period for which a refund is to be paid or
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1 additional premium is to be charged (which period shall
2 not be less than one year); and
3 (ii) the amount of the refund or additional premium
4 shall not exceed 20% of the Health Maintenance
5 Organization's profitable or unprofitable experience with
6 respect to the group or other enrollment unit for the
7 period (and, for purposes of a refund or additional
8 premium, the profitable or unprofitable experience shall
9 be calculated taking into account a pro rata share of the
10 Health Maintenance Organization's administrative and
11 marketing expenses, but shall not include any refund to
12 be made or additional premium to be paid pursuant to this
13 subsection (f)). The Health Maintenance Organization and
14 the group or enrollment unit may agree that the
15 profitable or unprofitable experience may be calculated
16 taking into account the refund period and the immediately
17 preceding 2 plan years.
18 The Health Maintenance Organization shall include a
19 statement in the evidence of coverage issued to each enrollee
20 describing the possibility of a refund or additional premium,
21 and upon request of any group or enrollment unit, provide to
22 the group or enrollment unit a description of the method used
23 to calculate (1) the Health Maintenance Organization's
24 profitable experience with respect to the group or enrollment
25 unit and the resulting refund to the group or enrollment unit
26 or (2) the Health Maintenance Organization's unprofitable
27 experience with respect to the group or enrollment unit and
28 the resulting additional premium to be paid by the group or
29 enrollment unit.
30 In no event shall the Illinois Health Maintenance
31 Organization Guaranty Association be liable to pay any
32 contractual obligation of an insolvent organization to pay
33 any refund authorized under this Section.
34 (Source: P.A. 89-90, eff. 6-30-95; 90-25, eff. 1-1-98;
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1 90-177, eff. 7-23-97; revised 11-21-97.)
2 (Text of Section after amendment by P.A. 90-372)
3 Sec. 5-3. Insurance Code provisions.
4 (a) Health Maintenance Organizations shall be subject to
5 the provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
6 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
7 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356v, 356w, 356x,
8 356t, 367i, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
9 paragraph (c) of subsection (2) of Section 367, and Articles
10 VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, and XXVI of the
11 Illinois Insurance Code.
12 (b) For purposes of the Illinois Insurance Code, except
13 for Articles XIII and XIII 1/2, Health Maintenance
14 Organizations in the following categories are deemed to be
15 "domestic companies":
16 (1) a corporation authorized under the Medical
17 Service Plan Act, the Dental Service Plan Act or, the
18 Voluntary Health Services Plans Plan Act, or the
19 Nonprofit Health Care Service Plan Act;
20 (2) a corporation organized under the laws of this
21 State; or
22 (3) a corporation organized under the laws of
23 another state, 30% or more of the enrollees of which are
24 residents of this State, except a corporation subject to
25 substantially the same requirements in its state of
26 organization as is a "domestic company" under Article
27 VIII 1/2 of the Illinois Insurance Code.
28 (c) In considering the merger, consolidation, or other
29 acquisition of control of a Health Maintenance Organization
30 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
31 (1) the Director shall give primary consideration
32 to the continuation of benefits to enrollees and the
33 financial conditions of the acquired Health Maintenance
34 Organization after the merger, consolidation, or other
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1 acquisition of control takes effect;
2 (2)(i) the criteria specified in subsection (1)(b)
3 of Section 131.8 of the Illinois Insurance Code shall not
4 apply and (ii) the Director, in making his determination
5 with respect to the merger, consolidation, or other
6 acquisition of control, need not take into account the
7 effect on competition of the merger, consolidation, or
8 other acquisition of control;
9 (3) the Director shall have the power to require
10 the following information:
11 (A) certification by an independent actuary of
12 the adequacy of the reserves of the Health
13 Maintenance Organization sought to be acquired;
14 (B) pro forma financial statements reflecting
15 the combined balance sheets of the acquiring company
16 and the Health Maintenance Organization sought to be
17 acquired as of the end of the preceding year and as
18 of a date 90 days prior to the acquisition, as well
19 as pro forma financial statements reflecting
20 projected combined operation for a period of 2
21 years;
22 (C) a pro forma business plan detailing an
23 acquiring party's plans with respect to the
24 operation of the Health Maintenance Organization
25 sought to be acquired for a period of not less than
26 3 years; and
27 (D) such other information as the Director
28 shall require.
29 (d) The provisions of Article VIII 1/2 of the Illinois
30 Insurance Code and this Section 5-3 shall apply to the sale
31 by any health maintenance organization of greater than 10% of
32 its enrollee population (including without limitation the
33 health maintenance organization's right, title, and interest
34 in and to its health care certificates).
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1 (e) In considering any management contract or service
2 agreement subject to Section 141.1 of the Illinois Insurance
3 Code, the Director (i) shall, in addition to the criteria
4 specified in Section 141.2 of the Illinois Insurance Code,
5 take into account the effect of the management contract or
6 service agreement on the continuation of benefits to
7 enrollees and the financial condition of the health
8 maintenance organization to be managed or serviced, and (ii)
9 need not take into account the effect of the management
10 contract or service agreement on competition.
11 (f) Except for small employer groups as defined in the
12 Small Employer Rating, Renewability and Portability Health
13 Insurance Act and except for medicare supplement policies as
14 defined in Section 363 of the Illinois Insurance Code, a
15 Health Maintenance Organization may by contract agree with a
16 group or other enrollment unit to effect refunds or charge
17 additional premiums under the following terms and conditions:
18 (i) the amount of, and other terms and conditions
19 with respect to, the refund or additional premium are set
20 forth in the group or enrollment unit contract agreed in
21 advance of the period for which a refund is to be paid or
22 additional premium is to be charged (which period shall
23 not be less than one year); and
24 (ii) the amount of the refund or additional premium
25 shall not exceed 20% of the Health Maintenance
26 Organization's profitable or unprofitable experience with
27 respect to the group or other enrollment unit for the
28 period (and, for purposes of a refund or additional
29 premium, the profitable or unprofitable experience shall
30 be calculated taking into account a pro rata share of the
31 Health Maintenance Organization's administrative and
32 marketing expenses, but shall not include any refund to
33 be made or additional premium to be paid pursuant to this
34 subsection (f)). The Health Maintenance Organization and
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1 the group or enrollment unit may agree that the
2 profitable or unprofitable experience may be calculated
3 taking into account the refund period and the immediately
4 preceding 2 plan years.
5 The Health Maintenance Organization shall include a
6 statement in the evidence of coverage issued to each enrollee
7 describing the possibility of a refund or additional premium,
8 and upon request of any group or enrollment unit, provide to
9 the group or enrollment unit a description of the method used
10 to calculate (1) the Health Maintenance Organization's
11 profitable experience with respect to the group or enrollment
12 unit and the resulting refund to the group or enrollment unit
13 or (2) the Health Maintenance Organization's unprofitable
14 experience with respect to the group or enrollment unit and
15 the resulting additional premium to be paid by the group or
16 enrollment unit.
17 In no event shall the Illinois Health Maintenance
18 Organization Guaranty Association be liable to pay any
19 contractual obligation of an insolvent organization to pay
20 any refund authorized under this Section.
21 (Source: P.A. 89-90, eff. 6-30-95; 90-25, eff. 1-1-98;
22 90-177, eff. 7-23-97; 90-372, eff. 7-1-98; revised 11-21-97.)
23 Section 40. The Limited Health Service Organization Act
24 is amended by changing Section 3009 as follows:
25 (215 ILCS 130/3009) (from Ch. 73, par. 1503-9)
26 Sec. 3009. Point-of-service limited health service
27 contracts.
28 (a) An LHSO that offers a POS contract:
29 (1) shall include as in-plan covered services all
30 services required by law to be provided by an LHSO;
31 (2) shall provide incentives, which shall include
32 financial incentives, for enrollees to use in-plan
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1 covered services;
2 (3) shall not offer services out-of-plan without
3 providing those services on an in-plan basis;
4 (4) may limit or exclude specific types of services
5 from coverage when obtained out-of-plan;
6 (5) may include annual out-of-pocket limits and
7 lifetime maximum benefits allowances for out-of-plan
8 services that are separate from any limits or allowances
9 applied to in-plan services;
10 (6) shall include an annual maximum benefit
11 allowance not to exceed $2,500 per year that is separate
12 from any limits or allowances applied to in-plan
13 services;
14 (7) may limit the groups to which a POS product is
15 offered, however, if a POS product is offered to a group,
16 then it must be offered to all eligible members of that
17 group, when an LHSO provider is available;
18 (8) shall not consider emergency services,
19 authorized referral services, or non-routine services
20 obtained out of the service area to be POS services; and
21 (9) may treat as out-of-plan services those
22 services that an enrollee obtains from a participating
23 provider, but for which the proper authorization was not
24 given by the LHSO.
25 (b) An LHSO offering a POS contract shall be subject to
26 the following limitations:
27 (1) The LHSO shall not expend in any calendar
28 quarter more than 20% of its total limited health
29 services expenditures for all its members for out-of-plan
30 covered services.
31 (2) If the amount specified in paragraph (1) is
32 exceeded by 2% in a quarter, the LHSO shall effect
33 compliance with paragraph (1) by the end of the following
34 quarter.
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1 (3) If compliance with the amount specified in
2 paragraph (1) is not demonstrated in the LHSO's next
3 quarterly report, the LHSO may not offer the POS contract
4 to new groups or include the POS option in the renewal of
5 an existing group until compliance with the amount
6 specified in paragraph (1) is demonstrated or otherwise
7 allowed by the Director.
8 (4) Any LHSO failing, without just cause, to comply
9 with the provisions of this subsection shall be required,
10 after notice and hearing, to pay a penalty of $250 for
11 each day out of compliance, to be recovered by the
12 Director of Insurance. Any penalty recovered shall be
13 paid into the General Revenue Fund. The Director may
14 reduce the penalty if the LHSO demonstrates to the
15 Director that the imposition of the penalty would
16 constitute a financial hardship to the LHSO.
17 (c) Any LHSO that offers a POS product shall:
18 (1) File a quarterly financial statement detailing
19 compliance with the requirements of subsection (b).
20 (2) Track out-of-plan POS utilization separately
21 from in-plan or non-POS out-of-plan emergency care,
22 referral care, and urgent care out of the service area
23 utilization.
24 (3) Record out-of-plan utilization in a manner that
25 will permit such utilization and cost reporting as the
26 Director may, by regulation, require.
27 (4) Demonstrate to the Director's satisfaction that
28 the LHSO has the fiscal, administrative, and marketing
29 capacity to control its POS enrollment, utilization, and
30 costs so as not to jeopardize the financial security of
31 the LHSO.
32 (5) Maintain the deposit required by subsection (b)
33 of Section 2006 in addition to any other deposit required
34 under this Act.
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1 (d) An LHSO shall not issue a POS contract until it has
2 filed and had approved by the Director a plan to comply with
3 the provisions of this Section. The compliance plan shall at
4 a minimum include provisions demonstrating that the LHSO will
5 do all of the following:
6 (1) Design the benefit levels and conditions of
7 coverage for in-plan covered services and out-of-plan
8 covered services as required by this Article.
9 (2) Provide or arrange for the provision of
10 adequate systems to:
11 (A) process and pay claims for all out-of-plan
12 covered services;
13 (B) meet the requirements for a POS contract
14 set forth in this Section and any additional
15 requirements that may be set forth by the Director;
16 and
17 (C) generate accurate data and financial and
18 regulatory reports on a timely basis so that the
19 Department can evaluate the LHSO's experience with
20 the POS contract and monitor compliance with POS
21 contract provisions.
22 (3) Comply initially and on an ongoing basis with
23 the requirements of subsections (b) and (c).
24 (e) A limited health service organization that offers a
25 POS contract must comply with Sections 356w and 356x of the
26 Illinois Insurance Code.
27 (Source: P.A. 87-1079; 88-667, eff. 9-16-94.)
28 Section 45. The Voluntary Health Services Plans Act is
29 amended by changing Section 10 as follows:
30 (215 ILCS 165/10) (from Ch. 32, par. 604)
31 Sec. 10. Application of Insurance Code provisions.
32 Health services plan corporations and all persons interested
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1 therein or dealing therewith shall be subject to the
2 provisions of Article XII 1/2 and Sections 3.1, 133, 140,
3 143, 143c, 149, 354, 355.2, 356r, 356t, 356u, 356v, 356w,
4 356x, 367.2, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
5 and paragraphs (7) and (15) of Section 367 of the Illinois
6 Insurance Code.
7 (Source: P.A. 89-514, eff. 7-17-96; 90-7, eff. 6-10-97;
8 90-25, eff. 1-1-98; revised 10-14-97.)
9 Section 50. The Illinois Public Aid Code is amended by
10 changing Section 5-16.8 as follows:
11 (305 ILCS 5/5-16.8)
12 Sec. 5-16.8. Required health benefits. The medical
13 assistance program shall provide the post-mastectomy care
14 benefits required to be covered by a policy of accident and
15 health insurance under Section 356t and the coverage required
16 under Sections Section 356u, 356w, and 356x of the Illinois
17 Insurance Code.
18 (Source: P.A. 90-7, eff. 6-10-97.)
19 Section 95. No acceleration or delay. Where this Act
20 makes changes in a statute that is represented in this Act by
21 text that is not yet or no longer in effect (for example, a
22 Section represented by multiple versions), the use of that
23 text does not accelerate or delay the taking effect of (i)
24 the changes made by this Act or (ii) provisions derived from
25 any other Public Act.
26 Section 99. Effective date. This Section and the
27 provisions of this Act amending Sections 4 and 356r of the
28 Illinois Insurance Code take effect upon becoming law; the
29 remaining provisions of this Act take effect January 1, 1999.