Bill Text: IL SB1527 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Illinois Insurance Code to provide that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2024 shall provide coverage for compression sleeves. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Medical Assistance Article of the Illinois Public Aid Code.

Spectrum: Moderate Partisan Bill (Democrat 12-2)

Status: (Passed) 2023-06-09 - Public Act . . . . . . . . . 103-0091 [SB1527 Detail]

Download: Illinois-2023-SB1527-Introduced.html


103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1527

Introduced 2/8/2023, by Sen. Laura Ellman

SYNOPSIS AS INTRODUCED:
5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
215 ILCS 5/356z.61 new
215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003 from Ch. 73, par. 1504-3
215 ILCS 165/10 from Ch. 32, par. 604
305 ILCS 5/5-16.8

Amends the Illinois Insurance Code to provide that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2024 shall provide coverage for compression sleeves. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Medical Assistance Article of the Illinois Public Aid Code.
LRB103 27266 BMS 53637 b
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT MAY APPLY

A BILL FOR

SB1527LRB103 27266 BMS 53637 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 6.11 as follows:
6 (5 ILCS 375/6.11)
7 (Text of Section before amendment by P.A. 102-768)
8 Sec. 6.11. Required health benefits; Illinois Insurance
9Code requirements. The program of health benefits shall
10provide the post-mastectomy care benefits required to be
11covered by a policy of accident and health insurance under
12Section 356t of the Illinois Insurance Code. The program of
13health benefits shall provide the coverage required under
14Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
15356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
16356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60 of
20the Illinois Insurance Code. The program of health benefits
21must comply with Sections 155.22a, 155.37, 355b, 356z.19,
22370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
23Code. The Department of Insurance shall enforce the

SB1527- 2 -LRB103 27266 BMS 53637 b
1requirements of this Section with respect to Sections 370c and
2370c.1 of the Illinois Insurance Code; all other requirements
3of this Section shall be enforced by the Department of Central
4Management Services.
5 Rulemaking authority to implement Public Act 95-1045, if
6any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
12101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
131-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
14eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
15102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
161-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
17eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
18revised 12-13-22.)
19 (Text of Section after amendment by P.A. 102-768)
20 Sec. 6.11. Required health benefits; Illinois Insurance
21Code requirements. The program of health benefits shall
22provide the post-mastectomy care benefits required to be
23covered by a policy of accident and health insurance under
24Section 356t of the Illinois Insurance Code. The program of
25health benefits shall provide the coverage required under

SB1527- 3 -LRB103 27266 BMS 53637 b
1Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
2356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
3356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
5356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
6356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
7356z.60, and 356z.61 of the Illinois Insurance Code. The
8program of health benefits must comply with Sections 155.22a,
9155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
10the Illinois Insurance Code. The Department of Insurance shall
11enforce the requirements of this Section with respect to
12Sections 370c and 370c.1 of the Illinois Insurance Code; all
13other requirements of this Section shall be enforced by the
14Department of Central Management Services.
15 Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
22101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
231-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
24eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
25102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
261-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,

SB1527- 4 -LRB103 27266 BMS 53637 b
1eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
2102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
3 Section 10. The Counties Code is amended by changing
4Section 5-1069.3 as follows:
5 (55 ILCS 5/5-1069.3)
6 Sec. 5-1069.3. Required health benefits. If a county,
7including a home rule county, is a self-insurer for purposes
8of providing health insurance coverage for its employees, the
9coverage shall include coverage for the post-mastectomy care
10benefits required to be covered by a policy of accident and
11health insurance under Section 356t and the coverage required
12under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
13356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
14356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
15356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
16356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
17356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61
18of the Illinois Insurance Code. The coverage shall comply with
19Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
20Insurance Code. The Department of Insurance shall enforce the
21requirements of this Section. The requirement that health
22benefits be covered as provided in this Section is an
23exclusive power and function of the State and is a denial and
24limitation under Article VII, Section 6, subsection (h) of the

SB1527- 5 -LRB103 27266 BMS 53637 b
1Illinois Constitution. A home rule county to which this
2Section applies must comply with every provision of this
3Section.
4 Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
11101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
121-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
13eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
14102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
151-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
16eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
17102-1117, eff. 1-13-23.)
18 Section 15. The Illinois Municipal Code is amended by
19changing Section 10-4-2.3 as follows:
20 (65 ILCS 5/10-4-2.3)
21 Sec. 10-4-2.3. Required health benefits. If a
22municipality, including a home rule municipality, is a
23self-insurer for purposes of providing health insurance
24coverage for its employees, the coverage shall include

SB1527- 6 -LRB103 27266 BMS 53637 b
1coverage for the post-mastectomy care benefits required to be
2covered by a policy of accident and health insurance under
3Section 356t and the coverage required under Sections 356g,
4356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
5356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
6356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
7356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
8356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
9356z.56, 356z.57, 356z.59, and 356z.60, and 356z.61 of the
10Illinois Insurance Code. The coverage shall comply with
11Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
12Insurance Code. The Department of Insurance shall enforce the
13requirements of this Section. The requirement that health
14benefits be covered as provided in this is an exclusive power
15and function of the State and is a denial and limitation under
16Article VII, Section 6, subsection (h) of the Illinois
17Constitution. A home rule municipality to which this Section
18applies must comply with every provision of this Section.
19 Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
26101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.

SB1527- 7 -LRB103 27266 BMS 53637 b
11-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
2eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
3102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
41-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
5eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
6102-1117, eff. 1-13-23.)
7 Section 20. The School Code is amended by changing Section
810-22.3f as follows:
9 (105 ILCS 5/10-22.3f)
10 Sec. 10-22.3f. Required health benefits. Insurance
11protection and benefits for employees shall provide the
12post-mastectomy care benefits required to be covered by a
13policy of accident and health insurance under Section 356t and
14the coverage required under Sections 356g, 356g.5, 356g.5-1,
15356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
16356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
18356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
20356z.61 of the Illinois Insurance Code. Insurance policies
21shall comply with Section 356z.19 of the Illinois Insurance
22Code. The coverage shall comply with Sections 155.22a, 355b,
23and 370c of the Illinois Insurance Code. The Department of
24Insurance shall enforce the requirements of this Section.

SB1527- 8 -LRB103 27266 BMS 53637 b
1 Rulemaking authority to implement Public Act 95-1045, if
2any, is conditioned on the rules being adopted in accordance
3with all provisions of the Illinois Administrative Procedure
4Act and all rules and procedures of the Joint Committee on
5Administrative Rules; any purported rule not so adopted, for
6whatever reason, is unauthorized.
7(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
8101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
91-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
10eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
11102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
121-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
13eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
14 Section 25. The Illinois Insurance Code is amended by
15adding Section 356z.61 as follows:
16 (215 ILCS 5/356z.61 new)
17 Sec. 356z.61. Coverage for compression sleeves. A group or
18individual policy of accident and health insurance or a
19managed care plan that is amended, delivered, issued, or
20renewed on or after January 1, 2024 shall provide coverage for
21compression sleeves.
22 Section 30. The Health Maintenance Organization Act is
23amended by changing Section 5-3 as follows:

SB1527- 9 -LRB103 27266 BMS 53637 b
1 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
2 Sec. 5-3. Insurance Code provisions.
3 (a) Health Maintenance Organizations shall be subject to
4the provisions of Sections 133, 134, 136, 137, 139, 140,
5141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
6154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
7355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
8356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
9356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
10356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
11356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
12356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
13356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
14356z.59, 356z.60, 356z.61, 364, 364.01, 364.3, 367.2, 367.2-5,
15367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
16402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
17paragraph (c) of subsection (2) of Section 367, and Articles
18IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
19XXXIIB of the Illinois Insurance Code.
20 (b) For purposes of the Illinois Insurance Code, except
21for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
22Health Maintenance Organizations in the following categories
23are deemed to be "domestic companies":
24 (1) a corporation authorized under the Dental Service
25 Plan Act or the Voluntary Health Services Plans Act;

SB1527- 10 -LRB103 27266 BMS 53637 b
1 (2) a corporation organized under the laws of this
2 State; or
3 (3) a corporation organized under the laws of another
4 state, 30% or more of the enrollees of which are residents
5 of this State, except a corporation subject to
6 substantially the same requirements in its state of
7 organization as is a "domestic company" under Article VIII
8 1/2 of the Illinois Insurance Code.
9 (c) In considering the merger, consolidation, or other
10acquisition of control of a Health Maintenance Organization
11pursuant to Article VIII 1/2 of the Illinois Insurance Code,
12 (1) the Director shall give primary consideration to
13 the continuation of benefits to enrollees and the
14 financial conditions of the acquired Health Maintenance
15 Organization after the merger, consolidation, or other
16 acquisition of control takes effect;
17 (2)(i) the criteria specified in subsection (1)(b) of
18 Section 131.8 of the Illinois Insurance Code shall not
19 apply and (ii) the Director, in making his determination
20 with respect to the merger, consolidation, or other
21 acquisition of control, need not take into account the
22 effect on competition of the merger, consolidation, or
23 other acquisition of control;
24 (3) the Director shall have the power to require the
25 following information:
26 (A) certification by an independent actuary of the

SB1527- 11 -LRB103 27266 BMS 53637 b
1 adequacy of the reserves of the Health Maintenance
2 Organization sought to be acquired;
3 (B) pro forma financial statements reflecting the
4 combined balance sheets of the acquiring company and
5 the Health Maintenance Organization sought to be
6 acquired as of the end of the preceding year and as of
7 a date 90 days prior to the acquisition, as well as pro
8 forma financial statements reflecting projected
9 combined operation for a period of 2 years;
10 (C) a pro forma business plan detailing an
11 acquiring party's plans with respect to the operation
12 of the Health Maintenance Organization sought to be
13 acquired for a period of not less than 3 years; and
14 (D) such other information as the Director shall
15 require.
16 (d) The provisions of Article VIII 1/2 of the Illinois
17Insurance Code and this Section 5-3 shall apply to the sale by
18any health maintenance organization of greater than 10% of its
19enrollee population (including without limitation the health
20maintenance organization's right, title, and interest in and
21to its health care certificates).
22 (e) In considering any management contract or service
23agreement subject to Section 141.1 of the Illinois Insurance
24Code, the Director (i) shall, in addition to the criteria
25specified in Section 141.2 of the Illinois Insurance Code,
26take into account the effect of the management contract or

SB1527- 12 -LRB103 27266 BMS 53637 b
1service agreement on the continuation of benefits to enrollees
2and the financial condition of the health maintenance
3organization to be managed or serviced, and (ii) need not take
4into account the effect of the management contract or service
5agreement on competition.
6 (f) Except for small employer groups as defined in the
7Small Employer Rating, Renewability and Portability Health
8Insurance Act and except for medicare supplement policies as
9defined in Section 363 of the Illinois Insurance Code, a
10Health Maintenance Organization may by contract agree with a
11group or other enrollment unit to effect refunds or charge
12additional premiums under the following terms and conditions:
13 (i) the amount of, and other terms and conditions with
14 respect to, the refund or additional premium are set forth
15 in the group or enrollment unit contract agreed in advance
16 of the period for which a refund is to be paid or
17 additional premium is to be charged (which period shall
18 not be less than one year); and
19 (ii) the amount of the refund or additional premium
20 shall not exceed 20% of the Health Maintenance
21 Organization's profitable or unprofitable experience with
22 respect to the group or other enrollment unit for the
23 period (and, for purposes of a refund or additional
24 premium, the profitable or unprofitable experience shall
25 be calculated taking into account a pro rata share of the
26 Health Maintenance Organization's administrative and

SB1527- 13 -LRB103 27266 BMS 53637 b
1 marketing expenses, but shall not include any refund to be
2 made or additional premium to be paid pursuant to this
3 subsection (f)). The Health Maintenance Organization and
4 the group or enrollment unit may agree that the profitable
5 or unprofitable experience may be calculated taking into
6 account the refund period and the immediately preceding 2
7 plan years.
8 The Health Maintenance Organization shall include a
9statement in the evidence of coverage issued to each enrollee
10describing the possibility of a refund or additional premium,
11and upon request of any group or enrollment unit, provide to
12the group or enrollment unit a description of the method used
13to calculate (1) the Health Maintenance Organization's
14profitable experience with respect to the group or enrollment
15unit and the resulting refund to the group or enrollment unit
16or (2) the Health Maintenance Organization's unprofitable
17experience with respect to the group or enrollment unit and
18the resulting additional premium to be paid by the group or
19enrollment unit.
20 In no event shall the Illinois Health Maintenance
21Organization Guaranty Association be liable to pay any
22contractual obligation of an insolvent organization to pay any
23refund authorized under this Section.
24 (g) Rulemaking authority to implement Public Act 95-1045,
25if any, is conditioned on the rules being adopted in
26accordance with all provisions of the Illinois Administrative

SB1527- 14 -LRB103 27266 BMS 53637 b
1Procedure Act and all rules and procedures of the Joint
2Committee on Administrative Rules; any purported rule not so
3adopted, for whatever reason, is unauthorized.
4(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
5101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
61-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
7eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
8102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
91-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
10eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
11102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
121-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
13eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
14 Section 35. The Limited Health Service Organization Act is
15amended by changing Section 4003 as follows:
16 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
17 Sec. 4003. Illinois Insurance Code provisions. Limited
18health service organizations shall be subject to the
19provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
20141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
21154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3,
22355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, 356z.21, 356z.22,
23356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
24356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.57,

SB1527- 15 -LRB103 27266 BMS 53637 b
1356z.59, 356z.61, 364.3, 368a, 401, 401.1, 402, 403, 403A,
2408, 408.2, 409, 412, 444, and 444.1 and Articles IIA, VIII
31/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the
4Illinois Insurance Code. Nothing in this Section shall require
5a limited health care plan to cover any service that is not a
6limited health service. For purposes of the Illinois Insurance
7Code, except for Sections 444 and 444.1 and Articles XIII and
8XIII 1/2, limited health service organizations in the
9following categories are deemed to be domestic companies:
10 (1) a corporation under the laws of this State; or
11 (2) a corporation organized under the laws of another
12 state, 30% or more of the enrollees of which are residents
13 of this State, except a corporation subject to
14 substantially the same requirements in its state of
15 organization as is a domestic company under Article VIII
16 1/2 of the Illinois Insurance Code.
17(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
18101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff.
191-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642,
20eff. 1-1-22; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
21102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff.
221-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
23 Section 40. The Voluntary Health Services Plans Act is
24amended by changing Section 10 as follows:

SB1527- 16 -LRB103 27266 BMS 53637 b
1 (215 ILCS 165/10) (from Ch. 32, par. 604)
2 Sec. 10. Application of Insurance Code provisions. Health
3services plan corporations and all persons interested therein
4or dealing therewith shall be subject to the provisions of
5Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
6143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
7356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
8356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
9356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
10356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
11356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
12356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
13356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 364.01, 364.3,
14367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
15and paragraphs (7) and (15) of Section 367 of the Illinois
16Insurance Code.
17 Rulemaking authority to implement Public Act 95-1045, if
18any, is conditioned on the rules being adopted in accordance
19with all provisions of the Illinois Administrative Procedure
20Act and all rules and procedures of the Joint Committee on
21Administrative Rules; any purported rule not so adopted, for
22whatever reason, is unauthorized.
23(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
24101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
251-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
26eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;

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1102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
21-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
3eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
4102-1117, eff. 1-13-23.)
5 Section 45. The Illinois Public Aid Code is amended by
6changing Section 5-16.8 as follows:
7 (305 ILCS 5/5-16.8)
8 Sec. 5-16.8. Required health benefits. The medical
9assistance program shall (i) provide the post-mastectomy care
10benefits required to be covered by a policy of accident and
11health insurance under Section 356t and the coverage required
12under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
13356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
14356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and
15356z.61 of the Illinois Insurance Code, (ii) be subject to the
16provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
17370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
18subject to the provisions of subsection (d-5) of Section 10 of
19the Network Adequacy and Transparency Act.
20 The Department, by rule, shall adopt a model similar to
21the requirements of Section 356z.39 of the Illinois Insurance
22Code.
23 On and after July 1, 2012, the Department shall reduce any
24rate of reimbursement for services or other payments or alter

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1any methodologies authorized by this Code to reduce any rate
2of reimbursement for services or other payments in accordance
3with Section 5-5e.
4 To ensure full access to the benefits set forth in this
5Section, on and after January 1, 2016, the Department shall
6ensure that provider and hospital reimbursement for
7post-mastectomy care benefits required under this Section are
8no lower than the Medicare reimbursement rate.
9(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
10101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
111-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
12eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
13102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.
141-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
15eff. 1-1-23; 102-1117, eff. 1-13-23.)
16 Section 95. No acceleration or delay. Where this Act makes
17changes in a statute that is represented in this Act by text
18that is not yet or no longer in effect (for example, a Section
19represented by multiple versions), the use of that text does
20not accelerate or delay the taking effect of (i) the changes
21made by this Act or (ii) provisions derived from any other
22Public Act.
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