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Public Act 103-0649 Public Act 0649 103RD GENERAL ASSEMBLY | Public Act 103-0649 | HB2499 Enrolled | LRB103 30875 AMQ 57395 b |
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| AN ACT concerning regulation. | Be it enacted by the People of the State of Illinois, | represented in the General Assembly: | Section 5. The Illinois Insurance Code is amended by | changing Sections 121-2.05, 356z.18, 367.3, 367a, and 368f and | by adding Section 352c as follows: | (215 ILCS 5/121-2.05) (from Ch. 73, par. 733-2.05) | Sec. 121-2.05. Group insurance policies issued and | delivered in other State-Transactions in this State. With the | exception of insurance transactions authorized under Sections | 230.2 or 367.3 of this Code or transactions described under | Section 352c , transactions in this State involving group | legal, group life and group accident and health or blanket | accident and health insurance or group annuities where the | master policy of such groups was lawfully issued and delivered | in, and under the laws of, a State in which the insurer was | authorized to do an insurance business, to a group properly | established pursuant to law or regulation, and where the | policyholder is domiciled or otherwise has a bona fide situs. | (Source: P.A. 86-753.) | (215 ILCS 5/352c new) | Sec. 352c. Short-term, limited-duration insurance |
| prohibited. | (a) In this Section: | "Excepted benefits" has the meaning given to that term in | 42 U.S.C. 300gg-91 and implementing regulations. "Excepted | benefits" includes individual, group, or blanket coverage. | "Short-term, limited-duration insurance" means any type of | accident and health insurance offered or provided within this | State pursuant to a group or individual policy or individual | certificate by a company, regardless of the situs state of the | delivery of the policy, that has an expiration date specified | in the contract that is fewer than 365 days after the original | effective date. Regardless of the duration of coverage, | "short-term, limited-duration insurance" does not include | excepted benefits or any student health insurance coverage. | (b) On and after January 1, 2025, no company shall issue, | deliver, amend, or renew short-term, limited-duration | insurance to any natural or legal person that is a resident or | domiciled in this State. | (215 ILCS 5/356z.18) | (Text of Section before amendment by P.A. 103-512 ) | Sec. 356z.18. Prosthetic and customized orthotic devices. | (a) For the purposes of this Section: | "Customized orthotic device" means a supportive device for | the body or a part of the body, the head, neck, or extremities, | and includes the replacement or repair of the device based on |
| the patient's physical condition as medically necessary, | excluding foot orthotics defined as an in-shoe device designed | to support the structural components of the foot during | weight-bearing activities. | "Licensed provider" means a prosthetist, orthotist, or | pedorthist licensed to practice in this State. | "Prosthetic device" means an artificial device to replace, | in whole or in part, an arm or leg and includes accessories | essential to the effective use of the device and the | replacement or repair of the device based on the patient's | physical condition as medically necessary. | (b) This amendatory Act of the 96th General Assembly shall | provide benefits to any person covered thereunder for expenses | incurred in obtaining a prosthetic or custom orthotic device | from any Illinois licensed prosthetist, licensed orthotist, or | licensed pedorthist as required under the Orthotics, | Prosthetics, and Pedorthics Practice Act. | (c) A group or individual major medical policy of accident | or health insurance or managed care plan or medical, health, | or hospital service corporation contract that provides | coverage for prosthetic or custom orthotic care and is | amended, delivered, issued, or renewed 6 months after the | effective date of this amendatory Act of the 96th General | Assembly must provide coverage for prosthetic and orthotic | devices in accordance with this subsection (c). The coverage | required under this Section shall be subject to the other |
| general exclusions, limitations, and financial requirements of | the policy, including coordination of benefits, participating | provider requirements, utilization review of health care | services, including review of medical necessity, case | management, and experimental and investigational treatments, | and other managed care provisions under terms and conditions | that are no less favorable than the terms and conditions that | apply to substantially all medical and surgical benefits | provided under the plan or coverage. | (d) The policy or plan or contract may require prior | authorization for the prosthetic or orthotic devices in the | same manner that prior authorization is required for any other | covered benefit. | (e) Repairs and replacements of prosthetic and orthotic | devices are also covered, subject to the co-payments and | deductibles, unless necessitated by misuse or loss. | (f) A policy or plan or contract may require that, if | coverage is provided through a managed care plan, the benefits | mandated pursuant to this Section shall be covered benefits | only if the prosthetic or orthotic devices are provided by a | licensed provider employed by a provider service who contracts | with or is designated by the carrier, to the extent that the | carrier provides in-network and out-of-network service, the | coverage for the prosthetic or orthotic device shall be | offered no less extensively. | (g) The policy or plan or contract shall also meet |
| adequacy requirements as established by the Health Care | Reimbursement Reform Act of 1985 of the Illinois Insurance | Code. | (h) This Section shall not apply to accident only, | specified disease, short-term travel hospital or medical , | hospital confinement indemnity or other fixed indemnity , | credit, dental, vision, Medicare supplement, long-term care, | basic hospital and medical-surgical expense coverage, | disability income insurance coverage, coverage issued as a | supplement to liability insurance, workers' compensation | insurance, or automobile medical payment insurance. | (Source: P.A. 96-833, eff. 6-1-10 .) | (Text of Section after amendment by P.A. 103-512 ) | Sec. 356z.18. Prosthetic and customized orthotic devices. | (a) For the purposes of this Section: | "Customized orthotic device" means a supportive device for | the body or a part of the body, the head, neck, or extremities, | and includes the replacement or repair of the device based on | the patient's physical condition as medically necessary, | excluding foot orthotics defined as an in-shoe device designed | to support the structural components of the foot during | weight-bearing activities. | "Licensed provider" means a prosthetist, orthotist, or | pedorthist licensed to practice in this State. | "Prosthetic device" means an artificial device to replace, |
| in whole or in part, an arm or leg and includes accessories | essential to the effective use of the device and the | replacement or repair of the device based on the patient's | physical condition as medically necessary. | (b) This amendatory Act of the 96th General Assembly shall | provide benefits to any person covered thereunder for expenses | incurred in obtaining a prosthetic or custom orthotic device | from any Illinois licensed prosthetist, licensed orthotist, or | licensed pedorthist as required under the Orthotics, | Prosthetics, and Pedorthics Practice Act. | (c) A group or individual major medical policy of accident | or health insurance or managed care plan or medical, health, | or hospital service corporation contract that provides | coverage for prosthetic or custom orthotic care and is | amended, delivered, issued, or renewed 6 months after the | effective date of this amendatory Act of the 96th General | Assembly must provide coverage for prosthetic and orthotic | devices in accordance with this subsection (c). The coverage | required under this Section shall be subject to the other | general exclusions, limitations, and financial requirements of | the policy, including coordination of benefits, participating | provider requirements, utilization review of health care | services, including review of medical necessity, case | management, and experimental and investigational treatments, | and other managed care provisions under terms and conditions | that are no less favorable than the terms and conditions that |
| apply to substantially all medical and surgical benefits | provided under the plan or coverage. | (d) With respect to an enrollee at any age, in addition to | coverage of a prosthetic or custom orthotic device required by | this Section, benefits shall be provided for a prosthetic or | custom orthotic device determined by the enrollee's provider | to be the most appropriate model that is medically necessary | for the enrollee to perform physical activities, as | applicable, such as running, biking, swimming, and lifting | weights, and to maximize the enrollee's whole body health and | strengthen the lower and upper limb function. | (e) The requirements of this Section do not constitute an | addition to this State's essential health benefits that | requires defrayal of costs by this State pursuant to 42 U.S.C. | 18031(d)(3)(B). | (f) The policy or plan or contract may require prior | authorization for the prosthetic or orthotic devices in the | same manner that prior authorization is required for any other | covered benefit. | (g) Repairs and replacements of prosthetic and orthotic | devices are also covered, subject to the co-payments and | deductibles, unless necessitated by misuse or loss. | (h) A policy or plan or contract may require that, if | coverage is provided through a managed care plan, the benefits | mandated pursuant to this Section shall be covered benefits | only if the prosthetic or orthotic devices are provided by a |
| licensed provider employed by a provider service who contracts | with or is designated by the carrier, to the extent that the | carrier provides in-network and out-of-network service, the | coverage for the prosthetic or orthotic device shall be | offered no less extensively. | (i) The policy or plan or contract shall also meet | adequacy requirements as established by the Health Care | Reimbursement Reform Act of 1985 of the Illinois Insurance | Code. | (j) This Section shall not apply to accident only, | specified disease, short-term travel hospital or medical , | hospital confinement indemnity or other fixed indemnity , | credit, dental, vision, Medicare supplement, long-term care, | basic hospital and medical-surgical expense coverage, | disability income insurance coverage, coverage issued as a | supplement to liability insurance, workers' compensation | insurance, or automobile medical payment insurance. | (Source: P.A. 103-512, eff. 1-1-25.) | (215 ILCS 5/367.3) (from Ch. 73, par. 979.3) | Sec. 367.3. Group accident and health insurance; | discretionary groups. | (a) No group health insurance offered to a resident of | this State under a policy issued to a group, other than one | specifically described in Section 367(1), shall be delivered | or issued for delivery in this State unless the Director |
| determines that: | (1) the issuance of the policy is not contrary to the | public interest; | (2) the issuance of the policy will result in | economies of acquisition and administration; and | (3) the benefits under the policy are reasonable in | relation to the premium charged. | (b) No such group health insurance may be offered in this | State under a policy issued in another state unless this State | or the state in which the group policy is issued has made a | determination that the requirements of subsection (a) have | been met. | Where insurance is to be offered in this State under a | policy described in this subsection, the insurer shall file | for informational review purposes: | (1) a copy of the group master contract; | (2) a copy of the statute authorizing the issuance of | the group policy in the state of situs, which statute has | the same or similar requirements as this State, or in the | absence of such statute, a certification by an officer of | the company that the policy meets the Illinois minimum | standards required for individual accident and health | policies under authority of Section 401 of this Code, as | now or hereafter amended, as promulgated by rule at 50 | Illinois Administrative Code, Ch. I, Sec. 2007, et seq., | as now or hereafter amended, or by a successor rule; |
| (3) evidence of approval by the state of situs of the | group master policy; and | (4) copies of all supportive material furnished to the | state of situs to satisfy the criteria for approval. | (c) The Director may, at any time after receipt of the | information required under subsection (b) and after finding | that the standards of subsection (a) have not been met, order | the insurer to cease the issuance or marketing of that | coverage in this State. | (d) Notwithstanding subsections (a) and (b), group Group | accident and health insurance subject to the provisions of | this Section is also subject to the provisions of Sections | 352c and Section 367i of this Code and rules thereunder . | (Source: P.A. 90-655, eff. 7-30-98.) | (215 ILCS 5/367a) (from Ch. 73, par. 979a) | Sec. 367a. Blanket accident and health insurance. | (1) Blanket accident and health insurance is the that form | of accident and health insurance providing excepted benefits, | as defined in Section 352c, that covers covering special | groups of persons as enumerated in one of the following | paragraphs (a) to (g), inclusive: | (a) Under a policy or contract issued to any carrier for | hire, which shall be deemed the policyholder, covering a group | defined as all persons who may become passengers on such | carrier. |
| (b) Under a policy or contract issued to an employer, who | shall be deemed the policyholder, covering all employees or | any group of employees defined by reference to exceptional | hazards incident to such employment. | (c) Under a policy or contract issued to a college, | school, or other institution of learning or to the head or | principal thereof, who or which shall be deemed the | policyholder, covering students or teachers. However, student | health insurance coverage, as defined in 45 CFR 147.145, shall | remain subject to the standards and requirements for | individual health insurance coverage except where inconsistent | with that regulation. An issuer providing student health | insurance coverage or a policy or contract covering students | for limited-scope dental or vision under 45 CFR 148.220 shall | require an individual application or enrollment form and shall | furnish each insured individual a certificate, which shall | have been approved by the Director under Section 355. | (d) Under a policy or contract issued in the name of any | volunteer fire department, first aid, or other such volunteer | group, which shall be deemed the policyholder, covering all of | the members of such department or group. | (e) Under a policy or contract issued to a creditor, who | shall be deemed the policyholder, to insure debtors of the | creditors; Provided, however, that in the case of a loan which | is subject to the Small Loans Act, no insurance premium or | other cost shall be directly or indirectly charged or assessed |
| against, or collected or received from the borrower. | (f) Under a policy or contract issued to a sports team or | to a camp, which team or camp sponsor shall be deemed the | policyholder, covering members or campers. | (g) Under a policy or contract issued to any other | substantially similar group which, in the discretion of the | Director, may be subject to the issuance of a blanket accident | and health policy or contract. | (2) Any insurance company authorized to write accident and | health insurance in this state shall have the power to issue | blanket accident and health insurance. No such blanket policy | may be issued or delivered in this State unless a copy of the | form thereof shall have been filed in accordance with Section | 355, and it contains in substance such of those provisions | contained in Sections 357.1 through 357.30 as may be | applicable to blanket accident and health insurance and the | following provisions: | (a) A provision that the policy and the application shall | constitute the entire contract between the parties, and that | all statements made by the policyholder shall, in absence of | fraud, be deemed representations and not warranties, and that | no such statements shall be used in defense to a claim under | the policy, unless it is contained in a written application. | (b) A provision that to the group or class thereof | originally insured shall be added from time to time all new | persons or individuals eligible for coverage. |
| (3) An individual application shall not be required from a | person covered under a blanket accident or health policy or | contract, nor shall it be necessary for the insurer to furnish | each person a certificate. | (4) All benefits under any blanket accident and health | policy shall be payable to the person insured, or to his | designated beneficiary or beneficiaries, or to his or her | estate, except that if the person insured be a minor or person | under legal disability, such benefits may be made payable to | his or her parent, guardian, or other person actually | supporting him or her. Provided further, however, that the | policy may provide that all or any portion of any indemnities | provided by any such policy on account of hospital, nursing, | medical or surgical services may, at the insurer's option, be | paid directly to the hospital or person rendering such | services; but the policy may not require that the service be | rendered by a particular hospital or person. Payment so made | shall discharge the insurer's obligation with respect to the | amount of insurance so paid. | (5) Nothing contained in this section shall be deemed to | affect the legal liability of policyholders for the death of | or injury to, any such member of such group. | (Source: P.A. 83-1362.) | (215 ILCS 5/368f) | Sec. 368f. Military service member insurance |
| reinstatement. | (a) No Illinois resident activated for military service | and no spouse or dependent of the resident who becomes | eligible for a federal government-sponsored health insurance | program, including the TriCare program providing coverage for | civilian dependents of military personnel, as a result of the | activation shall be denied reinstatement into the same | individual health insurance coverage with the health insurer | that the resident lapsed as a result of activation or becoming | covered by the federal government-sponsored health insurance | program. The resident shall have the right to reinstatement in | the same individual health insurance coverage without medical | underwriting, subject to payment of the current premium | charged to other persons of the same age and gender that are | covered under the same individual health coverage. Except in | the case of birth or adoption that occurs during the period of | activation, reinstatement must be into the same coverage type | as the resident held prior to lapsing the individual health | insurance coverage and at the same or, at the option of the | resident, higher deductible level. The reinstatement rights | provided under this subsection (a) are not available to a | resident or dependents if the activated person is discharged | from the military under other than honorable conditions. | (b) The health insurer with which the reinstatement is | being requested must receive a request for reinstatement no | later than 63 days following the later of (i) deactivation or |
| (ii) loss of coverage under the federal government-sponsored | health insurance program. The health insurer may request proof | of loss of coverage and the timing of the loss of coverage of | the government-sponsored coverage in order to determine | eligibility for reinstatement into the individual coverage. | The effective date of the reinstatement of individual health | coverage shall be the first of the month following receipt of | the notice requesting reinstatement. | (c) All insurers must provide written notice to the | policyholder of individual health coverage of the rights | described in subsection (a) of this Section. In lieu of the | inclusion of the notice in the individual health insurance | policy, an insurance company may satisfy the notification | requirement by providing a single written notice: | (1) in conjunction with the enrollment process for a | policyholder initially enrolling in the individual | coverage on or after the effective date of this amendatory | Act of the 94th General Assembly; or | (2) by mailing written notice to policyholders whose | coverage was effective prior to the effective date of this | amendatory Act of the 94th General Assembly no later than | 90 days following the effective date of this amendatory | Act of the 94th General Assembly. | (d) The provisions of subsection (a) of this Section do | not apply to any policy or certificate providing coverage for | any specified disease, specified accident or accident-only |
| coverage, credit, dental, disability income, hospital | indemnity or other fixed indemnity , long-term care, Medicare | supplement, vision care, or short-term travel nonrenewable | health policy or other limited-benefit supplemental insurance, | or any coverage issued as a supplement to any liability | insurance, workers' compensation or similar insurance, or any | insurance under which benefits are payable with or without | regard to fault, whether written on a group, blanket, or | individual basis. | (e) Nothing in this Section shall require an insurer to | reinstate the resident if the insurer requires residency in an | enrollment area and those residency requirements are not met | after deactivation or loss of coverage under the | government-sponsored health insurance program. | (f) All terms, conditions, and limitations of the | individual coverage into which reinstatement is made apply | equally to all insureds enrolled in the coverage. | (g) The Secretary may adopt rules as may be necessary to | carry out the provisions of this Section. | (Source: P.A. 94-1037, eff. 7-20-06.) | Section 10. The Health Maintenance Organization Act is | amended by changing Section 5-3 as follows: | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2) | Sec. 5-3. Insurance Code provisions. |
| (a) Health Maintenance Organizations shall be subject to | the provisions of Sections 133, 134, 136, 137, 139, 140, | 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, | 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 155.49, | 352c, 355.2, 355.3, 355b, 355c, 356f, 356g.5-1, 356m, 356q, | 356v, 356w, 356x, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, | 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, | 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.20, 356z.21, | 356z.22, 356z.23, 356z.24, 356z.25, 356z.26, 356z.28, 356z.29, | 356z.30, 356z.30a, 356z.31, 356z.32, 356z.33, 356z.34, | 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40, 356z.41, | 356z.44, 356z.45, 356z.46, 356z.47, 356z.48, 356z.49, 356z.50, | 356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.58, | 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.65, 356z.67, | 356z.68, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b, | 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, | 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of | subsection (2) of Section 367, and Articles IIA, VIII 1/2, | XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the | Illinois Insurance Code. | (b) For purposes of the Illinois Insurance Code, except | for Sections 444 and 444.1 and Articles XIII and XIII 1/2, | Health Maintenance Organizations in the following categories | are deemed to be "domestic companies": | (1) a corporation authorized under the Dental Service | Plan Act or the Voluntary Health Services Plans Act; |
| (2) a corporation organized under the laws of this | State; or | (3) a corporation organized under the laws of another | state, 30% or more of the enrollees of which are residents | of this State, except a corporation subject to | substantially the same requirements in its state of | organization as is a "domestic company" under Article VIII | 1/2 of the Illinois Insurance Code. | (c) In considering the merger, consolidation, or other | acquisition of control of a Health Maintenance Organization | pursuant to Article VIII 1/2 of the Illinois Insurance Code, | (1) the Director shall give primary consideration to | the continuation of benefits to enrollees and the | financial conditions of the acquired Health Maintenance | Organization after the merger, consolidation, or other | acquisition of control takes effect; | (2)(i) the criteria specified in subsection (1)(b) of | Section 131.8 of the Illinois Insurance Code shall not | apply and (ii) the Director, in making his determination | with respect to the merger, consolidation, or other | acquisition of control, need not take into account the | effect on competition of the merger, consolidation, or | other acquisition of control; | (3) the Director shall have the power to require the | following information: | (A) certification by an independent actuary of the |
| adequacy of the reserves of the Health Maintenance | Organization sought to be acquired; | (B) pro forma financial statements reflecting the | combined balance sheets of the acquiring company and | the Health Maintenance Organization sought to be | acquired as of the end of the preceding year and as of | a date 90 days prior to the acquisition, as well as pro | forma financial statements reflecting projected | combined operation for a period of 2 years; | (C) a pro forma business plan detailing an | acquiring party's plans with respect to the operation | of the Health Maintenance Organization sought to be | acquired for a period of not less than 3 years; and | (D) such other information as the Director shall | require. | (d) The provisions of Article VIII 1/2 of the Illinois | Insurance Code and this Section 5-3 shall apply to the sale by | any health maintenance organization of greater than 10% of its | enrollee population (including , without limitation , the health | maintenance organization's right, title, and interest in and | to its health care certificates). | (e) In considering any management contract or service | agreement subject to Section 141.1 of the Illinois Insurance | Code, the Director (i) shall, in addition to the criteria | specified in Section 141.2 of the Illinois Insurance Code, | take into account the effect of the management contract or |
| service agreement on the continuation of benefits to enrollees | and the financial condition of the health maintenance | organization to be managed or serviced, and (ii) need not take | into account the effect of the management contract or service | agreement on competition. | (f) Except for small employer groups as defined in the | Small Employer Rating, Renewability and Portability Health | Insurance Act and except for medicare supplement policies as | defined in Section 363 of the Illinois Insurance Code, a | Health Maintenance Organization may by contract agree with a | group or other enrollment unit to effect refunds or charge | additional premiums under the following terms and conditions: | (i) the amount of, and other terms and conditions with | respect to, the refund or additional premium are set forth | in the group or enrollment unit contract agreed in advance | of the period for which a refund is to be paid or | additional premium is to be charged (which period shall | not be less than one year); and | (ii) the amount of the refund or additional premium | shall not exceed 20% of the Health Maintenance | Organization's profitable or unprofitable experience with | respect to the group or other enrollment unit for the | period (and, for purposes of a refund or additional | premium, the profitable or unprofitable experience shall | be calculated taking into account a pro rata share of the | Health Maintenance Organization's administrative and |
| marketing expenses, but shall not include any refund to be | made or additional premium to be paid pursuant to this | subsection (f)). The Health Maintenance Organization and | the group or enrollment unit may agree that the profitable | or unprofitable experience may be calculated taking into | account the refund period and the immediately preceding 2 | plan years. | The Health Maintenance Organization shall include a | statement in the evidence of coverage issued to each enrollee | describing the possibility of a refund or additional premium, | and upon request of any group or enrollment unit, provide to | the group or enrollment unit a description of the method used | to calculate (1) the Health Maintenance Organization's | profitable experience with respect to the group or enrollment | unit and the resulting refund to the group or enrollment unit | or (2) the Health Maintenance Organization's unprofitable | experience with respect to the group or enrollment unit and | the resulting additional premium to be paid by the group or | enrollment unit. | In no event shall the Illinois Health Maintenance | Organization Guaranty Association be liable to pay any | contractual obligation of an insolvent organization to pay any | refund authorized under this Section. | (g) Rulemaking authority to implement Public Act 95-1045, | if any, is conditioned on the rules being adopted in | accordance with all provisions of the Illinois Administrative |
| Procedure Act and all rules and procedures of the Joint | Committee on Administrative Rules; any purported rule not so | adopted, for whatever reason, is unauthorized. | (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; | 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. | 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, | eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; | 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. | 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, | eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; | 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff. | 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, | eff. 1-1-24; 103-551, eff. 8-11-23; revised 8-29-23.) | Section 15. The Limited Health Service Organization Act is | amended by changing Section 4003 as follows: | (215 ILCS 130/4003) (from Ch. 73, par. 1504-3) | Sec. 4003. Illinois Insurance Code provisions. Limited | health service organizations shall be subject to the | provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, | 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, | 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c, | 355.2, 355.3, 355b, 356q, 356v, 356z.4, 356z.4a, 356z.10, | 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30a, | 356z.32, 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, |
| 356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, | 364.3, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, | 444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, | XIII 1/2, XXV, and XXVI of the Illinois Insurance Code. | Nothing in this Section shall require a limited health care | plan to cover any service that is not a limited health service. | For purposes of the Illinois Insurance Code, except for | Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited | health service organizations in the following categories are | deemed to be domestic companies: | (1) a corporation under the laws of this State; or | (2) a corporation organized under the laws of another | state, 30% or more of the enrollees of which are residents | of this State, except a corporation subject to | substantially the same requirements in its state of | organization as is a domestic company under Article VIII | 1/2 of the Illinois Insurance Code. | (Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; | 102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff. | 1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816, | eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; | 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. | 1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, | eff. 1-1-24; revised 8-29-23.) | (215 ILCS 190/Act rep.) |
| Section 20. The Short-Term, Limited-Duration Health | Insurance Coverage Act is repealed. | Section 95. No acceleration or delay. Where this Act makes | changes in a statute that is represented in this Act by text | that is not yet or no longer in effect (for example, a Section | represented by multiple versions), the use of that text does | not accelerate or delay the taking effect of (i) the changes | made by this Act or (ii) provisions derived from any other | Public Act. | Section 99. Effective date. This Act takes effect January | 1, 2025. |
Effective Date: 1/1/2025
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