Bill Text: IL HB3838 | 2023-2024 | 103rd General Assembly | Introduced
Bill Title: Amends the Counties Code. Provides that, on and after January 1, 2024, group life, health, accident, hospital, and medical insurance may not be provided to part-time county board members unless the same benefits are provided or offered to part-time employees of the county. Effective immediately.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced) 2023-03-16 - Added Co-Sponsor Rep. Chris Miller [HB3838 Detail]
Download: Illinois-2023-HB3838-Introduced.html
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1 | AN ACT concerning local government.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Counties Code is amended by changing | |||||||||||||||||||
5 | Section 5-1069 as follows:
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6 | (55 ILCS 5/5-1069) (from Ch. 34, par. 5-1069)
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7 | Sec. 5-1069. Group life, health, accident, hospital, and | |||||||||||||||||||
8 | medical
insurance. | |||||||||||||||||||
9 | (a) The county board of any county may arrange to provide, | |||||||||||||||||||
10 | for
the benefit of employees of the county, group life, | |||||||||||||||||||
11 | health, accident, hospital,
and medical insurance, or any one | |||||||||||||||||||
12 | or any combination of those types of
insurance, or the county | |||||||||||||||||||
13 | board may self-insure, for the benefit of its
employees, all | |||||||||||||||||||
14 | or a portion of the employees' group life, health, accident,
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15 | hospital, and medical insurance, or any one or any combination | |||||||||||||||||||
16 | of those
types of insurance, including a combination of | |||||||||||||||||||
17 | self-insurance and other
types of insurance authorized by this | |||||||||||||||||||
18 | Section, provided that the county
board complies with all | |||||||||||||||||||
19 | other requirements of this Section. The insurance
may include | |||||||||||||||||||
20 | provision for employees who rely on treatment by prayer or
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21 | spiritual means alone for healing in accordance with the | |||||||||||||||||||
22 | tenets and
practice of a well recognized religious | |||||||||||||||||||
23 | denomination. The county board may
provide for payment by the |
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1 | county of a portion or all of the premium or
charge for the | ||||||
2 | insurance with the employee paying the balance of the
premium | ||||||
3 | or charge, if any. If the county board undertakes a plan under
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4 | which the county pays only a portion of the premium or charge, | ||||||
5 | the county
board shall provide for withholding and deducting | ||||||
6 | from the compensation of
those employees who consent to join | ||||||
7 | the plan the balance of the premium or
charge for the | ||||||
8 | insurance.
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9 | (b) If the county board does not provide for | ||||||
10 | self-insurance or for a plan
under which the county pays a | ||||||
11 | portion or all of the premium or charge for a
group insurance | ||||||
12 | plan, the county board may provide for withholding and
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13 | deducting from the compensation of those employees who consent | ||||||
14 | thereto the
total premium or charge for any group life, | ||||||
15 | health, accident, hospital, and
medical insurance.
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16 | (c) The county board may exercise the powers granted in | ||||||
17 | this Section only if
it provides for self-insurance or, where | ||||||
18 | it makes arrangements to provide
group insurance through an | ||||||
19 | insurance carrier, if the kinds of group
insurance are | ||||||
20 | obtained from an insurance company authorized to do business
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21 | in the State of Illinois. The county board may enact an | ||||||
22 | ordinance
prescribing the method of operation of the insurance | ||||||
23 | program.
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24 | (c-5) On and after January 1, 2024, benefits under this | ||||||
25 | Section may not be provided to part-time county board members | ||||||
26 | unless the same benefits are provided or offered to part-time |
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1 | employees of the county. | ||||||
2 | (d) If a county, including a home rule county, is a | ||||||
3 | self-insurer for
purposes of providing health insurance | ||||||
4 | coverage for its employees, the
insurance coverage shall | ||||||
5 | include screening by low-dose mammography for all
women 35 | ||||||
6 | years of age or older for the presence of occult breast cancer
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7 | unless the county elects to provide mammograms itself under | ||||||
8 | Section
5-1069.1. The coverage shall be as follows:
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9 | (1) A baseline mammogram for women 35 to 39 years of | ||||||
10 | age.
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11 | (2) An annual mammogram for women 40 years of age or | ||||||
12 | older.
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13 | (3) A mammogram at the age and intervals considered | ||||||
14 | medically necessary by the woman's health care provider | ||||||
15 | for women under 40 years of age and having a family history | ||||||
16 | of breast cancer, prior personal history of breast cancer, | ||||||
17 | positive genetic testing, or other risk factors. | ||||||
18 | (4) For a group policy of accident and health | ||||||
19 | insurance that is amended, delivered, issued, or renewed | ||||||
20 | on or after the effective date of this amendatory Act of | ||||||
21 | the 101st General Assembly, a comprehensive ultrasound | ||||||
22 | screening of an entire breast or breasts if a mammogram | ||||||
23 | demonstrates heterogeneous or dense breast tissue or when | ||||||
24 | medically necessary as determined by a physician licensed | ||||||
25 | to practice medicine in all of its branches, advanced | ||||||
26 | practice registered nurse, or physician assistant. |
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1 | (5) For a group policy of accident and health | ||||||
2 | insurance that is amended, delivered, issued, or renewed | ||||||
3 | on or after the effective date of this amendatory Act of | ||||||
4 | the 101st General Assembly, a diagnostic mammogram when | ||||||
5 | medically necessary, as determined by a physician licensed | ||||||
6 | to practice medicine in all its branches, advanced | ||||||
7 | practice registered nurse, or physician assistant. | ||||||
8 | A policy subject to this subsection shall not impose a | ||||||
9 | deductible, coinsurance, copayment, or any other cost-sharing | ||||||
10 | requirement on the coverage provided; except that this | ||||||
11 | sentence does not apply to coverage of diagnostic mammograms | ||||||
12 | to the extent such coverage would disqualify a high-deductible | ||||||
13 | health plan from eligibility for a health savings account | ||||||
14 | pursuant to Section 223 of the Internal Revenue Code (26 | ||||||
15 | U.S.C. 223). | ||||||
16 | For purposes of this subsection: | ||||||
17 | "Diagnostic
mammogram" means a mammogram obtained using | ||||||
18 | diagnostic mammography. | ||||||
19 | "Diagnostic
mammography" means a method of screening that | ||||||
20 | is designed to
evaluate an abnormality in a breast, including | ||||||
21 | an abnormality seen
or suspected on a screening mammogram or a | ||||||
22 | subjective or objective
abnormality otherwise detected in the | ||||||
23 | breast. | ||||||
24 | "Low-dose mammography"
means the x-ray examination of the | ||||||
25 | breast using equipment dedicated
specifically for mammography, | ||||||
26 | including the x-ray tube, filter, compression
device, and |
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1 | image receptor, with an average radiation exposure
delivery of | ||||||
2 | less than one rad per breast for 2 views of an average size | ||||||
3 | breast. The term also includes digital mammography. | ||||||
4 | (d-5) Coverage as described by subsection (d) shall be | ||||||
5 | provided at no cost to the insured and shall not be applied to | ||||||
6 | an annual or lifetime maximum benefit. | ||||||
7 | (d-10) When health care services are available through | ||||||
8 | contracted providers and a person does not comply with plan | ||||||
9 | provisions specific to the use of contracted providers, the | ||||||
10 | requirements of subsection (d-5) are not applicable. When a | ||||||
11 | person does not comply with plan provisions specific to the | ||||||
12 | use of contracted providers, plan provisions specific to the | ||||||
13 | use of non-contracted providers must be applied without | ||||||
14 | distinction for coverage required by this Section and shall be | ||||||
15 | at least as favorable as for other radiological examinations | ||||||
16 | covered by the policy or contract. | ||||||
17 | (d-15) If a county, including a home rule county, is a | ||||||
18 | self-insurer for purposes of providing health insurance | ||||||
19 | coverage for its employees, the insurance coverage shall | ||||||
20 | include mastectomy coverage, which includes coverage for | ||||||
21 | prosthetic devices or reconstructive surgery incident to the | ||||||
22 | mastectomy. Coverage for breast reconstruction in connection | ||||||
23 | with a mastectomy shall include: | ||||||
24 | (1) reconstruction of the breast upon which the | ||||||
25 | mastectomy has been performed; | ||||||
26 | (2) surgery and reconstruction of the other breast to |
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1 | produce a symmetrical appearance; and | ||||||
2 | (3) prostheses and treatment for physical | ||||||
3 | complications at all stages of mastectomy, including | ||||||
4 | lymphedemas. | ||||||
5 | Care shall be determined in consultation with the attending | ||||||
6 | physician and the patient. The offered coverage for prosthetic | ||||||
7 | devices and reconstructive surgery shall be subject to the | ||||||
8 | deductible and coinsurance conditions applied to the | ||||||
9 | mastectomy, and all other terms and conditions applicable to | ||||||
10 | other benefits. When a mastectomy is performed and there is no | ||||||
11 | evidence of malignancy then the offered coverage may be | ||||||
12 | limited to the provision of prosthetic devices and | ||||||
13 | reconstructive surgery to within 2 years after the date of the | ||||||
14 | mastectomy. As used in this Section, "mastectomy" means the | ||||||
15 | removal of all or part of the breast for medically necessary | ||||||
16 | reasons, as determined by a licensed physician. | ||||||
17 | A county, including a home rule county, that is a | ||||||
18 | self-insurer for purposes of providing health insurance | ||||||
19 | coverage for its employees, may not penalize or reduce or | ||||||
20 | limit the reimbursement of an attending provider or provide | ||||||
21 | incentives (monetary or otherwise) to an attending provider to | ||||||
22 | induce the provider to provide care to an insured in a manner | ||||||
23 | inconsistent with this Section. | ||||||
24 | (d-20) The
requirement that mammograms be included in | ||||||
25 | health insurance coverage as
provided in subsections (d) | ||||||
26 | through (d-15) is an exclusive power and function of the
State |
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1 | and is a denial and limitation under Article VII, Section 6,
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2 | subsection (h) of the Illinois Constitution of home rule | ||||||
3 | county powers. A
home rule county to which subsections (d) | ||||||
4 | through (d-15) apply must comply with every
provision of those | ||||||
5 | subsections.
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6 | (e) The term "employees" as used in this Section includes | ||||||
7 | elected or
appointed officials but does not include temporary | ||||||
8 | employees.
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9 | (f) The county board may, by ordinance, arrange to provide | ||||||
10 | group life,
health, accident, hospital, and medical insurance, | ||||||
11 | or any one or a combination
of those types of insurance, under | ||||||
12 | this Section to retired former employees and
retired former | ||||||
13 | elected or appointed officials of the county.
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14 | (g) Rulemaking authority to implement this amendatory Act | ||||||
15 | of the 95th General Assembly, if any, is conditioned on the | ||||||
16 | rules being adopted in accordance with all provisions of the | ||||||
17 | Illinois Administrative Procedure Act and all rules and | ||||||
18 | procedures of the Joint Committee on Administrative Rules; any | ||||||
19 | purported rule not so adopted, for whatever reason, is | ||||||
20 | unauthorized. | ||||||
21 | (Source: P.A. 100-513, eff. 1-1-18; 101-580, eff. 1-1-20 .)
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22 | Section 99. Effective date. This Act takes effect upon | ||||||
23 | becoming law.
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