Bill Text: IL SB1557 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Illinois Insurance Code. Provides that no individual or group policy of accident and health insurance or managed care organization shall change an insured's eligibility or coverage during a contract period. Provides that during a contract period, insureds shall have the protection and continuity of their providers, medication, covered benefits, and formulary during the contract period. Amends the Illinois Public Aid Code making conforming changes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2025-01-07 - Session Sine Die [SB1557 Detail]

Download: Illinois-2023-SB1557-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1557 Introduced 2/8/2023, by Sen. Laura M. Murphy SYNOPSIS AS INTRODUCED:
215 ILCS 5/356z.61 new
305 ILCS 5/5-16.8
Amends the Illinois Insurance Code. Provides that no individual or group policy of accident and health insurance or managed care organization shall change an insured's eligibility or coverage during a contract period. Provides that during a contract period, insureds shall have the protection and continuity of their providers, medication, covered benefits, and formulary during the contract period. Amends the Illinois Public Aid Code making conforming changes.
LRB103 27648 BMS 54024 b
A BILL FOR
SB1557 LRB103 27648 BMS 54024 b
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
adding Section 356z.61 as follows:
(215 ILCS 5/356z.61 new)
Sec. 356z.61. Contract terms; coverage. No individual or
group policy of accident and health insurance or managed care
organization shall amend, deliver, issue, or renew a policy in
a way that changes an insured's eligibility or coverage during
a contract period. During a contract period, an insured shall
have the protection and continuity of his or her providers,
his or her medication, his or her covered benefits, and the
formulary during the contract period.
Section 10. The Illinois Public Aid Code is amended by
changing Section 5-16.8 as follows:
(305 ILCS 5/5-16.8)
Sec. 5-16.8. Required health benefits. The medical
assistance program shall (i) provide the post-mastectomy care
benefits required to be covered by a policy of accident and
health insurance under Section 356t and the coverage required

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under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
356z.47, 356z.51, 356z.53, 356z.56, 356z.59, and 356z.60, and
356z.61 of the Illinois Insurance Code, (ii) be subject to the
provisions of Sections 356z.19, 356z.44, 356z.49, 364.01,
370c, and 370c.1 of the Illinois Insurance Code, and (iii) be
subject to the provisions of subsection (d-5) of Section 10 of
the Network Adequacy and Transparency Act.
The Department, by rule, shall adopt a model similar to
the requirements of Section 356z.39 of the Illinois Insurance
Code.
On and after July 1, 2012, the Department shall reduce any
rate of reimbursement for services or other payments or alter
any methodologies authorized by this Code to reduce any rate
of reimbursement for services or other payments in accordance
with Section 5-5e.
To ensure full access to the benefits set forth in this
Section, on and after January 1, 2016, the Department shall
ensure that provider and hospital reimbursement for
post-mastectomy care benefits required under this Section are
no lower than the Medicare reimbursement rate.
(Source: P.A. 101-81, eff. 7-12-19; 101-218, eff. 1-1-20;
101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-574, eff.
1-1-20; 101-649, eff. 7-7-20; 102-30, eff. 1-1-22; 102-144,
eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff.

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1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093,
eff. 1-1-23; 102-1117, eff. 1-13-23.)