Bill Text: IL HB0235 | 2015-2016 | 99th General Assembly | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the Illinois Insurance Code. Provides that individual or group policies of accident and health insurance amended, delivered, issued, or renewed after the effective date of the Act shall cover charges incurred, and anesthetics provided, in conjunction with dental care that is provided to a covered individual in a dental office, oral surgeon's office, hospital, or ambulatory surgical treatment center if the individual is under age 26 and has been diagnosed with an autism spectrum disorder as defined in Section 10 of the Autism Spectrum Disorders Reporting Act.
Spectrum: Strong Partisan Bill (Democrat 53-4)
Status: (Passed) 2015-07-27 - Public Act . . . . . . . . . 99-0141 [HB0235 Detail]
Download: Illinois-2015-HB0235-Engrossed.html
Bill Title: Amends the Illinois Insurance Code. Provides that individual or group policies of accident and health insurance amended, delivered, issued, or renewed after the effective date of the Act shall cover charges incurred, and anesthetics provided, in conjunction with dental care that is provided to a covered individual in a dental office, oral surgeon's office, hospital, or ambulatory surgical treatment center if the individual is under age 26 and has been diagnosed with an autism spectrum disorder as defined in Section 10 of the Autism Spectrum Disorders Reporting Act.
Spectrum: Strong Partisan Bill (Democrat 53-4)
Status: (Passed) 2015-07-27 - Public Act . . . . . . . . . 99-0141 [HB0235 Detail]
Download: Illinois-2015-HB0235-Engrossed.html
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1 | AN ACT concerning insurance.
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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 Illinois Insurance Code is amended by | ||||||
5 | changing Section 356z.2 as follows:
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6 | (215 ILCS 5/356z.2)
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7 | Sec. 356z.2. Coverage for adjunctive services in dental | ||||||
8 | care.
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9 | (a) An individual or group policy of accident and health | ||||||
10 | insurance
amended, delivered, issued, or renewed after the | ||||||
11 | effective date of this
amendatory Act of the 92nd General | ||||||
12 | Assembly shall cover
charges incurred, and anesthetics | ||||||
13 | provided, in
conjunction with dental care that is provided to a | ||||||
14 | covered individual in a
hospital or
an ambulatory surgical | ||||||
15 | treatment center
if any of the
following
applies:
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16 | (1) the individual is a child age 6 or under;
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17 | (2) the individual has a medical condition that | ||||||
18 | requires
hospitalization or general anesthesia for dental | ||||||
19 | care; or
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20 | (3) the individual is disabled.
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21 | (a-5) An individual or group policy of accident and health | ||||||
22 | insurance amended, delivered, issued, or renewed after the | ||||||
23 | effective date of this amendatory Act of the 99th General |
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1 | Assembly shall cover charges incurred, and anesthetics | ||||||
2 | provided, in conjunction with dental care that is provided to a | ||||||
3 | covered individual in a dental office, oral surgeon's office, | ||||||
4 | hospital, or ambulatory surgical treatment center if the | ||||||
5 | individual is under age 26 and has been diagnosed with an | ||||||
6 | autism spectrum disorder as defined in Section 10 of the Autism | ||||||
7 | Spectrum Disorders Reporting Act or a developmental | ||||||
8 | disability. | ||||||
9 | For purposes of this subsection, "developmental | ||||||
10 | disability" means a disability that is attributable to an | ||||||
11 | intellectual disability or a related condition, if the related | ||||||
12 | condition meets all of the following conditions: | ||||||
13 | (1) it is attributable to cerebral palsy, epilepsy, or | ||||||
14 | any other condition, other than mental illness, found to be | ||||||
15 | closely related to an intellectual disability because that | ||||||
16 | condition results in impairment of general intellectual | ||||||
17 | functioning or adaptive behavior similar to that of | ||||||
18 | individuals with an intellectual disability and requires | ||||||
19 | treatment or services similar to those required for those | ||||||
20 | individuals; for purposes of this definition, autism is | ||||||
21 | considered a related condition; | ||||||
22 | (2) it is manifested before the individual reaches age | ||||||
23 | 22; | ||||||
24 | (3) it is likely to continue indefinitely; and | ||||||
25 | (4) it results in substantial functional limitations | ||||||
26 | in 3 or more of the following areas of major life activity: |
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1 | self-care, language, learning, mobility, self-direction, | ||||||
2 | and capacity for independent living. | ||||||
3 | (b) For purposes of this Section, "ambulatory surgical | ||||||
4 | treatment center"
has the meaning given to that term in Section | ||||||
5 | 3 of the Ambulatory
Surgical Treatment Center Act.
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6 | For purposes of this Section, "disabled" means a person, | ||||||
7 | regardless of age,
with a chronic
disability if the chronic | ||||||
8 | disability meets all of the following conditions:
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9 | (1) It is attributable to a mental or physical | ||||||
10 | impairment or
combination of mental and physical | ||||||
11 | impairments.
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12 | (2) It is likely to continue.
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13 | (3) It results in substantial functional limitations | ||||||
14 | in one or more of
the following areas of major life | ||||||
15 | activity:
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16 | (A) self-care;
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17 | (B) receptive and expressive language;
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18 | (C) learning;
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19 | (D) mobility;
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20 | (E) capacity for independent living; or
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21 | (F) economic self-sufficiency.
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22 | (c) The coverage required under this Section may be subject | ||||||
23 | to any
limitations, exclusions, or cost-sharing provisions | ||||||
24 | that apply generally under
the insurance policy.
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25 | (d) This Section does not apply to a policy that covers | ||||||
26 | only dental care.
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1 | (e) Nothing in this Section requires that the dental | ||||||
2 | services be
covered.
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3 | (f) The provisions of this Section do not apply to | ||||||
4 | short-term travel,
accident-only, limited, or specified | ||||||
5 | disease policies, nor to policies or
contracts designed for | ||||||
6 | issuance to persons eligible for coverage under Title
XVIII of | ||||||
7 | the Social Security Act, known as Medicare, or any other | ||||||
8 | similar
coverage under State or federal governmental plans.
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9 | (Source: P.A. 95-331, eff. 8-21-07.)
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