Bill Text: IL HB1076 | 2025-2026 | 104th General Assembly | Introduced

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Bill Title: Amends the Illinois Insurance Code. Provides that any individual or group policy of accident or health insurance that is delivered, extended, renewed, or modified after January 1, 2026 must provide coverage for at least one 6-month supply of each of the following for each infant covered by the policy: an early egg allergen introduction dietary supplement prescribed by a health care practitioner; and an early peanut allergen introduction dietary supplement prescribed by a health care practitioner. Provides that the coverage shall be provided without cost-sharing, except to the extent the cost-sharing limitation would cause a catastrophic plan to fail to be treated as a catastrophic plan under the Patient Protection and Affordable Care Act or would keep a high-deductible health plan from being treated as a high-deductible health plan or to the extent the cost-sharing limitation would disqualify the plan from a health savings account. Amends the State Employees Group Insurance Act of 1971 and the Medical Assistance Article of the Illinois Public Aid Code to require that coverage. Effective immediately.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2025-01-09 - Referred to Rules Committee [HB1076 Detail]

Download: Illinois-2025-HB1076-Introduced.html

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104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB1076 Introduced , by Rep. Margaret Croke SYNOPSIS AS INTRODUCED:
5 ILCS 375/6.11
215 ILCS 5/356z.80 new
305 ILCS 5/5-16.8
Amends the Illinois Insurance Code. Provides that any individual or group policy of accident or health insurance that is delivered, extended, renewed, or modified after January 1, 2026 must provide coverage for at least one 6-month supply of each of the following for each infant covered by the policy: an early egg allergen introduction dietary supplement prescribed by a health care practitioner; and an early peanut allergen introduction dietary supplement prescribed by a health care practitioner. Provides that the coverage shall be provided without cost-sharing, except to the extent the cost-sharing limitation would cause a catastrophic plan to fail to be treated as a catastrophic plan under the Patient Protection and Affordable Care Act or would keep a high-deductible health plan from being treated as a high-deductible health plan or to the extent the cost-sharing limitation would disqualify the plan from a health savings account. Amends the State Employees Group Insurance Act of 1971 and the Medical Assistance Article of the Illinois Public Aid Code to require that coverage. Effective immediately.
LRB104 05517 RPS 15546 b
A BILL FOR
HB1076 LRB104 05517 RPS 15546 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Section 6.11 as follows:
(5 ILCS 375/6.11)
Sec. 6.11. Required health benefits; Illinois Insurance
Code requirements. The program of health benefits shall
provide the post-mastectomy care benefits required to be
covered by a policy of accident and health insurance under
Section 356t of the Illinois Insurance Code. The program of
health benefits shall provide the coverage required under
Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10,
356w, 356x, 356z.2, 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.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59,
356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, and
356z.70, and 356z.71, 356z.74, 356z.76, 356z.77, and 356z.80
of the Illinois Insurance Code. The program of health benefits
must comply with Sections 155.22a, 155.37, 355b, 356z.19,
370c, and 370c.1 and Article XXXIIB of the Illinois Insurance

HB1076 - 2 - LRB104 05517 RPS 15546 b
Code. The program of health benefits shall provide the
coverage required under Section 356m of the Illinois Insurance
Code and, for the employees of the State Employee Group
Insurance Program only, the coverage as also provided in
Section 6.11B of this Act. The Department of Insurance shall
enforce the requirements of this Section with respect to
Sections 370c and 370c.1 of the Illinois Insurance Code; all
other requirements of this Section shall be enforced by the
Department of Central Management Services.
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; 102-103, eff. 1-1-22;
102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768,
eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
1-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84,
eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24;
103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff.
8-11-23; 103-605, eff. 7-1-24; 103-718, eff. 7-19-24; 103-751,
eff. 8-2-24; 103-870, eff. 1-1-25; 103-914, eff. 1-1-25;
103-918, eff. 1-1-25; 103-951, eff. 1-1-25; 103-1024, eff.

HB1076 - 3 - LRB104 05517 RPS 15546 b
1-1-25; revised 11-26-24.)
Section 10. The Illinois Insurance Code is amended by
adding Section 356z.80 as follows:
(215 ILCS 5/356z.80 new)
Sec. 356z.80. Coverage for allergenic protein dietary
supplements.
(a) In this Section:
"Dietary supplement" has the meaning given to that term in
the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. 321.
"Early egg allergen introduction dietary supplement" means
a dietary supplement that is prescribed to an infant by a
health care practitioner and that contains a concentration of
infant-safe, well-cooked egg protein sufficient to reduce the
risk of the infant acquiring an allergy to eggs.
"Early peanut allergen introduction dietary supplement"
means a dietary supplement that is prescribed to an infant by a
health care practitioner and that contains a concentration of
infant-safe peanut protein sufficient to reduce the risk of
the infant acquiring an allergy to peanuts.
"Health care practitioner" means a physician licensed to
practice medicine in all its branches under the Medical
Practice Act of 1987, a physician assistant under the
Physician Assistant Practice Act of 1987 with prescriptive
authority, or an advanced practice registered nurse with

HB1076 - 4 - LRB104 05517 RPS 15546 b
prescriptive authority under Article 65 of the Nurse Practice
Act.
"Infant" means a child who has not attained the age of one
year.
(b)(1) Any individual or group policy of accident or
health insurance that is delivered, extended, renewed, or
modified after January 1, 2026 must provide coverage for at
least one 6-month supply of each of the following for each
infant covered by the policy:
(A) an early egg allergen introduction dietary
supplement; and
(B) an early peanut allergen introduction dietary
supplement.
(2) The coverage required under paragraph (1) of this
subsection shall be provided without cost sharing.
(c)(1) This Section does not apply to accident-only,
specified disease, hospital indemnity, Medicare supplement,
long-term care, disability income, or other limited benefit
health insurance policies.
(2) The cost-sharing limitation under paragraph (2) of
subsection (b) does not apply to any catastrophic plan to the
extent limiting cost sharing would cause the plan to fail to be
treated as a catastrophic plan under subsection (e) of Section
1302 of the Patient Protection and Affordable Care Act, 42
U.S.C. 18022(e).
(3) The cost-sharing limitation provision under paragraph

HB1076 - 5 - LRB104 05517 RPS 15546 b
(2) of subsection (b) does not apply to a high-deductible
health plan to the extent the cost-sharing limitation would
disqualify the plan from being treated as a high-deductible
health plan or to the extent it would disqualify the plan from
eligibility for a health savings account under Section 223 of
the Internal Revenue Code.
Section 15. 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
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.59, 356z.60, 356z.61, 356z.64,
and 356z.67, and 356z.71, 356z.75, and 356z.80 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

HB1076 - 6 - LRB104 05517 RPS 15546 b
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. 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. 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; 103-84, eff. 1-1-24; 103-91, eff.
1-1-24; 103-420, eff. 1-1-24; 103-605, eff. 7-1-24; 103-703,
eff. 1-1-25; 103-758, eff. 1-1-25; 103-1024, eff. 1-1-25;
revised 11-26-24.)