Bill Text: IL HB3800 | 2025-2026 | 104th General Assembly | Introduced

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Bill Title: Amends the Burn Victims Relief Act. Dissolves the George Bailey Memorial Fund on June 30, 2025, or as soon thereafter as practical, and assigns any future deposits due to that Fund to the General Revenue Fund. Amends the Illinois Insurance Code. Requires every company licensed to do business in this State that is transacting the kind or kinds of business under Class 1, 2, or 3, as defined in the Code, to establish a customer affairs and information department to respond to policyholder inquiries and complaints. In provisions concerning kinds of agreements requiring approval, provides that the Director of Insurance has the right to request additional filing review and approval of all contracts that contribute to the statutory threshold trigger. Removes provisions concerning a working group related to the treatment and coverage of mental, emotional, nervous, or substance use disorders. Makes other changes. Amends the Dental Care Patient Protection Act. Makes changes concerning preemption of provisions. Amends the Health Maintenance Organization Act. Provides that health maintenance organizations are subject to provisions of the Illinois Insurance Code requiring coverage for certain at-home pregnancy tests and certain medically necessary treatments to address a major injury to the jaw. Amends the Network Adequacy and Transparency Act to make technical and combining changes to conform the changes made by Public Act 103-777 and 103-650. Amends the Limited Health Service Organization Act to make conforming changes. Amends the Criminal Code of 2012. Changes the definition of "insurance company". Effective immediately, except that certain changes to the Illinois Insurance Code are effective January 1, 2026 and certain other changes to the Illinois Insurance Code are effective 60 days after becoming law.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2025-02-18 - Referred to Rules Committee [HB3800 Detail]

Download: Illinois-2025-HB3800-Introduced.html

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104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3800 Introduced , by Rep. Bob Morgan SYNOPSIS AS INTRODUCED:
See Index
Amends the Burn Victims Relief Act. Dissolves the George Bailey Memorial Fund on June 30, 2025, or as soon thereafter as practical, and assigns any future deposits due to that Fund to the General Revenue Fund. Amends the Illinois Insurance Code. Requires every company licensed to do business in this State that is transacting the kind or kinds of business under Class 1, 2, or 3, as defined in the Code, to establish a customer affairs and information department to respond to policyholder inquiries and complaints. In provisions concerning kinds of agreements requiring approval, provides that the Director of Insurance has the right to request additional filing review and approval of all contracts that contribute to the statutory threshold trigger. Removes provisions concerning a working group related to the treatment and coverage of mental, emotional, nervous, or substance use disorders. Makes other changes. Amends the Dental Care Patient Protection Act. Makes changes concerning preemption of provisions. Amends the Health Maintenance Organization Act. Provides that health maintenance organizations are subject to provisions of the Illinois Insurance Code requiring coverage for certain at-home pregnancy tests and certain medically necessary treatments to address a major injury to the jaw. Amends the Network Adequacy and Transparency Act to make technical and combining changes to conform the changes made by Public Act 103-777 and 103-650. Amends the Limited Health Service Organization Act to make conforming changes. Amends the Criminal Code of 2012. Changes the definition of "insurance company". Effective immediately, except that certain changes to the Illinois Insurance Code are effective January 1, 2026 and certain other changes to the Illinois Insurance Code are effective 60 days after becoming law.
LRB104 09780 BAB 19846 b
A BILL FOR
HB3800 LRB104 09780 BAB 19846 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Burn Victims Relief Act is amended by
changing Section 10 as follows:
(20 ILCS 1410/10)
Sec. 10. Payments to the George Bailey Memorial Fund. The
George Bailey Memorial Fund is created as a special fund in the
State treasury. Funds received under Section 16-104d of the
Illinois Vehicle Code shall be repaid in full to the Fire Truck
Revolving Loan Fund, without the deduction of the 20%
administrative fee authorized in subsection (b) of Section 5,
upon receipt by the George Bailey Memorial Fund from the
person or his or her estate, trust, or heirs of any moneys from
a settlement for the injury that is the proximate cause of the
person's disability under this Act or moneys received from
Social Security disability benefits. Moneys in the George
Bailey Memorial Fund may only be used for the purposes set
forth in this Act. On June 30, 2025, or as soon thereafter as
practical, the State Comptroller shall direct the State
Treasurer to transfer the remaining balance from the George
Bailey Memorial Fund into the General Revenue Fund. Upon
completion of the transfer, the George Bailey Memorial Fund is

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dissolved, and any future deposits due to that Fund and any
outstanding obligations or liabilities of that Fund shall pass
to the General Revenue Fund.
(Source: P.A. 99-455, eff. 1-1-16; 100-987, eff. 7-1-19.)
Section 10. The Illinois Insurance Code is amended by
changing Sections 121-2.08, 143d, 174, 194, 356z.73, 368d,
370c.1, and 1563 and by renumbering and changing Section
356z.71 (as amended by Public Act 103-700) as follows:
(215 ILCS 5/121-2.08) (from Ch. 73, par. 733-2.08)
Sec. 121-2.08. Transactions in this State involving
contracts of insurance independently procured directly from an
unauthorized insurer by industrial insureds.
(a) As used in this Section:
"Exempt commercial purchaser" means exempt commercial
purchaser as the term is defined in subsection (1) of Section
445 of this Code.
"Home state" means home state as the term is defined in
subsection (1) of Section 445 of this Code.
"Industrial insured" means an insured:
(i) that procures the insurance of any risk or risks
of the kinds specified in Classes 2 and 3 of Section 4 of
this Code by use of the services of a full-time employee
who is a qualified risk manager or the services of a
regularly and continuously retained consultant who is a

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qualified risk manager;
(ii) that procures the insurance directly from an
unauthorized insurer without the services of an
intermediary insurance producer; and
(iii) that is an exempt commercial purchaser whose
home state is Illinois.
"Insurance producer" means insurance producer as the term
is defined in Section 500-10 of this Code.
"Qualified risk manager" means qualified risk manager as
the term is defined in subsection (1) of Section 445 of this
Code.
"Safety-Net Hospital" means an Illinois hospital that
qualifies as a Safety-Net Hospital under Section 5-5e.1 of the
Illinois Public Aid Code.
"Unauthorized insurer" means unauthorized insurer as the
term is defined in subsection (1) of Section 445 of this Code.
(b) For contracts of insurance effective January 1, 2015
or later, within 90 days after the effective date of each
contract of insurance issued under this Section, the insured
shall file a report with the Director by submitting the report
to the Surplus Line Association of Illinois in writing or in a
computer readable format and provide information as designated
by the Surplus Line Association of Illinois. The information
in the report shall be substantially similar to that required
for surplus line submissions as described in subsection (5) of
Section 445 of this Code. Where applicable, the report shall

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satisfy, with respect to the subject insurance, the reporting
requirement of Section 12 of the Fire Investigation Act.
(c) For contracts of insurance effective January 1, 2015
through December 31, 2017, within 30 days after filing the
report, the insured shall pay to the Director for the use and
benefit of the State a sum equal to the gross premium of the
contract of insurance multiplied by the surplus line tax rate,
as described in paragraph (3) of subsection (a) of Section 445
of this Code, and shall pay the fire marshal tax that would
otherwise be due annually in March for insurance subject to
tax under Section 12 of the Fire Investigation Act. For
contracts of insurance effective January 1, 2018 or later,
within 30 days after filing the report, the insured shall pay
to the Director for the use and benefit of the State a sum
equal to 0.5% of the gross premium of the contract of
insurance, and shall pay the fire marshal tax that would
otherwise be due annually in March for insurance subject to
tax under Section 12 of the Fire Investigation Act. For
contracts of insurance effective January 1, 2015 or later,
within 30 days after filing the report, the insured shall pay
to the Surplus Line Association of Illinois a countersigning
fee that shall be assessed at the same rate charged to members
pursuant to subsection (4) of Section 445.1 of this Code.
(d) For contracts of insurance effective January 1, 2015
or later, the insured shall withhold the amount of the taxes
and countersignature fee from the amount of premium charged by

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and otherwise payable to the insurer for the insurance. If the
insured fails to withhold the tax and countersignature fee
from the premium, then the insured shall be liable for the
amounts thereof and shall pay the amounts as prescribed in
subsection (c) of this Section.
(e) Contracts of insurance with an industrial insured that
qualifies as a Safety-Net Hospital are not subject to
subsections (b) through (d) of this Section.
(Source: P.A. 100-535, eff. 9-22-17; 100-1118, eff. 11-27-18.)
(215 ILCS 5/143d) (from Ch. 73, par. 755d)
Sec. 143d. Customer affairs and information department.
(a) Every company licensed to do business in this State
that is transacting the kind or kinds of business under Class
1, 2, or 3, of Section 4 of this Code issue policies of
insurance as defined in subsections (a) and (b) of Section
143.13 shall establish a customer affairs and information
department to respond to policyholder inquiries and
complaints. The department shall be staffed by an employee or
employees generally knowledgeable in the affairs and
operations of the company. The department shall be located in
either the home, regional, or branch office of the company and
must, during regular business hours, either maintain a toll
free telephone number or permit policyholders to call a
designated telephone number at the company's expense. The
telephone numbers shall be made available to policyholders in

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accordance with Section 143c 143(c).
(b) The customer affairs and information department shall
provide information and services that may reasonably be
requested by policyholders who are residents of this State and
must respond promptly to complaints made by policyholder.
Companies must provide a written response to written inquiries
and complaints within 21 days of receipt.
(c) Records of the customer affairs and information
department shall be maintained in compliance with Department
of Insurance regulations.
(Source: P.A. 86-1407.)
(215 ILCS 5/174) (from Ch. 73, par. 786)
Sec. 174. Kinds of agreements requiring approval.
(1) The following kinds of reinsurance agreements shall
not be entered into by any domestic company unless such
agreements are approved in writing by the Director:
(a) Agreements of reinsurance of any such company
transacting the kind or kinds of business enumerated in
Class 1 of Section 4, or as a Fraternal Benefit Society
under Article XVII, a Mutual Benefit Association under
Article XVIII, a Burial Society under Article XIX or an
Assessment Accident and Assessment Accident and Health
Company under Article XXI, cedes previously issued and
outstanding risks to any company, or cedes any risks to a
company not authorized to transact business in this State,

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or assumes any outstanding risks on which the aggregate
reserves and claim liabilities exceed 20% 20 percent of
the aggregate reserves and claim liabilities of the
assuming company, as reported in the preceding annual
statement, for the business of either life or accident and
health insurance.
(b) Any agreement or agreements of reinsurance whereby
any company transacting the kind or kinds of business
enumerated in either Class 2 or Class 3 of Section 4 cedes
to any company or companies at one time, or during a period
of six consecutive months more than 20% twenty per centum
of the total amount of its net previously retained
unearned premium reserve liability. The Director has the
right to request additional filing review and approval of
all contracts that contribute to the statutory threshold
trigger. As used in this Section, "net unearned premium
reserve liability" means a liability associated with
existing or in-force business that is not ceded to any
reinsurer before the effective date of the proposed
reinsurance contract.
(c) (Blank).
(2) Requests for approval shall be filed at least 30
working days prior to the stated effective date of the
agreement. An agreement which is not disapproved by the
Director within 30 working thirty days after its complete
submission shall be deemed approved.

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(Source: P.A. 98-969, eff. 1-1-15.)
(215 ILCS 5/194) (from Ch. 73, par. 806)
Sec. 194. Rights and liabilities of creditors fixed upon
liquidation.
(a) The rights and liabilities of the company and of its
creditors, policyholders, stockholders or members and all
other persons interested in its assets, except persons
entitled to file contingent claims, shall be fixed as of the
date of the entry of the Order directing liquidation or
rehabilitation unless otherwise provided by Order of the
Court. The rights of claimants entitled to file contingent
claims or to have their claims estimated shall be determined
as provided in Section 209.
(b) The Director may, within 2 years after the entry of an
order for rehabilitation or liquidation or within such further
time as applicable law permits, institute an action, claim,
suit, or proceeding upon any cause of action against which the
period of limitation fixed by applicable law has not expired
at the time of filing of the complaint upon which the order is
entered.
(c) The time between the filing of a complaint for
conservation, rehabilitation, or liquidation against the
company and the denial of the complaint shall not be
considered to be a part of the time within which any action may
be commenced against the company. Any action against the

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company that might have been commenced when the complaint was
filed may be commenced for at least 180 days after the
complaint is denied.
(d) Notwithstanding subsection (a) of this Section,
policies of life, disability income, long-term care, health
insurance or annuities covered by a guaranty association, or
portions of such policies covered by one or more guaranty
associations under applicable law shall continue in force,
subject to the terms of the policy (including any terms
restructured pursuant to a court-approved rehabilitation plan)
to the extent necessary to permit the guaranty associations to
discharge their statutory obligations. Policies of life,
disability income, long-term care, health insurance or
annuities, or portions of such policies not covered by one or
more guaranty associations shall terminate as provided under
subsection (a) of this Section and paragraph (6) of Section
193 of this Article, except to the extent the Director
proposes and the court approves the use of property of the
liquidation estate for the purpose of either (1) continuing
the contracts or coverage by transferring them to an assuming
reinsurer, or (2) distributing dividends under Section 210 of
this Article. Claims incurred during the extension of coverage
provided for in this Article shall be classified at priority
level (d) under paragraph (1) of Section 205 of this Article.
(Source: P.A. 88-297; 89-206, eff. 7-21-95.)

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(215 ILCS 5/356z.73)
Sec. 356z.73 356z.71. Insurance coverage for dependent
parents.
(a) A group or individual policy of accident and health
insurance issued, amended, delivered, or renewed on or after
January 1, 2026 that provides dependent coverage shall make
that dependent coverage available to the parent or stepparent
of the insured if the parent or stepparent meets the
definition of a qualifying relative under 26 U.S.C. 152(d) and
lives or resides within the accident and health insurance
policy's service area.
(b) This Section does not apply to specialized health care
service plans, Medicare supplement insurance, hospital-only
policies, accident-only policies, or specified disease
insurance policies that reimburse for hospital, medical, or
surgical expenses.
(Source: P.A. 103-700, eff. 1-1-25; revised 12-3-24.)
(215 ILCS 5/368d)
Sec. 368d. Recoupments.
(a) A health care professional or health care provider
shall be provided a remittance advice, which must include an
explanation of a recoupment or offset taken by an insurer,
health maintenance organization, independent practice
association, or physician hospital organization, if any. The
recoupment explanation shall, at a minimum, include the name

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of the patient; the date of service; the service code or if no
service code is available a service description; the
recoupment amount; and the reason for the recoupment or
offset. In addition, an insurer, health maintenance
organization, independent practice association, or physician
hospital organization shall provide with the remittance
advice, or with any demand for recoupment or offset, a
telephone number or mailing address to initiate an appeal of
the recoupment or offset together with the deadline for
initiating an appeal. Such information shall be prominently
displayed on the remittance advice or written document
containing the demand for recoupment or offset. Any appeal of
a recoupment or offset by a health care professional or health
care provider must be made within 60 days after receipt of the
remittance advice.
(b) It is not a recoupment when a health care professional
or health care provider is paid an amount prospectively or
concurrently under a contract with an insurer, health
maintenance organization, independent practice association, or
physician hospital organization that requires a retrospective
reconciliation based upon specific conditions outlined in the
contract.
(c) No recoupment or offset may be requested or withheld
from future payments 12 months or more after the original
payment is made, except in cases in which:
(1) a court, government administrative agency, other

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tribunal, or independent third-party arbitrator makes or
has made a formal finding of fraud or material
misrepresentation;
(2) an insurer is acting as a plan administrator for
the Comprehensive Health Insurance Plan under the
Comprehensive Health Insurance Plan Act;
(3) the provider has already been paid in full by any
other payer, third party, or workers' compensation
insurer; or
(4) an insurer contracted with the Department of
Healthcare and Family Services is required by the
Department of Healthcare and Family Services to recoup or
offset payments due to a federal Medicaid requirement.
No contract between an insurer and a health care professional
or health care provider may provide for recoupments in
violation of this Section. Nothing in this Section shall be
construed to preclude insurers, health maintenance
organizations, independent practice associations, or physician
hospital organizations from resolving coordination of benefits
between or among each other, including, but not limited to,
resolution of workers' compensation and third-party liability
cases, without recouping payment from the provider beyond the
12-month 18-month time limit provided in this subsection (c).
(Source: P.A. 102-632, eff. 1-1-22.)
(215 ILCS 5/370c.1)

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Sec. 370c.1. Mental, emotional, nervous, or substance use
disorder or condition parity.
(a) On and after July 23, 2021 (the effective date of
Public Act 102-135), every insurer that amends, delivers,
issues, or renews a group or individual policy of accident and
health insurance or a qualified health plan offered through
the Health Insurance Marketplace in this State providing
coverage for hospital or medical treatment and for the
treatment of mental, emotional, nervous, or substance use
disorders or conditions shall ensure prior to policy issuance
that:
(1) the financial requirements applicable to such
mental, emotional, nervous, or substance use disorder or
condition benefits are no more restrictive than the
predominant financial requirements applied to
substantially all hospital and medical benefits covered by
the policy and that there are no separate cost-sharing
requirements that are applicable only with respect to
mental, emotional, nervous, or substance use disorder or
condition benefits; and
(2) the treatment limitations applicable to such
mental, emotional, nervous, or substance use disorder or
condition benefits are no more restrictive than the
predominant treatment limitations applied to substantially
all hospital and medical benefits covered by the policy
and that there are no separate treatment limitations that

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are applicable only with respect to mental, emotional,
nervous, or substance use disorder or condition benefits.
(b) The following provisions shall apply concerning
aggregate lifetime limits:
(1) In the case of a group or individual policy of
accident and health insurance or a qualified health plan
offered through the Health Insurance Marketplace amended,
delivered, issued, or renewed in this State on or after
September 9, 2015 (the effective date of Public Act
99-480) that provides coverage for hospital or medical
treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions the
following provisions shall apply:
(A) if the policy does not include an aggregate
lifetime limit on substantially all hospital and
medical benefits, then the policy may not impose any
aggregate lifetime limit on mental, emotional,
nervous, or substance use disorder or condition
benefits; or
(B) if the policy includes an aggregate lifetime
limit on substantially all hospital and medical
benefits (in this subsection referred to as the
"applicable lifetime limit"), then the policy shall
either:
(i) apply the applicable lifetime limit both
to the hospital and medical benefits to which it

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otherwise would apply and to mental, emotional,
nervous, or substance use disorder or condition
benefits and not distinguish in the application of
the limit between the hospital and medical
benefits and mental, emotional, nervous, or
substance use disorder or condition benefits; or
(ii) not include any aggregate lifetime limit
on mental, emotional, nervous, or substance use
disorder or condition benefits that is less than
the applicable lifetime limit.
(2) In the case of a policy that is not described in
paragraph (1) of subsection (b) of this Section and that
includes no or different aggregate lifetime limits on
different categories of hospital and medical benefits, the
Director shall establish rules under which subparagraph
(B) of paragraph (1) of subsection (b) of this Section is
applied to such policy with respect to mental, emotional,
nervous, or substance use disorder or condition benefits
by substituting for the applicable lifetime limit an
average aggregate lifetime limit that is computed taking
into account the weighted average of the aggregate
lifetime limits applicable to such categories.
(c) The following provisions shall apply concerning annual
limits:
(1) In the case of a group or individual policy of
accident and health insurance or a qualified health plan

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offered through the Health Insurance Marketplace amended,
delivered, issued, or renewed in this State on or after
September 9, 2015 (the effective date of Public Act
99-480) that provides coverage for hospital or medical
treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions the
following provisions shall apply:
(A) if the policy does not include an annual limit
on substantially all hospital and medical benefits,
then the policy may not impose any annual limits on
mental, emotional, nervous, or substance use disorder
or condition benefits; or
(B) if the policy includes an annual limit on
substantially all hospital and medical benefits (in
this subsection referred to as the "applicable annual
limit"), then the policy shall either:
(i) apply the applicable annual limit both to
the hospital and medical benefits to which it
otherwise would apply and to mental, emotional,
nervous, or substance use disorder or condition
benefits and not distinguish in the application of
the limit between the hospital and medical
benefits and mental, emotional, nervous, or
substance use disorder or condition benefits; or
(ii) not include any annual limit on mental,
emotional, nervous, or substance use disorder or

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condition benefits that is less than the
applicable annual limit.
(2) In the case of a policy that is not described in
paragraph (1) of subsection (c) of this Section and that
includes no or different annual limits on different
categories of hospital and medical benefits, the Director
shall establish rules under which subparagraph (B) of
paragraph (1) of subsection (c) of this Section is applied
to such policy with respect to mental, emotional, nervous,
or substance use disorder or condition benefits by
substituting for the applicable annual limit an average
annual limit that is computed taking into account the
weighted average of the annual limits applicable to such
categories.
(d) With respect to mental, emotional, nervous, or
substance use disorders or conditions, an insurer shall use
policies and procedures for the election and placement of
mental, emotional, nervous, or substance use disorder or
condition treatment drugs on their formulary that are no less
favorable to the insured as those policies and procedures the
insurer uses for the selection and placement of drugs for
medical or surgical conditions and shall follow the expedited
coverage determination requirements for substance abuse
treatment drugs set forth in Section 45.2 of the Managed Care
Reform and Patient Rights Act.
(e) This Section shall be interpreted in a manner

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consistent with all applicable federal parity regulations
including, but not limited to, the Paul Wellstone and Pete
Domenici Mental Health Parity and Addiction Equity Act of
2008, final regulations issued under the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act of
2008 and final regulations applying the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act of
2008 to Medicaid managed care organizations, the Children's
Health Insurance Program, and alternative benefit plans.
(f) The provisions of subsections (b) and (c) of this
Section shall not be interpreted to allow the use of lifetime
or annual limits otherwise prohibited by State or federal law.
(g) As used in this Section:
"Financial requirement" includes deductibles, copayments,
coinsurance, and out-of-pocket maximums, but does not include
an aggregate lifetime limit or an annual limit subject to
subsections (b) and (c).
"Mental, emotional, nervous, or substance use disorder or
condition" means a condition or disorder that involves a
mental health condition or substance use disorder that falls
under any of the diagnostic categories listed in the mental
and behavioral disorders chapter of the current edition of the
International Classification of Disease or that is listed in
the most recent version of the Diagnostic and Statistical
Manual of Mental Disorders.
"Treatment limitation" includes limits on benefits based

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on the frequency of treatment, number of visits, days of
coverage, days in a waiting period, or other similar limits on
the scope or duration of treatment. "Treatment limitation"
includes both quantitative treatment limitations, which are
expressed numerically (such as 50 outpatient visits per year),
and nonquantitative treatment limitations, which otherwise
limit the scope or duration of treatment. A permanent
exclusion of all benefits for a particular condition or
disorder shall not be considered a treatment limitation.
"Nonquantitative treatment" means those limitations as
described under federal regulations (26 CFR 54.9812-1).
"Nonquantitative treatment limitations" include, but are not
limited to, those limitations described under federal
regulations 26 CFR 54.9812-1, 29 CFR 2590.712, and 45 CFR
146.136.
(h) The Department of Insurance shall implement the
following education initiatives:
(1) By January 1, 2016, the Department shall develop a
plan for a Consumer Education Campaign on parity. The
Consumer Education Campaign shall focus its efforts
throughout the State and include trainings in the
northern, southern, and central regions of the State, as
defined by the Department, as well as each of the 5 managed
care regions of the State as identified by the Department
of Healthcare and Family Services. Under this Consumer
Education Campaign, the Department shall: (1) by January

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1, 2017, provide at least one live training in each region
on parity for consumers and providers and one webinar
training to be posted on the Department website and (2)
establish a consumer hotline to assist consumers in
navigating the parity process by March 1, 2017. By January
1, 2018 the Department shall issue a report to the General
Assembly on the success of the Consumer Education
Campaign, which shall indicate whether additional training
is necessary or would be recommended.
(2) (Blank). The Department, in coordination with the
Department of Human Services and the Department of
Healthcare and Family Services, shall convene a working
group of health care insurance carriers, mental health
advocacy groups, substance abuse patient advocacy groups,
and mental health physician groups for the purpose of
discussing issues related to the treatment and coverage of
mental, emotional, nervous, or substance use disorders or
conditions and compliance with parity obligations under
State and federal law. Compliance shall be measured,
tracked, and shared during the meetings of the working
group. The working group shall meet once before January 1,
2016 and shall meet semiannually thereafter. The
Department shall issue an annual report to the General
Assembly that includes a list of the health care insurance
carriers, mental health advocacy groups, substance abuse
patient advocacy groups, and mental health physician

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groups that participated in the working group meetings,
details on the issues and topics covered, and any
legislative recommendations developed by the working
group.
(3) Not later than January 1 of each year, the
Department, in conjunction with the Department of
Healthcare and Family Services, shall issue a joint report
to the General Assembly and provide an educational
presentation to the General Assembly. The report and
presentation shall:
(A) Cover the methodology the Departments use to
check for compliance with the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008, 42 U.S.C. 18031(j), and any
federal regulations or guidance relating to the
compliance and oversight of the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008 and 42 U.S.C. 18031(j).
(B) Cover the methodology the Departments use to
check for compliance with this Section and Sections
356z.23 and 370c of this Code.
(C) Identify market conduct examinations or, in
the case of the Department of Healthcare and Family
Services, audits conducted or completed during the
preceding 12-month period regarding compliance with
parity in mental, emotional, nervous, and substance

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use disorder or condition benefits under State and
federal laws and summarize the results of such market
conduct examinations and audits. This shall include:
(i) the number of market conduct examinations
and audits initiated and completed;
(ii) the benefit classifications examined by
each market conduct examination and audit;
(iii) the subject matter of each market
conduct examination and audit, including
quantitative and nonquantitative treatment
limitations; and
(iv) a summary of the basis for the final
decision rendered in each market conduct
examination and audit.
Individually identifiable information shall be
excluded from the reports consistent with federal
privacy protections.
(D) Detail any educational or corrective actions
the Departments have taken to ensure compliance with
the federal Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008, 42
U.S.C. 18031(j), this Section, and Sections 356z.23
and 370c of this Code.
(E) The report must be written in non-technical,
readily understandable language and shall be made
available to the public by, among such other means as

HB3800 - 23 - LRB104 09780 BAB 19846 b
the Departments find appropriate, posting the report
on the Departments' websites.
(i) The Parity Advancement Fund is created as a special
fund in the State treasury. Moneys from fines and penalties
collected from insurers for violations of this Section shall
be deposited into the Fund. Moneys deposited into the Fund for
appropriation by the General Assembly to the Department shall
be used for the purpose of providing financial support of the
Consumer Education Campaign, parity compliance advocacy, and
other initiatives that support parity implementation and
enforcement on behalf of consumers.
(j) (Blank).
(j-5) The Department of Insurance shall collect the
following information:
(1) The number of employment disability insurance
plans offered in this State, including, but not limited
to:
(A) individual short-term policies;
(B) individual long-term policies;
(C) group short-term policies; and
(D) group long-term policies.
(2) The number of policies referenced in paragraph (1)
of this subsection that limit mental health and substance
use disorder benefits.
(3) The average defined benefit period for the
policies referenced in paragraph (1) of this subsection,

HB3800 - 24 - LRB104 09780 BAB 19846 b
both for those policies that limit and those policies that
have no limitation on mental health and substance use
disorder benefits.
(4) Whether the policies referenced in paragraph (1)
of this subsection are purchased on a voluntary or
non-voluntary basis.
(5) The identities of the individuals, entities, or a
combination of the 2 that assume the cost associated with
covering the policies referenced in paragraph (1) of this
subsection.
(6) The average defined benefit period for plans that
cover physical disability and mental health and substance
abuse without limitation, including, but not limited to:
(A) individual short-term policies;
(B) individual long-term policies;
(C) group short-term policies; and
(D) group long-term policies.
(7) The average premiums for disability income
insurance issued in this State for:
(A) individual short-term policies that limit
mental health and substance use disorder benefits;
(B) individual long-term policies that limit
mental health and substance use disorder benefits;
(C) group short-term policies that limit mental
health and substance use disorder benefits;
(D) group long-term policies that limit mental

HB3800 - 25 - LRB104 09780 BAB 19846 b
health and substance use disorder benefits;
(E) individual short-term policies that include
mental health and substance use disorder benefits
without limitation;
(F) individual long-term policies that include
mental health and substance use disorder benefits
without limitation;
(G) group short-term policies that include mental
health and substance use disorder benefits without
limitation; and
(H) group long-term policies that include mental
health and substance use disorder benefits without
limitation.
The Department shall present its findings regarding
information collected under this subsection (j-5) to the
General Assembly no later than April 30, 2024. Information
regarding a specific insurance provider's contributions to the
Department's report shall be exempt from disclosure under
paragraph (t) of subsection (1) of Section 7 of the Freedom of
Information Act. The aggregated information gathered by the
Department shall not be exempt from disclosure under paragraph
(t) of subsection (1) of Section 7 of the Freedom of
Information Act.
(k) An insurer that amends, delivers, issues, or renews a
group or individual policy of accident and health insurance or
a qualified health plan offered through the health insurance

HB3800 - 26 - LRB104 09780 BAB 19846 b
marketplace in this State providing coverage for hospital or
medical treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions shall submit
an annual report, the format and definitions for which will be
determined by the Department and the Department of Healthcare
and Family Services and posted on their respective websites,
starting on September 1, 2023 and annually thereafter, that
contains the following information separately for inpatient
in-network benefits, inpatient out-of-network benefits,
outpatient in-network benefits, outpatient out-of-network
benefits, emergency care benefits, and prescription drug
benefits in the case of accident and health insurance or
qualified health plans, or inpatient, outpatient, emergency
care, and prescription drug benefits in the case of medical
assistance:
(1) A summary of the plan's pharmacy management
processes for mental, emotional, nervous, or substance use
disorder or condition benefits compared to those for other
medical benefits.
(2) A summary of the internal processes of review for
experimental benefits and unproven technology for mental,
emotional, nervous, or substance use disorder or condition
benefits and those for other medical benefits.
(3) A summary of how the plan's policies and
procedures for utilization management for mental,
emotional, nervous, or substance use disorder or condition

HB3800 - 27 - LRB104 09780 BAB 19846 b
benefits compare to those for other medical benefits.
(4) A description of the process used to develop or
select the medical necessity criteria for mental,
emotional, nervous, or substance use disorder or condition
benefits and the process used to develop or select the
medical necessity criteria for medical and surgical
benefits.
(5) Identification of all nonquantitative treatment
limitations that are applied to both mental, emotional,
nervous, or substance use disorder or condition benefits
and medical and surgical benefits within each
classification of benefits.
(6) The results of an analysis that demonstrates that
for the medical necessity criteria described in
subparagraph (A) and for each nonquantitative treatment
limitation identified in subparagraph (B), as written and
in operation, the processes, strategies, evidentiary
standards, or other factors used in applying the medical
necessity criteria and each nonquantitative treatment
limitation to mental, emotional, nervous, or substance use
disorder or condition benefits within each classification
of benefits are comparable to, and are applied no more
stringently than, the processes, strategies, evidentiary
standards, or other factors used in applying the medical
necessity criteria and each nonquantitative treatment
limitation to medical and surgical benefits within the

HB3800 - 28 - LRB104 09780 BAB 19846 b
corresponding classification of benefits; at a minimum,
the results of the analysis shall:
(A) identify the factors used to determine that a
nonquantitative treatment limitation applies to a
benefit, including factors that were considered but
rejected;
(B) identify and define the specific evidentiary
standards used to define the factors and any other
evidence relied upon in designing each nonquantitative
treatment limitation;
(C) provide the comparative analyses, including
the results of the analyses, performed to determine
that the processes and strategies used to design each
nonquantitative treatment limitation, as written, for
mental, emotional, nervous, or substance use disorder
or condition benefits are comparable to, and are
applied no more stringently than, the processes and
strategies used to design each nonquantitative
treatment limitation, as written, for medical and
surgical benefits;
(D) provide the comparative analyses, including
the results of the analyses, performed to determine
that the processes and strategies used to apply each
nonquantitative treatment limitation, in operation,
for mental, emotional, nervous, or substance use
disorder or condition benefits are comparable to, and

HB3800 - 29 - LRB104 09780 BAB 19846 b
applied no more stringently than, the processes or
strategies used to apply each nonquantitative
treatment limitation, in operation, for medical and
surgical benefits; and
(E) disclose the specific findings and conclusions
reached by the insurer that the results of the
analyses described in subparagraphs (C) and (D)
indicate that the insurer is in compliance with this
Section and the Mental Health Parity and Addiction
Equity Act of 2008 and its implementing regulations,
which includes 42 CFR Parts 438, 440, and 457 and 45
CFR 146.136 and any other related federal regulations
found in the Code of Federal Regulations.
(7) Any other information necessary to clarify data
provided in accordance with this Section requested by the
Director, including information that may be proprietary or
have commercial value, under the requirements of Section
30 of the Viatical Settlements Act of 2009.
(l) An insurer that amends, delivers, issues, or renews a
group or individual policy of accident and health insurance or
a qualified health plan offered through the health insurance
marketplace in this State providing coverage for hospital or
medical treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions on or after
January 1, 2019 (the effective date of Public Act 100-1024)
shall, in advance of the plan year, make available to the

HB3800 - 30 - LRB104 09780 BAB 19846 b
Department or, with respect to medical assistance, the
Department of Healthcare and Family Services and to all plan
participants and beneficiaries the information required in
subparagraphs (C) through (E) of paragraph (6) of subsection
(k). For plan participants and medical assistance
beneficiaries, the information required in subparagraphs (C)
through (E) of paragraph (6) of subsection (k) shall be made
available on a publicly available website whose web address is
prominently displayed in plan and managed care organization
informational and marketing materials.
(m) In conjunction with its compliance examination program
conducted in accordance with the Illinois State Auditing Act,
the Auditor General shall undertake a review of compliance by
the Department and the Department of Healthcare and Family
Services with Section 370c and this Section. Any findings
resulting from the review conducted under this Section shall
be included in the applicable State agency's compliance
examination report. Each compliance examination report shall
be issued in accordance with Section 3-14 of the Illinois
State Auditing Act. A copy of each report shall also be
delivered to the head of the applicable State agency and
posted on the Auditor General's website.
(Source: P.A. 102-135, eff. 7-23-21; 102-579, eff. 8-25-21;
102-813, eff. 5-13-22; 103-94, eff. 1-1-24; 103-105, eff.
6-27-23; 103-605, eff. 7-1-24.)

HB3800 - 31 - LRB104 09780 BAB 19846 b
(215 ILCS 5/1563)
Sec. 1563. Fees. The fees required by this Article are as
follows:
(1) Public adjuster license fee of $250 for a person
who is a resident of Illinois and $500 for a person who is
not a resident of Illinois, payable once every 2 years.
(2) Business entity license fee of $250, payable once
every 2 years.
(3) Application fee of $50 for processing each request
to take the written examination for a public adjuster
license.
(Source: P.A. 100-863, eff. 8-14-18.)
Section 15. The Dental Care Patient Protection Act is
amended by changing Section 75 as follows:
(215 ILCS 109/75)
Sec. 75. Application of other law.
(a) All provisions of this Act and other applicable law
that are not in conflict with this Act shall apply to managed
care dental plans and other persons subject to this Act. To the
extent that any provision of this Act or rule under this Act
would prevent the application of any standard or requirement
under the Network Adequacy and Transparency Act to a plan that
is subject to both statutes, the Network Adequacy and
Transparency Act shall supersede this Act.

HB3800 - 32 - LRB104 09780 BAB 19846 b
(b) Solicitation of enrollees by a managed care entity
granted a certificate of authority or its representatives
shall not be construed to violate any provision of law
relating to solicitation or advertising by health
professionals.
(Source: P.A. 91-355, eff. 1-1-00.)
Section 20. The Network Adequacy and Transparency Act is
amended by changing Sections 5, 10, and 25 as follows:
(215 ILCS 124/5)
(Text of Section from P.A. 102-813)
Sec. 5. Definitions. In this Act:
"Authorized representative" means a person to whom a
beneficiary has given express written consent to represent the
beneficiary; a person authorized by law to provide substituted
consent for a beneficiary; or the beneficiary's treating
provider only when the beneficiary or his or her family member
is unable to provide consent.
"Beneficiary" means an individual, an enrollee, an
insured, a participant, or any other person entitled to
reimbursement for covered expenses of or the discounting of
provider fees for health care services under a program in
which the beneficiary has an incentive to utilize the services
of a provider that has entered into an agreement or
arrangement with an insurer.

HB3800 - 33 - LRB104 09780 BAB 19846 b
"Department" means the Department of Insurance.
"Director" means the Director of Insurance.
"Family caregiver" means a relative, partner, friend, or
neighbor who has a significant relationship with the patient
and administers or assists the patient with activities of
daily living, instrumental activities of daily living, or
other medical or nursing tasks for the quality and welfare of
that patient.
"Insurer" means any entity that offers individual or group
accident and health insurance, including, but not limited to,
health maintenance organizations, preferred provider
organizations, exclusive provider organizations, and other
plan structures requiring network participation, excluding the
medical assistance program under the Illinois Public Aid Code,
the State employees group health insurance program, workers
compensation insurance, and pharmacy benefit managers.
"Material change" means a significant reduction in the
number of providers available in a network plan, including,
but not limited to, a reduction of 10% or more in a specific
type of providers, the removal of a major health system that
causes a network to be significantly different from the
network when the beneficiary purchased the network plan, or
any change that would cause the network to no longer satisfy
the requirements of this Act or the Department's rules for
network adequacy and transparency.
"Network" means the group or groups of preferred providers

HB3800 - 34 - LRB104 09780 BAB 19846 b
providing services to a network plan.
"Network plan" means an individual or group policy of
accident and health insurance that either requires a covered
person to use or creates incentives, including financial
incentives, for a covered person to use providers managed,
owned, under contract with, or employed by the insurer.
"Ongoing course of treatment" means (1) treatment for a
life-threatening condition, which is a disease or condition
for which likelihood of death is probable unless the course of
the disease or condition is interrupted; (2) treatment for a
serious acute condition, defined as a disease or condition
requiring complex ongoing care that the covered person is
currently receiving, such as chemotherapy, radiation therapy,
or post-operative visits; (3) a course of treatment for a
health condition that a treating provider attests that
discontinuing care by that provider would worsen the condition
or interfere with anticipated outcomes; or (4) the third
trimester of pregnancy through the post-partum period.
"Preferred provider" means any provider who has entered,
either directly or indirectly, into an agreement with an
employer or risk-bearing entity relating to health care
services that may be rendered to beneficiaries under a network
plan.
"Providers" means physicians licensed to practice medicine
in all its branches, other health care professionals,
hospitals, or other health care institutions that provide

HB3800 - 35 - LRB104 09780 BAB 19846 b
health care services.
"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.
"Telehealth" has the meaning given to that term in Section
356z.22 of the Illinois Insurance Code.
"Telemedicine" has the meaning given to that term in
Section 49.5 of the Medical Practice Act of 1987.
"Tiered network" means a network that identifies and
groups some or all types of provider and facilities into
specific groups to which different provider reimbursement,
covered person cost-sharing or provider access requirements,
or any combination thereof, apply for the same services.
"Woman's principal health care provider" means a physician
licensed to practice medicine in all of its branches
specializing in obstetrics, gynecology, or family practice.
(Source: P.A. 102-92, eff. 7-9-21; 102-813, eff. 5-13-22.)
(Text of Section from P.A. 103-650)
Sec. 5. Definitions. In this Act:

HB3800 - 36 - LRB104 09780 BAB 19846 b
"Authorized representative" means a person to whom a
beneficiary has given express written consent to represent the
beneficiary; a person authorized by law to provide substituted
consent for a beneficiary; or the beneficiary's treating
provider only when the beneficiary or his or her family member
is unable to provide consent.
"Beneficiary" means an individual, an enrollee, an
insured, a participant, or any other person entitled to
reimbursement for covered expenses of or the discounting of
provider fees for health care services under a program in
which the beneficiary has an incentive to utilize the services
of a provider that has entered into an agreement or
arrangement with an issuer.
"Department" means the Department of Insurance.
"Essential community provider" has the meaning ascribed to
that term in 45 CFR 156.235.
"Excepted benefits" has the meaning ascribed to that term
in 42 U.S.C. 300gg-91(c) and implementing regulations.
"Excepted benefits" includes individual, group, or blanket
coverage.
"Exchange" has the meaning ascribed to that term in 45 CFR
155.20.
"Director" means the Director of Insurance.
"Family caregiver" means a relative, partner, friend, or
neighbor who has a significant relationship with the patient
and administers or assists the patient with activities of

HB3800 - 37 - LRB104 09780 BAB 19846 b
daily living, instrumental activities of daily living, or
other medical or nursing tasks for the quality and welfare of
that patient.
"Group health plan" has the meaning ascribed to that term
in Section 5 of the Illinois Health Insurance Portability and
Accountability Act.
"Health insurance coverage" has the meaning ascribed to
that term in Section 5 of the Illinois Health Insurance
Portability and Accountability Act. "Health insurance
coverage" does not include any coverage or benefits under
Medicare or under the medical assistance program established
under Article V of the Illinois Public Aid Code.
"Issuer" means a "health insurance issuer" as defined in
Section 5 of the Illinois Health Insurance Portability and
Accountability Act.
"Material change" means a significant reduction in the
number of providers available in a network plan, including,
but not limited to, a reduction of 10% or more in a specific
type of providers within any county, the removal of a major
health system that causes a network to be significantly
different within any county from the network when the
beneficiary purchased the network plan, or any change that
would cause the network to no longer satisfy the requirements
of this Act or the Department's rules for network adequacy and
transparency.
"Network" means the group or groups of preferred providers

HB3800 - 38 - LRB104 09780 BAB 19846 b
providing services to a network plan.
"Network plan" means an individual or group policy of
health insurance coverage that either requires a covered
person to use or creates incentives, including financial
incentives, for a covered person to use providers managed,
owned, under contract with, or employed by the issuer or by a
third party contracted to arrange, contract for, or administer
such provider-related incentives for the issuer.
"Ongoing course of treatment" means (1) treatment for a
life-threatening condition, which is a disease or condition
for which likelihood of death is probable unless the course of
the disease or condition is interrupted; (2) treatment for a
serious acute condition, defined as a disease or condition
requiring complex ongoing care that the covered person is
currently receiving, such as chemotherapy, radiation therapy,
post-operative visits, or a serious and complex condition as
defined under 42 U.S.C. 300gg-113(b)(2); (3) a course of
treatment for a health condition that a treating provider
attests that discontinuing care by that provider would worsen
the condition or interfere with anticipated outcomes; (4) the
third trimester of pregnancy through the post-partum period;
(5) undergoing a course of institutional or inpatient care
from the provider within the meaning of 42 U.S.C.
300gg-113(b)(1)(B); (6) being scheduled to undergo nonelective
surgery from the provider, including receipt of preoperative
or postoperative care from such provider with respect to such

HB3800 - 39 - LRB104 09780 BAB 19846 b
a surgery; (7) being determined to be terminally ill, as
determined under 42 U.S.C. 1395x(dd)(3)(A), and receiving
treatment for such illness from such provider; or (8) any
other treatment of a condition or disease that requires
repeated health care services pursuant to a plan of treatment
by a provider because of the potential for changes in the
therapeutic regimen or because of the potential for a
recurrence of symptoms.
"Preferred provider" means any provider who has entered,
either directly or indirectly, into an agreement with an
employer or risk-bearing entity relating to health care
services that may be rendered to beneficiaries under a network
plan.
"Providers" means physicians licensed to practice medicine
in all its branches, other health care professionals,
hospitals, or other health care institutions or facilities
that provide health care services.
"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.

HB3800 - 40 - LRB104 09780 BAB 19846 b
"Stand-alone dental plan" has the meaning ascribed to that
term in 45 CFR 156.400.
"Telehealth" has the meaning given to that term in Section
356z.22 of the Illinois Insurance Code.
"Telemedicine" has the meaning given to that term in
Section 49.5 of the Medical Practice Act of 1987.
"Tiered network" means a network that identifies and
groups some or all types of provider and facilities into
specific groups to which different provider reimbursement,
covered person cost-sharing or provider access requirements,
or any combination thereof, apply for the same services.
"Woman's principal health care provider" means a physician
licensed to practice medicine in all of its branches
specializing in obstetrics, gynecology, or family practice.
(Source: P.A. 102-92, eff. 7-9-21; 102-813, eff. 5-13-22;
103-650, eff. 1-1-25.)
(Text of Section from P.A. 103-718)
Sec. 5. Definitions. In this Act:
"Authorized representative" means a person to whom a
beneficiary has given express written consent to represent the
beneficiary; a person authorized by law to provide substituted
consent for a beneficiary; or the beneficiary's treating
provider only when the beneficiary or his or her family member
is unable to provide consent.
"Beneficiary" means an individual, an enrollee, an

HB3800 - 41 - LRB104 09780 BAB 19846 b
insured, a participant, or any other person entitled to
reimbursement for covered expenses of or the discounting of
provider fees for health care services under a program in
which the beneficiary has an incentive to utilize the services
of a provider that has entered into an agreement or
arrangement with an insurer.
"Department" means the Department of Insurance.
"Director" means the Director of Insurance.
"Family caregiver" means a relative, partner, friend, or
neighbor who has a significant relationship with the patient
and administers or assists the patient with activities of
daily living, instrumental activities of daily living, or
other medical or nursing tasks for the quality and welfare of
that patient.
"Insurer" means any entity that offers individual or group
accident and health insurance, including, but not limited to,
health maintenance organizations, preferred provider
organizations, exclusive provider organizations, and other
plan structures requiring network participation, excluding the
medical assistance program under the Illinois Public Aid Code,
the State employees group health insurance program, workers
compensation insurance, and pharmacy benefit managers.
"Material change" means a significant reduction in the
number of providers available in a network plan, including,
but not limited to, a reduction of 10% or more in a specific
type of providers, the removal of a major health system that

HB3800 - 42 - LRB104 09780 BAB 19846 b
causes a network to be significantly different from the
network when the beneficiary purchased the network plan, or
any change that would cause the network to no longer satisfy
the requirements of this Act or the Department's rules for
network adequacy and transparency.
"Network" means the group or groups of preferred providers
providing services to a network plan.
"Network plan" means an individual or group policy of
accident and health insurance that either requires a covered
person to use or creates incentives, including financial
incentives, for a covered person to use providers managed,
owned, under contract with, or employed by the insurer.
"Ongoing course of treatment" means (1) treatment for a
life-threatening condition, which is a disease or condition
for which likelihood of death is probable unless the course of
the disease or condition is interrupted; (2) treatment for a
serious acute condition, defined as a disease or condition
requiring complex ongoing care that the covered person is
currently receiving, such as chemotherapy, radiation therapy,
or post-operative visits; (3) a course of treatment for a
health condition that a treating provider attests that
discontinuing care by that provider would worsen the condition
or interfere with anticipated outcomes; or (4) the third
trimester of pregnancy through the post-partum period.
"Preferred provider" means any provider who has entered,
either directly or indirectly, into an agreement with an

HB3800 - 43 - LRB104 09780 BAB 19846 b
employer or risk-bearing entity relating to health care
services that may be rendered to beneficiaries under a network
plan.
"Providers" means physicians licensed to practice medicine
in all its branches, other health care professionals,
hospitals, or other health care institutions that provide
health care services.
"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.
"Telehealth" has the meaning given to that term in Section
356z.22 of the Illinois Insurance Code.
"Telemedicine" has the meaning given to that term in
Section 49.5 of the Medical Practice Act of 1987.
"Tiered network" means a network that identifies and
groups some or all types of provider and facilities into
specific groups to which different provider reimbursement,
covered person cost-sharing or provider access requirements,
or any combination thereof, apply for the same services.
(Source: P.A. 102-92, eff. 7-9-21; 102-813, eff. 5-13-22;

HB3800 - 44 - LRB104 09780 BAB 19846 b
103-718, eff. 7-19-24.)
(Text of Section from P.A. 103-777)
Sec. 5. Definitions. In this Act:
"Authorized representative" means a person to whom a
beneficiary has given express written consent to represent the
beneficiary; a person authorized by law to provide substituted
consent for a beneficiary; or the beneficiary's treating
provider only when the beneficiary or his or her family member
is unable to provide consent.
"Beneficiary" means an individual, an enrollee, an
insured, a participant, or any other person entitled to
reimbursement for covered expenses of or the discounting of
provider fees for health care services under a program in
which the beneficiary has an incentive to utilize the services
of a provider that has entered into an agreement or
arrangement with an insurer.
"Department" means the Department of Insurance.
"Director" means the Director of Insurance.
"Excepted benefits" has the meaning given to that term in
42 U.S.C. 300gg-91(c).
"Family caregiver" means a relative, partner, friend, or
neighbor who has a significant relationship with the patient
and administers or assists the patient with activities of
daily living, instrumental activities of daily living, or
other medical or nursing tasks for the quality and welfare of

HB3800 - 45 - LRB104 09780 BAB 19846 b
that patient.
"Insurer" means any entity that offers individual or group
accident and health insurance, including, but not limited to,
health maintenance organizations, preferred provider
organizations, exclusive provider organizations, and other
plan structures requiring network participation, excluding the
medical assistance program under the Illinois Public Aid Code,
the State employees group health insurance program, workers
compensation insurance, and pharmacy benefit managers.
"Material change" means a significant reduction in the
number of providers available in a network plan, including,
but not limited to, a reduction of 10% or more in a specific
type of providers, the removal of a major health system that
causes a network to be significantly different from the
network when the beneficiary purchased the network plan, or
any change that would cause the network to no longer satisfy
the requirements of this Act or the Department's rules for
network adequacy and transparency.
"Network" means the group or groups of preferred providers
providing services to a network plan.
"Network plan" means an individual or group policy of
accident and health insurance that either requires a covered
person to use or creates incentives, including financial
incentives, for a covered person to use providers managed,
owned, under contract with, or employed by the insurer.
"Ongoing course of treatment" means (1) treatment for a

HB3800 - 46 - LRB104 09780 BAB 19846 b
life-threatening condition, which is a disease or condition
for which likelihood of death is probable unless the course of
the disease or condition is interrupted; (2) treatment for a
serious acute condition, defined as a disease or condition
requiring complex ongoing care that the covered person is
currently receiving, such as chemotherapy, radiation therapy,
or post-operative visits; (3) a course of treatment for a
health condition that a treating provider attests that
discontinuing care by that provider would worsen the condition
or interfere with anticipated outcomes; or (4) the third
trimester of pregnancy through the post-partum period.
"Preferred provider" means any provider who has entered,
either directly or indirectly, into an agreement with an
employer or risk-bearing entity relating to health care
services that may be rendered to beneficiaries under a network
plan.
"Providers" means physicians licensed to practice medicine
in all its branches, other health care professionals,
hospitals, or other health care institutions that provide
health care services.
"Short-term, limited-duration health insurance coverage"
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

HB3800 - 47 - LRB104 09780 BAB 19846 b
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. has the meaning given to that term in
Section 5 of the Short-Term, Limited-Duration Health Insurance
Coverage Act.
"Stand-alone dental plan" has the meaning given to that
term in 45 CFR 156.400.
"Telehealth" has the meaning given to that term in Section
356z.22 of the Illinois Insurance Code.
"Telemedicine" has the meaning given to that term in
Section 49.5 of the Medical Practice Act of 1987.
"Tiered network" means a network that identifies and
groups some or all types of provider and facilities into
specific groups to which different provider reimbursement,
covered person cost-sharing or provider access requirements,
or any combination thereof, apply for the same services.
"Woman's principal health care provider" means a physician
licensed to practice medicine in all of its branches
specializing in obstetrics, gynecology, or family practice.
(Source: P.A. 102-92, eff. 7-9-21; 102-813, eff. 5-13-22;
103-777, eff. 1-1-25.)
(215 ILCS 124/10)
(Text of Section from P.A. 103-650)
Sec. 10. Network adequacy.

HB3800 - 48 - LRB104 09780 BAB 19846 b
(a) Before issuing, delivering, or renewing a network
plan, an issuer providing a network plan shall file a
description of all of the following with the Director:
(1) The written policies and procedures for adding
providers to meet patient needs based on increases in the
number of beneficiaries, changes in the
patient-to-provider ratio, changes in medical and health
care capabilities, and increased demand for services.
(2) The written policies and procedures for making
referrals within and outside the network.
(3) The written policies and procedures on how the
network plan will provide 24-hour, 7-day per week access
to network-affiliated primary care, emergency services,
and women's principal health care providers.
An issuer shall not prohibit a preferred provider from
discussing any specific or all treatment options with
beneficiaries irrespective of the insurer's position on those
treatment options or from advocating on behalf of
beneficiaries within the utilization review, grievance, or
appeals processes established by the issuer in accordance with
any rights or remedies available under applicable State or
federal law.
(b) Before issuing, delivering, or renewing a network
plan, an issuer must file for review a description of the
services to be offered through a network plan. The description
shall include all of the following:

HB3800 - 49 - LRB104 09780 BAB 19846 b
(1) A geographic map of the area proposed to be served
by the plan by county service area and zip code, including
marked locations for preferred providers.
(2) As deemed necessary by the Department, the names,
addresses, phone numbers, and specialties of the providers
who have entered into preferred provider agreements under
the network plan.
(3) The number of beneficiaries anticipated to be
covered by the network plan.
(4) An Internet website and toll-free telephone number
for beneficiaries and prospective beneficiaries to access
current and accurate lists of preferred providers in each
plan, additional information about the plan, as well as
any other information required by Department rule.
(5) A description of how health care services to be
rendered under the network plan are reasonably accessible
and available to beneficiaries. The description shall
address all of the following:
(A) the type of health care services to be
provided by the network plan;
(B) the ratio of physicians and other providers to
beneficiaries, by specialty and including primary care
physicians and facility-based physicians when
applicable under the contract, necessary to meet the
health care needs and service demands of the currently
enrolled population;

HB3800 - 50 - LRB104 09780 BAB 19846 b
(C) the travel and distance standards for plan
beneficiaries in county service areas; and
(D) a description of how the use of telemedicine,
telehealth, or mobile care services may be used to
partially meet the network adequacy standards, if
applicable.
(6) A provision ensuring that whenever a beneficiary
has made a good faith effort, as evidenced by accessing
the provider directory, calling the network plan, and
calling the provider, to utilize preferred providers for a
covered service and it is determined the insurer does not
have the appropriate preferred providers due to
insufficient number, type, unreasonable travel distance or
delay, or preferred providers refusing to provide a
covered service because it is contrary to the conscience
of the preferred providers, as protected by the Health
Care Right of Conscience Act, the issuer shall ensure,
directly or indirectly, by terms contained in the payer
contract, that the beneficiary will be provided the
covered service at no greater cost to the beneficiary than
if the service had been provided by a preferred provider.
This paragraph (6) does not apply to: (A) a beneficiary
who willfully chooses to access a non-preferred provider
for health care services available through the panel of
preferred providers, or (B) a beneficiary enrolled in a
health maintenance organization. In these circumstances,

HB3800 - 51 - LRB104 09780 BAB 19846 b
the contractual requirements for non-preferred provider
reimbursements shall apply unless Section 356z.3a of the
Illinois Insurance Code requires otherwise. In no event
shall a beneficiary who receives care at a participating
health care facility be required to search for
participating providers under the circumstances described
in subsection (b) or (b-5) of Section 356z.3a of the
Illinois Insurance Code except under the circumstances
described in paragraph (2) of subsection (b-5).
(7) A provision that the beneficiary shall receive
emergency care coverage such that payment for this
coverage is not dependent upon whether the emergency
services are performed by a preferred or non-preferred
provider and the coverage shall be at the same benefit
level as if the service or treatment had been rendered by a
preferred provider. For purposes of this paragraph (7),
"the same benefit level" means that the beneficiary is
provided the covered service at no greater cost to the
beneficiary than if the service had been provided by a
preferred provider. This provision shall be consistent
with Section 356z.3a of the Illinois Insurance Code.
(8) A limitation that, if the plan provides that the
beneficiary will incur a penalty for failing to
pre-certify inpatient hospital treatment, the penalty may
not exceed $1,000 per occurrence in addition to the plan
cost sharing provisions.

HB3800 - 52 - LRB104 09780 BAB 19846 b
(9) For a network plan to be offered through the
Exchange in the individual or small group market, as well
as any off-Exchange mirror of such a network plan,
evidence that the network plan includes essential
community providers in accordance with rules established
by the Exchange that will operate in this State for the
applicable plan year.
(c) The issuer shall demonstrate to the Director a minimum
ratio of providers to plan beneficiaries as required by the
Department for each network plan.
(1) The minimum ratio of physicians or other providers
to plan beneficiaries shall be established by the
Department in consultation with the Department of Public
Health based upon the guidance from the federal Centers
for Medicare and Medicaid Services. The Department shall
not establish ratios for vision or dental providers who
provide services under dental-specific or vision-specific
benefits, except to the extent provided under federal law
for stand-alone dental plans. The Department shall
consider establishing ratios for the following physicians
or other providers:
(A) Primary Care;
(B) Pediatrics;
(C) Cardiology;
(D) Gastroenterology;
(E) General Surgery;

HB3800 - 53 - LRB104 09780 BAB 19846 b
(F) Neurology;
(G) OB/GYN;
(H) Oncology/Radiation;
(I) Ophthalmology;
(J) Urology;
(K) Behavioral Health;
(L) Allergy/Immunology;
(M) Chiropractic;
(N) Dermatology;
(O) Endocrinology;
(P) Ears, Nose, and Throat (ENT)/Otolaryngology;
(Q) Infectious Disease;
(R) Nephrology;
(S) Neurosurgery;
(T) Orthopedic Surgery;
(U) Physiatry/Rehabilitative;
(V) Plastic Surgery;
(W) Pulmonary;
(X) Rheumatology;
(Y) Anesthesiology;
(Z) Pain Medicine;
(AA) Pediatric Specialty Services;
(BB) Outpatient Dialysis; and
(CC) HIV.
(2) The Director shall establish a process for the
review of the adequacy of these standards, along with an

HB3800 - 54 - LRB104 09780 BAB 19846 b
assessment of additional specialties to be included in the
list under this subsection (c).
(3) Notwithstanding any other law or rule, the minimum
ratio for each provider type shall be no less than any such
ratio established for qualified health plans in
Federally-Facilitated Exchanges by federal law or by the
federal Centers for Medicare and Medicaid Services, even
if the network plan is issued in the large group market or
is otherwise not issued through an exchange. Federal
standards for stand-alone dental plans shall only apply to
such network plans. In the absence of an applicable
Department rule, the federal standards shall apply for the
time period specified in the federal law, regulation, or
guidance. If the Centers for Medicare and Medicaid
Services establish standards that are more stringent than
the standards in effect under any Department rule, the
Department may amend its rules to conform to the more
stringent federal standards.
(d) The network plan shall demonstrate to the Director
maximum travel and distance standards and appointment wait
time standards for plan beneficiaries, which shall be
established by the Department in consultation with the
Department of Public Health based upon the guidance from the
federal Centers for Medicare and Medicaid Services. These
standards shall consist of the maximum minutes or miles to be
traveled by a plan beneficiary for each county type, such as

HB3800 - 55 - LRB104 09780 BAB 19846 b
large counties, metro counties, or rural counties as defined
by Department rule.
The maximum travel time and distance standards must
include standards for each physician and other provider
category listed for which ratios have been established.
The Director shall establish a process for the review of
the adequacy of these standards along with an assessment of
additional specialties to be included in the list under this
subsection (d).
Notwithstanding any other law or Department rule, the
maximum travel time and distance standards and appointment
wait time standards shall be no greater than any such
standards established for qualified health plans in
Federally-Facilitated Exchanges by federal law or by the
federal Centers for Medicare and Medicaid Services, even if
the network plan is issued in the large group market or is
otherwise not issued through an exchange. Federal standards
for stand-alone dental plans shall only apply to such network
plans. In the absence of an applicable Department rule, the
federal standards shall apply for the time period specified in
the federal law, regulation, or guidance. If the Centers for
Medicare and Medicaid Services establish standards that are
more stringent than the standards in effect under any
Department rule, the Department may amend its rules to conform
to the more stringent federal standards.
If the federal area designations for the maximum time or

HB3800 - 56 - LRB104 09780 BAB 19846 b
distance or appointment wait time standards required are
changed by the most recent Letter to Issuers in the
Federally-facilitated Marketplaces, the Department shall post
on its website notice of such changes and may amend its rules
to conform to those designations if the Director deems
appropriate.
(d-5)(1) Every issuer shall ensure that beneficiaries have
timely and proximate access to treatment for mental,
emotional, nervous, or substance use disorders or conditions
in accordance with the provisions of paragraph (4) of
subsection (a) of Section 370c of the Illinois Insurance Code.
Issuers shall use a comparable process, strategy, evidentiary
standard, and other factors in the development and application
of the network adequacy standards for timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions and those for the access
to treatment for medical and surgical conditions. As such, the
network adequacy standards for timely and proximate access
shall equally be applied to treatment facilities and providers
for mental, emotional, nervous, or substance use disorders or
conditions and specialists providing medical or surgical
benefits pursuant to the parity requirements of Section 370c.1
of the Illinois Insurance Code and the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008. Notwithstanding the foregoing, the network
adequacy standards for timely and proximate access to

HB3800 - 57 - LRB104 09780 BAB 19846 b
treatment for mental, emotional, nervous, or substance use
disorders or conditions shall, at a minimum, satisfy the
following requirements:
(A) For beneficiaries residing in the metropolitan
counties of Cook, DuPage, Kane, Lake, McHenry, and Will,
network adequacy standards for timely and proximate access
to treatment for mental, emotional, nervous, or substance
use disorders or conditions means a beneficiary shall not
have to travel longer than 30 minutes or 30 miles from the
beneficiary's residence to receive outpatient treatment
for mental, emotional, nervous, or substance use disorders
or conditions. Beneficiaries shall not be required to wait
longer than 10 business days between requesting an initial
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(B) For beneficiaries residing in Illinois counties
other than those counties listed in subparagraph (A) of

HB3800 - 58 - LRB104 09780 BAB 19846 b
this paragraph, network adequacy standards for timely and
proximate access to treatment for mental, emotional,
nervous, or substance use disorders or conditions means a
beneficiary shall not have to travel longer than 60
minutes or 60 miles from the beneficiary's residence to
receive outpatient treatment for mental, emotional,
nervous, or substance use disorders or conditions.
Beneficiaries shall not be required to wait longer than 10
business days between requesting an initial appointment
and being seen by the facility or provider of mental,
emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(2) For beneficiaries residing in all Illinois counties,
network adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions means a beneficiary shall not have to
travel longer than 60 minutes or 60 miles from the
beneficiary's residence to receive inpatient or residential

HB3800 - 59 - LRB104 09780 BAB 19846 b
treatment for mental, emotional, nervous, or substance use
disorders or conditions.
(3) If there is no in-network facility or provider
available for a beneficiary to receive timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions in accordance with the
network adequacy standards outlined in this subsection, the
issuer shall provide necessary exceptions to its network to
ensure admission and treatment with a provider or at a
treatment facility in accordance with the network adequacy
standards in this subsection.
(4) If the federal Centers for Medicare and Medicaid
Services establishes or law requires more stringent standards
for qualified health plans in the Federally-Facilitated
Exchanges, the federal standards shall control for all network
plans for the time period specified in the federal law,
regulation, or guidance, even if the network plan is issued in
the large group market, is issued through a different type of
Exchange, or is otherwise not issued through an Exchange.
(e) Except for network plans solely offered as a group
health plan, these ratio and time and distance standards apply
to the lowest cost-sharing tier of any tiered network.
(f) The network plan may consider use of other health care
service delivery options, such as telemedicine or telehealth,
mobile clinics, and centers of excellence, or other ways of
delivering care to partially meet the requirements set under

HB3800 - 60 - LRB104 09780 BAB 19846 b
this Section.
(g) Except for the requirements set forth in subsection
(d-5), insurers issuers who are not able to comply with the
provider ratios, and time and distance standards, and or
appointment wait-time wait time standards established under
this Act or federal law may request an exception to these
requirements from the Department. The Department may grant an
exception in the following circumstances:
(1) if no providers or facilities meet the specific
time and distance standard in a specific service area and
the issuer (i) discloses information on the distance and
travel time points that beneficiaries would have to travel
beyond the required criterion to reach the next closest
contracted provider outside of the service area and (ii)
provides contact information, including names, addresses,
and phone numbers for the next closest contracted provider
or facility;
(2) if patterns of care in the service area do not
support the need for the requested number of provider or
facility type and the issuer provides data on local
patterns of care, such as claims data, referral patterns,
or local provider interviews, indicating where the
beneficiaries currently seek this type of care or where
the physicians currently refer beneficiaries, or both; or
(3) other circumstances deemed appropriate by the
Department consistent with the requirements of this Act.

HB3800 - 61 - LRB104 09780 BAB 19846 b
(h) Issuers are required to report to the Director any
material change to an approved network plan within 15 business
days after the change occurs and any change that would result
in failure to meet the requirements of this Act. The issuer
shall submit a revised version of the portions of the network
adequacy filing affected by the material change, as determined
by the Director by rule, and the issuer shall attach versions
with the changes indicated for each document that was revised
from the previous version of the filing. Upon notice from the
issuer, the Director shall reevaluate the network plan's
compliance with the network adequacy and transparency
standards of this Act. For every day past 15 business days that
the issuer fails to submit a revised network adequacy filing
to the Director, the Director may order a fine of $5,000 per
day.
(i) If a network plan is inadequate under this Act with
respect to a provider type in a county, and if the network plan
does not have an approved exception for that provider type in
that county pursuant to subsection (g), an issuer shall cover
out-of-network claims for covered health care services
received from that provider type within that county at the
in-network benefit level and shall retroactively adjudicate
and reimburse beneficiaries to achieve that objective if their
claims were processed at the out-of-network level contrary to
this subsection. Nothing in this subsection shall be construed
to supersede Section 356z.3a of the Illinois Insurance Code.

HB3800 - 62 - LRB104 09780 BAB 19846 b
(j) If the Director determines that a network is
inadequate in any county and no exception has been granted
under subsection (g) and the issuer does not have a process in
place to comply with subsection (d-5), the Director may
prohibit the network plan from being issued or renewed within
that county until the Director determines that the network is
adequate apart from processes and exceptions described in
subsections (d-5) and (g). Nothing in this subsection shall be
construed to terminate any beneficiary's health insurance
coverage under a network plan before the expiration of the
beneficiary's policy period if the Director makes a
determination under this subsection after the issuance or
renewal of the beneficiary's policy or certificate because of
a material change. Policies or certificates issued or renewed
in violation of this subsection may subject the issuer to a
civil penalty of $5,000 per policy.
(k) For the Department to enforce any new or modified
federal standard before the Department adopts the standard by
rule, the Department must, no later than May 15 before the
start of the plan year, give public notice to the affected
health insurance issuers through a bulletin.
(Source: P.A. 102-144, eff. 1-1-22; 102-901, eff. 7-1-22;
102-1117, eff. 1-13-23; 103-650, eff. 1-1-25.)
(Text of Section from P.A. 103-656)
Sec. 10. Network adequacy.

HB3800 - 63 - LRB104 09780 BAB 19846 b
(a) An insurer providing a network plan shall file a
description of all of the following with the Director:
(1) The written policies and procedures for adding
providers to meet patient needs based on increases in the
number of beneficiaries, changes in the
patient-to-provider ratio, changes in medical and health
care capabilities, and increased demand for services.
(2) The written policies and procedures for making
referrals within and outside the network.
(3) The written policies and procedures on how the
network plan will provide 24-hour, 7-day per week access
to network-affiliated primary care, emergency services,
and women's principal health care providers.
An insurer shall not prohibit a preferred provider from
discussing any specific or all treatment options with
beneficiaries irrespective of the insurer's position on those
treatment options or from advocating on behalf of
beneficiaries within the utilization review, grievance, or
appeals processes established by the insurer in accordance
with any rights or remedies available under applicable State
or federal law.
(b) Insurers must file for review a description of the
services to be offered through a network plan. The description
shall include all of the following:
(1) A geographic map of the area proposed to be served
by the plan by county service area and zip code, including

HB3800 - 64 - LRB104 09780 BAB 19846 b
marked locations for preferred providers.
(2) As deemed necessary by the Department, the names,
addresses, phone numbers, and specialties of the providers
who have entered into preferred provider agreements under
the network plan.
(3) The number of beneficiaries anticipated to be
covered by the network plan.
(4) An Internet website and toll-free telephone number
for beneficiaries and prospective beneficiaries to access
current and accurate lists of preferred providers,
additional information about the plan, as well as any
other information required by Department rule.
(5) A description of how health care services to be
rendered under the network plan are reasonably accessible
and available to beneficiaries. The description shall
address all of the following:
(A) the type of health care services to be
provided by the network plan;
(B) the ratio of physicians and other providers to
beneficiaries, by specialty and including primary care
physicians and facility-based physicians when
applicable under the contract, necessary to meet the
health care needs and service demands of the currently
enrolled population;
(C) the travel and distance standards for plan
beneficiaries in county service areas; and

HB3800 - 65 - LRB104 09780 BAB 19846 b
(D) a description of how the use of telemedicine,
telehealth, or mobile care services may be used to
partially meet the network adequacy standards, if
applicable.
(6) A provision ensuring that whenever a beneficiary
has made a good faith effort, as evidenced by accessing
the provider directory, calling the network plan, and
calling the provider, to utilize preferred providers for a
covered service and it is determined the insurer does not
have the appropriate preferred providers due to
insufficient number, type, unreasonable travel distance or
delay, or preferred providers refusing to provide a
covered service because it is contrary to the conscience
of the preferred providers, as protected by the Health
Care Right of Conscience Act, the insurer shall ensure,
directly or indirectly, by terms contained in the payer
contract, that the beneficiary will be provided the
covered service at no greater cost to the beneficiary than
if the service had been provided by a preferred provider.
This paragraph (6) does not apply to: (A) a beneficiary
who willfully chooses to access a non-preferred provider
for health care services available through the panel of
preferred providers, or (B) a beneficiary enrolled in a
health maintenance organization. In these circumstances,
the contractual requirements for non-preferred provider
reimbursements shall apply unless Section 356z.3a of the

HB3800 - 66 - LRB104 09780 BAB 19846 b
Illinois Insurance Code requires otherwise. In no event
shall a beneficiary who receives care at a participating
health care facility be required to search for
participating providers under the circumstances described
in subsection (b) or (b-5) of Section 356z.3a of the
Illinois Insurance Code except under the circumstances
described in paragraph (2) of subsection (b-5).
(7) A provision that the beneficiary shall receive
emergency care coverage such that payment for this
coverage is not dependent upon whether the emergency
services are performed by a preferred or non-preferred
provider and the coverage shall be at the same benefit
level as if the service or treatment had been rendered by a
preferred provider. For purposes of this paragraph (7),
"the same benefit level" means that the beneficiary is
provided the covered service at no greater cost to the
beneficiary than if the service had been provided by a
preferred provider. This provision shall be consistent
with Section 356z.3a of the Illinois Insurance Code.
(8) A limitation that complies with subsections (d)
and (e) of Section 55 of the Prior Authorization Reform
Act.
(c) The network plan shall demonstrate to the Director a
minimum ratio of providers to plan beneficiaries as required
by the Department.
(1) The ratio of physicians or other providers to plan

HB3800 - 67 - LRB104 09780 BAB 19846 b
beneficiaries shall be established annually by the
Department in consultation with the Department of Public
Health based upon the guidance from the federal Centers
for Medicare and Medicaid Services. The Department shall
not establish ratios for vision or dental providers who
provide services under dental-specific or vision-specific
benefits. The Department shall consider establishing
ratios for the following physicians or other providers:
(A) Primary Care;
(B) Pediatrics;
(C) Cardiology;
(D) Gastroenterology;
(E) General Surgery;
(F) Neurology;
(G) OB/GYN;
(H) Oncology/Radiation;
(I) Ophthalmology;
(J) Urology;
(K) Behavioral Health;
(L) Allergy/Immunology;
(M) Chiropractic;
(N) Dermatology;
(O) Endocrinology;
(P) Ears, Nose, and Throat (ENT)/Otolaryngology;
(Q) Infectious Disease;
(R) Nephrology;

HB3800 - 68 - LRB104 09780 BAB 19846 b
(S) Neurosurgery;
(T) Orthopedic Surgery;
(U) Physiatry/Rehabilitative;
(V) Plastic Surgery;
(W) Pulmonary;
(X) Rheumatology;
(Y) Anesthesiology;
(Z) Pain Medicine;
(AA) Pediatric Specialty Services;
(BB) Outpatient Dialysis; and
(CC) HIV.
(2) The Director shall establish a process for the
review of the adequacy of these standards, along with an
assessment of additional specialties to be included in the
list under this subsection (c).
(d) The network plan shall demonstrate to the Director
maximum travel and distance standards for plan beneficiaries,
which shall be established annually by the Department in
consultation with the Department of Public Health based upon
the guidance from the federal Centers for Medicare and
Medicaid Services. These standards shall consist of the
maximum minutes or miles to be traveled by a plan beneficiary
for each county type, such as large counties, metro counties,
or rural counties as defined by Department rule.
The maximum travel time and distance standards must
include standards for each physician and other provider

HB3800 - 69 - LRB104 09780 BAB 19846 b
category listed for which ratios have been established.
The Director shall establish a process for the review of
the adequacy of these standards along with an assessment of
additional specialties to be included in the list under this
subsection (d).
(d-5)(1) Every insurer shall ensure that beneficiaries
have timely and proximate access to treatment for mental,
emotional, nervous, or substance use disorders or conditions
in accordance with the provisions of paragraph (4) of
subsection (a) of Section 370c of the Illinois Insurance Code.
Insurers shall use a comparable process, strategy, evidentiary
standard, and other factors in the development and application
of the network adequacy standards for timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions and those for the access
to treatment for medical and surgical conditions. As such, the
network adequacy standards for timely and proximate access
shall equally be applied to treatment facilities and providers
for mental, emotional, nervous, or substance use disorders or
conditions and specialists providing medical or surgical
benefits pursuant to the parity requirements of Section 370c.1
of the Illinois Insurance Code and the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008. Notwithstanding the foregoing, the network
adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use

HB3800 - 70 - LRB104 09780 BAB 19846 b
disorders or conditions shall, at a minimum, satisfy the
following requirements:
(A) For beneficiaries residing in the metropolitan
counties of Cook, DuPage, Kane, Lake, McHenry, and Will,
network adequacy standards for timely and proximate access
to treatment for mental, emotional, nervous, or substance
use disorders or conditions means a beneficiary shall not
have to travel longer than 30 minutes or 30 miles from the
beneficiary's residence to receive outpatient treatment
for mental, emotional, nervous, or substance use disorders
or conditions. Beneficiaries shall not be required to wait
longer than 10 business days between requesting an initial
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(B) For beneficiaries residing in Illinois counties
other than those counties listed in subparagraph (A) of
this paragraph, network adequacy standards for timely and

HB3800 - 71 - LRB104 09780 BAB 19846 b
proximate access to treatment for mental, emotional,
nervous, or substance use disorders or conditions means a
beneficiary shall not have to travel longer than 60
minutes or 60 miles from the beneficiary's residence to
receive outpatient treatment for mental, emotional,
nervous, or substance use disorders or conditions.
Beneficiaries shall not be required to wait longer than 10
business days between requesting an initial appointment
and being seen by the facility or provider of mental,
emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(2) For beneficiaries residing in all Illinois counties,
network adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions means a beneficiary shall not have to
travel longer than 60 minutes or 60 miles from the
beneficiary's residence to receive inpatient or residential
treatment for mental, emotional, nervous, or substance use

HB3800 - 72 - LRB104 09780 BAB 19846 b
disorders or conditions.
(3) If there is no in-network facility or provider
available for a beneficiary to receive timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions in accordance with the
network adequacy standards outlined in this subsection, the
insurer shall provide necessary exceptions to its network to
ensure admission and treatment with a provider or at a
treatment facility in accordance with the network adequacy
standards in this subsection.
(e) Except for network plans solely offered as a group
health plan, these ratio and time and distance standards apply
to the lowest cost-sharing tier of any tiered network.
(f) The network plan may consider use of other health care
service delivery options, such as telemedicine or telehealth,
mobile clinics, and centers of excellence, or other ways of
delivering care to partially meet the requirements set under
this Section.
(g) Except for the requirements set forth in subsection
(d-5), insurers who are not able to comply with the provider
ratios, and time and distance standards, and appointment
wait-time standards established under this Act or federal law
by the Department may request an exception to these
requirements from the Department. The Department may grant an
exception in the following circumstances:
(1) if no providers or facilities meet the specific

HB3800 - 73 - LRB104 09780 BAB 19846 b
time and distance standard in a specific service area and
the insurer (i) discloses information on the distance and
travel time points that beneficiaries would have to travel
beyond the required criterion to reach the next closest
contracted provider outside of the service area and (ii)
provides contact information, including names, addresses,
and phone numbers for the next closest contracted provider
or facility;
(2) if patterns of care in the service area do not
support the need for the requested number of provider or
facility type and the insurer provides data on local
patterns of care, such as claims data, referral patterns,
or local provider interviews, indicating where the
beneficiaries currently seek this type of care or where
the physicians currently refer beneficiaries, or both; or
(3) other circumstances deemed appropriate by the
Department consistent with the requirements of this Act.
(h) Insurers are required to report to the Director any
material change to an approved network plan within 15 days
after the change occurs and any change that would result in
failure to meet the requirements of this Act. Upon notice from
the insurer, the Director shall reevaluate the network plan's
compliance with the network adequacy and transparency
standards of this Act.
(Source: P.A. 102-144, eff. 1-1-22; 102-901, eff. 7-1-22;
102-1117, eff. 1-13-23; 103-656, eff. 1-1-25.)

HB3800 - 74 - LRB104 09780 BAB 19846 b
(Text of Section from P.A. 103-718)
Sec. 10. Network adequacy.
(a) An insurer providing a network plan shall file a
description of all of the following with the Director:
(1) The written policies and procedures for adding
providers to meet patient needs based on increases in the
number of beneficiaries, changes in the
patient-to-provider ratio, changes in medical and health
care capabilities, and increased demand for services.
(2) The written policies and procedures for making
referrals within and outside the network.
(3) The written policies and procedures on how the
network plan will provide 24-hour, 7-day per week access
to network-affiliated primary care, emergency services,
and obstetrical and gynecological health care
professionals.
An insurer shall not prohibit a preferred provider from
discussing any specific or all treatment options with
beneficiaries irrespective of the insurer's position on those
treatment options or from advocating on behalf of
beneficiaries within the utilization review, grievance, or
appeals processes established by the insurer in accordance
with any rights or remedies available under applicable State
or federal law.
(b) Insurers must file for review a description of the

HB3800 - 75 - LRB104 09780 BAB 19846 b
services to be offered through a network plan. The description
shall include all of the following:
(1) A geographic map of the area proposed to be served
by the plan by county service area and zip code, including
marked locations for preferred providers.
(2) As deemed necessary by the Department, the names,
addresses, phone numbers, and specialties of the providers
who have entered into preferred provider agreements under
the network plan.
(3) The number of beneficiaries anticipated to be
covered by the network plan.
(4) An Internet website and toll-free telephone number
for beneficiaries and prospective beneficiaries to access
current and accurate lists of preferred providers,
additional information about the plan, as well as any
other information required by Department rule.
(5) A description of how health care services to be
rendered under the network plan are reasonably accessible
and available to beneficiaries. The description shall
address all of the following:
(A) the type of health care services to be
provided by the network plan;
(B) the ratio of physicians and other providers to
beneficiaries, by specialty and including primary care
physicians and facility-based physicians when
applicable under the contract, necessary to meet the

HB3800 - 76 - LRB104 09780 BAB 19846 b
health care needs and service demands of the currently
enrolled population;
(C) the travel and distance standards for plan
beneficiaries in county service areas; and
(D) a description of how the use of telemedicine,
telehealth, or mobile care services may be used to
partially meet the network adequacy standards, if
applicable.
(6) A provision ensuring that whenever a beneficiary
has made a good faith effort, as evidenced by accessing
the provider directory, calling the network plan, and
calling the provider, to utilize preferred providers for a
covered service and it is determined the insurer does not
have the appropriate preferred providers due to
insufficient number, type, unreasonable travel distance or
delay, or preferred providers refusing to provide a
covered service because it is contrary to the conscience
of the preferred providers, as protected by the Health
Care Right of Conscience Act, the insurer shall ensure,
directly or indirectly, by terms contained in the payer
contract, that the beneficiary will be provided the
covered service at no greater cost to the beneficiary than
if the service had been provided by a preferred provider.
This paragraph (6) does not apply to: (A) a beneficiary
who willfully chooses to access a non-preferred provider
for health care services available through the panel of

HB3800 - 77 - LRB104 09780 BAB 19846 b
preferred providers, or (B) a beneficiary enrolled in a
health maintenance organization. In these circumstances,
the contractual requirements for non-preferred provider
reimbursements shall apply unless Section 356z.3a of the
Illinois Insurance Code requires otherwise. In no event
shall a beneficiary who receives care at a participating
health care facility be required to search for
participating providers under the circumstances described
in subsection (b) or (b-5) of Section 356z.3a of the
Illinois Insurance Code except under the circumstances
described in paragraph (2) of subsection (b-5).
(7) A provision that the beneficiary shall receive
emergency care coverage such that payment for this
coverage is not dependent upon whether the emergency
services are performed by a preferred or non-preferred
provider and the coverage shall be at the same benefit
level as if the service or treatment had been rendered by a
preferred provider. For purposes of this paragraph (7),
"the same benefit level" means that the beneficiary is
provided the covered service at no greater cost to the
beneficiary than if the service had been provided by a
preferred provider. This provision shall be consistent
with Section 356z.3a of the Illinois Insurance Code.
(8) A limitation that, if the plan provides that the
beneficiary will incur a penalty for failing to
pre-certify inpatient hospital treatment, the penalty may

HB3800 - 78 - LRB104 09780 BAB 19846 b
not exceed $1,000 per occurrence in addition to the plan
cost-sharing provisions.
(c) The network plan shall demonstrate to the Director a
minimum ratio of providers to plan beneficiaries as required
by the Department.
(1) The ratio of physicians or other providers to plan
beneficiaries shall be established annually by the
Department in consultation with the Department of Public
Health based upon the guidance from the federal Centers
for Medicare and Medicaid Services. The Department shall
not establish ratios for vision or dental providers who
provide services under dental-specific or vision-specific
benefits. The Department shall consider establishing
ratios for the following physicians or other providers:
(A) Primary Care;
(B) Pediatrics;
(C) Cardiology;
(D) Gastroenterology;
(E) General Surgery;
(F) Neurology;
(G) OB/GYN;
(H) Oncology/Radiation;
(I) Ophthalmology;
(J) Urology;
(K) Behavioral Health;
(L) Allergy/Immunology;

HB3800 - 79 - LRB104 09780 BAB 19846 b
(M) Chiropractic;
(N) Dermatology;
(O) Endocrinology;
(P) Ears, Nose, and Throat (ENT)/Otolaryngology;
(Q) Infectious Disease;
(R) Nephrology;
(S) Neurosurgery;
(T) Orthopedic Surgery;
(U) Physiatry/Rehabilitative;
(V) Plastic Surgery;
(W) Pulmonary;
(X) Rheumatology;
(Y) Anesthesiology;
(Z) Pain Medicine;
(AA) Pediatric Specialty Services;
(BB) Outpatient Dialysis; and
(CC) HIV.
(2) The Director shall establish a process for the
review of the adequacy of these standards, along with an
assessment of additional specialties to be included in the
list under this subsection (c).
(d) The network plan shall demonstrate to the Director
maximum travel and distance standards for plan beneficiaries,
which shall be established annually by the Department in
consultation with the Department of Public Health based upon
the guidance from the federal Centers for Medicare and

HB3800 - 80 - LRB104 09780 BAB 19846 b
Medicaid Services. These standards shall consist of the
maximum minutes or miles to be traveled by a plan beneficiary
for each county type, such as large counties, metro counties,
or rural counties as defined by Department rule.
The maximum travel time and distance standards must
include standards for each physician and other provider
category listed for which ratios have been established.
The Director shall establish a process for the review of
the adequacy of these standards along with an assessment of
additional specialties to be included in the list under this
subsection (d).
(d-5)(1) Every insurer shall ensure that beneficiaries
have timely and proximate access to treatment for mental,
emotional, nervous, or substance use disorders or conditions
in accordance with the provisions of paragraph (4) of
subsection (a) of Section 370c of the Illinois Insurance Code.
Insurers shall use a comparable process, strategy, evidentiary
standard, and other factors in the development and application
of the network adequacy standards for timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions and those for the access
to treatment for medical and surgical conditions. As such, the
network adequacy standards for timely and proximate access
shall equally be applied to treatment facilities and providers
for mental, emotional, nervous, or substance use disorders or
conditions and specialists providing medical or surgical

HB3800 - 81 - LRB104 09780 BAB 19846 b
benefits pursuant to the parity requirements of Section 370c.1
of the Illinois Insurance Code and the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008. Notwithstanding the foregoing, the network
adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions shall, at a minimum, satisfy the
following requirements:
(A) For beneficiaries residing in the metropolitan
counties of Cook, DuPage, Kane, Lake, McHenry, and Will,
network adequacy standards for timely and proximate access
to treatment for mental, emotional, nervous, or substance
use disorders or conditions means a beneficiary shall not
have to travel longer than 30 minutes or 30 miles from the
beneficiary's residence to receive outpatient treatment
for mental, emotional, nervous, or substance use disorders
or conditions. Beneficiaries shall not be required to wait
longer than 10 business days between requesting an initial
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a

HB3800 - 82 - LRB104 09780 BAB 19846 b
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(B) For beneficiaries residing in Illinois counties
other than those counties listed in subparagraph (A) of
this paragraph, network adequacy standards for timely and
proximate access to treatment for mental, emotional,
nervous, or substance use disorders or conditions means a
beneficiary shall not have to travel longer than 60
minutes or 60 miles from the beneficiary's residence to
receive outpatient treatment for mental, emotional,
nervous, or substance use disorders or conditions.
Beneficiaries shall not be required to wait longer than 10
business days between requesting an initial appointment
and being seen by the facility or provider of mental,
emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(2) For beneficiaries residing in all Illinois counties,

HB3800 - 83 - LRB104 09780 BAB 19846 b
network adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions means a beneficiary shall not have to
travel longer than 60 minutes or 60 miles from the
beneficiary's residence to receive inpatient or residential
treatment for mental, emotional, nervous, or substance use
disorders or conditions.
(3) If there is no in-network facility or provider
available for a beneficiary to receive timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions in accordance with the
network adequacy standards outlined in this subsection, the
insurer shall provide necessary exceptions to its network to
ensure admission and treatment with a provider or at a
treatment facility in accordance with the network adequacy
standards in this subsection.
(e) Except for network plans solely offered as a group
health plan, these ratio and time and distance standards apply
to the lowest cost-sharing tier of any tiered network.
(f) The network plan may consider use of other health care
service delivery options, such as telemedicine or telehealth,
mobile clinics, and centers of excellence, or other ways of
delivering care to partially meet the requirements set under
this Section.
(g) Except for the requirements set forth in subsection
(d-5), insurers who are not able to comply with the provider

HB3800 - 84 - LRB104 09780 BAB 19846 b
ratios, and time and distance standards, and appointment
wait-time standards established under this Act or federal law
by the Department may request an exception to these
requirements from the Department. The Department may grant an
exception in the following circumstances:
(1) if no providers or facilities meet the specific
time and distance standard in a specific service area and
the insurer (i) discloses information on the distance and
travel time points that beneficiaries would have to travel
beyond the required criterion to reach the next closest
contracted provider outside of the service area and (ii)
provides contact information, including names, addresses,
and phone numbers for the next closest contracted provider
or facility;
(2) if patterns of care in the service area do not
support the need for the requested number of provider or
facility type and the insurer provides data on local
patterns of care, such as claims data, referral patterns,
or local provider interviews, indicating where the
beneficiaries currently seek this type of care or where
the physicians currently refer beneficiaries, or both; or
(3) other circumstances deemed appropriate by the
Department consistent with the requirements of this Act.
(h) Insurers are required to report to the Director any
material change to an approved network plan within 15 days
after the change occurs and any change that would result in

HB3800 - 85 - LRB104 09780 BAB 19846 b
failure to meet the requirements of this Act. Upon notice from
the insurer, the Director shall reevaluate the network plan's
compliance with the network adequacy and transparency
standards of this Act.
(Source: P.A. 102-144, eff. 1-1-22; 102-901, eff. 7-1-22;
102-1117, eff. 1-13-23; 103-718, eff. 7-19-24.)
(Text of Section from P.A. 103-777)
Sec. 10. Network adequacy.
(a) An insurer providing a network plan shall file a
description of all of the following with the Director:
(1) The written policies and procedures for adding
providers to meet patient needs based on increases in the
number of beneficiaries, changes in the
patient-to-provider ratio, changes in medical and health
care capabilities, and increased demand for services.
(2) The written policies and procedures for making
referrals within and outside the network.
(3) The written policies and procedures on how the
network plan will provide 24-hour, 7-day per week access
to network-affiliated primary care, emergency services,
and women's principal health care providers.
An insurer shall not prohibit a preferred provider from
discussing any specific or all treatment options with
beneficiaries irrespective of the insurer's position on those
treatment options or from advocating on behalf of

HB3800 - 86 - LRB104 09780 BAB 19846 b
beneficiaries within the utilization review, grievance, or
appeals processes established by the insurer in accordance
with any rights or remedies available under applicable State
or federal law.
(b) Insurers must file for review a description of the
services to be offered through a network plan. The description
shall include all of the following:
(1) A geographic map of the area proposed to be served
by the plan by county service area and zip code, including
marked locations for preferred providers.
(2) As deemed necessary by the Department, the names,
addresses, phone numbers, and specialties of the providers
who have entered into preferred provider agreements under
the network plan.
(3) The number of beneficiaries anticipated to be
covered by the network plan.
(4) An Internet website and toll-free telephone number
for beneficiaries and prospective beneficiaries to access
current and accurate lists of preferred providers,
additional information about the plan, as well as any
other information required by Department rule.
(5) A description of how health care services to be
rendered under the network plan are reasonably accessible
and available to beneficiaries. The description shall
address all of the following:
(A) the type of health care services to be

HB3800 - 87 - LRB104 09780 BAB 19846 b
provided by the network plan;
(B) the ratio of physicians and other providers to
beneficiaries, by specialty and including primary care
physicians and facility-based physicians when
applicable under the contract, necessary to meet the
health care needs and service demands of the currently
enrolled population;
(C) the travel and distance standards for plan
beneficiaries in county service areas; and
(D) a description of how the use of telemedicine,
telehealth, or mobile care services may be used to
partially meet the network adequacy standards, if
applicable.
(6) A provision ensuring that whenever a beneficiary
has made a good faith effort, as evidenced by accessing
the provider directory, calling the network plan, and
calling the provider, to utilize preferred providers for a
covered service and it is determined the insurer does not
have the appropriate preferred providers due to
insufficient number, type, unreasonable travel distance or
delay, or preferred providers refusing to provide a
covered service because it is contrary to the conscience
of the preferred providers, as protected by the Health
Care Right of Conscience Act, the insurer shall ensure,
directly or indirectly, by terms contained in the payer
contract, that the beneficiary will be provided the

HB3800 - 88 - LRB104 09780 BAB 19846 b
covered service at no greater cost to the beneficiary than
if the service had been provided by a preferred provider.
This paragraph (6) does not apply to: (A) a beneficiary
who willfully chooses to access a non-preferred provider
for health care services available through the panel of
preferred providers, or (B) a beneficiary enrolled in a
health maintenance organization. In these circumstances,
the contractual requirements for non-preferred provider
reimbursements shall apply unless Section 356z.3a of the
Illinois Insurance Code requires otherwise. In no event
shall a beneficiary who receives care at a participating
health care facility be required to search for
participating providers under the circumstances described
in subsection (b) or (b-5) of Section 356z.3a of the
Illinois Insurance Code except under the circumstances
described in paragraph (2) of subsection (b-5).
(7) A provision that the beneficiary shall receive
emergency care coverage such that payment for this
coverage is not dependent upon whether the emergency
services are performed by a preferred or non-preferred
provider and the coverage shall be at the same benefit
level as if the service or treatment had been rendered by a
preferred provider. For purposes of this paragraph (7),
"the same benefit level" means that the beneficiary is
provided the covered service at no greater cost to the
beneficiary than if the service had been provided by a

HB3800 - 89 - LRB104 09780 BAB 19846 b
preferred provider. This provision shall be consistent
with Section 356z.3a of the Illinois Insurance Code.
(8) A limitation that, if the plan provides that the
beneficiary will incur a penalty for failing to
pre-certify inpatient hospital treatment, the penalty may
not exceed $1,000 per occurrence in addition to the plan
cost sharing provisions.
(c) The network plan shall demonstrate to the Director a
minimum ratio of providers to plan beneficiaries as required
by the Department.
(1) The ratio of physicians or other providers to plan
beneficiaries shall be established annually by the
Department in consultation with the Department of Public
Health based upon the guidance from the federal Centers
for Medicare and Medicaid Services. The Department shall
not establish ratios for vision or dental providers who
provide services under dental-specific or vision-specific
benefits, except to the extent provided under federal law
for stand-alone dental plans. The Department shall
consider establishing ratios for the following physicians
or other providers:
(A) Primary Care;
(B) Pediatrics;
(C) Cardiology;
(D) Gastroenterology;
(E) General Surgery;

HB3800 - 90 - LRB104 09780 BAB 19846 b
(F) Neurology;
(G) OB/GYN;
(H) Oncology/Radiation;
(I) Ophthalmology;
(J) Urology;
(K) Behavioral Health;
(L) Allergy/Immunology;
(M) Chiropractic;
(N) Dermatology;
(O) Endocrinology;
(P) Ears, Nose, and Throat (ENT)/Otolaryngology;
(Q) Infectious Disease;
(R) Nephrology;
(S) Neurosurgery;
(T) Orthopedic Surgery;
(U) Physiatry/Rehabilitative;
(V) Plastic Surgery;
(W) Pulmonary;
(X) Rheumatology;
(Y) Anesthesiology;
(Z) Pain Medicine;
(AA) Pediatric Specialty Services;
(BB) Outpatient Dialysis; and
(CC) HIV.
(2) The Director shall establish a process for the
review of the adequacy of these standards, along with an

HB3800 - 91 - LRB104 09780 BAB 19846 b
assessment of additional specialties to be included in the
list under this subsection (c).
(3) If the federal Centers for Medicare and Medicaid
Services establishes minimum provider ratios for
stand-alone dental plans in the type of exchange in use in
this State for a given plan year, the Department shall
enforce those standards for stand-alone dental plans for
that plan year.
(d) The network plan shall demonstrate to the Director
maximum travel and distance standards for plan beneficiaries,
which shall be established annually by the Department in
consultation with the Department of Public Health based upon
the guidance from the federal Centers for Medicare and
Medicaid Services. These standards shall consist of the
maximum minutes or miles to be traveled by a plan beneficiary
for each county type, such as large counties, metro counties,
or rural counties as defined by Department rule.
The maximum travel time and distance standards must
include standards for each physician and other provider
category listed for which ratios have been established.
The Director shall establish a process for the review of
the adequacy of these standards along with an assessment of
additional specialties to be included in the list under this
subsection (d).
If the federal Centers for Medicare and Medicaid Services
establishes appointment wait-time standards for qualified

HB3800 - 92 - LRB104 09780 BAB 19846 b
health plans, including stand-alone dental plans, in the type
of exchange in use in this State for a given plan year, the
Department shall enforce those standards for the same types of
qualified health plans for that plan year. If the federal
Centers for Medicare and Medicaid Services establishes time
and distance standards for stand-alone dental plans in the
type of exchange in use in this State for a given plan year,
the Department shall enforce those standards for stand-alone
dental plans for that plan year.
(d-5)(1) Every insurer shall ensure that beneficiaries
have timely and proximate access to treatment for mental,
emotional, nervous, or substance use disorders or conditions
in accordance with the provisions of paragraph (4) of
subsection (a) of Section 370c of the Illinois Insurance Code.
Insurers shall use a comparable process, strategy, evidentiary
standard, and other factors in the development and application
of the network adequacy standards for timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions and those for the access
to treatment for medical and surgical conditions. As such, the
network adequacy standards for timely and proximate access
shall equally be applied to treatment facilities and providers
for mental, emotional, nervous, or substance use disorders or
conditions and specialists providing medical or surgical
benefits pursuant to the parity requirements of Section 370c.1
of the Illinois Insurance Code and the federal Paul Wellstone

HB3800 - 93 - LRB104 09780 BAB 19846 b
and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008. Notwithstanding the foregoing, the network
adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions shall, at a minimum, satisfy the
following requirements:
(A) For beneficiaries residing in the metropolitan
counties of Cook, DuPage, Kane, Lake, McHenry, and Will,
network adequacy standards for timely and proximate access
to treatment for mental, emotional, nervous, or substance
use disorders or conditions means a beneficiary shall not
have to travel longer than 30 minutes or 30 miles from the
beneficiary's residence to receive outpatient treatment
for mental, emotional, nervous, or substance use disorders
or conditions. Beneficiaries shall not be required to wait
longer than 10 business days between requesting an initial
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an

HB3800 - 94 - LRB104 09780 BAB 19846 b
appointment outside of these required time frames.
(B) For beneficiaries residing in Illinois counties
other than those counties listed in subparagraph (A) of
this paragraph, network adequacy standards for timely and
proximate access to treatment for mental, emotional,
nervous, or substance use disorders or conditions means a
beneficiary shall not have to travel longer than 60
minutes or 60 miles from the beneficiary's residence to
receive outpatient treatment for mental, emotional,
nervous, or substance use disorders or conditions.
Beneficiaries shall not be required to wait longer than 10
business days between requesting an initial appointment
and being seen by the facility or provider of mental,
emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(2) For beneficiaries residing in all Illinois counties,
network adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use

HB3800 - 95 - LRB104 09780 BAB 19846 b
disorders or conditions means a beneficiary shall not have to
travel longer than 60 minutes or 60 miles from the
beneficiary's residence to receive inpatient or residential
treatment for mental, emotional, nervous, or substance use
disorders or conditions.
(3) If there is no in-network facility or provider
available for a beneficiary to receive timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions in accordance with the
network adequacy standards outlined in this subsection, the
insurer shall provide necessary exceptions to its network to
ensure admission and treatment with a provider or at a
treatment facility in accordance with the network adequacy
standards in this subsection.
(4) If the federal Centers for Medicare and Medicaid
Services establishes a more stringent standard in any county
than specified in paragraph (1) or (2) of this subsection
(d-5) for qualified health plans in the type of exchange in use
in this State for a given plan year, the federal standard shall
apply in lieu of the standard in paragraph (1) or (2) of this
subsection (d-5) for qualified health plans for that plan
year.
(e) Except for network plans solely offered as a group
health plan, these ratio and time and distance standards apply
to the lowest cost-sharing tier of any tiered network.
(f) The network plan may consider use of other health care

HB3800 - 96 - LRB104 09780 BAB 19846 b
service delivery options, such as telemedicine or telehealth,
mobile clinics, and centers of excellence, or other ways of
delivering care to partially meet the requirements set under
this Section.
(g) Except for the requirements set forth in subsection
(d-5), insurers who are not able to comply with the provider
ratios, time and distance standards, and appointment wait-time
standards established under this Act or federal law may
request an exception to these requirements from the
Department. The Department may grant an exception in the
following circumstances:
(1) if no providers or facilities meet the specific
time and distance standard in a specific service area and
the insurer (i) discloses information on the distance and
travel time points that beneficiaries would have to travel
beyond the required criterion to reach the next closest
contracted provider outside of the service area and (ii)
provides contact information, including names, addresses,
and phone numbers for the next closest contracted provider
or facility;
(2) if patterns of care in the service area do not
support the need for the requested number of provider or
facility type and the insurer provides data on local
patterns of care, such as claims data, referral patterns,
or local provider interviews, indicating where the
beneficiaries currently seek this type of care or where

HB3800 - 97 - LRB104 09780 BAB 19846 b
the physicians currently refer beneficiaries, or both; or
(3) other circumstances deemed appropriate by the
Department consistent with the requirements of this Act.
(h) Insurers are required to report to the Director any
material change to an approved network plan within 15 days
after the change occurs and any change that would result in
failure to meet the requirements of this Act. Upon notice from
the insurer, the Director shall reevaluate the network plan's
compliance with the network adequacy and transparency
standards of this Act.
(Source: P.A. 102-144, eff. 1-1-22; 102-901, eff. 7-1-22;
102-1117, eff. 1-13-23; 103-777, eff. 1-1-25.)
(Text of Section from P.A. 103-906)
Sec. 10. Network adequacy.
(a) An insurer providing a network plan shall file a
description of all of the following with the Director:
(1) The written policies and procedures for adding
providers to meet patient needs based on increases in the
number of beneficiaries, changes in the
patient-to-provider ratio, changes in medical and health
care capabilities, and increased demand for services.
(2) The written policies and procedures for making
referrals within and outside the network.
(3) The written policies and procedures on how the
network plan will provide 24-hour, 7-day per week access

HB3800 - 98 - LRB104 09780 BAB 19846 b
to network-affiliated primary care, emergency services,
and women's principal health care providers.
An insurer shall not prohibit a preferred provider from
discussing any specific or all treatment options with
beneficiaries irrespective of the insurer's position on those
treatment options or from advocating on behalf of
beneficiaries within the utilization review, grievance, or
appeals processes established by the insurer in accordance
with any rights or remedies available under applicable State
or federal law.
(b) Insurers must file for review a description of the
services to be offered through a network plan. The description
shall include all of the following:
(1) A geographic map of the area proposed to be served
by the plan by county service area and zip code, including
marked locations for preferred providers.
(2) As deemed necessary by the Department, the names,
addresses, phone numbers, and specialties of the providers
who have entered into preferred provider agreements under
the network plan.
(3) The number of beneficiaries anticipated to be
covered by the network plan.
(4) An Internet website and toll-free telephone number
for beneficiaries and prospective beneficiaries to access
current and accurate lists of preferred providers,
additional information about the plan, as well as any

HB3800 - 99 - LRB104 09780 BAB 19846 b
other information required by Department rule.
(5) A description of how health care services to be
rendered under the network plan are reasonably accessible
and available to beneficiaries. The description shall
address all of the following:
(A) the type of health care services to be
provided by the network plan;
(B) the ratio of physicians and other providers to
beneficiaries, by specialty and including primary care
physicians and facility-based physicians when
applicable under the contract, necessary to meet the
health care needs and service demands of the currently
enrolled population;
(C) the travel and distance standards for plan
beneficiaries in county service areas; and
(D) a description of how the use of telemedicine,
telehealth, or mobile care services may be used to
partially meet the network adequacy standards, if
applicable.
(6) A provision ensuring that whenever a beneficiary
has made a good faith effort, as evidenced by accessing
the provider directory, calling the network plan, and
calling the provider, to utilize preferred providers for a
covered service and it is determined the insurer does not
have the appropriate preferred providers due to
insufficient number, type, unreasonable travel distance or

HB3800 - 100 - LRB104 09780 BAB 19846 b
delay, or preferred providers refusing to provide a
covered service because it is contrary to the conscience
of the preferred providers, as protected by the Health
Care Right of Conscience Act, the insurer shall ensure,
directly or indirectly, by terms contained in the payer
contract, that the beneficiary will be provided the
covered service at no greater cost to the beneficiary than
if the service had been provided by a preferred provider.
This paragraph (6) does not apply to: (A) a beneficiary
who willfully chooses to access a non-preferred provider
for health care services available through the panel of
preferred providers, or (B) a beneficiary enrolled in a
health maintenance organization. In these circumstances,
the contractual requirements for non-preferred provider
reimbursements shall apply unless Section 356z.3a of the
Illinois Insurance Code requires otherwise. In no event
shall a beneficiary who receives care at a participating
health care facility be required to search for
participating providers under the circumstances described
in subsection (b) or (b-5) of Section 356z.3a of the
Illinois Insurance Code except under the circumstances
described in paragraph (2) of subsection (b-5).
(7) A provision that the beneficiary shall receive
emergency care coverage such that payment for this
coverage is not dependent upon whether the emergency
services are performed by a preferred or non-preferred

HB3800 - 101 - LRB104 09780 BAB 19846 b
provider and the coverage shall be at the same benefit
level as if the service or treatment had been rendered by a
preferred provider. For purposes of this paragraph (7),
"the same benefit level" means that the beneficiary is
provided the covered service at no greater cost to the
beneficiary than if the service had been provided by a
preferred provider. This provision shall be consistent
with Section 356z.3a of the Illinois Insurance Code.
(8) A limitation that, if the plan provides that the
beneficiary will incur a penalty for failing to
pre-certify inpatient hospital treatment, the penalty may
not exceed $1,000 per occurrence in addition to the plan
cost sharing provisions.
(c) The network plan shall demonstrate to the Director a
minimum ratio of providers to plan beneficiaries as required
by the Department.
(1) The ratio of physicians or other providers to plan
beneficiaries shall be established annually by the
Department in consultation with the Department of Public
Health based upon the guidance from the federal Centers
for Medicare and Medicaid Services. The Department shall
not establish ratios for vision or dental providers who
provide services under dental-specific or vision-specific
benefits. The Department shall consider establishing
ratios for the following physicians or other providers:
(A) Primary Care;

HB3800 - 102 - LRB104 09780 BAB 19846 b
(B) Pediatrics;
(C) Cardiology;
(D) Gastroenterology;
(E) General Surgery;
(F) Neurology;
(G) OB/GYN;
(H) Oncology/Radiation;
(I) Ophthalmology;
(J) Urology;
(K) Behavioral Health;
(L) Allergy/Immunology;
(M) Chiropractic;
(N) Dermatology;
(O) Endocrinology;
(P) Ears, Nose, and Throat (ENT)/Otolaryngology;
(Q) Infectious Disease;
(R) Nephrology;
(S) Neurosurgery;
(T) Orthopedic Surgery;
(U) Physiatry/Rehabilitative;
(V) Plastic Surgery;
(W) Pulmonary;
(X) Rheumatology;
(Y) Anesthesiology;
(Z) Pain Medicine;
(AA) Pediatric Specialty Services;

HB3800 - 103 - LRB104 09780 BAB 19846 b
(BB) Outpatient Dialysis; and
(CC) HIV.
(1.5) Beginning January 1, 2026, every insurer shall
demonstrate to the Director that each in-network hospital
has at least one radiologist, pathologist,
anesthesiologist, and emergency room physician as a
preferred provider in a network plan. The Department may,
by rule, require additional types of hospital-based
medical specialists to be included as preferred providers
in each in-network hospital in a network plan.
(2) The Director shall establish a process for the
review of the adequacy of these standards, along with an
assessment of additional specialties to be included in the
list under this subsection (c).
(d) The network plan shall demonstrate to the Director
maximum travel and distance standards for plan beneficiaries,
which shall be established annually by the Department in
consultation with the Department of Public Health based upon
the guidance from the federal Centers for Medicare and
Medicaid Services. These standards shall consist of the
maximum minutes or miles to be traveled by a plan beneficiary
for each county type, such as large counties, metro counties,
or rural counties as defined by Department rule.
The maximum travel time and distance standards must
include standards for each physician and other provider
category listed for which ratios have been established.

HB3800 - 104 - LRB104 09780 BAB 19846 b
The Director shall establish a process for the review of
the adequacy of these standards along with an assessment of
additional specialties to be included in the list under this
subsection (d).
(d-5)(1) Every insurer shall ensure that beneficiaries
have timely and proximate access to treatment for mental,
emotional, nervous, or substance use disorders or conditions
in accordance with the provisions of paragraph (4) of
subsection (a) of Section 370c of the Illinois Insurance Code.
Insurers shall use a comparable process, strategy, evidentiary
standard, and other factors in the development and application
of the network adequacy standards for timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions and those for the access
to treatment for medical and surgical conditions. As such, the
network adequacy standards for timely and proximate access
shall equally be applied to treatment facilities and providers
for mental, emotional, nervous, or substance use disorders or
conditions and specialists providing medical or surgical
benefits pursuant to the parity requirements of Section 370c.1
of the Illinois Insurance Code and the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008. Notwithstanding the foregoing, the network
adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions shall, at a minimum, satisfy the

HB3800 - 105 - LRB104 09780 BAB 19846 b
following requirements:
(A) For beneficiaries residing in the metropolitan
counties of Cook, DuPage, Kane, Lake, McHenry, and Will,
network adequacy standards for timely and proximate access
to treatment for mental, emotional, nervous, or substance
use disorders or conditions means a beneficiary shall not
have to travel longer than 30 minutes or 30 miles from the
beneficiary's residence to receive outpatient treatment
for mental, emotional, nervous, or substance use disorders
or conditions. Beneficiaries shall not be required to wait
longer than 10 business days between requesting an initial
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(B) For beneficiaries residing in Illinois counties
other than those counties listed in subparagraph (A) of
this paragraph, network adequacy standards for timely and
proximate access to treatment for mental, emotional,

HB3800 - 106 - LRB104 09780 BAB 19846 b
nervous, or substance use disorders or conditions means a
beneficiary shall not have to travel longer than 60
minutes or 60 miles from the beneficiary's residence to
receive outpatient treatment for mental, emotional,
nervous, or substance use disorders or conditions.
Beneficiaries shall not be required to wait longer than 10
business days between requesting an initial appointment
and being seen by the facility or provider of mental,
emotional, nervous, or substance use disorders or
conditions for outpatient treatment or to wait longer than
20 business days between requesting a repeat or follow-up
appointment and being seen by the facility or provider of
mental, emotional, nervous, or substance use disorders or
conditions for outpatient treatment; however, subject to
the protections of paragraph (3) of this subsection, a
network plan shall not be held responsible if the
beneficiary or provider voluntarily chooses to schedule an
appointment outside of these required time frames.
(2) For beneficiaries residing in all Illinois counties,
network adequacy standards for timely and proximate access to
treatment for mental, emotional, nervous, or substance use
disorders or conditions means a beneficiary shall not have to
travel longer than 60 minutes or 60 miles from the
beneficiary's residence to receive inpatient or residential
treatment for mental, emotional, nervous, or substance use
disorders or conditions.

HB3800 - 107 - LRB104 09780 BAB 19846 b
(3) If there is no in-network facility or provider
available for a beneficiary to receive timely and proximate
access to treatment for mental, emotional, nervous, or
substance use disorders or conditions in accordance with the
network adequacy standards outlined in this subsection, the
insurer shall provide necessary exceptions to its network to
ensure admission and treatment with a provider or at a
treatment facility in accordance with the network adequacy
standards in this subsection.
(e) Except for network plans solely offered as a group
health plan, these ratio and time and distance standards apply
to the lowest cost-sharing tier of any tiered network.
(f) The network plan may consider use of other health care
service delivery options, such as telemedicine or telehealth,
mobile clinics, and centers of excellence, or other ways of
delivering care to partially meet the requirements set under
this Section.
(g) Except for the requirements set forth in subsection
(d-5), insurers who are not able to comply with the provider
ratios, and time and distance standards, and appointment
wait-time standards established under this Act or federal law
by the Department may request an exception to these
requirements from the Department. The Department may grant an
exception in the following circumstances:
(1) if no providers or facilities meet the specific
time and distance standard in a specific service area and

HB3800 - 108 - LRB104 09780 BAB 19846 b
the insurer (i) discloses information on the distance and
travel time points that beneficiaries would have to travel
beyond the required criterion to reach the next closest
contracted provider outside of the service area and (ii)
provides contact information, including names, addresses,
and phone numbers for the next closest contracted provider
or facility;
(2) if patterns of care in the service area do not
support the need for the requested number of provider or
facility type and the insurer provides data on local
patterns of care, such as claims data, referral patterns,
or local provider interviews, indicating where the
beneficiaries currently seek this type of care or where
the physicians currently refer beneficiaries, or both; or
(3) other circumstances deemed appropriate by the
Department consistent with the requirements of this Act.
(h) Insurers are required to report to the Director any
material change to an approved network plan within 15 days
after the change occurs and any change that would result in
failure to meet the requirements of this Act. Upon notice from
the insurer, the Director shall reevaluate the network plan's
compliance with the network adequacy and transparency
standards of this Act.
(Source: P.A. 102-144, eff. 1-1-22; 102-901, eff. 7-1-22;
102-1117, eff. 1-13-23; 103-906, eff. 1-1-25.)

HB3800 - 109 - LRB104 09780 BAB 19846 b
(215 ILCS 124/25)
(Text of Section from P.A. 103-605)
Sec. 25. Network transparency.
(a) A network plan shall post electronically an
up-to-date, accurate, and complete provider directory for each
of its network plans, with the information and search
functions, as described in this Section.
(1) In making the directory available electronically,
the network plans shall ensure that the general public is
able to view all of the current providers for a plan
through a clearly identifiable link or tab and without
creating or accessing an account or entering a policy or
contract number.
(2) The network plan shall update the online provider
directory at least monthly. Providers shall notify the
network plan electronically or in writing of any changes
to their information as listed in the provider directory,
including the information required in subparagraph (K) of
paragraph (1) of subsection (b). The network plan shall
update its online provider directory in a manner
consistent with the information provided by the provider
within 10 business days after being notified of the change
by the provider. Nothing in this paragraph (2) shall void
any contractual relationship between the provider and the
plan.
(3) The network plan shall audit periodically at least

HB3800 - 110 - LRB104 09780 BAB 19846 b
25% of its provider directories for accuracy, make any
corrections necessary, and retain documentation of the
audit. The network plan shall submit the audit to the
Director upon request. As part of these audits, the
network plan shall contact any provider in its network
that has not submitted a claim to the plan or otherwise
communicated his or her intent to continue participation
in the plan's network.
(4) A network plan shall provide a printed copy of a
current provider directory or a printed copy of the
requested directory information upon request of a
beneficiary or a prospective beneficiary. Printed copies
must be updated quarterly and an errata that reflects
changes in the provider network must be updated quarterly.
(5) For each network plan, a network plan shall
include, in plain language in both the electronic and
print directory, the following general information:
(A) in plain language, a description of the
criteria the plan has used to build its provider
network;
(B) if applicable, in plain language, a
description of the criteria the insurer or network
plan has used to create tiered networks;
(C) if applicable, in plain language, how the
network plan designates the different provider tiers
or levels in the network and identifies for each

HB3800 - 111 - LRB104 09780 BAB 19846 b
specific provider, hospital, or other type of facility
in the network which tier each is placed, for example,
by name, symbols, or grouping, in order for a
beneficiary-covered person or a prospective
beneficiary-covered person to be able to identify the
provider tier; and
(D) if applicable, a notation that authorization
or referral may be required to access some providers.
(6) A network plan shall make it clear for both its
electronic and print directories what provider directory
applies to which network plan, such as including the
specific name of the network plan as marketed and issued
in this State. The network plan shall include in both its
electronic and print directories a customer service email
address and telephone number or electronic link that
beneficiaries or the general public may use to notify the
network plan of inaccurate provider directory information
and contact information for the Department's Office of
Consumer Health Insurance.
(7) A provider directory, whether in electronic or
print format, shall accommodate the communication needs of
individuals with disabilities, and include a link to or
information regarding available assistance for persons
with limited English proficiency.
(b) For each network plan, a network plan shall make
available through an electronic provider directory the

HB3800 - 112 - LRB104 09780 BAB 19846 b
following information in a searchable format:
(1) for health care professionals:
(A) name;
(B) gender;
(C) participating office locations;
(D) specialty, if applicable;
(E) medical group affiliations, if applicable;
(F) facility affiliations, if applicable;
(G) participating facility affiliations, if
applicable;
(H) languages spoken other than English, if
applicable;
(I) whether accepting new patients;
(J) board certifications, if applicable; and
(K) use of telehealth or telemedicine, including,
but not limited to:
(i) whether the provider offers the use of
telehealth or telemedicine to deliver services to
patients for whom it would be clinically
appropriate;
(ii) what modalities are used and what types
of services may be provided via telehealth or
telemedicine; and
(iii) whether the provider has the ability and
willingness to include in a telehealth or
telemedicine encounter a family caregiver who is

HB3800 - 113 - LRB104 09780 BAB 19846 b
in a separate location than the patient if the
patient wishes and provides his or her consent;
(2) for hospitals:
(A) hospital name;
(B) hospital type (such as acute, rehabilitation,
children's, or cancer);
(C) participating hospital location; and
(D) hospital accreditation status; and
(3) for facilities, other than hospitals, by type:
(A) facility name;
(B) facility type;
(C) types of services performed; and
(D) participating facility location or locations.
(c) For the electronic provider directories, for each
network plan, a network plan shall make available all of the
following information in addition to the searchable
information required in this Section:
(1) for health care professionals:
(A) contact information; and
(B) languages spoken other than English by
clinical staff, if applicable;
(2) for hospitals, telephone number; and
(3) for facilities other than hospitals, telephone
number.
(d) The insurer or network plan shall make available in
print, upon request, the following provider directory

HB3800 - 114 - LRB104 09780 BAB 19846 b
information for the applicable network plan:
(1) for health care professionals:
(A) name;
(B) contact information;
(C) participating office location or locations;
(D) specialty, if applicable;
(E) languages spoken other than English, if
applicable;
(F) whether accepting new patients; and
(G) use of telehealth or telemedicine, including,
but not limited to:
(i) whether the provider offers the use of
telehealth or telemedicine to deliver services to
patients for whom it would be clinically
appropriate;
(ii) what modalities are used and what types
of services may be provided via telehealth or
telemedicine; and
(iii) whether the provider has the ability and
willingness to include in a telehealth or
telemedicine encounter a family caregiver who is
in a separate location than the patient if the
patient wishes and provides his or her consent;
(2) for hospitals:
(A) hospital name;
(B) hospital type (such as acute, rehabilitation,

HB3800 - 115 - LRB104 09780 BAB 19846 b
children's, or cancer); and
(C) participating hospital location and telephone
number; and
(3) for facilities, other than hospitals, by type:
(A) facility name;
(B) facility type;
(C) types of services performed; and
(D) participating facility location or locations
and telephone numbers.
(e) The network plan shall include a disclosure in the
print format provider directory that the information included
in the directory is accurate as of the date of printing and
that beneficiaries or prospective beneficiaries should consult
the insurer's electronic provider directory on its website and
contact the provider. The network plan shall also include a
telephone number in the print format provider directory for a
customer service representative where the beneficiary can
obtain current provider directory information.
(f) The Director may conduct periodic audits of the
accuracy of provider directories. A network plan shall not be
subject to any fines or penalties for information required in
this Section that a provider submits that is inaccurate or
incomplete.
(Source: P.A. 102-92, eff. 7-9-21; 103-605, eff. 7-1-24.)
(Text of Section from P.A. 103-650)

HB3800 - 116 - LRB104 09780 BAB 19846 b
Sec. 25. Network transparency.
(a) A network plan shall post electronically an
up-to-date, accurate, and complete provider directory for each
of its network plans, with the information and search
functions, as described in this Section.
(1) In making the directory available electronically,
the network plans shall ensure that the general public is
able to view all of the current providers for a plan
through a clearly identifiable link or tab and without
creating or accessing an account or entering a policy or
contract number.
(2) An issuer's failure to update a network plan's
directory shall subject the issuer to a civil penalty of
$5,000 per month. Providers shall notify the network plan
electronically or in writing within 10 business days of
any changes to their information as listed in the provider
directory, including the information required in
subsections (b), (c), and (d). With regard to subparagraph
(I) of paragraph (1) of subsection (b), the provider must
give notice to the issuer within 20 business days of
deciding to cease accepting new patients covered by the
plan if the new patient limitation is expected to last 40
business days or longer. The network plan shall update its
online provider directory in a manner consistent with the
information provided by the provider within 2 business
days after being notified of the change by the provider.

HB3800 - 117 - LRB104 09780 BAB 19846 b
Nothing in this paragraph (2) shall void any contractual
relationship between the provider and the plan.
(3) At least once every 90 days, the issuer shall
self-audit each network plan's provider directories for
accuracy, make any corrections necessary, and retain
documentation of the audit. The issuer shall submit the
self-audit and a summary to the Department, and the
Department shall make the summary of each self-audit
publicly available. The Department shall specify the
requirements of the summary, which shall be statistical in
nature except for a high-level narrative evaluating the
impact of internal and external factors on the accuracy of
the directory and the timeliness of updates. As part of
these self-audits, the network plan shall contact any
provider in its network that has not submitted a claim to
the plan or otherwise communicated his or her intent to
continue participation in the plan's network. The
self-audits shall comply with 42 U.S.C. 300gg-115(a)(2),
except that "provider directory information" shall include
all information required to be included in a provider
directory pursuant to this Act.
(4) A network plan shall provide a print copy of a
current provider directory or a print copy of the
requested directory information upon request of a
beneficiary or a prospective beneficiary. Except when an
issuer's print copies use the same provider information as

HB3800 - 118 - LRB104 09780 BAB 19846 b
the electronic provider directory on each print copy's
date of printing, print copies must be updated at least
every 90 days and errata that reflects changes in the
provider network must be included in each update.
(5) For each network plan, a network plan shall
include, in plain language in both the electronic and
print directory, the following general information:
(A) in plain language, a description of the
criteria the plan has used to build its provider
network;
(B) if applicable, in plain language, a
description of the criteria the issuer or network plan
has used to create tiered networks;
(C) if applicable, in plain language, how the
network plan designates the different provider tiers
or levels in the network and identifies for each
specific provider, hospital, or other type of facility
in the network which tier each is placed, for example,
by name, symbols, or grouping, in order for a
beneficiary-covered person or a prospective
beneficiary-covered person to be able to identify the
provider tier;
(D) if applicable, a notation that authorization
or referral may be required to access some providers;
(E) a telephone number and email address for a
customer service representative to whom directory

HB3800 - 119 - LRB104 09780 BAB 19846 b
inaccuracies may be reported; and
(F) a detailed description of the process to
dispute charges for out-of-network providers,
hospitals, or facilities that were incorrectly listed
as in-network prior to the provision of care and a
telephone number and email address to dispute such
charges.
(6) A network plan shall make it clear for both its
electronic and print directories what provider directory
applies to which network plan, such as including the
specific name of the network plan as marketed and issued
in this State. The network plan shall include in both its
electronic and print directories a customer service email
address and telephone number or electronic link that
beneficiaries or the general public may use to notify the
network plan of inaccurate provider directory information
and contact information for the Department's Office of
Consumer Health Insurance.
(7) A provider directory, whether in electronic or
print format, shall accommodate the communication needs of
individuals with disabilities, and include a link to or
information regarding available assistance for persons
with limited English proficiency.
(b) For each network plan, a network plan shall make
available through an electronic provider directory the
following information in a searchable format:

HB3800 - 120 - LRB104 09780 BAB 19846 b
(1) for health care professionals:
(A) name;
(B) gender;
(C) participating office locations;
(D) patient population served (such as pediatric,
adult, elderly, or women) and specialty or
subspecialty, if applicable;
(E) medical group affiliations, if applicable;
(F) facility affiliations, if applicable;
(G) participating facility affiliations, if
applicable;
(H) languages spoken other than English, if
applicable;
(I) whether accepting new patients;
(J) board certifications, if applicable;
(K) use of telehealth or telemedicine, including,
but not limited to:
(i) whether the provider offers the use of
telehealth or telemedicine to deliver services to
patients for whom it would be clinically
appropriate;
(ii) what modalities are used and what types
of services may be provided via telehealth or
telemedicine; and
(iii) whether the provider has the ability and
willingness to include in a telehealth or

HB3800 - 121 - LRB104 09780 BAB 19846 b
telemedicine encounter a family caregiver who is
in a separate location than the patient if the
patient wishes and provides his or her consent;
(L) whether the health care professional accepts
appointment requests from patients; and
(M) the anticipated date the provider will leave
the network, if applicable, which shall be included no
more than 10 days after the issuer confirms that the
provider is scheduled to leave the network;
(2) for hospitals:
(A) hospital name;
(B) hospital type (such as acute, rehabilitation,
children's, or cancer);
(C) participating hospital location;
(D) hospital accreditation status; and
(E) the anticipated date the hospital will leave
the network, if applicable, which shall be included no
more than 10 days after the issuer confirms the
hospital is scheduled to leave the network; and
(3) for facilities, other than hospitals, by type:
(A) facility name;
(B) facility type;
(C) types of services performed;
(D) participating facility location or locations;
and
(E) the anticipated date the facility will leave

HB3800 - 122 - LRB104 09780 BAB 19846 b
the network, if applicable, which shall be included no
more than 10 days after the issuer confirms the
facility is scheduled to leave the network.
(c) For the electronic provider directories, for each
network plan, a network plan shall make available all of the
following information in addition to the searchable
information required in this Section:
(1) for health care professionals:
(A) contact information, including both a
telephone number and digital contact information if
the provider has supplied digital contact information;
and
(B) languages spoken other than English by
clinical staff, if applicable;
(2) for hospitals, telephone number and digital
contact information; and
(3) for facilities other than hospitals, telephone
number.
(d) The issuer or network plan shall make available in
print, upon request, the following provider directory
information for the applicable network plan:
(1) for health care professionals:
(A) name;
(B) contact information, including a telephone
number and digital contact information if the provider
has supplied digital contact information;

HB3800 - 123 - LRB104 09780 BAB 19846 b
(C) participating office location or locations;
(D) patient population (such as pediatric, adult,
elderly, or women) and specialty or subspecialty, if
applicable;
(E) languages spoken other than English, if
applicable;
(F) whether accepting new patients;
(G) use of telehealth or telemedicine, including,
but not limited to:
(i) whether the provider offers the use of
telehealth or telemedicine to deliver services to
patients for whom it would be clinically
appropriate;
(ii) what modalities are used and what types
of services may be provided via telehealth or
telemedicine; and
(iii) whether the provider has the ability and
willingness to include in a telehealth or
telemedicine encounter a family caregiver who is
in a separate location than the patient if the
patient wishes and provides his or her consent;
and
(H) whether the health care professional accepts
appointment requests from patients.
(2) for hospitals:
(A) hospital name;

HB3800 - 124 - LRB104 09780 BAB 19846 b
(B) hospital type (such as acute, rehabilitation,
children's, or cancer); and
(C) participating hospital location, telephone
number, and digital contact information; and
(3) for facilities, other than hospitals, by type:
(A) facility name;
(B) facility type;
(C) patient population (such as pediatric, adult,
elderly, or women) served, if applicable, and types of
services performed; and
(D) participating facility location or locations,
telephone numbers, and digital contact information for
each location.
(e) The network plan shall include a disclosure in the
print format provider directory that the information included
in the directory is accurate as of the date of printing and
that beneficiaries or prospective beneficiaries should consult
the issuer's electronic provider directory on its website and
contact the provider. The network plan shall also include a
telephone number and email address in the print format
provider directory for a customer service representative where
the beneficiary can obtain current provider directory
information or report provider directory inaccuracies. The
printed provider directory shall include a detailed
description of the process to dispute charges for
out-of-network providers, hospitals, or facilities that were

HB3800 - 125 - LRB104 09780 BAB 19846 b
incorrectly listed as in-network prior to the provision of
care and a telephone number and email address to dispute those
charges.
(f) The Director may conduct periodic audits of the
accuracy of provider directories. A network plan shall not be
subject to any fines or penalties for information required in
this Section that a provider submits that is inaccurate or
incomplete.
(g) To the extent not otherwise provided in this Act, an
issuer shall comply with the requirements of 42 U.S.C.
300gg-115, except that "provider directory information" shall
include all information required to be included in a provider
directory pursuant to this Section.
(h) If the issuer or the Department identifies a provider
incorrectly listed in the provider directory, the issuer shall
check each of the issuer's network plan provider directories
for the provider within 2 business days to ascertain whether
the provider is a preferred provider in that network plan and,
if the provider is incorrectly listed in the provider
directory, remove the provider from the provider directory
without delay.
(i) If the Director determines that an issuer violated
this Section, the Director may assess a fine up to $5,000 per
violation, except for inaccurate information given by a
provider to the issuer. If an issuer, or any entity or person
acting on the issuer's behalf, knew or reasonably should have

HB3800 - 126 - LRB104 09780 BAB 19846 b
known that a provider was incorrectly included in a provider
directory, the Director may assess a fine of up to $25,000 per
violation against the issuer.
(j) This Section applies to network plans not otherwise
exempt under Section 3, including stand-alone dental plans.
(Source: P.A. 102-92, eff. 7-9-21; 103-650, eff. 1-1-25.)
(Text of Section from P.A. 103-777)
Sec. 25. Network transparency.
(a) A network plan shall post electronically an
up-to-date, accurate, and complete provider directory for each
of its network plans, with the information and search
functions, as described in this Section.
(1) In making the directory available electronically,
the network plans shall ensure that the general public is
able to view all of the current providers for a plan
through a clearly identifiable link or tab and without
creating or accessing an account or entering a policy or
contract number.
(2) The network plan shall update the online provider
directory at least monthly. Providers shall notify the
network plan electronically or in writing of any changes
to their information as listed in the provider directory,
including the information required in subparagraph (K) of
paragraph (1) of subsection (b). The network plan shall
update its online provider directory in a manner

HB3800 - 127 - LRB104 09780 BAB 19846 b
consistent with the information provided by the provider
within 10 business days after being notified of the change
by the provider. Nothing in this paragraph (2) shall void
any contractual relationship between the provider and the
plan.
(3) The network plan shall audit periodically at least
25% of its provider directories for accuracy, make any
corrections necessary, and retain documentation of the
audit. The network plan shall submit the audit to the
Director upon request. As part of these audits, the
network plan shall contact any provider in its network
that has not submitted a claim to the plan or otherwise
communicated his or her intent to continue participation
in the plan's network.
(4) A network plan shall provide a printed copy of a
current provider directory or a printed copy of the
requested directory information upon request of a
beneficiary or a prospective beneficiary. Printed copies
must be updated quarterly and an errata that reflects
changes in the provider network must be updated quarterly.
(5) For each network plan, a network plan shall
include, in plain language in both the electronic and
print directory, the following general information:
(A) in plain language, a description of the
criteria the plan has used to build its provider
network;

HB3800 - 128 - LRB104 09780 BAB 19846 b
(B) if applicable, in plain language, a
description of the criteria the insurer or network
plan has used to create tiered networks;
(C) if applicable, in plain language, how the
network plan designates the different provider tiers
or levels in the network and identifies for each
specific provider, hospital, or other type of facility
in the network which tier each is placed, for example,
by name, symbols, or grouping, in order for a
beneficiary-covered person or a prospective
beneficiary-covered person to be able to identify the
provider tier; and
(D) if applicable, a notation that authorization
or referral may be required to access some providers.
(6) A network plan shall make it clear for both its
electronic and print directories what provider directory
applies to which network plan, such as including the
specific name of the network plan as marketed and issued
in this State. The network plan shall include in both its
electronic and print directories a customer service email
address and telephone number or electronic link that
beneficiaries or the general public may use to notify the
network plan of inaccurate provider directory information
and contact information for the Department's Office of
Consumer Health Insurance.
(7) A provider directory, whether in electronic or

HB3800 - 129 - LRB104 09780 BAB 19846 b
print format, shall accommodate the communication needs of
individuals with disabilities, and include a link to or
information regarding available assistance for persons
with limited English proficiency.
(b) For each network plan, a network plan shall make
available through an electronic provider directory the
following information in a searchable format:
(1) for health care professionals:
(A) name;
(B) gender;
(C) participating office locations;
(D) specialty, if applicable;
(E) medical group affiliations, if applicable;
(F) facility affiliations, if applicable;
(G) participating facility affiliations, if
applicable;
(H) languages spoken other than English, if
applicable;
(I) whether accepting new patients;
(J) board certifications, if applicable; and
(K) use of telehealth or telemedicine, including,
but not limited to:
(i) whether the provider offers the use of
telehealth or telemedicine to deliver services to
patients for whom it would be clinically
appropriate;

HB3800 - 130 - LRB104 09780 BAB 19846 b
(ii) what modalities are used and what types
of services may be provided via telehealth or
telemedicine; and
(iii) whether the provider has the ability and
willingness to include in a telehealth or
telemedicine encounter a family caregiver who is
in a separate location than the patient if the
patient wishes and provides his or her consent;
(2) for hospitals:
(A) hospital name;
(B) hospital type (such as acute, rehabilitation,
children's, or cancer);
(C) participating hospital location; and
(D) hospital accreditation status; and
(3) for facilities, other than hospitals, by type:
(A) facility name;
(B) facility type;
(C) types of services performed; and
(D) participating facility location or locations.
(c) For the electronic provider directories, for each
network plan, a network plan shall make available all of the
following information in addition to the searchable
information required in this Section:
(1) for health care professionals:
(A) contact information; and
(B) languages spoken other than English by

HB3800 - 131 - LRB104 09780 BAB 19846 b
clinical staff, if applicable;
(2) for hospitals, telephone number; and
(3) for facilities other than hospitals, telephone
number.
(d) The insurer or network plan shall make available in
print, upon request, the following provider directory
information for the applicable network plan:
(1) for health care professionals:
(A) name;
(B) contact information;
(C) participating office location or locations;
(D) specialty, if applicable;
(E) languages spoken other than English, if
applicable;
(F) whether accepting new patients; and
(G) use of telehealth or telemedicine, including,
but not limited to:
(i) whether the provider offers the use of
telehealth or telemedicine to deliver services to
patients for whom it would be clinically
appropriate;
(ii) what modalities are used and what types
of services may be provided via telehealth or
telemedicine; and
(iii) whether the provider has the ability and
willingness to include in a telehealth or

HB3800 - 132 - LRB104 09780 BAB 19846 b
telemedicine encounter a family caregiver who is
in a separate location than the patient if the
patient wishes and provides his or her consent;
(2) for hospitals:
(A) hospital name;
(B) hospital type (such as acute, rehabilitation,
children's, or cancer); and
(C) participating hospital location and telephone
number; and
(3) for facilities, other than hospitals, by type:
(A) facility name;
(B) facility type;
(C) types of services performed; and
(D) participating facility location or locations
and telephone numbers.
(e) The network plan shall include a disclosure in the
print format provider directory that the information included
in the directory is accurate as of the date of printing and
that beneficiaries or prospective beneficiaries should consult
the insurer's electronic provider directory on its website and
contact the provider. The network plan shall also include a
telephone number in the print format provider directory for a
customer service representative where the beneficiary can
obtain current provider directory information.
(f) The Director may conduct periodic audits of the
accuracy of provider directories. A network plan shall not be

HB3800 - 133 - LRB104 09780 BAB 19846 b
subject to any fines or penalties for information required in
this Section that a provider submits that is inaccurate or
incomplete.
(g) This Section applies to network plans that are not
otherwise exempt under Section 3, including stand-alone dental
plans that are subject to provider directory requirements
under federal law.
(Source: P.A. 102-92, eff. 7-9-21; 103-777, eff. 1-1-25.)
Section 23. 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)
(Text of Section before amendment by P.A. 103-808)
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, 143.31, 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, 355.6, 355b, 355c, 356f, 356g.5-1,
356m, 356q, 356u.10, 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.31, 356z.32, 356z.33,
356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40,

HB3800 - 134 - LRB104 09780 BAB 19846 b
356z.40a, 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.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 356z.69,
356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 356z.76,
356z.77, 356z.78, 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

HB3800 - 135 - LRB104 09780 BAB 19846 b
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;

HB3800 - 136 - LRB104 09780 BAB 19846 b
(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

HB3800 - 137 - LRB104 09780 BAB 19846 b
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

HB3800 - 138 - LRB104 09780 BAB 19846 b
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,

HB3800 - 139 - LRB104 09780 BAB 19846 b
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; 103-605, eff. 7-1-24;
103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff.
1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751,
eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25;
103-777, eff. 8-2-24; 103-914, eff. 1-1-25; 103-918, eff.
1-1-25; 103-1024, eff. 1-1-25; revised 9-26-24.)
(Text of Section after amendment by P.A. 103-808)
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, 143.31, 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, 355.6, 355b, 355c, 356f, 356g,
356g.5-1, 356m, 356q, 356u.10, 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.31, 356z.32,
356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
356z.40, 356z.40a, 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,

HB3800 - 140 - LRB104 09780 BAB 19846 b
356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
356z.76, 356z.77, 356z.78, 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

HB3800 - 141 - LRB104 09780 BAB 19846 b
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

HB3800 - 142 - LRB104 09780 BAB 19846 b
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:

HB3800 - 143 - LRB104 09780 BAB 19846 b
(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

HB3800 - 144 - LRB104 09780 BAB 19846 b
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,

HB3800 - 145 - LRB104 09780 BAB 19846 b
eff. 1-1-24; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24;
103-618, eff. 1-1-25; 103-649, eff. 1-1-25; 103-656, eff.
1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 103-751,
eff. 8-2-24; 103-753, eff. 8-2-24; 103-758, eff. 1-1-25;
103-777, eff. 8-2-24; 103-808, eff. 1-1-26; 103-914, eff.
1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; revised
11-26-24.)
Section 25. 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, 143.31, 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, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 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, 356z.71,
356z.73, 356z.74, 356z.75, 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, and
XXXIIB of the Illinois Insurance Code. Nothing in this Section
shall require a limited health care plan to cover any service

HB3800 - 146 - LRB104 09780 BAB 19846 b
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; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25;
103-656, eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff.
7-19-24; 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832,
eff. 1-1-25; 103-1024, eff. 1-1-25; revised 11-26-24.)
Section 30. The Criminal Code of 2012 is amended by
changing Section 17-0.5 as follows:

HB3800 - 147 - LRB104 09780 BAB 19846 b
(720 ILCS 5/17-0.5)
Sec. 17-0.5. Definitions. In this Article:
"Altered credit card or debit card" means any instrument
or device, whether known as a credit card or debit card, which
has been changed in any respect by addition or deletion of any
material, except for the signature by the person to whom the
card is issued.
"Cardholder" means the person or organization named on the
face of a credit card or debit card to whom or for whose
benefit the credit card or debit card is issued by an issuer.
"Computer" means a device that accepts, processes, stores,
retrieves, or outputs data and includes, but is not limited
to, auxiliary storage, including cloud-based networks of
remote services hosted on the Internet, and telecommunications
devices connected to computers.
"Computer network" means a set of related, remotely
connected devices and any communications facilities including
more than one computer with the capability to transmit data
between them through the communications facilities.
"Computer program" or "program" means a series of coded
instructions or statements in a form acceptable to a computer
which causes the computer to process data and supply the
results of the data processing.
"Computer services" means computer time or services,
including data processing services, Internet services,
electronic mail services, electronic message services, or

HB3800 - 148 - LRB104 09780 BAB 19846 b
information or data stored in connection therewith.
"Counterfeit" means to manufacture, produce or create, by
any means, a credit card or debit card without the purported
issuer's consent or authorization.
"Credit card" means any instrument or device, whether
known as a credit card, credit plate, charge plate or any other
name, issued with or without fee by an issuer for the use of
the cardholder in obtaining money, goods, services or anything
else of value on credit or in consideration or an undertaking
or guaranty by the issuer of the payment of a check drawn by
the cardholder.
"Data" means a representation in any form of information,
knowledge, facts, concepts, or instructions, including program
documentation, which is prepared or has been prepared in a
formalized manner and is stored or processed in or transmitted
by a computer or in a system or network. Data is considered
property and may be in any form, including, but not limited to,
printouts, magnetic or optical storage media, punch cards, or
data stored internally in the memory of the computer.
"Debit card" means any instrument or device, known by any
name, issued with or without fee by an issuer for the use of
the cardholder in obtaining money, goods, services, and
anything else of value, payment of which is made against funds
previously deposited by the cardholder. A debit card which
also can be used to obtain money, goods, services and anything
else of value on credit shall not be considered a debit card

HB3800 - 149 - LRB104 09780 BAB 19846 b
when it is being used to obtain money, goods, services or
anything else of value on credit.
"Document" includes, but is not limited to, any document,
representation, or image produced manually, electronically, or
by computer.
"Electronic fund transfer terminal" means any machine or
device that, when properly activated, will perform any of the
following services:
(1) Dispense money as a debit to the cardholder's
account; or
(2) Print the cardholder's account balances on a
statement; or
(3) Transfer funds between a cardholder's accounts; or
(4) Accept payments on a cardholder's loan; or
(5) Dispense cash advances on an open end credit or a
revolving charge agreement; or
(6) Accept deposits to a customer's account; or
(7) Receive inquiries of verification of checks and
dispense information that verifies that funds are
available to cover such checks; or
(8) Cause money to be transferred electronically from
a cardholder's account to an account held by any business,
firm, retail merchant, corporation, or any other
organization.
"Electronic funds transfer system", hereafter referred to
as "EFT System", means that system whereby funds are

HB3800 - 150 - LRB104 09780 BAB 19846 b
transferred electronically from a cardholder's account to any
other account.
"Electronic mail service provider" means any person who
(i) is an intermediary in sending or receiving electronic mail
and (ii) provides to end-users of electronic mail services the
ability to send or receive electronic mail.
"Expired credit card or debit card" means a credit card or
debit card which is no longer valid because the term on it has
elapsed.
"False academic degree" means a certificate, diploma,
transcript, or other document purporting to be issued by an
institution of higher learning or purporting to indicate that
a person has completed an organized academic program of study
at an institution of higher learning when the person has not
completed the organized academic program of study indicated on
the certificate, diploma, transcript, or other document.
"False claim" means any statement made to any insurer,
purported insurer, servicing corporation, insurance broker, or
insurance agent, or any agent or employee of one of those
entities, and made as part of, or in support of, a claim for
payment or other benefit under a policy of insurance, or as
part of, or in support of, an application for the issuance of,
or the rating of, any insurance policy, when the statement
does any of the following:
(1) Contains any false, incomplete, or misleading
information concerning any fact or thing material to the

HB3800 - 151 - LRB104 09780 BAB 19846 b
claim.
(2) Conceals (i) the occurrence of an event that is
material to any person's initial or continued right or
entitlement to any insurance benefit or payment or (ii)
the amount of any benefit or payment to which the person is
entitled.
"Financial institution" means any bank, savings and loan
association, credit union, or other depository of money or
medium of savings and collective investment.
"Governmental entity" means: each officer, board,
commission, and agency created by the Constitution, whether in
the executive, legislative, or judicial branch of State
government; each officer, department, board, commission,
agency, institution, authority, university, and body politic
and corporate of the State; each administrative unit or
corporate outgrowth of State government that is created by or
pursuant to statute, including units of local government and
their officers, school districts, and boards of election
commissioners; and each administrative unit or corporate
outgrowth of the foregoing items and as may be created by
executive order of the Governor.
"Incomplete credit card or debit card" means a credit card
or debit card which is missing part of the matter other than
the signature of the cardholder which an issuer requires to
appear on the credit card or debit card before it can be used
by a cardholder, and this includes credit cards or debit cards

HB3800 - 152 - LRB104 09780 BAB 19846 b
which have not been stamped, embossed, imprinted or written
on.
"Institution of higher learning" means a public or private
college, university, or community college located in the State
of Illinois that is authorized by the Board of Higher
Education or the Illinois Community College Board to issue
post-secondary degrees, or a public or private college,
university, or community college located anywhere in the
United States that is or has been legally constituted to offer
degrees and instruction in its state of origin or
incorporation.
"Insurance company" means any "company" as defined under
Section 2 of the Illinois Insurance Code, "dental service plan
corporation" as defined in Section 3 of the Dental Service
Plan Act, "health maintenance organization" as defined in
Section 1-2 of the Health Maintenance Organization Act,
"limited health service organization" as defined in Section
1002 of the Limited Health Service Organization Act, "health
services plan corporation" as defined in Section 2 of the
Voluntary Health Services Plans Act, or any trust fund
organized under the Religious and Charitable Risk Pooling
Trust Act.
"Issuer" means the business organization or financial
institution which issues a credit card or debit card, or its
duly authorized agent.
"Merchant" has the meaning ascribed to it in Section

HB3800 - 153 - LRB104 09780 BAB 19846 b
16-0.1 of this Code.
"Person" means any individual, corporation, government,
governmental subdivision or agency, business trust, estate,
trust, partnership or association or any other entity.
"Receives" or "receiving" means acquiring possession or
control.
"Record of charge form" means any document submitted or
intended to be submitted to an issuer as evidence of a credit
transaction for which the issuer has agreed to reimburse
persons providing money, goods, property, services or other
things of value.
"Revoked credit card or debit card" means a credit card or
debit card which is no longer valid because permission to use
it has been suspended or terminated by the issuer.
"Sale" means any delivery for value.
"Scheme or artifice to defraud" includes a scheme or
artifice to deprive another of the intangible right to honest
services.
"Self-insured entity" means any person, business,
partnership, corporation, or organization that sets aside
funds to meet his, her, or its losses or to absorb fluctuations
in the amount of loss, the losses being charged against the
funds set aside or accumulated.
"Social networking website" means an Internet website
containing profile web pages of the members of the website
that include the names or nicknames of such members,

HB3800 - 154 - LRB104 09780 BAB 19846 b
photographs placed on the profile web pages by such members,
or any other personal or personally identifying information
about such members and links to other profile web pages on
social networking websites of friends or associates of such
members that can be accessed by other members or visitors to
the website. A social networking website provides members of
or visitors to such website the ability to leave messages or
comments on the profile web page that are visible to all or
some visitors to the profile web page and may also include a
form of electronic mail for members of the social networking
website.
"Statement" means any assertion, oral, written, or
otherwise, and includes, but is not limited to: any notice,
letter, or memorandum; proof of loss; bill of lading; receipt
for payment; invoice, account, or other financial statement;
estimate of property damage; bill for services; diagnosis or
prognosis; prescription; hospital, medical, or dental chart or
other record, x-ray, photograph, videotape, or movie film;
test result; other evidence of loss, injury, or expense;
computer-generated document; and data in any form.
"Universal Price Code Label" means a unique symbol that
consists of a machine-readable code and human-readable
numbers.
"With intent to defraud" means to act knowingly, and with
the specific intent to deceive or cheat, for the purpose of
causing financial loss to another or bringing some financial

HB3800 - 155 - LRB104 09780 BAB 19846 b
gain to oneself, regardless of whether any person was actually
defrauded or deceived. This includes an intent to cause
another to assume, create, transfer, alter, or terminate any
right, obligation, or power with reference to any person or
property.
(Source: P.A. 101-87, eff. 1-1-20.)
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 upon
becoming law, except that the changes to Sections 143d and
1563 of the Illinois Insurance Code take effect January 1,
2026, and the changes to Section 174 of the Illinois Insurance
Code take effect 60 days after this Act becomes law.
HB3800 - 156 - LRB104 09780 BAB 19846 b
INDEX
Statutes amended in order of appearance
20 ILCS 1410/10
215 ILCS 5/121-2.08 from Ch. 73, par. 733-2.08
215 ILCS 5/143d from Ch. 73, par. 755d
215 ILCS 5/174 from Ch. 73, par. 786
215 ILCS 5/194 from Ch. 73, par. 806
215 ILCS 5/356z.73
215 ILCS 5/368d
215 ILCS 5/370c.1
215 ILCS 5/1563
215 ILCS 109/75
215 ILCS 124/5
215 ILCS 124/10
215 ILCS 124/25
215 ILCS 125/5-3 from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003 from Ch. 73, par. 1504-3
720 ILCS 5/17-0.5