HB4112 EngrossedLRB103 33223 LNS 63031 b


1 AN ACT concerning regulation.

2 Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:

4 Section 5. The State Employees Group Insurance Act of 1971 
5is amended by changing Section 6.11B as follows:

6 (5 ILCS 375/6.11B)
7 Sec. 6.11B. Infertility coverage.
8 (a) Beginning on January 1, 2024, the State Employees 
9Group Insurance Program shall provide coverage for the 
10diagnosis and treatment of infertility, including, but not 
11limited to, in vitro fertilization, uterine embryo lavage, 
12embryo transfer, artificial insemination, gamete 
13intrafallopian tube transfer, zygote intrafallopian tube 
14transfer, and low tubal ovum transfer. The coverage required 
15shall include procedures necessary to screen or diagnose a 
16fertilized egg before implantation, including, but not limited 
17to, preimplantation genetic diagnosis, preimplantation genetic 
18screening, and prenatal genetic diagnosis.
19 (b) Beginning on January 1, 2024, coverage under this 
20Section for procedures for in vitro fertilization, gamete 
21intrafallopian tube transfer, or zygote intrafallopian tube 
22transfer shall be required only if the procedures:
23  (1) are considered medically appropriate based on 
 
 
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1 clinical guidelines or standards developed by the American 
2 Society for Reproductive Medicine, the American College of 
3 Obstetricians and Gynecologists, or the Society for 
4 Assisted Reproductive Technology; and
5  (2) are performed at medical facilities or clinics 
6 that conform to the American College of Obstetricians and 
7 Gynecologists guidelines for in vitro fertilization or the 
8 American Society for Reproductive Medicine minimum 
9 standards for practices offering assisted reproductive 
10 technologies. 
11 (c) As used in this Section, "infertility" means a 
12disease, condition, or status characterized by: 
13  (1) a failure to establish a pregnancy or to carry a 
14 pregnancy to live birth after 12 months of regular, 
15 unprotected sexual intercourse if the woman is 35 years of 
16 age or younger, or after 6 months of regular, unprotected 
17 sexual intercourse if the woman is over 35 years of age; 
18 conceiving but having a miscarriage does not restart the 
19 12-month or 6-month term for determining infertility;
20  (2) a person's inability to reproduce either as a 
21 single individual or with a partner without medical 
22 intervention; or
23  (3) a licensed physician's findings based on a 
24 patient's medical, sexual, and reproductive history, age, 
25 physical findings, or diagnostic testing. 
26 (d) The State Employees Group Insurance Program may not 
 
 
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1impose any exclusions, limitations, or other restrictions on 
2coverage of fertility medications that are different from 
3those imposed on any other prescription medications, nor may 
4it impose any exclusions, limitations, or other restrictions 
5on coverage of any fertility services based on a covered 
6individual's participation in fertility services provided by 
7or to a third party, nor may it impose deductibles, 
8copayments, coinsurance, benefit maximums, waiting periods, or 
9any other limitations on coverage for the diagnosis of 
10infertility, treatment for infertility, and standard fertility 
11preservation services, except as provided in this Section, 
12that are different from those imposed upon benefits for 
13services not related to infertility. 
14 (e) This Section applies only to coverage provided on or 
15after January 1, 2024 and before July 1, 2026. 
16 (f) This Section is repealed on July 1, 2026. 
17(Source: P.A. 103-8, eff. 1-1-24.)

18 Section 10. The Counties Code is amended by changing 
19Section 5-1069.3 as follows:

20 (55 ILCS 5/5-1069.3)
21 Sec. 5-1069.3. Required health benefits. If a county, 
22including a home rule county, is a self-insurer for purposes 
23of providing health insurance coverage for its employees, the 
24coverage shall include coverage for the post-mastectomy care 
 
 
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1benefits required to be covered by a policy of accident and 
2health insurance under Section 356t and the coverage required 
3under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 
4356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 
5356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 
6356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 
7356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 
8356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, and 
9356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70 
10of the Illinois Insurance Code. The coverage shall comply with 
11Sections 155.22a, 355b, 356z.19, and 370c of the Illinois 
12Insurance Code. The Department of Insurance shall enforce the 
13requirements of this Section. The requirement that health 
14benefits be covered as provided in this Section is an 
15exclusive power and function of the State and is a denial and 
16limitation under Article VII, Section 6, subsection (h) of the 
17Illinois Constitution. A home rule county to which this 
18Section applies must comply with every provision of this 
19Section. 
20 Rulemaking authority to implement Public Act 95-1045, if 
21any, is conditioned on the rules being adopted in accordance 
22with all provisions of the Illinois Administrative Procedure 
23Act and all rules and procedures of the Joint Committee on 
24Administrative Rules; any purported rule not so adopted, for 
25whatever reason, is unauthorized. 
26(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 
 
 
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1102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 
21-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, 
3eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 
4102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 
51-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, 
6eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 
7103-535, eff. 8-11-23; 103-551, eff. 8-11-23; revised 
88-29-23.)

9 Section 15. The Illinois Municipal Code is amended by 
10changing Section 10-4-2.3 as follows:

11 (65 ILCS 5/10-4-2.3)
12 Sec. 10-4-2.3. Required health benefits. If a 
13municipality, including a home rule municipality, is a 
14self-insurer for purposes of providing health insurance 
15coverage for its employees, the coverage shall include 
16coverage for the post-mastectomy care benefits required to be 
17covered by a policy of accident and health insurance under 
18Section 356t and the coverage required under Sections 356g, 
19356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x, 356z.4, 
20356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 
21356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 
22356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 
23356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 
24356z.56, 356z.57, 356z.59, 356z.60, and 356z.61, and 356z.62, 
 
 
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1356z.64, 356z.67, 356z.68, and 356z.70 of the Illinois 
2Insurance Code. The coverage shall comply with Sections 
3155.22a, 355b, 356z.19, and 370c of the Illinois Insurance 
4Code. The Department of Insurance shall enforce the 
5requirements of this Section. The requirement that health 
6benefits be covered as provided in this is an exclusive power 
7and function of the State and is a denial and limitation under 
8Article VII, Section 6, subsection (h) of the Illinois 
9Constitution. A home rule municipality to which this Section 
10applies must comply with every provision of this Section. 
11 Rulemaking authority to implement Public Act 95-1045, if 
12any, is conditioned on the rules being adopted in accordance 
13with all provisions of the Illinois Administrative Procedure 
14Act and all rules and procedures of the Joint Committee on 
15Administrative Rules; any purported rule not so adopted, for 
16whatever reason, is unauthorized. 
17(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 
18102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 
191-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, 
20eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 
21102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 
221-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, 
23eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 
24103-535, eff. 8-11-23; 103-551, eff. 8-11-23; revised 
258-29-23.)

 
 
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1 Section 20. The School Code is amended by changing Section 
210-22.3f as follows:

3 (105 ILCS 5/10-22.3f)
4 Sec. 10-22.3f. Required health benefits. Insurance 
5protection and benefits for employees shall provide the 
6post-mastectomy care benefits required to be covered by a 
7policy of accident and health insurance under Section 356t and 
8the coverage required under Sections 356g, 356g.5, 356g.5-1, 
9356m, 356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 
10356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 
11356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 
12356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, 
13356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, and 
14356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70 
15of the Illinois Insurance Code. Insurance policies shall 
16comply with Section 356z.19 of the Illinois Insurance Code. 
17The coverage shall comply with Sections 155.22a, 355b, and 
18370c of the Illinois Insurance Code. The Department of 
19Insurance shall enforce the requirements of this Section. 
20 Rulemaking authority to implement Public Act 95-1045, if 
21any, is conditioned on the rules being adopted in accordance 
22with all provisions of the Illinois Administrative Procedure 
23Act and all rules and procedures of the Joint Committee on 
24Administrative Rules; any purported rule not so adopted, for 
25whatever reason, is unauthorized. 
 
 
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1(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 
2102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 
31-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, 
4eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 
5102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 
61-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, 
7eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 
8103-551, eff. 8-11-23; revised 8-29-23.)

9 Section 25. The Illinois Insurance Code is amended by 
10changing Section 356m as follows:

11 (215 ILCS 5/356m) (from Ch. 73, par. 968m)
12 Sec. 356m. Infertility coverage. 
13 (a) No group policy of accident and health insurance 
14providing coverage for more than 25 employees that provides 
15pregnancy related benefits may be issued, amended, delivered, 
16or renewed in this State after January 1, 2016 through 
17December 31, 2025 the effective date of this amendatory Act of 
18the 99th General Assembly unless the policy contains coverage 
19for the diagnosis and treatment of infertility including, but 
20not limited to, in vitro fertilization, uterine embryo lavage, 
21embryo transfer, artificial insemination, gamete 
22intrafallopian tube transfer, zygote intrafallopian tube 
23transfer, and low tubal ovum transfer.
24 (b) The coverage required under subsection (a) for 
 
 
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1procedures for in vitro fertilization, gamete intrafallopian 
2tube transfer, or zygote intrafallopian tube transfer shall be 
3required only if: is subject to the following conditions:
4  (1) Coverage for procedures for in vitro 
5 fertilization, gamete intrafallopian tube transfer, or 
6 zygote intrafallopian tube transfer shall be required only 
7 if:
8  (1) (A) the covered individual has been unable to 
9 attain a viable pregnancy, maintain a viable pregnancy, or 
10 sustain a successful pregnancy through reasonable, less 
11 costly medically appropriate infertility treatments for 
12 which coverage is available under the policy, plan, or 
13 contract;
14  (2) (B) the covered individual has not undergone 4 
15 completed oocyte retrievals, except that if a live birth 
16 follows a completed oocyte retrieval, then 2 more 
17 completed oocyte retrievals shall be covered; and
18  (3) (C) the procedures are performed at medical 
19 facilities that conform to the American College of 
20 Obstetric and Gynecology guidelines for in vitro 
21 fertilization clinics or to the American Fertility Society 
22 minimal standards for programs of in vitro fertilization.
23  (2) The procedures required to be covered under this 
24 Section are not required to be contained in any policy or 
25 plan issued to or by a religious institution or 
26 organization or to or by an entity sponsored by a 
 
 
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1 religious institution or organization that finds the 
2 procedures required to be covered under this Section to 
3 violate its religious and moral teachings and beliefs.
4 (c) No group policy of accident and health insurance that 
5provides pregnancy related benefits may be issued, amended, 
6delivered, or renewed in this State on or after January 1, 2026 
7unless the policy contains coverage for the diagnosis and 
8treatment of infertility, including, but not limited to, in 
9vitro fertilization, uterine embryo lavage, embryo transfer, 
10artificial insemination, gamete intrafallopian tube transfer, 
11zygote intrafallopian tube transfer, and low tubal ovum 
12transfer and procedures necessary to screen or diagnose a 
13fertilized egg before implantation, including, but not limited 
14to, preimplantation genetic diagnosis, preimplantation genetic 
15screening, and prenatal genetic diagnosis. Coverage under this 
16subsection for the diagnosis and treatment of infertility 
17shall be required only if the procedures: 
18  (1) are considered medically appropriate by the 
19 patient's medical provider based on clinical guidelines or 
20 standards developed by the American Society for 
21 Reproductive Medicine, the American College of 
22 Obstetricians and Gynecologists, or the Society for 
23 Assisted Reproductive Technology; and 
24  (2) are performed at medical facilities or clinics 
25 that conform to the American College of Obstetricians and 
26 Gynecologists guidelines for in vitro fertilization or the 
 
 
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1 American Society for Reproductive Medicine minimum 
2 standards for practices offering assisted reproductive 
3 technologies. 
4 (d) (c) As used in this Section, "infertility" means a 
5disease, condition, or status characterized by:
6  (1) a failure to establish a pregnancy or to carry a 
7 pregnancy to live birth after 12 months of regular, 
8 unprotected sexual intercourse if the woman is 35 years of 
9 age or younger, or after 6 months of regular, unprotected 
10 sexual intercourse if the woman is over 35 years of age; 
11 conceiving but having a miscarriage does not restart the 
12 12-month or 6-month term for determining infertility;
13  (2) a person's inability to reproduce either as a 
14 single individual or with a partner without medical 
15 intervention; or
16  (3) a licensed physician's findings based on a 
17 patient's medical, sexual, and reproductive history, age, 
18 physical findings, or diagnostic testing. 
19 (e) (d) A policy, contract, or certificate may not impose 
20any exclusions, limitations, or other restrictions on coverage 
21of fertility medications that are different from those imposed 
22on any other prescription medications, nor may it impose any 
23exclusions, limitations, or other restrictions on coverage of 
24any fertility services based on a covered individual's 
25participation in fertility services provided by or to a third 
26party, nor may it impose deductibles, copayments, coinsurance, 
 
 
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1benefit maximums, waiting periods, or any other limitations on 
2coverage for the diagnosis of infertility, treatment for 
3infertility, and standard fertility preservation services, 
4except as provided in this Section, that are different from 
5those imposed upon benefits for services not related to 
6infertility.
7 (f) The procedures required to be covered under this 
8Section are not required to be contained in any policy or plan 
9issued to or by a religious institution or organization or to 
10or by an entity sponsored by a religious institution or 
11organization that finds the procedures required to be covered 
12under this Section to violate its religious and moral 
13teachings and beliefs. 
14(Source: P.A. 102-170, eff. 1-1-22.)

15 Section 30. The Limited Health Service Organization Act is 
16amended by changing Section 4003 as follows:

17 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
18 Sec. 4003. Illinois Insurance Code provisions. Limited 
19health service organizations shall be subject to the 
20provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, 
21141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 
22154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 355.2, 
23355.3, 355b, 356m, 356q, 356v, 356z.4, 356z.4a, 356z.10, 
24356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30a, 
 
 
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1356z.32, 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 
2356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 
3364.3, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 
4444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, 
5XIII 1/2, XXV, and XXVI of the Illinois Insurance Code. 
6Nothing in this Section shall require a limited health care 
7plan to cover any service that is not a limited health service. 
8For purposes of the Illinois Insurance Code, except for 
9Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited 
10health service organizations in the following categories are 
11deemed to be domestic companies:
12  (1) a corporation under the laws of this State; or
13  (2) a corporation organized under the laws of another 
14 state, 30% or more of the enrollees of which are residents 
15 of this State, except a corporation subject to 
16 substantially the same requirements in its state of 
17 organization as is a domestic company under Article VIII 
18 1/2 of the Illinois Insurance Code.
19(Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 
20102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff. 
211-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816, 
22eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 
23102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 
241-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, 
25eff. 1-1-24; revised 8-29-23.)

 
 
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1 Section 35. The Voluntary Health Services Plans Act is 
2amended by changing Section 10 as follows:

3 (215 ILCS 165/10) (from Ch. 32, par. 604)
4 Sec. 10. Application of Insurance Code provisions. Health 
5services plan corporations and all persons interested therein 
6or dealing therewith shall be subject to the provisions of 
7Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140, 
8143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, 
9356g, 356g.5, 356g.5-1, 356m, 356q, 356r, 356t, 356u, 356v, 
10356w, 356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 
11356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 
12356z.13, 356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 
13356z.25, 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 
14356z.33, 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 
15356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 
16356z.64, 356z.67, 356z.68, 364.01, 364.3, 367.2, 368a, 401, 
17401.1, 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7) 
18and (15) of Section 367 of the Illinois Insurance Code.
19 Rulemaking authority to implement Public Act 95-1045, if 
20any, is conditioned on the rules being adopted in accordance 
21with all provisions of the Illinois Administrative Procedure 
22Act and all rules and procedures of the Joint Committee on 
23Administrative Rules; any purported rule not so adopted, for 
24whatever reason, is unauthorized. 
25(Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 
 
 
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1102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 
210-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, 
3eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 
4102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 
51-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, 
6eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 
7103-551, eff. 8-11-23; revised 8-29-23.)