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| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB2781 Introduced 2/4/2020, by Sen. Laura Fine SYNOPSIS AS INTRODUCED:
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| 215 ILCS 5/356c | from Ch. 73, par. 968c | 215 ILCS 5/356z.41 new | |
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Amends the Illinois Insurance Code. In provisions requiring coverage for newborn infants, provides that coverage for congenital defects shall include treatment of cranial facial anomalies. Provides that an individual or group policy of accident and health insurance amended, delivered, issued, or renewed after the effective date of the amendatory Act shall cover charges incurred and services provided for outpatient and inpatient care in conjunction with services that are provided to a covered individual related to the diagnosis and treatment of a congenital anomaly or birth defect. Provides that the required coverage includes any service to functionally improve, repair, or restore any body part involving the cranial facial area that is medically necessary to achieve normal function or appearance. Provides that any coverage provided may be subject to coverage limits, such as pre-authorization or pre-certification, as required by the plan or issuer that are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the plan. Provides that the coverage does not apply to a policy that covers only dental care. Defines "treatment". Effective January 1, 2021.
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| | A BILL FOR |
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| | SB2781 | | LRB101 15490 BMS 64833 b |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Illinois Insurance Code is amended by |
5 | | changing Section 356c and by adding Section 356z.41 as follows:
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6 | | (215 ILCS 5/356c) (from Ch. 73, par. 968c)
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7 | | Sec. 356c.
(1) No policy of accident and health insurance |
8 | | providing
coverage of hospital expenses or medical expenses or
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9 | | both on an expense incurred basis which in addition to covering |
10 | | the
insured, also covers members of the insured's immediate |
11 | | family, shall
contain any disclaimer, waiver or other |
12 | | limitation of coverage relative to
the hospital or medical
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13 | | coverage or insurability of newborn infants from and after
the |
14 | | moment of birth.
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15 | | (2) Each such policy of accident and health insurance shall |
16 | | contain
a provision stating that the accident and health |
17 | | insurance benefits
applicable for children shall be granted |
18 | | immediately with respect to a
newly born child from the moment |
19 | | of birth. The coverage for newly born
children shall include |
20 | | coverage of illness, injury, congenital defects (including the |
21 | | treatment of cranial facial anomalies) ,
birth abnormalities |
22 | | and premature birth.
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23 | | (3) If payment of a specific premium is required to provide |