Bill Text: IL SB3203 | 2023-2024 | 103rd General Assembly | Chaptered
Bill Title: Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or before December 31, 2025 that provides coverage for prescription drugs may not deny or limit coverage for prescription inhalers (instead of prescription inhalants) based upon any restriction on the number of days before an inhaler refill may be obtained if, contrary to those restrictions, the inhalants have been ordered or prescribed by the treating physician and are medically appropriate. Provides that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2026 that provides coverage for prescription drugs shall limit the total amount that a covered person is required to pay for a covered prescription inhaler to an amount not to exceed $25 per 30-day supply, and provides that nothing in the provisions prevents a group or individual policy of accident and health insurance or managed care plan from reducing a covered person's cost sharing to an amount less than the cap. Makes a conforming change. Provides that coverage for prescription inhalers shall not be subject to any deductible, except to the extent that the coverage would disqualify a high-deductible health plan from eligibility for a health savings account. Authorizes rulemaking and enforcement by the Department of Insurance. Amends the State Employees Group Insurance Act of 1971. Provides that the program of health benefits shall provide coverage for prescription inhalers under the Illinois Insurance Code.
Spectrum: Strong Partisan Bill (Democrat 53-3)
Status: (Passed) 2024-08-09 - Public Act . . . . . . . . . 103-0951 [SB3203 Detail]
Download: Illinois-2023-SB3203-Chaptered.html
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| Public Act 103-0951 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois, | ||||
represented in the General Assembly:
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Section 5. The State Employees Group Insurance Act of 1971 | ||||
is amended by changing Section 6.11 as follows:
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(5 ILCS 375/6.11) | ||||
Sec. 6.11. Required health benefits; Illinois Insurance | ||||
Code requirements. The program of health benefits shall | ||||
provide the post-mastectomy care benefits required to be | ||||
covered by a policy of accident and health insurance under | ||||
Section 356t of the Illinois Insurance Code. The program of | ||||
health benefits shall provide the coverage required under | ||||
Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x, | ||||
356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, | ||||
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, | ||||
356z.22, 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, | ||||
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, | ||||
356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, | ||||
356z.60, and 356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, | ||||
and 356z.70 of the Illinois Insurance Code. The program of | ||||
health benefits must comply with Sections 155.22a, 155.37, | ||||
355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the | ||||
Illinois Insurance Code. The program of health benefits shall | ||||
provide the coverage required under Section 356m of the | ||
Illinois Insurance Code and, for the employees of the State | ||
Employee Group Insurance Program only, the coverage as also | ||
provided in Section 6.11B of this Act. The Department of | ||
Insurance shall enforce the requirements of this Section with | ||
respect to Sections 370c and 370c.1 of the Illinois Insurance | ||
Code; all other requirements of this Section shall be enforced | ||
by the Department of Central Management Services. | ||
Rulemaking authority to implement Public Act 95-1045, if | ||
any, is conditioned on the rules being adopted in accordance | ||
with all provisions of the Illinois Administrative Procedure | ||
Act and all rules and procedures of the Joint Committee on | ||
Administrative Rules; any purported rule not so adopted, for | ||
whatever reason, is unauthorized. | ||
(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; | ||
102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. | ||
1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-768, | ||
eff. 1-1-24; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; | ||
102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. | ||
1-1-23; 102-1117, eff. 1-13-23; 103-8, eff. 1-1-24; 103-84, | ||
eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24; | ||
103-445, eff. 1-1-24; 103-535, eff. 8-11-23; 103-551, eff. | ||
8-11-23; revised 8-29-23.)
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Section 10. The Illinois Insurance Code is amended by | ||
changing Section 356z.5 as follows:
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