Amends the Illinois Health Benefits Exchange Law. Provides that the Illinois Health Benefits Exchange shall allow a special enrollment period for an uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, if the uninsured taxpayer requested health insurance benefit information through the easy enrollment program under the Illinois Income Tax Act and the uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, are eligible to enroll in a qualified health plan through the Exchange. Establishes notification requirements for the Exchange. Provides that the uninsured taxpayer and the uninsured taxpayer's dependents shall have 60 days from the date of the letter to select and enroll in a qualified health plan. Provides that coverage shall be effective the first day of the month that follows the plan selection. Grants the Department of Insurance and the Department of Healthcare and Family Services rulemaking authority to implement an easy enrollment special enrollment period. Effective immediately.
Amends the Illinois Insurance Code, the Dental Care Patient Protection Act, and the Dental Service Plan Act. Provides that no insurer, dental service plan corporation, professional service corporation, insurance network leasing company, company offering a managed care dental plan, company offering a point-of-service plan, or any company that amends, delivers, issues, or renews an individual or group policy of accident and health insurance that provides dental insurance in this State may deny coverage for replacement of teeth to any insured on the basis of those teeth having been extracted or otherwise lost prior to the person becoming covered under the plan.
Amends the Illinois Insurance Code. Provides that no provision of the Illinois Insurance Code, or any other law, prohibits assignability rights to an insured under any policy of dental insurance (in addition to accident and health insurance). Provides that if an enrollee or insured of an insurer, health maintenance organization, managed care plan, health care plan, preferred provider organization, dental service plan corporation, dental insurer, or third party administrator assigns a claim to a health care professional, or health care facility, a dental care provider, or a dental care facility, then payment shall be made directly to the health care professional, or health care facility, dental care provider, or dental care facility, including any required interest. Effective immediately.
Creates the Complex Wheelchair Right to Repair Act. Provides that, for complex wheelchairs and parts for complex wheelchairs sold or used in the State, an original equipment manufacturer shall make available to an independent repair provider, solely for the purpose of repairing complex wheelchairs, on fair and reasonable terms, any documentation, parts, service access methods, and tools, including, but not limited to, any updates to information, firmware, or embedded software that is needed for purposes of repair of complex wheelchairs and training courses and materials on the operation, inspection, diagnosis, maintenance, and repair of complex wheelchairs. Provides that a violation of any of the provisions of the Act is an unlawful practice under the Consumer Fraud and Deceptive Business Practices Act. Provides for penalties. Provides that nothing in the Act shall require an original equipment manufacturer to divulge a trade secret to an independent repair provider. Amends the Illinois Insurance Code. Prohibits a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 from requiring a qualified complex rehabilitation technology supplier to obtain any form of prior authorization or any medical documentation to complete repairs for consumer-owned complex rehab technology. Requires coverage for time and labor expenses; travel allowance; and maintenance and repair of a consumer's backup power wheelchair or a rental wheelchair. Provides coverage for preventive maintenance. Amends various Acts to require coverage under those provisions. Amends the Consumer Fraud and Deceptive Business Practices Act to make a conforming change. Effective January 1, 2026.
Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 that provides coverage for: habilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental; rehabilitative services shall provide coverage for rehabilitative speech therapy as a treatment for stuttering; or habilitative services and rehabilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental, and shall provide coverage for rehabilitative speech therapy as a treatment for stuttering. Sets forth requirements and limitations for the coverage. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. Amends the State Mandates Act to require implementation without reimbursement. Effective January 1, 2027.
Amends the Managed Care Reform and Patient Rights Act. Sets forth requirements for carriers that offer a provider panel. Requires notice of the development of a provider panel to be filed with Department of Public Health prior to establishment. Provides that a carrier that uses a provider panel shall establish procedure for notifying an enrollee of the termination of a health care provider. Sets forth provisions permitting, under certain circumstances, a health care provider to continue to render health care services following termination from the carrier's provider panel. Requires a carrier to provide a list of members in the carrier's provider panel. Establishes notice requirements for benefit reductions and termination of health care providers from the carrier's provider panel. Requires any carrier requiring preauthorization for medical treatment to have personnel available to provide preauthorization at all times when the preauthorization is required. Provides that no contract between a health care provider and a carrier shall include provisions that require a health care provider to deny covered services that the provider knows to be medically necessary and appropriate that are provided with respect to a specific enrollee or group of enrollees with similar medical conditions. Sets forth prohibited provisions in a contract between a carrier and a health care provider. Defines terms. Makes other and conforming changes.
Amends the Public Safety Employee Benefits Act. Provides that, if the injured employee subsequently dies, the employer shall continue to pay the entire health insurance premium for the surviving spouse (rather than the surviving spouse until remarried) and for the dependent children under specified conditions.
Amends the Illinois Health Benefits Exchange Law. Provides that the Illinois Health Benefits Exchange shall allow a special enrollment period for an uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, if the uninsured taxpayer requested health insurance benefit information through the easy enrollment program under the Illinois Income Tax Act and the uninsured taxpayer and the uninsured taxpayer's qualified dependents, if applicable, are eligible to enroll in a qualified health plan through the Exchange. Establishes notification requirements for the Exchange. Provides that the uninsured taxpayer and the uninsured taxpayer's dependents shall have 60 days from the date of the letter to select and enroll in a qualified health plan. Provides that coverage shall be effective the first day of the month that follows the plan selection. Grants the Department of Insurance and the Department of Healthcare and Family Services rulemaking authority to implement an easy enrollment special enrollment period. Effective immediately.
Amends the Illinois Insurance Code to create the Consumer Protection from Surprise Health Care Billing Act. Provides that, on or after July 1, 2025, notwithstanding any other applicable provision, when a beneficiary, insured, or enrollee receives services from a nonparticipating ground ambulance service provider, the health insurance issuer shall ensure that the beneficiary, insured, or enrollee shall incur no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating ground ambulance service provider. Provides that any cost-sharing requirements shall be applied as though the services provided by the nonparticipating ground ambulance service provider had been provided by a participating ground ambulance service provider. Sets forth provisions concerning payment for ground ambulance services; calculating the recognized amount; limitations for the cost sharing amount for any occurrence in which a ground ambulance service is provided to a beneficiary; appeals for payments made by health insurance issuers; the maximum allowable payment amounts, by individual service types, for nonparticipating ground ambulance service providers owned, operated, or controlled by a private organization; and payments to nonparticipating ground ambulance service providers owned, operated, or controlled, by a unit of government which participates in the Ground Emergency Medical Transportation program administered by the Department of Healthcare and Family Services. Makes conforming changes. Provides that the failure by a health insurance issuer to comply with the specified requirements constitutes an unlawful practice under the Consumer Fraud and Deceptive Business Practices Act and enforcement authority is granted to the Attorney General. Amends the Health Maintenance Organization Act and the Consumer Fraud and Deceptive Business Practices Act to make corresponding changes. Effective July 1, 2025.
Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for one crib and one car seat for each postpartum individual covered under the policy. Provides that the postpartum individual must be covered by the insurance policy at the time of child birth and must submit a claim within 6 months after the birth. Provides that the insurer must either reimburse the postpartum individual for the purchase of an approved crib and car seat upon submission of a valid receipt or provide a car seat and crib to the postpartum individual that complies with all federal and State safety standards. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions.
