SB2762: INS-SEIZURE DETECTION DEVICE

SB2762 Enrolled LRB104 16499 BAB 29895 b 1 AN ACT concerning regulation. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Counties Code is amended by changing 5 Section 5-1069.3 as follows: 6 (55 ILCS 5/5-1069.3) 7 (Text of Section before amendment by P.A. 104-446 ) 8 Sec. 5-1069.3. Required health benefits. If a county, 9 including a home rule county, is a self-insurer for purposes 10 of providing health insurance coverage for its employees, the 11 coverage shall include coverage for the post-mastectomy care 12 benefits required to be covered by a policy of accident and 13 health insurance under Section 356t and the coverage required 14 under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 15 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 16 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 17 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 18 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 19 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 20 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, 21 and 356z.77, 356z.79, and 356z.80 , 356z.81, 356z.82, 356z.83, 22 356z.84, 356z.85, 356z.88, and 356z.89 of the Illinois 23 Insurance Code. The coverage shall comply with Sections SB2762 Enrolled - 2 - LRB104 16499 BAB 29895 b 1 155.22a, 355b, 356z.19, and 370c of the Illinois Insurance 2 Code. The Department of Insurance shall enforce the 3 requirements of this Section. The requirement that health 4 benefits be covered as provided in this Section is an 5 exclusive power and function of the State and is a denial and 6 limitation under Article VII, Section 6, subsection (h) of the 7 Illinois Constitution. A home rule county to which this 8 Section applies must comply with every provision of this 9 Section. 10 Rulemaking authority to implement Public Act 95-1045, if 11 any, is conditioned on the rules being adopted in accordance 12 with all provisions of the Illinois Administrative Procedure 13 Act and all rules and procedures of the Joint Committee on 14 Administrative Rules; any purported rule not so adopted, for 15 whatever reason, is unauthorized. 16 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 17 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 18 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 19 eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 20 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 21 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 22 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 23 eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-7-26.) 24 (Text of Section after amendment by P.A. 104-446 ) 25 Sec. 5-1069.3. Required health benefits. If a county, SB2762 Enrolled - 3 - LRB104 16499 BAB 29895 b 1 including a home rule county, is a self-insurer for purposes 2 of providing health insurance coverage for its employees, the 3 coverage shall include coverage for the post-mastectomy care 4 benefits required to be covered by a policy of accident and 5 health insurance under Section 356t and the coverage required 6 under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 7 356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 8 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 9 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 10 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 11 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 12 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, 13 and 356z.77, 356z.79, and 356z.80 , 356z.81, 356z.82, 356z.83, 14 356z.84, 356z.85, 356z.88, and 356z.89 of the Illinois 15 Insurance Code. The coverage shall comply with Sections 16 155.22a, 355b, 356z.19, 370c, and 370c.4 of the Illinois 17 Insurance Code. The Department of Insurance shall enforce the 18 requirements of this Section. The requirement that health 19 benefits be covered as provided in this Section is an 20 exclusive power and function of the State and is a denial and 21 limitation under Article VII, Section 6, subsection (h) of the 22 Illinois Constitution. A home rule county to which this 23 Section applies must comply with every provision of this 24 Section. 25 Rulemaking authority to implement Public Act 95-1045, if 26 any, is conditioned on the rules being adopted in accordance SB2762 Enrolled - 4 - LRB104 16499 BAB 29895 b 1 with all provisions of the Illinois Administrative Procedure 2 Act and all rules and procedures of the Joint Committee on 3 Administrative Rules; any purported rule not so adopted, for 4 whatever reason, is unauthorized. 5 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 6 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 7 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 8 eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 9 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 10 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 11 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 12 eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26; 13 revised 1-7-26.) 14 Section 10. The Illinois Municipal Code is amended by 15 changing Section 10-4-2.3 as follows: 16 (65 ILCS 5/10-4-2.3) 17 (Text of Section before amendment by P.A. 104-446 ) 18 Sec. 10-4-2.3. Required health benefits. If a 19 municipality, including a home rule municipality, is a 20 self-insurer for purposes of providing health insurance 21 coverage for its employees, the coverage shall include 22 coverage for the post-mastectomy care benefits required to be 23 covered by a policy of accident and health insurance under 24 Section 356t and the coverage required under Sections 356g, SB2762 Enrolled - 5 - LRB104 16499 BAB 29895 b 1 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, 2 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 3 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 4 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 5 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 6 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 7 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, and 356z.77, 8 356z.79, and 356z.80 , 356z.81, 356z.82, 356z.83, 356z.84, 9 356z.85, 356z.88, and 356z.89 of the Illinois Insurance Code. 10 The coverage shall comply with Sections 155.22a, 355b, 11 356z.19, and 370c of the Illinois Insurance Code. The 12 Department of Insurance shall enforce the requirements of this 13 Section. The requirement that health benefits be covered as 14 provided in this Section is an exclusive power and function of 15 the State and is a denial and limitation under Article VII, 16 Section 6, subsection (h) of the Illinois Constitution. A home 17 rule municipality to which this Section applies must comply 18 with every provision of this Section. 19 Rulemaking authority to implement Public Act 95-1045, if 20 any, is conditioned on the rules being adopted in accordance 21 with all provisions of the Illinois Administrative Procedure 22 Act and all rules and procedures of the Joint Committee on 23 Administrative Rules; any purported rule not so adopted, for 24 whatever reason, is unauthorized. 25 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 26 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. SB2762 Enrolled - 6 - LRB104 16499 BAB 29895 b 1 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 2 eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 3 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 4 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 5 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 6 eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-8-26.) 7 (Text of Section after amendment by P.A. 104-446 ) 8 Sec. 10-4-2.3. Required health benefits. If a 9 municipality, including a home rule municipality, is a 10 self-insurer for purposes of providing health insurance 11 coverage for its employees, the coverage shall include 12 coverage for the post-mastectomy care benefits required to be 13 covered by a policy of accident and health insurance under 14 Section 356t and the coverage required under Sections 356g, 15 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x, 16 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 17 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 18 356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 19 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54, 20 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 21 356z.67, 356z.68, 356z.70, 356z.71, 356z.74, and 356z.77, 22 356z.79, and 356z.80 , 356z.81, 356z.82, 356z.83, 356z.84, 23 356z.85, 356z.88, and 356z.89 of the Illinois Insurance Code. 24 The coverage shall comply with Sections 155.22a, 355b, 25 356z.19, 370c, and 370c.4 of the Illinois Insurance Code. The SB2762 Enrolled - 7 - LRB104 16499 BAB 29895 b 1 Department of Insurance shall enforce the requirements of this 2 Section. The requirement that health benefits be covered as 3 provided in this Section is an exclusive power and function of 4 the State and is a denial and limitation under Article VII, 5 Section 6, subsection (h) of the Illinois Constitution. A home 6 rule municipality to which this Section applies must comply 7 with every provision of this Section. 8 Rulemaking authority to implement Public Act 95-1045, if 9 any, is conditioned on the rules being adopted in accordance 10 with all provisions of the Illinois Administrative Procedure 11 Act and all rules and procedures of the Joint Committee on 12 Administrative Rules; any purported rule not so adopted, for 13 whatever reason, is unauthorized. 14 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 15 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 16 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 17 eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 18 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 19 6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff. 20 1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, 21 eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26; 22 revised 1-8-26.) 23 Section 15. The School Code is amended by changing Section 24 10-22.3f as follows: SB2762 Enrolled - 8 - LRB104 16499 BAB 29895 b 1 (105 ILCS 5/10-22.3f) 2 (Text of Section before amendment by P.A. 104-446 ) 3 Sec. 10-22.3f. Required health benefits. Insurance 4 protection and benefits for employees shall provide the 5 post-mastectomy care benefits required to be covered by a 6 policy of accident and health insurance under Section 356t and 7 the coverage required under Sections 356g, 356g.5, 356g.5-1, 8 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, 9 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 10 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 11 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 12 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 13 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 14 356z.74, and 356z.77, 356z.79, and 356z.80 , 356z.81, 356z.82, 15 356z.83, 356z.84, 356z.85, 356z.88, and 356z.89 of the 16 Illinois Insurance Code. Insurance policies shall comply with 17 Section 356z.19 of the Illinois Insurance Code. The coverage 18 shall comply with Sections 155.22a, 355b, and 370c and Article 19 XXXIIB of the Illinois Insurance Code. The Department of 20 Insurance shall enforce the requirements of this Section. 21 Rulemaking authority to implement Public Act 95-1045, if 22 any, is conditioned on the rules being adopted in accordance 23 with all provisions of the Illinois Administrative Procedure 24 Act and all rules and procedures of the Joint Committee on 25 Administrative Rules; any purported rule not so adopted, for 26 whatever reason, is unauthorized. SB2762 Enrolled - 9 - LRB104 16499 BAB 29895 b 1 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 2 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 3 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 4 eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 5 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6 6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 7 1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324, 8 eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; 9 revised 1-8-26.) 10 (Text of Section after amendment by P.A. 104-446 ) 11 Sec. 10-22.3f. Required health benefits. Insurance 12 protection and benefits for employees shall provide the 13 post-mastectomy care benefits required to be covered by a 14 policy of accident and health insurance under Section 356t and 15 the coverage required under Sections 356g, 356g.5, 356g.5-1, 16 356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a, 17 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 18 356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 19 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 20 356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 21 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 22 356z.74, and 356z.77, 356z.79, and 356z.80 , 356z.81, 356z.82, 23 356z.83, 356z.84, 356z.85, 356z.88, and 356z.89 of the 24 Illinois Insurance Code. Insurance policies shall comply with 25 Section 356z.19 of the Illinois Insurance Code. The coverage SB2762 Enrolled - 10 - LRB104 16499 BAB 29895 b 1 shall comply with Sections 155.22a, 355b, 370c, and 370c.4 and 2 Article XXXIIB of the Illinois Insurance Code. The Department 3 of Insurance shall enforce the requirements of this Section. 4 Rulemaking authority to implement Public Act 95-1045, if 5 any, is conditioned on the rules being adopted in accordance 6 with all provisions of the Illinois Administrative Procedure 7 Act and all rules and procedures of the Joint Committee on 8 Administrative Rules; any purported rule not so adopted, for 9 whatever reason, is unauthorized. 10 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 11 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 12 8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718, 13 eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25; 14 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 15 6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 16 1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324, 17 eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; 18 104-446, eff. 6-1-26; revised 1-8-26.) 19 Section 20. The Illinois Insurance Code is amended by 20 adding Sections 356z.88 and 356z.89 as follows: 21 (215 ILCS 5/356z.88 new) 22 Sec. 356z.88. Coverage for seizure detection devices. 23 (a) For the purposes of this Section, "seizure detection 24 device" means a monitoring device cleared by the United States SB2762 Enrolled - 11 - LRB104 16499 BAB 29895 b 1 Food and Drug Administration, and any related technology, 2 application, service, or subscription supporting the 3 prescribed use of the device, that provides the following: 4 (1) individual monitoring and alert services relating 5 to seizure activity; 6 (2) detection or prediction of seizure activity and 7 transmission of notification of the seizure activity to 8 the individual or a caregiver for appropriate medical 9 response; or 10 (3) collection of data of the seizure activity of the 11 individual that can be used by a health care provider to 12 diagnose or appropriately treat a health care condition 13 that causes the seizure activity. 14 (b) A group or individual plan of accident and health 15 insurance or managed care plan amended, delivered, issued, or 16 renewed on or after January 1, 2029 shall provide coverage for 17 medically prescribed seizure detection devices. 18 (c) All seizure detection devices covered under this 19 Section shall be approved for use by individuals, and the 20 choice of device shall be made based upon the individual's 21 circumstances and medical needs in consultation with the 22 individual's medical provider. 23 (d) Any individual who has been prescribed a seizure 24 detection device shall not be required to obtain prior 25 authorization for coverage for a seizure detection device, and 26 coverage shall be continuous once the seizure detection device SB2762 Enrolled - 12 - LRB104 16499 BAB 29895 b 1 is prescribed. 2 (e) A group or individual policy of accident and health 3 insurance or a managed care plan that is amended, delivered, 4 issued, or renewed on or after January 1, 2029 shall not impose 5 a deductible, coinsurance, copayment, or any other 6 cost-sharing requirement of more than $50 on the coverage of a 7 seizure detection device per plan year. The provisions of this 8 subsection do not apply to coverage under this Section to the 9 extent that the coverage would disqualify a high-deductible 10 health plan from eligibility for a health savings account. 11 (215 ILCS 5/356z.89 new) 12 Sec. 356z.89. Coverage for preeclampsia biomarker testing. 13 Any group or individual policy of accident and health 14 insurance or managed care plan amended, delivered, issued, or 15 renewed on or after January 1, 2028 shall cover, without 16 imposing a deductible, coinsurance, copayment, or any other 17 cost-sharing requirement upon the insured, preeclampsia 18 biomarker testing for predictive screening in asymptomatic 19 individuals, or for diagnosis and management when symptoms are 20 present. 21 Section 25. The Health Maintenance Organization Act is 22 amended by changing Section 5-3 as follows: 23 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2) SB2762 Enrolled - 13 - LRB104 16499 BAB 29895 b 1 Sec. 5-3. Illinois Insurance Code provisions. 2 (a) Health Maintenance Organizations shall be subject to 3 the provisions of Sections 133, 134, 136, 137, 139, 140, 4 141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 5 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 6 155.49, 352c, 355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f, 7 356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 8 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 9 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 10 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 11 356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 12 356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 13 356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 14 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 15 356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 16 356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 17 356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 18 356z.76, 356z.77, 356z.78, 356z.79, 356z.80, 356z.81, 356z.82, 19 356z.83, 356z.84, 356z.85, 356z.88, 356z.89, 364, 364.01, 20 364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 21 370a, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 22 409, 412, 444, and 444.1, paragraph (c) of subsection (2) of 23 Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, 24 XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance 25 Code. 26 (b) For purposes of the Illinois Insurance Code, except SB2762 Enrolled - 14 - LRB104 16499 BAB 29895 b 1 for Sections 444 and 444.1 and Articles XIII and XIII 1/2, 2 Health Maintenance Organizations in the following categories 3 are deemed to be "domestic companies": 4 (1) a corporation authorized under the Dental Service 5 Plan Act or the Voluntary Health Services Plans Act; 6 (2) a corporation organized under the laws of this 7 State; or 8 (3) a corporation organized under the laws of another 9 state, 30% or more of the enrollees of which are residents 10 of this State, except a corporation subject to 11 substantially the same requirements in its state of 12 organization as is a "domestic company" under Article VIII 13 1/2 of the Illinois Insurance Code. 14 (c) In considering the merger, consolidation, or other 15 acquisition of control of a Health Maintenance Organization 16 pursuant to Article VIII 1/2 of the Illinois Insurance Code, 17 (1) the Director shall give primary consideration to 18 the continuation of benefits to enrollees and the 19 financial conditions of the acquired Health Maintenance 20 Organization after the merger, consolidation, or other 21 acquisition of control takes effect; 22 (2)(i) the criteria specified in subsection (1)(b) of 23 Section 131.8 of the Illinois Insurance Code shall not 24 apply and (ii) the Director, in making his determination 25 with respect to the merger, consolidation, or other 26 acquisition of control, need not take into account the SB2762 Enrolled - 15 - LRB104 16499 BAB 29895 b 1 effect on competition of the merger, consolidation, or 2 other acquisition of control; 3 (3) the Director shall have the power to require the 4 following information: 5 (A) certification by an independent actuary of the 6 adequacy of the reserves of the Health Maintenance 7 Organization sought to be acquired; 8 (B) pro forma financial statements reflecting the 9 combined balance sheets of the acquiring company and 10 the Health Maintenance Organization sought to be 11 acquired as of the end of the preceding year and as of 12 a date 90 days prior to the acquisition, as well as pro 13 forma financial statements reflecting projected 14 combined operation for a period of 2 years; 15 (C) a pro forma business plan detailing an 16 acquiring party's plans with respect to the operation 17 of the Health Maintenance Organization sought to be 18 acquired for a period of not less than 3 years; and 19 (D) such other information as the Director shall 20 require. 21 (d) The provisions of Article VIII 1/2 of the Illinois 22 Insurance Code and this Section 5-3 shall apply to the sale by 23 any health maintenance organization of greater than 10% of its 24 enrollee population (including, without limitation, the health 25 maintenance organization's right, title, and interest in and 26 to its health care certificates). SB2762 Enrolled - 16 - LRB104 16499 BAB 29895 b 1 (e) In considering any management contract or service 2 agreement subject to Section 141.1 of the Illinois Insurance 3 Code, the Director (i) shall, in addition to the criteria 4 specified in Section 141.2 of the Illinois Insurance Code, 5 take into account the effect of the management contract or 6 service agreement on the continuation of benefits to enrollees 7 and the financial condition of the health maintenance 8 organization to be managed or serviced, and (ii) need not take 9 into account the effect of the management contract or service 10 agreement on competition. 11 (f) Except for small employer groups as defined in the 12 Small Employer Rating, Renewability and Portability Health 13 Insurance Act and except for medicare supplement policies as 14 defined in Section 363 of the Illinois Insurance Code, a 15 Health Maintenance Organization may by contract agree with a 16 group or other enrollment unit to effect refunds or charge 17 additional premiums under the following terms and conditions: 18 (i) the amount of, and other terms and conditions with 19 respect to, the refund or additional premium are set forth 20 in the group or enrollment unit contract agreed in advance 21 of the period for which a refund is to be paid or 22 additional premium is to be charged (which period shall 23 not be less than one year); and 24 (ii) the amount of the refund or additional premium 25 shall not exceed 20% of the Health Maintenance 26 Organization's profitable or unprofitable experience with SB2762 Enrolled - 17 - LRB104 16499 BAB 29895 b 1 respect to the group or other enrollment unit for the 2 period (and, for purposes of a refund or additional 3 premium, the profitable or unprofitable experience shall 4 be calculated taking into account a pro rata share of the 5 Health Maintenance Organization's administrative and 6 marketing expenses, but shall not include any refund to be 7 made or additional premium to be paid pursuant to this 8 subsection (f)). The Health Maintenance Organization and 9 the group or enrollment unit may agree that the profitable 10 or unprofitable experience may be calculated taking into 11 account the refund period and the immediately preceding 2 12 plan years. 13 The Health Maintenance Organization shall include a 14 statement in the evidence of coverage issued to each enrollee 15 describing the possibility of a refund or additional premium, 16 and upon request of any group or enrollment unit, provide to 17 the group or enrollment unit a description of the method used 18 to calculate (1) the Health Maintenance Organization's 19 profitable experience with respect to the group or enrollment 20 unit and the resulting refund to the group or enrollment unit 21 or (2) the Health Maintenance Organization's unprofitable 22 experience with respect to the group or enrollment unit and 23 the resulting additional premium to be paid by the group or 24 enrollment unit. 25 In no event shall the Illinois Health Maintenance 26 Organization Guaranty Association be liable to pay any SB2762 Enrolled - 18 - LRB104 16499 BAB 29895 b 1 contractual obligation of an insolvent organization to pay any 2 refund authorized under this Section. 3 (g) Rulemaking authority to implement Public Act 95-1045, 4 if any, is conditioned on the rules being adopted in 5 accordance with all provisions of the Illinois Administrative 6 Procedure Act and all rules and procedures of the Joint 7 Committee on Administrative Rules; any purported rule not so 8 adopted, for whatever reason, is unauthorized. 9 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 10 103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff. 11 1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551, 12 eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25; 13 103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff. 14 1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, 15 eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24; 16 103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff. 17 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28, 18 eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, 19 eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26; 20 104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff. 21 1-1-26; 104-417, eff. 8-15-25; revised 11-21-25.) 22 Section 30. The Limited Health Service Organization Act is 23 amended by changing Section 4003 as follows: 24 (215 ILCS 130/4003) (from Ch. 73, par. 1504-3) SB2762 Enrolled - 19 - LRB104 16499 BAB 29895 b 1 Sec. 4003. Illinois Insurance Code provisions. Limited 2 health service organizations shall be subject to the 3 provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, 4 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153, 5 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c, 6 355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a, 7 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32, 8 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 9 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71, 10 356z.73, 356z.74, 356z.75, 356z.79, 356z.80, 356z.81, 356z.83, 11 356z.84, 356z.85, 356z.88, 356z.89, 364.3, 368a, 370a, 401, 12 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and 13 Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, 14 XXVI, and XXXIIB of the Illinois Insurance Code. Nothing in 15 this Section shall require a limited health care plan to cover 16 any service that is not a limited health service. For purposes 17 of the Illinois Insurance Code, except for Sections 444 and 18 444.1 and Articles XIII and XIII 1/2, limited health service 19 organizations in the following categories are deemed to be 20 domestic companies: 21 (1) a corporation under the laws of this State; or 22 (2) a corporation organized under the laws of another 23 state, 30% or more of the enrollees of which are residents 24 of this State, except a corporation subject to 25 substantially the same requirements in its state of 26 organization as is a domestic company under Article VIII SB2762 Enrolled - 20 - LRB104 16499 BAB 29895 b 1 1/2 of the Illinois Insurance Code. 2 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 3 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 4 1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656, 5 eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24; 6 103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff. 7 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42, 8 eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26; 9 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff. 10 8-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised 11 11-21-25.) 12 Section 35. The Voluntary Health Services Plans Act is 13 amended by changing Section 10 as follows: 14 (215 ILCS 165/10) (from Ch. 32, par. 604) 15 Sec. 10. Application of Illinois Insurance Code 16 provisions. Health services plan corporations and all persons 17 interested therein or dealing therewith shall be subject to 18 the provisions of Articles IIA and XII 1/2 and Sections 3.1, 19 133, 136, 139, 140, 143, 143.31, 143c, 149, 155.22a, 155.37, 20 354, 355.2, 355.3, 355.7, 355b, 355d, 356g, 356g.5, 356g.5-1, 21 356m, 356q, 356r, 356t, 356u, 356u.10, 356v, 356w, 356x, 356y, 22 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 23 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 24 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, SB2762 Enrolled - 21 - LRB104 16499 BAB 29895 b 1 356z.29, 356z.30, 356z.32, 356z.32a, 356z.33, 356z.40, 2 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56, 3 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 4 356z.68, 356z.71, 356z.72, 356z.74, 356z.75, 356z.77, 356z.79, 5 356z.80, 356z.81, 356z.83, 356z.84, 356z.85, 356z.88, 356z.89, 6 364.01, 364.3, 367.2, 368a, 370a, 401, 401.1, 402, 403, 403A, 7 408, 408.2, and 412, and paragraphs (7) and (15) of Section 367 8 of the Illinois Insurance Code. 9 Rulemaking authority to implement Public Act 95-1045, if 10 any, is conditioned on the rules being adopted in accordance 11 with all provisions of the Illinois Administrative Procedure 12 Act and all rules and procedures of the Joint Committee on 13 Administrative Rules; any purported rule not so adopted, for 14 whatever reason, is unauthorized. 15 (Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 16 103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-551, eff. 17 8-11-23; 103-605, eff. 7-1-24; 103-656, eff. 1-1-25; 103-718, 18 eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, eff. 8-2-24; 19 103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 103-914, eff. 20 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, 21 eff. 6-9-25; 104-28, eff. 1-1-26; 104-42, eff. 8-1-25; 104-73, 22 eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26; 23 104-324, eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 24 8-15-25; revised 11-21-25.) 25 Section 95. No acceleration or delay. Where this Act makes SB2762 Enrolled - 22 - LRB104 16499 BAB 29895 b 1 changes in a statute that is represented in this Act by text 2 that is not yet or no longer in effect (for example, a Section 3 represented by multiple versions), the use of that text does 4 not accelerate or delay the taking effect of (i) the changes 5 made by this Act or (ii) provisions derived from any other 6 Public Act. 7 Section 99. Effective date. This Act takes effect upon 8 becoming law.