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Legislative Report March 28, 2025
Prepared by: Alie Wagner
Insurance
Bill Information
ST GROUP INS-TRS PARTICIPANTS
(REP. WAYNE ROSENTHAL)

Amends the State Employees Group Insurance Act of 1971. Provides that, by no later than January 1, 2026, the Department of Central Management Services shall, by rule, establish a program to allow the active members of TRS and their dependent beneficiaries to participate in the program of group health benefits made available under the Act to TRS benefit recipients and TRS dependent beneficiaries, including the program of group health benefits for Medicare-primary members and their Medicare-primary dependents, in lieu of health benefits otherwise provided by the school district. Provides that the Department of Central Management Services shall adopt any rules necessary to implement and administer the program, including, but not limited to, the manner of electing to participate in the program, eligibility for participation in the program, and contributions for coverage through the program. Effective immediately.

  CURRENT STATUS

3/21/2025 - Rule 19(a) / Re-referred to Rules Committee

TEACHERS INS-RETURN TO SERVICE
(REP. RYAN SPAIN)

Amends the State Employees Group Insurance Act of 1971. Provides that the eligibility of an annuitant or TRS benefit recipient to participate in the program of health benefits established under specified provisions of the Act shall not be suspended for any period during which he or she accepts employment from a school board or other employer in accordance with a provision of the Downstate Teacher Article of the Illinois Pension Code that allows annuitants to accept employment as a teacher without impairing retirement status if certain conditions are met, including a limit on the number of paid days the annuitant may work, or a provision for annuitants returning to teach in a subject shortage area. Provides that an annuitant or TRS benefit recipient shall not be deemed an active teacher based solely on the annuitant's or TRS benefit recipient's employment exceeding the limit on the number of paid days an annuitant may work without impairing retirement status. Amends the Downstate Teacher Article of the Illinois Pension Code to make conforming changes.

  CURRENT STATUS

3/21/2025 - Rule 19(a) / Re-referred to Rules Committee

UNEMPLOYMENT INS-SCHOOLS
(REP. JAWAHARIAL WILLIAMS)

Amends the Unemployment Insurance Act. Provides that, subject to appropriation, school districts and public institutions of higher education are eligible to receive unemployment insurance aid. Sets forth provisions concerning the calculation of the amount of unemployment insurance aid to be given to each school district and public institutions of higher education. Provides that, if the total unemployment insurance aid for a fiscal year is greater than the annual appropriation for that year, the State Board of Education or the Board of Higher Education shall proportionately reduce the aid payment to each school district and public institution of higher education. Sets forth reporting requirements. Makes conforming changes. Effective January 1, 2026.

  CURRENT STATUS

3/21/2025 - Rule 19(a) / Re-referred to Rules Committee

INS CD-EDUCATION PROVIDER
(REP. JAY HOFFMAN)

Amends the Insurance Producers, Limited Insurance Representatives, and Registered Firms Article of the Illinois Insurance Code. Provides that the annual registration fee for an education provider that is not based in the State of Illinois is $2,000. Makes a conforming change.

  CURRENT STATUS

3/26/2025 - House Bills on Third Reading

DENTAL INSURANCE ASSIGNABILITY
(REP. RICK RYAN)

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.

  CURRENT STATUS

3/26/2025 - House Floor Amendment No. 2 Referred to Rules Committee

INS CD-STUTTERING COVERAGE
(REP. MARCUS EVANS, JR.)

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.

  CURRENT STATUS

3/26/2025 - Held on Calendar Order of Second Reading - Short Debate

EMPLOYMENT-ACADEMIC PERSONNEL
(REP. GREGG JOHNSON)

Amends the Unemployment Insurance Act. Provides that with respect to a week of unemployment beginning on or after March 15, 2020 (rather than beginning on or after March 15, 2020, and before September 4, 2021 (including any week of unemployment beginning on or after January 1, 2021 and on or before June 25, 2021)) benefits shall be payable to an individual on the basis of wages for employment in other than an instructional, research, or principal administrative capacity performed for an educational institution or an educational service agency under specified circumstances, as long as the individual is otherwise eligible for benefits.

  CURRENT STATUS

3/21/2025 - Rule 19(a) / Re-referred to Rules Committee

INS CD-STUTTERING COVERAGE
(SEN. WILLIE PRESTON)

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.

  CURRENT STATUS

3/20/2025 - Placed on Calendar Order of 3rd Reading April 1, 2025

INS CD-MENTAL HEALTH PARITY
(SEN. KARINA VILLA)

Amends the Illinois Insurance Code. Establishes reimbursement rates for mental health and substance use disorder treatment services for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027 or for any contracted third party administering the behavioral health benefits for the insurer. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 or any contracted third party administering the behavioral health benefits for the insurer to cover certain medically necessary mental health and substance use disorder treatment services. Provides that, if the Department of Insurance determines that an insurer or a contracted third party administering the behavioral health benefits for the insurer has violated a provision concerning mental health and substance use parity, the Department shall by order assess a civil penalty of $1,000 for each violation. Excludes certain health care plans serving Medicaid populations who are enrolled under the Illinois Public Aid Code or under the Children's Health Insurance Program Act from provisions concerning mental health and substance use parity. Requires the Department to review the impact of the proposed mental health and substance abuse mandate on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Permits the Department to examine out-of-network utilization and out-of-pocket costs for insureds for mental health and substance use treatment and services for all plans to compare with in-network utilization. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under those provisions. Effective immediately.

  CURRENT STATUS

1/13/2025 - Referred to Senate Assignments

INS CODE-RIDING THERAPY
(SEN. LAURA MURPHY)

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after the effective date of the amendatory Act shall provide coverage for hippotherapy and other forms of therapeutic riding. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, and the Health Maintenance Organization Act.

Senate Committee Amendment No. 1 - Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes: Makes changes to defined terms. Provides that a group or individual policy of accident and health insurance (instead of including a managed care plan) that is amended, delivered, issued, or renewed after January 1, 2027 (instead of after the effective date of this amendatory Act of the 104th General Assembly) shall provide coverage for medically necessary services that incorporate equine movement as part of a therapeutic intervention (instead of coverage for hippotherapy and other forms of therapeutic riding).

  CURRENT STATUS

3/20/2025 - Senate Bills on Third Reading

INS-HEALTH PLAN BENEFIT DATA
(SEN. LAKESIA COLLINS)

Amends the Illinois Insurance Code. Provides that no later than July 1, 2026, each health plan and pharmacy benefit manager operating in this State shall, upon request of a covered individual, his or her health care provider, or an authorized third party on his or her behalf, furnish specified cost, benefit, and coverage data to the covered individual, his or her health care provider, or the third party of his or her choosing and shall ensure that the data is: (1) current no later than one business day after any change is made; (2) provided in real time; and (3) in a format that is easily accessible to the covered individual or, in the case of his or her health care provider, through an electronic health records system. Provides that the format of the request shall use specified industry content and transport standards. Provides that a facsimile is not an acceptable electronic format. Provides that upon request, specified data shall be provided for any drug covered under the covered individual's health plan. Makes other changes. Defines terms.

  CURRENT STATUS

3/21/2025 - Rule 3-9(a) / Re-referred to Assignments

PRIOR AUTH-PRESCRIPTION DRUGS
(SEN. GRACIELA GUZMÁN)

Amends the Prior Authorization Reform Act. Provides that a health insurance issuer may not require prior authorization for: a prescription drug prescribed to a patient by a health care professional for 6 or more consecutive months, regardless of whether the prescription drug is a non-preferred medication pursuant to the patient's health insurance coverage; the following prescription drugs or the therapeutic equivalent approved by the United States Food and Drug Administration: insulin; human immunodeficiency virus prevention medication; human immunodeficiency virus treatment medication; viral hepatitis medication; estrogen; and progesterone; or human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis drugs approved by the United States Food and Drug Administration; Truvada; Harvoni; Descovy; and Apretude.

  CURRENT STATUS

3/21/2025 - Rule 2-10 Committee Deadline Established As April 4, 2025

INS CD-FERTILITY PRESERVATION
(SEN. GRACIELA GUZMÁN)

Amends the Illinois Insurance Code. Requires an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in the State after June 1, 2026 to provide coverage for expenses for standard fertility preservation services and follow-up services related to that coverage. Defines "standard fertility preservation services" as procedures based upon current evidence-based standards of care established by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or other national medical associations that follow current evidence-based standards of care. Makes conforming changes in 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, and the Illinois Public Aid Code. Effective immediately.

  CURRENT STATUS

4/2/2025 - Senate Insurance

GENERAL ANESTHESIA COVERAGE
(SEN. DORIS TURNER)

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 shall provide coverage for medically necessary general anesthesia, regardless of the duration, for any procedure covered by the policy, and that medical necessity shall be determined by the attending anesthesiologist or licensed anesthesia provider. Provides that an individual or group policy of accident and health insurance is prohibited from denying payment or reimbursement for anesthesia services solely because the duration of care exceeded a preset time limit. 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 Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. Effective immediately.

  CURRENT STATUS

1/31/2025 - Referred to Senate Assignments

INS-BEHAVIORIAL HEALTH
(SEN. LAURA FINE)

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, 2026, shall not impose any prior authorization or utilization management controls on covered behavioral health services. Makes conforming changes to the State Employees Group Insurance Act of 1971, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, and the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Insurance and the Department of Healthcare and Family Services to establish a process for receiving complaints from providers and covered individuals for violations of the mandate. Grants the Department of Insurance and the Department of Healthcare and Family Services the authority to issue cease and desist orders and administrative fines. Amends the Prior Authorization Reform Act. Provides that the Department of Healthcare and Family Services shall adopt rules consistent with the Act. Provisions amending the Prior Authorization Reform Act are effective immediately.

  CURRENT STATUS

3/21/2025 - Rule 2-10 Committee Deadline Established As April 4, 2025

INS CD-CRIBS AND CAR SEATS
(SEN. CHRISTOPHER BELT)

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.

  CURRENT STATUS

2/5/2025 - Referred to Senate Assignments