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

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

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

5/7/2025 - House Labor & Commerce

Senate Floor Amendment No. 2 - Replaces everything after the enacting clause. Provides that the amendatory Act may be referred to as the Prescription Drug Affordability Act. Amends the Department of Commerce and Economic Opportunity Law of the Civil Administrative Code of Illinois. Provides that the Department of Insurance shall use moneys deposited into the DCEO Projects Fund pursuant to specified provisions of the Illinois Insurance Code to make a grant to a statewide retail association representing pharmacies to promote access to pharmacies and pharmacist services. Amends the Illinois Insurance Code. Makes changes to defined terms in provisions concerning pharmacy benefit manager contracts. Provides that a pharmacy benefit manager or an affiliate acting on its behalf shall not conduct spread pricing, steer a covered individual, or limit a covered individual's access to drugs from a pharmacy or pharmacist enrolled with the health benefit plan under the terms offered to all pharmacies in the plan coverage area by designating the covered drug as a specialty drug contrary to the specified definition. Provides that a pharmacy benefit manager or affiliated rebate aggregator must remit no less than 100% of any amounts paid by a pharmaceutical manufacturer, wholesaler, or other distributor of a drug. Provides that the contract between the pharmacy benefit manager and the insurer or health benefit plan sponsor must allow and provide for the pharmacy benefit manager's compliance with an audit at least once per calendar year of the rebate and fee records remitted from a pharmacy benefit manager or its affiliated party to a health benefit plan. Provides that the changes made to provisions concerning pharmacy benefit manager contracts by the Act shall apply with respect to any health benefit plan that provides coverage for drugs that is amended, delivered, issued, or renewed on or after January 1, 2026. Sets forth provisions concerning pharmacy benefit manager reporting requirements. In provisions concerning pharmacy benefit manager licensure requirements, provides that on or before August 1, 2025, the pharmacy benefit manager shall submit a report to the Department that lists the name of each health benefit plan it administers, provides the number of covered individuals for each health benefit plan as of the date of submission, and provides the total covered individuals across all health benefit plans the pharmacy benefit manager administers. Provides that on or before September 1, 2025, a registered pharmacy benefit manager, as a condition of its authority to transact business in the State, must submit to the Department an amount equal to $15 or an alternate amount as determined by the Director by rule per covered individual enrolled by the pharmacy benefit manager in the State. Provides that on or before September 1, 2026 and each September 1 thereafter, payments submitted in provisions concerning pharmacy benefit manager licensure requirements shall be based on the number of covered individuals reported to the Department in specified provisions of the Illinois Insurance Code. Makes changes to provisions concerning examinations of registered pharmacy benefit managers. Amends the Illinois Public Aid Code. Makes changes to provisions concerning critical access care pharmacies. In provisions concerning pharmacy benefits, provides that a pharmacy benefit manager must comply with all provisions of the Pharmacy Benefit Managers Article of the Illinois Insurance Code to the extent that the provisions do not prevent the application of any provision of the Article or applicable federal law. Amends the State Employees Group Insurance Act of 1971 and the School Code to require coverage from specified provisions of the Illinois Insurance Code under the provisions of those Acts. Amends the Juvenile Court Act of 1987, the Unified Code of Corrections, and the County Jail Act to require specified contracts and pharmacy benefit manager activities to be subject to the Pharmacy Benefit Managers Article of the Illinois Insurance Code and the authority of the Director of Insurance to enforce those provisions. Makes other changes. Effective January 1, 2026, except that certain provisions are effective immediately.

Senate Floor Amendment No. 4 - In an applicability provision concerning violations of pharmacy benefit manager contract requirements, specifies that the provisions do not apply to a contract directly between a 340B entity and the plan sponsor of a self-funded, single-employer or multiemployer (rather than only single-employer) employee welfare benefit plan subject to 29 U.S.C. 1144. In provisions concerning amounts transferred to the Prescription Drug Affordability Fund, specifies that the first $25,000,000 transferred into the DCEO Projects Fund shall be for grants to pharmacies under specified provisions of the Department of Commerce and Economic Opportunity Law. Removes provision excluding a pharmacy that participates or contracts in the 340B program as a contract pharmacy from the definition of "critical access pharmacy". Provides that 340B pharmacies that are participants in the critical access care pharmacy program shall only be reimbursed for the actual acquisition costs of the 340B covered drugs dispensed to participants in the State's medical assistance program as defined in the Illinois Public Aid Code.

Senate Floor Amendment No. 5 - Removes language providing that moneys deposited into the Prescription Drug Affordability Fund shall be used to pay the expenses of the Department of Insurance.

  CURRENT STATUS

7/1/2025 - Public Act . . . . . . . . . 104-0027

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

4/11/2025 - Rule 19(a) / Re-referred to Rules Committee

Senate Floor Amendment No. 2 - Replaces everything after the enacting clause. Creates the Patient Access to Pharmacy Protection Act. Provides that no person, including a pharmaceutical manufacturer, may deny, restrict, prohibit, condition, or otherwise interfere with, either directly or indirectly, the acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B covered entity or a 340B contract pharmacy authorized to receive 340B drugs on behalf of the 340B covered entity unless the receipt is prohibited by federal law; impose any restriction on the ability of a 340B covered entity to contract with or designate a 340B contract pharmacy; or require or compel a 340B covered entity or 340B contract pharmacy to perform the specified actions. Provides that each individual transaction of 340B drugs that is subject to a prohibited act, as specified, shall constitute a separate violation of the Act. Sets forth provisions concerning reporting requirements for a 340B covered entity and the Department of Healthcare and Family Services; 340B prescription drug applicability; preventing duplication of 340B discounts; enforcement of the Act by the Attorney General; penalties; and preemption. Effective immediately.

  CURRENT STATUS

7/1/2025 - Senate Floor Amendment No. 2 Rule 19(b) / Motion Referred to Rules Committee

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

4/11/2025 - Rule 19(a) / Re-referred to Rules Committee

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

House Committee Amendment No. 1 - Replaces everything after the enacting clause. Amends the Agency Energy Efficiency Act. Makes a technical change in a Section concerning the short title.

  CURRENT STATUS

6/1/2025 - House Floor Amendment No. 6 Rule 19(c) / Re-referred to Rules Committee

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

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

6/18/2025 - Sent to Governor for Signature

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 provide coverage for the cost of a karyotype test or related hormone testing to diagnose Klinefelter syndrome. 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.

Senate Floor Amendment No. 1 - 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 (instead of 2026) shall provide coverage for a karyotype test or related hormone testing (instead of the cost of a karyotype test or related hormone testing) to diagnose Klinefelter syndrome.

  CURRENT STATUS

6/18/2025 - Sent to Governor for Signature

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

Amends the Corporate Fiduciary Act. Makes a technical change in the Section concerning the short title of the Act.

  CURRENT STATUS

6/2/2025 - Rule 3-9(a) / Re-referred to Assignments

Amends the Residential Mortgage License Act of 1987. Makes a technical change in the Section concerning the short title of the Act.

  CURRENT STATUS

6/2/2025 - Rule 3-9(a) / Re-referred to Assignments

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

5/9/2025 - Rule 3-9(a) / Re-referred to Assignments

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

4/11/2025 - Rule 3-9(a) / Re-referred to Assignments

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

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

4/11/2025 - Rule 3-9(a) / Re-referred to Assignments

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

Creates the Patient Access to Pharmacy Protection Act. Defines terms. Provides that no person, including a pharmaceutical manufacturer, may deny, restrict, prohibit, condition, or otherwise interfere with, either directly or indirectly, the acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B covered entity or a 340B contract pharmacy authorized to receive 340B drugs on behalf of the 340B covered entity unless such receipt is prohibited by federal law. Provides that no person, including a pharmaceutical manufacturer, may impose any restriction on the ability of a 340B covered entity to contract with or designate a 340B contract pharmacy including restrictions relating to the number, location, ownership, or type of 340B contract pharmacy. Provides that no person, including a pharmaceutical manufacturer, may require or compel a 340B covered entity or 340B contract pharmacy to submit or otherwise provide ingredient cost or pricing data pertinent to 340B drugs unless required by State or federal law; institute requirements in any way relating to how a 340B covered entity manages its inventory of 340B drugs that are not required by a State or federal agency, including requirements relating to the frequency or scope of audits of inventory management systems of a 340B covered entity or a 340B contract pharmacy; or submit data or information that is not required by State or federal law as a condition for a 340B covered entity, its 340B contract pharmacy, or a location otherwise authorized by a 340B covered entity to receive 340B drugs. Sets forth provisions concerning enforcement of this Act; preemption of this Act; and severability of this Act. Effective immediately.

  CURRENT STATUS

6/2/2025 - Rule 3-9(a) / Re-referred to Assignments