GENDER-AFFIRMING HEALTH CARE

Illinois General Assembly - Full Text of HB4425

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4425

Introduced 1/14/2026, by Rep. Anne Stava

SYNOPSIS AS INTRODUCED:

5 ILCS 375/6.11
55 ILCS 5/5-1069.3
65 ILCS 5/10-4-2.3
105 ILCS 5/10-22.3f
110 ILCS 330/11 new
210 ILCS 85/11.11 new
215 ILCS 5/356z.88 new
215 ILCS 125/5-3

from Ch. 111 1/2, par. 1411.2
215 ILCS 130/4003

from Ch. 73, par. 1504-3
215 ILCS 165/10

from Ch. 32, par. 604
305 ILCS 5/5-16.8

Amends the Hospital Licensing Act and the University of Illinois
Hospital Act. Provides that, unless otherwise required by Illinois law, no
hospital, individual affiliated with a hospital, or person contracted with
a hospital shall release information related to any person or entity that
allows a child to receive gender-affirming health care or gender-affirming
mental health care in response to any criminal or civil action, including a
foreign subpoena, based on another state's law that authorizes a civil
action to be brought against any person or entity that allows a child to
receive gender-affirming health care or gender-affirming mental health
care. Amends the Illinois Insurance Code, 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 prohibit the same release of information from
an issuer of a policy of accident or health insurance.
LRB104 17384 BAB 30809 b

A BILL FOR

HB4425
LRB104 17384 BAB 30809 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 State Employees Group Insurance Act of 1971
5
is amended by changing Section 6.11 as follows:

6

(5 ILCS 375/6.11)
7

(Text of Section before amendment by P.A. 104-1
)
8

Sec. 6.11.
Required health benefits; Illinois Insurance
9
Code requirements.
The program of health benefits shall
10
provide the post-mastectomy care benefits required to be
11
covered by a policy of accident and health insurance under
12
Section 356t of the Illinois Insurance Code. The program of
13
health benefits shall provide the coverage required under
14
Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10,
15
356w, 356x, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
16
356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
17
356z.17, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
18
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
19
356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59,
20
356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70,
21
356z.71, 356z.74, 356z.76,
and
356z.77,
and
356z.80
, 356z.81,
22
356z.82, 356z.83, 356z.84, and 356z.85
of the Illinois
23
Insurance Code. The program of health benefits must comply

HB4425
- 2 -
LRB104 17384 BAB 30809 b
1
with Sections 155.22a, 155.37, 355b, 356z.19,
356z.88,
370c,
2
and 370c.1 and Article XXXIIB of the Illinois Insurance Code.
3
The program of health benefits shall provide the coverage
4
required under Section 356m of the Illinois Insurance Code
5
and, for the employees of the State Employee Group Insurance
6
Program only, the coverage as also provided in Section 6.11B
7
of this Act. The Department of Insurance shall enforce the
8
requirements of this Section with respect to Sections 370c and
9
370c.1 and Article XXXIIB of the Illinois Insurance Code; all
10
other requirements of this Section shall be enforced by the
11
Department of Central Management Services.
12

Rulemaking authority to implement Public Act 95-1045, if
13
any, is conditioned on the rules being adopted in accordance
14
with all provisions of the Illinois Administrative Procedure
15
Act and all rules and procedures of the Joint Committee on
16
Administrative Rules; any purported rule not so adopted, for
17
whatever reason, is unauthorized.
18
(Source: P.A. 103-8, eff. 1-1-24; 103-84, eff. 1-1-24; 103-91,
19
eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
20
103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
21
7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-870,
22
eff. 1-1-25; 103-914, eff. 1-1-25; 103-918, eff. 1-1-25;
23
103-951, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-27, eff.
24
1-1-26, 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
25
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
26
eff. 1-1-26; 104-417, eff. 8-15-25; revised 11-19-25.)

HB4425
- 3 -
LRB104 17384 BAB 30809 b
1

(Text of Section after amendment by P.A. 104-1
)
2

Sec. 6.11.
Required health benefits; Illinois Insurance
3
Code requirements.
The program of health benefits shall
4
provide the post-mastectomy care benefits required to be
5
covered by a policy of accident and health insurance under
6
Section 356t of the Illinois Insurance Code. The program of
7
health benefits shall provide the coverage required under
8
Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10,
9
356w, 356x, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8,
10
356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
11
356z.17, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
12
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
13
356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59,
14
356z.60, 356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70,
15
356z.71, 356z.74, 356z.76,
and
356z.77,
356z.79,

and
356z.80
,
16
356z.81, 356z.82, 356z.83, 356z.84, and 356z.85
of the
17
Illinois Insurance Code. The program of health benefits must
18
comply with Sections 155.22a, 155.37, 355b, 356z.19,
356z.88,

19
370c, and 370c.1 and Article XXXIIB of the Illinois Insurance
20
Code. The program of health benefits shall provide the
21
coverage required under Section 356m of the Illinois Insurance
22
Code and, for the employees of the State Employee Group
23
Insurance Program only, the coverage as also provided in
24
Section 6.11B of this Act. The Department of Insurance shall
25
enforce the requirements of this Section with respect to

HB4425
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LRB104 17384 BAB 30809 b
1
Sections 370c and 370c.1 and Article XXXIIB of the Illinois
2
Insurance Code; all other requirements of this Section shall
3
be enforced by the Department of Central Management Services.
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. 103-8, eff. 1-1-24; 103-84, eff. 1-1-24; 103-91,
11
eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
12
103-535, eff. 8-11-23; 103-551, eff. 8-11-23; 103-605, eff.
13
7-1-24; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-870,
14
eff. 1-1-25; 103-914, eff. 1-1-25; 103-918, eff. 1-1-25;
15
103-951, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
16
7-1-27; 104-27, eff. 1-1-26, 104-42, eff. 8-1-25; 104-68, eff.
17
1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
18
eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
19
revised 11-19-25.)

20

Section 10.
The Counties Code is amended by changing
21
Section 5-1069.3 as follows:

22

(55 ILCS 5/5-1069.3)
23

(Text of Section before amendment by P.A. 104-446
)
24

Sec. 5-1069.3.
Required health benefits.
If a county,

HB4425
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LRB104 17384 BAB 30809 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, and 356z.85
of the Illinois Insurance Code. The
15
coverage shall comply with Sections 155.22a, 355b, 356z.19,
16
356z.88,
and 370c of the Illinois Insurance Code. The
17
Department of Insurance shall enforce the requirements of this
18
Section. The requirement that health benefits be covered as
19
provided in this Section is an exclusive power and function of
20
the State and is a denial and limitation under Article VII,
21
Section 6, subsection (h) of the Illinois Constitution. A home
22
rule county to which this Section applies must comply with
23
every provision of this Section.
24

Rulemaking authority to implement Public Act 95-1045, if
25
any, is conditioned on the rules being adopted in accordance
26
with all provisions of the Illinois Administrative Procedure

HB4425
- 6 -
LRB104 17384 BAB 30809 b
1
Act and all rules and procedures of the Joint Committee on
2
Administrative Rules; any purported rule not so adopted, for
3
whatever reason, is unauthorized.
4
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
5
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
6
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
7
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
8
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
9
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
10
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
11
eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-7-26.)

12

(Text of Section after amendment by P.A. 104-446
)
13

Sec. 5-1069.3.
Required health benefits.
If a county,
14
including a home rule county, is a self-insurer for purposes
15
of providing health insurance coverage for its employees, the
16
coverage shall include coverage for the post-mastectomy care
17
benefits required to be covered by a policy of accident and
18
health insurance under Section 356t and the coverage required
19
under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
20
356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
21
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
22
356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
23
356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
24
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
25
356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74,

HB4425
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LRB104 17384 BAB 30809 b
1
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83,
2
356z.84, and 356z.85
of the Illinois Insurance Code. The
3
coverage shall comply with Sections 155.22a, 355b, 356z.19,
4
356z.88,
370c, and 370c.4 of the Illinois Insurance Code. The
5
Department of Insurance shall enforce the requirements of this
6
Section. The requirement that health benefits be covered as
7
provided in this Section is an exclusive power and function of
8
the State and is a denial and limitation under Article VII,
9
Section 6, subsection (h) of the Illinois Constitution. A home
10
rule county to which this Section applies must comply with
11
every provision of this Section.
12

Rulemaking authority to implement Public Act 95-1045, if
13
any, is conditioned on the rules being adopted in accordance
14
with all provisions of the Illinois Administrative Procedure
15
Act and all rules and procedures of the Joint Committee on
16
Administrative Rules; any purported rule not so adopted, for
17
whatever reason, is unauthorized.
18
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
19
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
20
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
21
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
22
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
23
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
24
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
25
eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26;
26
revised 1-7-26.)

HB4425
- 8 -
LRB104 17384 BAB 30809 b
1

Section 15.
The Illinois Municipal Code is amended by
2
changing Section 10-4-2.3 as follows:

3

(65 ILCS 5/10-4-2.3)
4

(Text of Section before amendment by P.A. 104-446
)
5

Sec. 10-4-2.3.
Required health benefits.
If a
6
municipality, including a home rule municipality, is a
7
self-insurer for purposes of providing health insurance
8
coverage for its employees, the coverage shall include
9
coverage for the post-mastectomy care benefits required to be
10
covered by a policy of accident and health insurance under
11
Section 356t and the coverage required under Sections 356g,
12
356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
13
356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
14
356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
15
356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
16
356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
17
356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
18
356z.67, 356z.68, 356z.70, 356z.71, 356z.74,
and
356z.77,
19
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83, 356z.84, and
20
356z.85
of the Illinois Insurance Code. The coverage shall
21
comply with Sections 155.22a, 355b, 356z.19,
356z.88,
and 370c
22
of the Illinois Insurance Code. The Department of Insurance
23
shall enforce the requirements of this Section. The
24
requirement that health benefits be covered as provided in

HB4425
- 9 -
LRB104 17384 BAB 30809 b
1
this
Section
is an exclusive power and function of the State
2
and is a denial and limitation under Article VII, Section 6,
3
subsection (h) of the Illinois Constitution. A home rule
4
municipality to which this Section applies must comply with
5
every provision of this Section.
6

Rulemaking authority to implement Public Act 95-1045, if
7
any, is conditioned on the rules being adopted in accordance
8
with all provisions of the Illinois Administrative Procedure
9
Act and all rules and procedures of the Joint Committee on
10
Administrative Rules; any purported rule not so adopted, for
11
whatever reason, is unauthorized.
12
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
13
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
14
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
15
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
16
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
17
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
18
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
19
eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-8-26.)

20

(Text of Section after amendment by P.A. 104-446
)
21

Sec. 10-4-2.3.
Required health benefits.
If a
22
municipality, including a home rule municipality, is a
23
self-insurer for purposes of providing health insurance
24
coverage for its employees, the coverage shall include
25
coverage for the post-mastectomy care benefits required to be

HB4425
- 10 -
LRB104 17384 BAB 30809 b
1
covered by a policy of accident and health insurance under
2
Section 356t and the coverage required under Sections 356g,
3
356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
4
356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
5
356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
6
356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
7
356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
8
356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
9
356z.67, 356z.68, 356z.70, 356z.71, 356z.74,
and
356z.77,
10
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83, 356z.84, and
11
356z.85
of the Illinois Insurance Code. The coverage shall
12
comply with Sections 155.22a, 355b, 356z.19,
356z.88,
370c,
13
and 370c.4 of the Illinois Insurance Code. The Department of
14
Insurance shall enforce the requirements of this Section. The
15
requirement that health benefits be covered as provided in
16
this
Section
is an exclusive power and function of the State
17
and is a denial and limitation under Article VII, Section 6,
18
subsection (h) of the Illinois Constitution. A home rule
19
municipality to which this Section applies must comply with
20
every provision 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.

HB4425
- 11 -
LRB104 17384 BAB 30809 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; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
7
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
8
eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26;
9
revised 1-8-26.)

10

Section 20.
The School Code is amended by changing Section
11
10-22.3f as follows:

12

(105 ILCS 5/10-22.3f)
13

(Text of Section before amendment by P.A. 104-446
)
14

Sec. 10-22.3f.
Required health benefits.
Insurance
15
protection and benefits for employees shall provide the
16
post-mastectomy care benefits required to be covered by a
17
policy of accident and health insurance under Section 356t and
18
the coverage required under Sections 356g, 356g.5, 356g.5-1,
19
356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
20
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
21
356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
22
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
23
356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
24
356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71,

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1
356z.74,
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82,
2
356z.83, 356z.84, and 356z.85
of the Illinois Insurance Code.
3
Insurance policies shall comply with Section 356z.19 of the
4
Illinois Insurance Code. The coverage shall comply with
5
Sections 155.22a, 355b,
356z.88,
and 370c and Article XXXIIB
6
of the Illinois Insurance Code. The Department of Insurance
7
shall enforce the requirements 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; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff.
20
1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
21
eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
22
revised 1-8-26.)

23

(Text of Section after amendment by P.A. 104-446
)
24

Sec. 10-22.3f.
Required health benefits.
Insurance
25
protection and benefits for employees shall provide the

HB4425
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LRB104 17384 BAB 30809 b
1
post-mastectomy care benefits required to be covered by a
2
policy of accident and health insurance under Section 356t and
3
the coverage required under Sections 356g, 356g.5, 356g.5-1,
4
356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
5
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
6
356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
7
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
8
356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
9
356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71,
10
356z.74,
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82,
11
356z.83, 356z.84, and 356z.85
of the Illinois Insurance Code.
12
Insurance policies shall comply with Section 356z.19 of the
13
Illinois Insurance Code. The coverage shall comply with
14
Sections 155.22a, 355b,
356z.88,
370c, and 370c.4 and Article
15
XXXIIB of the Illinois Insurance Code. The Department of
16
Insurance shall enforce the requirements of this Section.
17

Rulemaking authority to implement Public Act 95-1045, if
18
any, is conditioned on the rules being adopted in accordance
19
with all provisions of the Illinois Administrative Procedure
20
Act and all rules and procedures of the Joint Committee on
21
Administrative Rules; any purported rule not so adopted, for
22
whatever reason, is unauthorized.
23
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
24
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
25
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
26
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;

HB4425
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1
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
2
6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff.
3
1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
4
eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
5
104-446, eff. 6-1-26; revised 1-8-26.)

6

Section 25.
The University of Illinois Hospital Act is
7
amended by adding Section 11 as follows:

8

(110 ILCS 330/11 new)
9

Sec. 11.
Release of information related to
10
gender-affirming care.
The University of Illinois Hospital
11
shall comply with Section 11.11 of the Hospital Licensing Act.

12

Section 30.
The Hospital Licensing Act is amended by
13
adding Section 11.11 as follows:

14

(210 ILCS 85/11.11 new)
15

Sec. 11.11.
Release of information related to
16
gender-affirming care.
17

(a) As used in this Section:
18

"Gender-affirming health care" means any kind of medical
19
intervention, including hormonal or surgical, designed to
20
support or affirm an individual's gender identity.
21

"Gender-affirming mental health care" means any kind of
22
social, psychological, or behavioral intervention designed to

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1
support or affirm an individual's gender identity.
2

(b) Unless otherwise required by Illinois law, no
3
hospital, individual affiliated with a hospital, or person
4
contracted with a hospital shall release information related
5
to any person or entity that allows a child to receive
6
gender-affirming health care or gender-affirming mental health
7
care in response to any criminal or civil action, including a
8
foreign subpoena, based on another state's law that authorizes
9
a civil action to be brought against any person or entity that
10
allows a child to receive gender-affirming health care or
11
gender-affirming mental health care.

12

Section 35.
The Illinois Insurance Code is amended by
13
adding Section 356z.88 as follows:

14

(215 ILCS 5/356z.88 new)
15

Sec. 356z.88.
Release of information related to
16
gender-affirming care.

17

(a) As used in this Section:
18

"Gender-affirming health care" means any kind of medical
19
intervention, including hormonal or surgical, designed to
20
support or affirm an individual's gender identity.
21

"Gender-affirming mental health care" means any kind of
22
social, psychological, or behavioral intervention designed to
23
support or affirm an individual's gender identity.
24

(b) Unless otherwise required by Illinois law, no issuer

HB4425
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LRB104 17384 BAB 30809 b
1
of a policy of accident or health insurance shall release
2
information related to any person or entity that allows a
3
child to receive gender-affirming health care or
4
gender-affirming mental health care in response to any
5
criminal or civil action, including a foreign subpoena, based
6
on another state's law that authorizes a civil action to be
7
brought against any person or entity that allows a child to
8
receive gender-affirming health care or gender-affirming
9
mental health care.

10

Section 40.
The Health Maintenance Organization Act is
11
amended by changing Section 5-3 as follows:

12

(215 ILCS 125/5-3)

(from Ch. 111 1/2, par. 1411.2)
13

Sec. 5-3.
Illinois Insurance Code provisions.
14

(a) Health Maintenance Organizations shall be subject to
15
the provisions of Sections 133, 134, 136, 137, 139, 140,
16
141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
17
152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
18
155.49, 352c, 355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f,
19
356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
20
356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
21
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
22
356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
23
356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
24
356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,

HB4425
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LRB104 17384 BAB 30809 b
1
356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
2
356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
3
356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
4
356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
5
356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
6
356z.76, 356z.77, 356z.78,
356z.79,
356z.80,
356z.81, 356z.82,
7
356z.83, 356z.84, 356z.85, 356z.88,
364, 364.01, 364.3, 367.2,
8
367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370a, 370c,
9
370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444,
10
and 444.1, paragraph (c) of subsection (2) of Section 367, and
11
Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV,
12
XXVI, and XXXIIB of the Illinois Insurance Code.
13

(b) For purposes of the Illinois Insurance Code, except
14
for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
15
Health Maintenance Organizations in the following categories
16
are deemed to be "domestic companies":
17

(1) a corporation authorized under the Dental Service
18

Plan Act or the Voluntary Health Services Plans Act;
19

(2) a corporation organized under the laws of this
20

State; or
21

(3) a corporation organized under the laws of another
22

state, 30% or more of the enrollees of which are residents
23

of this State, except a corporation subject to
24

substantially the same requirements in its state of
25

organization as is a "domestic company" under Article VIII
26

1/2 of the Illinois Insurance Code.

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LRB104 17384 BAB 30809 b
1

(c) In considering the merger, consolidation, or other
2
acquisition of control of a Health Maintenance Organization
3
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
4

(1) the Director shall give primary consideration to
5

the continuation of benefits to enrollees and the
6

financial conditions of the acquired Health Maintenance
7

Organization after the merger, consolidation, or other
8

acquisition of control takes effect;
9

(2)(i) the criteria specified in subsection (1)(b) of
10

Section 131.8 of the Illinois Insurance Code shall not
11

apply and (ii) the Director, in making his determination
12

with respect to the merger, consolidation, or other
13

acquisition of control, need not take into account the
14

effect on competition of the merger, consolidation, or
15

other acquisition of control;
16

(3) the Director shall have the power to require the
17

following information:
18

(A) certification by an independent actuary of the
19

adequacy of the reserves of the Health Maintenance
20

Organization sought to be acquired;
21

(B) pro forma financial statements reflecting the
22

combined balance sheets of the acquiring company and
23

the Health Maintenance Organization sought to be
24

acquired as of the end of the preceding year and as of
25

a date 90 days prior to the acquisition, as well as pro
26

forma financial statements reflecting projected

HB4425
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LRB104 17384 BAB 30809 b
1

combined operation for a period of 2 years;
2

(C) a pro forma business plan detailing an
3

acquiring party's plans with respect to the operation
4

of the Health Maintenance Organization sought to be
5

acquired for a period of not less than 3 years; and
6

(D) such other information as the Director shall
7

require.
8

(d) The provisions of Article VIII 1/2 of the Illinois
9
Insurance Code and this Section 5-3 shall apply to the sale by
10
any health maintenance organization of greater than 10% of its
11
enrollee population (including, without limitation, the health
12
maintenance organization's right, title, and interest in and
13
to its health care certificates).
14

(e) In considering any management contract or service
15
agreement subject to Section 141.1 of the Illinois Insurance
16
Code, the Director (i) shall, in addition to the criteria
17
specified in Section 141.2 of the Illinois Insurance Code,
18
take into account the effect of the management contract or
19
service agreement on the continuation of benefits to enrollees
20
and the financial condition of the health maintenance
21
organization to be managed or serviced, and (ii) need not take
22
into account the effect of the management contract or service
23
agreement on competition.
24

(f) Except for small employer groups as defined in the
25
Small Employer Rating, Renewability and Portability Health
26
Insurance Act and except for medicare supplement policies as

HB4425
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LRB104 17384 BAB 30809 b
1
defined in Section 363 of the Illinois Insurance Code, a
2
Health Maintenance Organization may by contract agree with a
3
group or other enrollment unit to effect refunds or charge
4
additional premiums under the following terms and conditions:
5

(i) the amount of, and other terms and conditions with
6

respect to, the refund or additional premium are set forth
7

in the group or enrollment unit contract agreed in advance
8

of the period for which a refund is to be paid or
9

additional premium is to be charged (which period shall
10

not be less than one year); and
11

(ii) the amount of the refund or additional premium
12

shall not exceed 20% of the Health Maintenance
13

Organization's profitable or unprofitable experience with
14

respect to the group or other enrollment unit for the
15

period (and, for purposes of a refund or additional
16

premium, the profitable or unprofitable experience shall
17

be calculated taking into account a pro rata share of the
18

Health Maintenance Organization's administrative and
19

marketing expenses, but shall not include any refund to be
20

made or additional premium to be paid pursuant to this
21

subsection (f)). The Health Maintenance Organization and
22

the group or enrollment unit may agree that the profitable
23

or unprofitable experience may be calculated taking into
24

account the refund period and the immediately preceding 2
25

plan years.
26

The Health Maintenance Organization shall include a

HB4425
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LRB104 17384 BAB 30809 b
1
statement in the evidence of coverage issued to each enrollee
2
describing the possibility of a refund or additional premium,
3
and upon request of any group or enrollment unit, provide to
4
the group or enrollment unit a description of the method used
5
to calculate (1) the Health Maintenance Organization's
6
profitable experience with respect to the group or enrollment
7
unit and the resulting refund to the group or enrollment unit
8
or (2) the Health Maintenance Organization's unprofitable
9
experience with respect to the group or enrollment unit and
10
the resulting additional premium to be paid by the group or
11
enrollment unit.
12

In no event shall the Illinois Health Maintenance
13
Organization Guaranty Association be liable to pay any
14
contractual obligation of an insolvent organization to pay any
15
refund authorized under this Section.
16

(g) Rulemaking authority to implement Public Act 95-1045,
17
if any, is conditioned on the rules being adopted in
18
accordance with all provisions of the Illinois Administrative
19
Procedure Act and all rules and procedures of the Joint
20
Committee on Administrative Rules; any purported rule not so
21
adopted, for whatever reason, is unauthorized.
22
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
23
103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
24
1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
25
eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
26
103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.

HB4425
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LRB104 17384 BAB 30809 b
1
1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
2
eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
3
103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff.
4
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28,
5
eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73,
6
eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
7
104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff.
8
1-1-26; 104-417, eff. 8-15-25; revised 11-21-25.)

9

Section 45.
The Limited Health Service Organization Act is
10
amended by changing Section 4003 as follows:

11

(215 ILCS 130/4003)

(from Ch. 73, par. 1504-3)
12

Sec. 4003.
Illinois Insurance Code provisions.
Limited
13
health service organizations shall be subject to the
14
provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
15
141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
16
154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
17
355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
18
356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
19
356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
20
356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
21
356z.73, 356z.74, 356z.75, 356z.79, 356z.80,
356z.81, 356z.83,
22
356z.84, 356z.85, 356z.88,
364.3, 368a, 370a, 401, 401.1, 402,
23
403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles
24
IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and

HB4425
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LRB104 17384 BAB 30809 b
1
XXXIIB of the Illinois Insurance Code. Nothing in this Section
2
shall require a limited health care plan to cover any service
3
that is not a limited health service. For purposes of the
4
Illinois Insurance Code, except for Sections 444 and 444.1 and
5
Articles XIII and XIII 1/2, limited health service
6
organizations in the following categories are deemed to be
7
domestic companies:
8

(1) a corporation under the laws of this State; or
9

(2) a corporation organized under the laws of another
10

state, 30% or more of the enrollees of which are residents
11

of this State, except a corporation subject to
12

substantially the same requirements in its state of
13

organization as is a domestic company under Article VIII
14

1/2 of the Illinois Insurance Code.
15
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
16
103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
17
1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
18
eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
19
103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
20
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
21
eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26;
22
104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff.
23
8-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised
24
11-21-25.)

25

Section 50.
The Voluntary Health Services Plans Act is

HB4425
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LRB104 17384 BAB 30809 b
1
amended by changing Section 10 as follows:

2

(215 ILCS 165/10)

(from Ch. 32, par. 604)
3

Sec. 10.
Application of Illinois Insurance Code
4
provisions.
Health services plan corporations and all persons
5
interested therein or dealing therewith shall be subject to
6
the provisions of Articles IIA and XII 1/2 and Sections 3.1,
7
133, 136, 139, 140, 143, 143.31, 143c, 149, 155.22a, 155.37,
8
354, 355.2, 355.3, 355.7, 355b, 355d, 356g, 356g.5, 356g.5-1,
9
356m, 356q, 356r, 356t, 356u, 356u.10, 356v, 356w, 356x, 356y,
10
356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
11
356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
12
356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26,
13
356z.29, 356z.30, 356z.32, 356z.32a, 356z.33, 356z.40,
14
356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56,
15
356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67,
16
356z.68, 356z.71, 356z.72, 356z.74, 356z.75, 356z.77,
356z.79,

17
356z.80,
356z.81, 356z.83, 356z.84, 356z.85, 356z.88,
364.01,
18
364.3, 367.2, 368a, 370a, 401, 401.1, 402, 403, 403A, 408,
19
408.2, and 412, and paragraphs (7) and (15) of Section 367 of
20
the Illinois Insurance Code.
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

HB4425
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LRB104 17384 BAB 30809 b
1
whatever reason, is unauthorized.
2
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
3
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-551, eff.
4
8-11-23; 103-605, eff. 7-1-24; 103-656, eff. 1-1-25; 103-718,
5
eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, eff. 8-2-24;
6
103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 103-914, eff.
7
1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1,
8
eff. 6-9-25; 104-28, eff. 1-1-26; 104-42, eff. 8-1-25; 104-73,
9
eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
10
104-324, eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff.
11
8-15-25; revised 11-21-25.)

12

Section 55.
The Illinois Public Aid Code is amended by
13
changing Section 5-16.8 as follows:

14

(305 ILCS 5/5-16.8)
15

Sec. 5-16.8.
Required health benefits.
The medical
16
assistance program shall (i) provide the post-mastectomy care
17
benefits required to be covered by a policy of accident and
18
health insurance under Section 356t and the coverage required
19
under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
20
356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
21
356z.47, 356z.51, 356z.53, 356z.59, 356z.60, 356z.61, 356z.64,
22
356z.67, 356z.71,
and
356z.75,
and
356z.80
, 356z.84, and
23
356z.85
of the Illinois Insurance Code, (ii) be subject to the
24
provisions of Sections 356z.19, 356z.44, 356z.49,
356z.88,

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LRB104 17384 BAB 30809 b
1
364.01, 370c, and 370c.1 of the Illinois Insurance Code, and
2
(iii) be subject to the provisions of subsection (d-5) of
3
Section 10 of the Network Adequacy and Transparency Act.
4

The Department, by rule, shall adopt a model similar to
5
the requirements of Section 356z.39 of the Illinois Insurance
6
Code.
7

On and after July 1, 2012, the Department shall reduce any
8
rate of reimbursement for services or other payments or alter
9
any methodologies authorized by this Code to reduce any rate
10
of reimbursement for services or other payments in accordance
11
with Section 5-5e.
12

To ensure full access to the benefits set forth in this
13
Section, on and after January 1, 2016, the Department shall
14
ensure that provider and hospital reimbursement for
15
post-mastectomy care benefits required under this Section are
16
no lower than the Medicare reimbursement rate.
17
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
18
103-420, eff. 1-1-24; 103-605, eff. 7-1-24; 103-703, eff.
19
1-1-25; 103-758, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-73,
20
eff. 1-1-26; 104-324, eff. 1-1-26; 104-379, eff. 1-1-26;
21
104-417, eff. 8-15-25; revised 11-21-25.)

22

Section 95.
No acceleration or delay.
Where this Act makes
23
changes in a statute that is represented in this Act by text
24
that is not yet or no longer in effect (for example, a Section
25
represented by multiple versions), the use of that text does

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LRB104 17384 BAB 30809 b
1
not accelerate or delay the taking effect of (i) the changes
2
made by this Act or (ii) provisions derived from any other
3
Public Act.

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