SHORT-TERM HEALTH INSURANCE

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB2757

Introduced 1/13/2026, by Sen. Jil Tracy

SYNOPSIS AS INTRODUCED:

215 ILCS 5/121-2.05

from Ch. 73, par. 733-2.05
215 ILCS 5/367.3

from Ch. 73, par. 979.3
215 ILCS 5/367a

from Ch. 73, par. 979a
215 ILCS 5/352c rep.
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 190/Act title
215 ILCS 190/1
215 ILCS 190/5
215 ILCS 190/10
215 ILCS 190/15
215 ILCS 190/20
215 ILCS 190/99

Amends the Illinois Insurance Code. Repeals provisions prohibiting
short-term, limited-duration insurance and makes conforming changes.
Amends the Health Maintenance Organization Act and the Limited Health
Service Organization Act to make conforming changes. Reenacts the
Short-Term, Limited-Duration Health Insurance Coverage Act.
LRB104 16590 BAB 29989 b

A BILL FOR

SB2757
LRB104 16590 BAB 29989 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 Illinois Insurance Code is amended by
5
changing Sections 121-2.05, 367.3, and 367a as follows:

6

(215 ILCS 5/121-2.05)

(from Ch. 73, par. 733-2.05)
7

Sec. 121-2.05.
Group insurance policies issued and
8
delivered in other State-Transactions in this State. With the
9
exception of insurance transactions authorized under Sections
10
230.2 or 367.3 of this Code
or transactions described under
11
Section 352c
, transactions in this State involving group
12
legal, group life and group accident and health or blanket
13
accident and health insurance or group annuities where the
14
master policy of such groups was lawfully issued and delivered
15
in, and under the laws of, a State in which the insurer was
16
authorized to do an insurance business, to a group properly
17
established pursuant to law or regulation, and where the
18
policyholder is domiciled or otherwise has a bona fide situs.
19
(Source: P.A. 103-649, eff. 1-1-25
.)

20

(215 ILCS 5/367.3)

(from Ch. 73, par. 979.3)
21

Sec. 367.3.
Group accident and health insurance;
22
discretionary groups.

SB2757
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LRB104 16590 BAB 29989 b
1

(a) No group health insurance offered to a resident of
2
this State under a policy issued to a group, other than one
3
specifically described in Section 367(1), shall be delivered
4
or issued for delivery in this State unless the Director
5
determines that:

6

(1) the issuance of the policy is not contrary to the
7

public interest;

8

(2) the issuance of the policy will result in
9

economies of acquisition and administration; and

10

(3) the benefits under the policy are reasonable in
11

relation to the premium charged.
12

(b) No such group health insurance may be offered in this
13
State under a policy issued in another state unless this State
14
or the state in which the group policy is issued has made a
15
determination that the requirements of subsection (a) have
16
been met.
17

Where insurance is to be offered in this State under a
18
policy described in this subsection, the insurer shall file
19
for informational review purposes:

20

(1) a copy of the group master contract;

21

(2) a copy of the statute authorizing the issuance of
22

the group policy in the state of situs, which statute has
23

the same or similar requirements as this State, or in the
24

absence of such statute, a certification by an officer of
25

the company that the policy meets the Illinois minimum
26

standards required for individual accident and health

SB2757
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LRB104 16590 BAB 29989 b
1

policies under authority of Section 401 of this Code, as
2

now or hereafter amended, as promulgated by rule at 50
3

Illinois Administrative Code, Ch. I, Sec. 2007, et seq.,
4

as now or hereafter amended, or by a successor rule;

5

(3) evidence of approval by the state of situs of the
6

group master policy; and

7

(4) copies of all supportive material furnished to the
8

state of situs to satisfy the criteria for approval.
9

(c) The Director may, at any time after receipt of the
10
information required under subsection (b) and after finding
11
that the standards of subsection (a) have not been met, order
12
the insurer to cease the issuance or marketing of that
13
coverage in this State.
14

(d) Notwithstanding subsections (a) and (b), group
15
accident and health insurance subject to the provisions of
16
this Section is also subject to the provisions of
Sections
17
352c and

Section
367i of this Code and rules thereunder.
18
(Source: P.A. 103-649, eff. 1-1-25
.)

19

(215 ILCS 5/367a)

(from Ch. 73, par. 979a)
20

Sec. 367a.
Blanket accident and health insurance.

21

(1) Blanket accident and health insurance is the form of
22
accident and health insurance providing excepted benefits, as
23
defined in
42 U.S.C. 300gg-91 and implementing regulations

24
Section 352c
, that covers special groups of persons as
25
enumerated in one of the following paragraphs (a) to (g),

SB2757
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LRB104 16590 BAB 29989 b
1
inclusive:
2

(a) Under a policy or contract issued to any carrier
3

for hire, which shall be deemed the policyholder, covering
4

a group defined as all persons who may become passengers
5

on such carrier.
6

(b) Under a policy or contract issued to an employer,
7

who shall be deemed the policyholder, covering all
8

employees or any group of employees defined by reference
9

to exceptional hazards incident to such employment.
10

(c) Under a policy or contract issued to a college,
11

school, or other institution of learning or to the head or
12

principal thereof, who or which shall be deemed the
13

policyholder, covering students or teachers. However,
14

student health insurance coverage, as defined in 45 CFR
15

147.145, shall remain subject to the standards and
16

requirements for individual health insurance coverage
17

except where inconsistent with that regulation. Student
18

health insurance coverage shall not be subject to the
19

Short-Term, Limited-Duration Health Insurance Coverage
20

Act. An insurer providing student health insurance
21

coverage or a policy or contract covering students for
22

limited-scope dental or vision under 45 CFR 148.220 shall
23

require an individual application or enrollment form and
24

shall furnish each insured individual a certificate, which
25

shall have been approved by the Director under Section
26

355.

SB2757
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LRB104 16590 BAB 29989 b
1

(d) Under a policy or contract issued in the name of
2

any volunteer fire department, first aid, or other such
3

volunteer group, which shall be deemed the policyholder,
4

covering all of the members of such department or group.
5

(e) Under a policy or contract issued to a creditor,
6

who shall be deemed the policyholder, to insure debtors of
7

the creditors; Provided, however, that in the case of a
8

loan which is subject to the Small Loans Act, no insurance
9

premium or other cost shall be directly or indirectly
10

charged or assessed against, or collected or received from
11

the borrower.
12

(f) Under a policy or contract issued to a sports team
13

or to a camp, which team or camp sponsor shall be deemed
14

the policyholder, covering members or campers.
15

(g) Under a policy or contract issued to any other
16

substantially similar group which, in the discretion of
17

the Director, may be subject to the issuance of a blanket
18

accident and health policy or contract.
19

(2) Any insurance company authorized to write accident and
20
health insurance in this state shall have the power to issue
21
blanket accident and health insurance. No such blanket policy
22
may be issued or delivered in this State unless a copy of the
23
form thereof shall have been filed in accordance with Section
24
355, and it contains in substance such of those provisions
25
contained in Sections 357.1 through 357.30 as may be
26
applicable to blanket accident and health insurance and the

SB2757
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LRB104 16590 BAB 29989 b
1
following provisions:
2

(a) A provision that the policy and the application
3

shall constitute the entire contract between the parties,
4

and that all statements made by the policyholder shall, in
5

absence of fraud, be deemed representations and not
6

warranties, and that no such statements shall be used in
7

defense to a claim under the policy, unless it is
8

contained in a written application.
9

(b) A provision that to the group or class thereof
10

originally insured shall be added from time to time all
11

new persons or individuals eligible for coverage.
12

(3) An individual application shall not be required from a
13
person covered under a blanket accident or health policy or
14
contract, nor shall it be necessary for the insurer to furnish
15
each person a certificate.
16

(3.5) Subsection (3) does not apply to major medical
17
insurance, or to any excepted benefits or short-term,
18
limited-duration health insurance coverage for which an
19
insured individual pays premiums or contributions. In those
20
cases, the insurer shall require an individual application or
21
enrollment form and shall furnish each insured individual a
22
certificate, which shall have been approved by the Director
23
under Section 355 of this Code.
24

(4) All benefits under any blanket accident and health
25
policy shall be payable to the person insured, or to his
26
designated beneficiary or beneficiaries, or to his or her

SB2757
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LRB104 16590 BAB 29989 b
1
estate, except that if the person insured be a minor or person
2
under legal disability, such benefits may be made payable to
3
his or her parent, guardian, or other person actually
4
supporting him or her. Provided further, however, that the
5
policy may provide that all or any portion of any indemnities
6
provided by any such policy on account of hospital, nursing,
7
medical or surgical services may, at the insurer's option, be
8
paid directly to the hospital or person rendering such
9
services; but the policy may not require that the service be
10
rendered by a particular hospital or person. Payment so made
11
shall discharge the insurer's obligation with respect to the
12
amount of insurance so paid.
13

(5) Nothing contained in this Section shall be deemed to
14
affect the legal liability of policyholders for the death of
15
or injury to, any such member of such group.
16
(Source: P.A. 103-649, eff. 1-1-25; 103-718, eff. 1-1-25;
17
104-417, eff. 8-15-25.)

18

(215 ILCS 5/352c rep.)
19

Section 7.
The Illinois Insurance Code is amended by
20
repealing Section 352c.

21

Section 10.
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)

SB2757
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LRB104 16590 BAB 29989 b
1

(Text of Section before amendment by P.A. 103-808, 104-28,
2
104-68, 104-73, 104-98, 104-289, 104-324, and 104-379
)
3

Sec. 5-3.
Illinois
Insurance Code provisions.
4

(a) Health Maintenance Organizations shall be subject to
5
the provisions of Sections 133, 134, 136, 137, 139, 140,
6
141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
7
152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
8
155.49,
352c,
355.2, 355.3, 355.6, 355b, 355c, 356f, 356g.5-1,
9
356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 356z.3a,
10
356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10,
11
356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18,
12
356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 356z.25,
13
356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 356z.33,
14
356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40,
15
356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 356z.47,
16
356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 356z.55,
17
356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 356z.62,
18
356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 356z.69,
19
356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 356z.76,
20
356z.77, 356z.78,
356z.79, 356z.81,

356z.80,
364, 364.01,
21
364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e,
22
370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 409,
23
412, 444, and 444.1, paragraph (c) of subsection (2) of
24
Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
25
XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance
26
Code. Section
356z.81

365z.80
of the Illinois Insurance Code

SB2757
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LRB104 16590 BAB 29989 b
1
is not applicable to health care plans under contract with the
2
Department of Healthcare and Family Services.
3

(b) For purposes of the Illinois Insurance Code, except
4
for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
5
Health Maintenance Organizations in the following categories
6
are deemed to be "domestic companies":
7

(1) a corporation authorized under the Dental Service
8

Plan Act or the Voluntary Health Services Plans Act;
9

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

State; or
11

(3) a corporation organized under the laws of another
12

state, 30% or more of the enrollees of which are residents
13

of this State, except a corporation subject to
14

substantially the same requirements in its state of
15

organization as is a "domestic company" under Article VIII
16

1/2 of the Illinois Insurance Code.
17

(c) In considering the merger, consolidation, or other
18
acquisition of control of a Health Maintenance Organization
19
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
20

(1) the Director shall give primary consideration to
21

the continuation of benefits to enrollees and the
22

financial conditions of the acquired Health Maintenance
23

Organization after the merger, consolidation, or other
24

acquisition of control takes effect;
25

(2)(i) the criteria specified in subsection (1)(b) of
26

Section 131.8 of the Illinois Insurance Code shall not

SB2757
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LRB104 16590 BAB 29989 b
1

apply and (ii) the Director, in making his determination
2

with respect to the merger, consolidation, or other
3

acquisition of control, need not take into account the
4

effect on competition of the merger, consolidation, or
5

other acquisition of control;
6

(3) the Director shall have the power to require the
7

following information:
8

(A) certification by an independent actuary of the
9

adequacy of the reserves of the Health Maintenance
10

Organization sought to be acquired;
11

(B) pro forma financial statements reflecting the
12

combined balance sheets of the acquiring company and
13

the Health Maintenance Organization sought to be
14

acquired as of the end of the preceding year and as of
15

a date 90 days prior to the acquisition, as well as pro
16

forma financial statements reflecting projected
17

combined operation for a period of 2 years;
18

(C) a pro forma business plan detailing an
19

acquiring party's plans with respect to the operation
20

of the Health Maintenance Organization sought to be
21

acquired for a period of not less than 3 years; and
22

(D) such other information as the Director shall
23

require.
24

(d) The provisions of Article VIII 1/2 of the Illinois
25
Insurance Code and this Section 5-3 shall apply to the sale by
26
any health maintenance organization of greater than 10% of its

SB2757
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LRB104 16590 BAB 29989 b
1
enrollee population (including, without limitation, the health
2
maintenance organization's right, title, and interest in and
3
to its health care certificates).
4

(e) In considering any management contract or service
5
agreement subject to Section 141.1 of the Illinois Insurance
6
Code, the Director (i) shall, in addition to the criteria
7
specified in Section 141.2 of the Illinois Insurance Code,
8
take into account the effect of the management contract or
9
service agreement on the continuation of benefits to enrollees
10
and the financial condition of the health maintenance
11
organization to be managed or serviced, and (ii) need not take
12
into account the effect of the management contract or service
13
agreement on competition.
14

(f) Except for small employer groups as defined in the
15
Small Employer Rating, Renewability and Portability Health
16
Insurance Act and except for medicare supplement policies as
17
defined in Section 363 of the Illinois Insurance Code, a
18
Health Maintenance Organization may by contract agree with a
19
group or other enrollment unit to effect refunds or charge
20
additional premiums under the following terms and conditions:
21

(i) the amount of, and other terms and conditions with
22

respect to, the refund or additional premium are set forth
23

in the group or enrollment unit contract agreed in advance
24

of the period for which a refund is to be paid or
25

additional premium is to be charged (which period shall
26

not be less than one year); and

SB2757
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LRB104 16590 BAB 29989 b
1

(ii) the amount of the refund or additional premium
2

shall not exceed 20% of the Health Maintenance
3

Organization's profitable or unprofitable experience with
4

respect to the group or other enrollment unit for the
5

period (and, for purposes of a refund or additional
6

premium, the profitable or unprofitable experience shall
7

be calculated taking into account a pro rata share of the
8

Health Maintenance Organization's administrative and
9

marketing expenses, but shall not include any refund to be
10

made or additional premium to be paid pursuant to this
11

subsection (f)). The Health Maintenance Organization and
12

the group or enrollment unit may agree that the profitable
13

or unprofitable experience may be calculated taking into
14

account the refund period and the immediately preceding 2
15

plan years.
16

The Health Maintenance Organization shall include a
17
statement in the evidence of coverage issued to each enrollee
18
describing the possibility of a refund or additional premium,
19
and upon request of any group or enrollment unit, provide to
20
the group or enrollment unit a description of the method used
21
to calculate (1) the Health Maintenance Organization's
22
profitable experience with respect to the group or enrollment
23
unit and the resulting refund to the group or enrollment unit
24
or (2) the Health Maintenance Organization's unprofitable
25
experience with respect to the group or enrollment unit and
26
the resulting additional premium to be paid by the group or

SB2757
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LRB104 16590 BAB 29989 b
1
enrollment unit.
2

In no event shall the Illinois Health Maintenance
3
Organization Guaranty Association be liable to pay any
4
contractual obligation of an insolvent organization to pay any
5
refund authorized under this Section.
6

(g) Rulemaking authority to implement Public Act 95-1045,
7
if any, is conditioned on the rules being adopted in
8
accordance with all provisions of the Illinois Administrative
9
Procedure Act and all rules and procedures of the Joint
10
Committee on Administrative Rules; any purported rule not so
11
adopted, for whatever reason, is unauthorized.
12
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
13
103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
14
1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
15
eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
16
103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.
17
1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
18
eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
19
103-914, eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff.
20
1-1-25; 104-1, eff. 6-9-25; 104-42, eff. 8-1-25; 104-334, eff.
21
8-15-25; 104-417, eff. 8-15-25; revised 10-3-25.)

22

(Text of Section after amendment by P.A. 103-808, 104-28,
23
104-68, 104-73, 104-98, 104-289, 104-324, and 104-379
)
24

Sec. 5-3.
Illinois Insurance Code provisions.
25

(a) Health Maintenance Organizations shall be subject to

SB2757
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LRB104 16590 BAB 29989 b
1
the provisions of Sections 133, 134, 136, 137, 139, 140,
2
141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
3
152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
4
155.49,
352c,
355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f,
5
356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
6
356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
7
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
8
356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
9
356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
10
356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
11
356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
12
356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
13
356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
14
356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
15
356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
16
356z.76, 356z.77, 356z.78,
356z.79,
356z.80,
356z.81, 356z.82,
17
356z.83, 356z.84, 356z.85,
364, 364.01, 364.3, 367.2, 367.2-5,
18
367i, 368a, 368b, 368c, 368d, 368e, 370a, 370c, 370c.1, 401,
19
401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
20
paragraph (c) of subsection (2) of Section 367, and Articles
21
IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
22
XXXIIB of the Illinois Insurance Code.
23

(b) For purposes of the Illinois Insurance Code, except
24
for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
25
Health Maintenance Organizations in the following categories
26
are deemed to be "domestic companies":

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1

(1) a corporation authorized under the Dental Service
2

Plan Act or the Voluntary Health Services Plans Act;
3

(2) a corporation organized under the laws of this
4

State; or
5

(3) a corporation organized under the laws of another
6

state, 30% or more of the enrollees of which are residents
7

of this State, except a corporation subject to
8

substantially the same requirements in its state of
9

organization as is a "domestic company" under Article VIII
10

1/2 of the Illinois Insurance Code.
11

(c) In considering the merger, consolidation, or other
12
acquisition of control of a Health Maintenance Organization
13
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
14

(1) the Director shall give primary consideration to
15

the continuation of benefits to enrollees and the
16

financial conditions of the acquired Health Maintenance
17

Organization after the merger, consolidation, or other
18

acquisition of control takes effect;
19

(2)(i) the criteria specified in subsection (1)(b) of
20

Section 131.8 of the Illinois Insurance Code shall not
21

apply and (ii) the Director, in making his determination
22

with respect to the merger, consolidation, or other
23

acquisition of control, need not take into account the
24

effect on competition of the merger, consolidation, or
25

other acquisition of control;
26

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

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1

following information:
2

(A) certification by an independent actuary of the
3

adequacy of the reserves of the Health Maintenance
4

Organization sought to be acquired;
5

(B) pro forma financial statements reflecting the
6

combined balance sheets of the acquiring company and
7

the Health Maintenance Organization sought to be
8

acquired as of the end of the preceding year and as of
9

a date 90 days prior to the acquisition, as well as pro
10

forma financial statements reflecting projected
11

combined operation for a period of 2 years;
12

(C) a pro forma business plan detailing an
13

acquiring party's plans with respect to the operation
14

of the Health Maintenance Organization sought to be
15

acquired for a period of not less than 3 years; and
16

(D) such other information as the Director shall
17

require.
18

(d) The provisions of Article VIII 1/2 of the Illinois
19
Insurance Code and this Section 5-3 shall apply to the sale by
20
any health maintenance organization of greater than 10% of its
21
enrollee population (including, without limitation, the health
22
maintenance organization's right, title, and interest in and
23
to its health care certificates).
24

(e) In considering any management contract or service
25
agreement subject to Section 141.1 of the Illinois Insurance
26
Code, the Director (i) shall, in addition to the criteria

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1
specified in Section 141.2 of the Illinois Insurance Code,
2
take into account the effect of the management contract or
3
service agreement on the continuation of benefits to enrollees
4
and the financial condition of the health maintenance
5
organization to be managed or serviced, and (ii) need not take
6
into account the effect of the management contract or service
7
agreement on competition.
8

(f) Except for small employer groups as defined in the
9
Small Employer Rating, Renewability and Portability Health
10
Insurance Act and except for medicare supplement policies as
11
defined in Section 363 of the Illinois Insurance Code, a
12
Health Maintenance Organization may by contract agree with a
13
group or other enrollment unit to effect refunds or charge
14
additional premiums under the following terms and conditions:
15

(i) the amount of, and other terms and conditions with
16

respect to, the refund or additional premium are set forth
17

in the group or enrollment unit contract agreed in advance
18

of the period for which a refund is to be paid or
19

additional premium is to be charged (which period shall
20

not be less than one year); and
21

(ii) the amount of the refund or additional premium
22

shall not exceed 20% of the Health Maintenance
23

Organization's profitable or unprofitable experience with
24

respect to the group or other enrollment unit for the
25

period (and, for purposes of a refund or additional
26

premium, the profitable or unprofitable experience shall

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1

be calculated taking into account a pro rata share of the
2

Health Maintenance Organization's administrative and
3

marketing expenses, but shall not include any refund to be
4

made or additional premium to be paid pursuant to this
5

subsection (f)). The Health Maintenance Organization and
6

the group or enrollment unit may agree that the profitable
7

or unprofitable experience may be calculated taking into
8

account the refund period and the immediately preceding 2
9

plan years.
10

The Health Maintenance Organization shall include a
11
statement in the evidence of coverage issued to each enrollee
12
describing the possibility of a refund or additional premium,
13
and upon request of any group or enrollment unit, provide to
14
the group or enrollment unit a description of the method used
15
to calculate (1) the Health Maintenance Organization's
16
profitable experience with respect to the group or enrollment
17
unit and the resulting refund to the group or enrollment unit
18
or (2) the Health Maintenance Organization's unprofitable
19
experience with respect to the group or enrollment unit and
20
the resulting additional premium to be paid by the group or
21
enrollment unit.
22

In no event shall the Illinois Health Maintenance
23
Organization Guaranty Association be liable to pay any
24
contractual obligation of an insolvent organization to pay any
25
refund authorized under this Section.
26

(g) Rulemaking authority to implement Public Act 95-1045,

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1
if any, is conditioned on the rules being adopted in
2
accordance with all provisions of the Illinois Administrative
3
Procedure Act and all rules and procedures of the Joint
4
Committee on Administrative Rules; any purported rule not so
5
adopted, for whatever reason, is unauthorized.
6
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
7
103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
8
1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
9
eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
10
103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.
11
1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
12
eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
13
103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff.
14
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28,
15
eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73,
16
eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
17
104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff.
18
1-1-26; 104-417, eff. 8-15-25; revised 10-3-25.)

19

Section 15.
The Limited Health Service Organization Act is
20
amended by changing Section 4003 as follows:

21

(215 ILCS 130/4003)

(from Ch. 73, par. 1504-3)
22

(Text of Section before amendment by P.A. 104-73, 104-98,
23
104-289, 104-324, and 104-379
)
24

Sec. 4003.
Illinois Insurance Code provisions.
Limited

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1
health service organizations shall be subject to the
2
provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
3
141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
4
154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49,
352c,

5
355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
6
356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
7
356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
8
356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
9
356z.73, 356z.74, 356z.75, 356z.79,
356z.81,

356z.80,
364.3,
10
368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444,
11
and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII
12
1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance Code.
13
Nothing in this Section shall require a limited health care
14
plan to cover any service that is not a limited health service.
15
For purposes of the Illinois Insurance Code, except for
16
Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited
17
health service organizations in the following categories are
18
deemed to be domestic companies:
19

(1) a corporation under the laws of this State; or
20

(2) a corporation organized under the laws of another
21

state, 30% or more of the enrollees of which are residents
22

of this State, except a corporation subject to
23

substantially the same requirements in its state of
24

organization as is a domestic company under Article VIII
25

1/2 of the Illinois Insurance Code.
26
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;

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1
103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
2
1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
3
eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
4
103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
5
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
6
eff. 8-1-25; 104-334, eff. 8-15-25; 104-417, eff. 8-15-25;
7
revised 10-3-25.)

8

(Text of Section after amendment by P.A. 104-73, 104-98,
9
104-289, 104-324, and 104-379
)
10

Sec. 4003.
Illinois Insurance Code provisions.
Limited
11
health service organizations shall be subject to the
12
provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
13
141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
14
154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49,
352c,

15
355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
16
356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
17
356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
18
356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
19
356z.73, 356z.74, 356z.75, 356z.79, 356z.80,
356z.81, 356z.83,
20
356z.84, 356z.85,
364.3, 368a, 370a, 401, 401.1, 402, 403,
21
403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles IIA,
22
VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB
23
of the Illinois Insurance Code. Nothing in this Section shall
24
require a limited health care plan to cover any service that is
25
not a limited health service. For purposes of the Illinois

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LRB104 16590 BAB 29989 b
1
Insurance Code, except for Sections 444 and 444.1 and Articles
2
XIII and XIII 1/2, limited health service organizations in the
3
following categories are deemed to be domestic companies:
4

(1) a corporation under the laws of this State; or
5

(2) a corporation organized under the laws of another
6

state, 30% or more of the enrollees of which are residents
7

of this State, except a corporation subject to
8

substantially the same requirements in its state of
9

organization as is a domestic company under Article VIII
10

1/2 of the Illinois Insurance Code.
11
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
12
103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
13
1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
14
eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
15
103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
16
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
17
eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26;
18
104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff.
19
8-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised
20
10-3-25.)

21

Section 20.
The Short-Term, Limited-Duration Health
22
Insurance Coverage Act is reenacted as follows:

23

(215 ILCS 190/Act title)
24

An Act concerning regulation.

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1

(215 ILCS 190/1)
2

Sec. 1.
Short title.
This Act may be cited as the
3
Short-Term, Limited-Duration Health Insurance Coverage Act.
4
(Source: P.A. 100-1118, eff. 11-27-18.)

5

(215 ILCS 190/5)
6

Sec. 5.
Definitions.
In this Act:
7

"Department" means the Department of Insurance.
8

"Health insurance coverage" has the meaning given to that
9
term in the Illinois Health Insurance Portability and
10
Accountability Act.
11

"Health insurance issuer" has the meaning given to that
12
term in the Illinois Health Insurance Portability and
13
Accountability Act.
14

"Fraud" means an intentional misrepresentation of a
15
material fact in connection with the coverage.
16

"Short-term, limited-duration health insurance coverage"
17
means health insurance coverage provided pursuant to a policy
18
with an issuer, regardless of the situs of the delivery of the
19
policy, that is less than 365 days after the effective date of
20
the policy.
21
(Source: P.A. 100-1118, eff. 11-27-18.)

22

(215 ILCS 190/10)
23

Sec. 10.
Application; scope; duration of coverage.

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1

(a) This Act applies to health insurance issuers that
2
offer short-term, limited-duration health insurance coverage
3
to individuals in this State and to short-term,
4
limited-duration health insurance coverage that is delivered
5
or issued for delivery in this State, including coverage
6
issued outside of this State that covers individuals in this
7
State.
8

(b) A short-term, limited-duration health insurance
9
coverage policy may not be issued or delivered to any person
10
residing in this State unless the policy, when delivered or
11
issued for delivery in this State, complies with the
12
provisions of this Act.
13

(c) Any short-term, limited-duration health insurance
14
coverage policy that is delivered or issued for delivery in
15
this State must have an expiration date in the policy that is
16
less than 181 days after the effective date and shall not be
17
renewable or extendable within a period of 365 days after the
18
individual's coverage under the policy ends, either at the
19
option of the issuer or the individual. Renewal of a
20
short-term, limited-duration health insurance coverage policy
21
includes the issuance of a new short-term, limited-duration
22
health insurance policy by an issuer to a policyholder within
23
60 days after the expiration of a policy previously issued by
24
the issuer to the policyholder.
25

(d) Any short-term, limited-duration health insurance
26
coverage policy that is delivered or issued for delivery in

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1
this State may not be rescinded before the expiration date in
2
the policy, except in cases of nonpayment of premiums, fraud,
3
or as provided in subsection (e).
4

(e) Any short-term, limited-duration health insurance
5
coverage policy that is delivered or issued for delivery in
6
this State shall contain an option for an individual to cancel
7
coverage after any 30-day interval during the term of the
8
plan.
9
(Source: P.A. 100-1118, eff. 11-27-18.)

10

(215 ILCS 190/15)
11

Sec. 15.
Disclosure requirements.
12

(a) A health insurance issuer that offers short-term,
13
limited-duration health insurance coverage to be delivered or
14
issued for delivery in this State shall, in addition to all
15
other documents required, including, but not limited to, the
16
policy, the certificate, the membership booklet, and a
17
description of appeal and external review rights, deliver an
18
outline of coverage to an applicant for or an enrollee in
19
short-term, limited-duration health insurance coverage
20
delivered or issued for delivery in this State.
21

(b) Any short-term, limited-duration health insurance
22
coverage policy that is delivered or issued for delivery in
23
the State shall display prominently in the policy, any
24
application, sales, and marketing materials provided in
25
connection with enrollment in such coverage, and the outline

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LRB104 16590 BAB 29989 b
1
of coverage for such coverage, in at least 14-point, bold
2
type, the following: "NOTICE: THE SHORT-TERM, LIMITED-DURATION
3
INSURANCE BENEFITS UNDER THIS COVERAGE DO NOT MEET ALL FEDERAL
4
REQUIREMENTS TO QUALIFY AS "MINIMUM ESSENTIAL COVERAGE" FOR
5
HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. THIS PLAN OF
6
COVERAGE DOES NOT INCLUDE ALL ESSENTIAL HEALTH BENEFITS AS
7
REQUIRED BY THE AFFORDABLE CARE ACT. PREEXISTING CONDITIONS
8
ARE NOT COVERED UNDER THIS PLAN OF COVERAGE. BE SURE TO CHECK
9
YOUR POLICY CAREFULLY TO MAKE SURE YOU UNDERSTAND WHAT THE
10
POLICY DOES AND DOES NOT COVER. IF THIS COVERAGE EXPIRES OR YOU
11
LOSE ELIGIBILITY FOR THIS COVERAGE, YOU MIGHT HAVE TO WAIT
12
UNTIL THE NEXT OPEN ENROLLMENT PERIOD TO GET OTHER HEALTH
13
INSURANCE COVERAGE. YOU MAY BE ABLE TO GET LONGER TERM
14
INSURANCE THAT QUALIFIES AS "MINIMUM ESSENTIAL COVERAGE" FOR
15
HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT NOW AND HELP TO
16
PAY FOR IT AT WWW.HEALTHCARE.GOV.".
17

(c) Any individual selling a short-term, limited-duration
18
health insurance coverage policy in this State in face-to-face
19
or telephonic sales interactions must read out loud the
20
disclosure in subsection (b) to a prospective purchaser. An
21
entity selling a short-term, limited-duration health insurance
22
coverage policy in Illinois must display the disclosure in
23
subsection (b) on the webpage where a prospective purchaser
24
would purchase coverage.
25

(d) Nothing in this Section precludes an insurer from
26
providing disclosures in addition to those required in

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LRB104 16590 BAB 29989 b
1
subsections (b) and (c). Nothing in this Section precludes an
2
insurer from providing disclosures intended to clarify those
3
required in subsections (b) and (c) if approved by the
4
Department.
5
(Source: P.A. 100-1118, eff. 11-27-18.)

6

(215 ILCS 190/20)
7

Sec. 20.
Filing and approval.

8

(a) Coverage subject to this Act may not be delivered or
9
issued for delivery in this State unless the policy evidencing
10
such coverage has been filed with and been approved by the
11
Department.
12

(b) A health insurance issuer who intends to deliver or
13
issue for delivery a short-term, limited-duration health
14
insurance coverage policy in this State shall file with the
15
Department:
16

(1) all paperwork required for individual health
17

insurance coverage pursuant to 50 Ill. Adm. Code 916; and
18

(2) all sales and marketing materials provided in
19

connection with enrollment in such coverage for
20

informational purposes.
21

(c) The Department shall adopt any rules necessary to
22
carry out the provisions of this Act.
23
(Source: P.A. 100-1118, eff. 11-27-18.)

24

(215 ILCS 190/99)

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LRB104 16590 BAB 29989 b
1

Sec. 99.
Effective date.
This Act takes effect upon
2
becoming law, except that the provisions changing Sections
3
456, 457, and 458 of the Illinois Insurance Code and the
4
provisions repealing Section 460 of the Illinois Insurance
5
Code take effect February 1, 2019.
6
(Source: P.A. 100-1118, eff. 11-27-18.)

7

Section 95.
No acceleration or delay.
Where this Act makes
8
changes in a statute that is represented in this Act by text
9
that is not yet or no longer in effect (for example, a Section
10
represented by multiple versions), the use of that text does
11
not accelerate or delay the taking effect of (i) the changes
12
made by this Act or (ii) provisions derived from any other
13
Public Act.

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