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SB2762 Enrolled
LRB104 16499 BAB 29895 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

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

6

(55 ILCS 5/5-1069.3)
7

(Text of Section before amendment by P.A. 104-446
)
8

Sec. 5-1069.3.
Required health benefits.
If a county,
9
including a home rule county, is a self-insurer for purposes
10
of providing health insurance coverage for its employees, the
11
coverage shall include coverage for the post-mastectomy care
12
benefits required to be covered by a policy of accident and
13
health insurance under Section 356t and the coverage required
14
under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
15
356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
16
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17
356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
18
356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
19
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
20
356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74,
21
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83,
22
356z.84, 356z.85, 356z.88, and 356z.89
of the Illinois
23
Insurance Code. The coverage shall comply with Sections

SB2762 Enrolled
- 2 -
LRB104 16499 BAB 29895 b
1
155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
2
Code. The Department of Insurance shall enforce the
3
requirements of this Section. The requirement that health
4
benefits be covered as provided in this Section is an
5
exclusive power and function of the State and is a denial and
6
limitation under Article VII, Section 6, subsection (h) of the
7
Illinois Constitution. A home rule county to which this
8
Section applies must comply with every provision of this
9
Section.
10

Rulemaking authority to implement Public Act 95-1045, if
11
any, is conditioned on the rules being adopted in accordance
12
with all provisions of the Illinois Administrative Procedure
13
Act and all rules and procedures of the Joint Committee on
14
Administrative Rules; any purported rule not so adopted, for
15
whatever reason, is unauthorized.
16
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
17
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
18
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
19
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
20
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
21
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
22
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
23
eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-7-26.)

24

(Text of Section after amendment by P.A. 104-446
)
25

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

SB2762 Enrolled
- 3 -
LRB104 16499 BAB 29895 b
1
including a home rule county, is a self-insurer for purposes
2
of providing health insurance coverage for its employees, the
3
coverage shall include coverage for the post-mastectomy care
4
benefits required to be covered by a policy of accident and
5
health insurance under Section 356t and the coverage required
6
under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
7
356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
8
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
9
356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
10
356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
11
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
12
356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71, 356z.74,
13
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83,
14
356z.84, 356z.85, 356z.88, and 356z.89
of the Illinois
15
Insurance Code. The coverage shall comply with Sections
16
155.22a, 355b, 356z.19, 370c, and 370c.4 of the Illinois
17
Insurance Code. The Department of Insurance shall enforce the
18
requirements of this Section. The requirement that health
19
benefits be covered as provided in this Section is an
20
exclusive power and function of the State and is a denial and
21
limitation under Article VII, Section 6, subsection (h) of the
22
Illinois Constitution. A home rule county to which this
23
Section applies must comply with every provision of this
24
Section.
25

Rulemaking authority to implement Public Act 95-1045, if
26
any, is conditioned on the rules being adopted in accordance

SB2762 Enrolled
- 4 -
LRB104 16499 BAB 29895 b
1
with all provisions of the Illinois Administrative Procedure
2
Act and all rules and procedures of the Joint Committee on
3
Administrative Rules; any purported rule not so adopted, for
4
whatever reason, is unauthorized.
5
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
6
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
7
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
8
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
9
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
10
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
11
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
12
eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26;
13
revised 1-7-26.)

14

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

16

(65 ILCS 5/10-4-2.3)
17

(Text of Section before amendment by P.A. 104-446
)
18

Sec. 10-4-2.3.
Required health benefits.
If a
19
municipality, including a home rule municipality, is a
20
self-insurer for purposes of providing health insurance
21
coverage for its employees, the coverage shall include
22
coverage for the post-mastectomy care benefits required to be
23
covered by a policy of accident and health insurance under
24
Section 356t and the coverage required under Sections 356g,

SB2762 Enrolled
- 5 -
LRB104 16499 BAB 29895 b
1
356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
2
356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
3
356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
4
356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
5
356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
6
356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
7
356z.67, 356z.68, 356z.70, 356z.71, 356z.74,
and
356z.77,
8
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83, 356z.84,
9
356z.85, 356z.88, and 356z.89
of the Illinois Insurance Code.
10
The coverage shall comply with Sections 155.22a, 355b,
11
356z.19, and 370c of the Illinois Insurance Code. The
12
Department of Insurance shall enforce the requirements of this
13
Section. The requirement that health benefits be covered as
14
provided in this
Section
is an exclusive power and function of
15
the State and is a denial and limitation under Article VII,
16
Section 6, subsection (h) of the Illinois Constitution. A home
17
rule municipality to which this Section applies must comply
18
with every provision of this Section.
19

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

SB2762 Enrolled
- 6 -
LRB104 16499 BAB 29895 b
1
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
2
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
3
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
4
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
5
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
6
eff. 1-1-26; 104-417, eff. 8-15-25; revised 1-8-26.)

7

(Text of Section after amendment by P.A. 104-446
)
8

Sec. 10-4-2.3.
Required health benefits.
If a
9
municipality, including a home rule municipality, is a
10
self-insurer for purposes of providing health insurance
11
coverage for its employees, the coverage shall include
12
coverage for the post-mastectomy care benefits required to be
13
covered by a policy of accident and health insurance under
14
Section 356t and the coverage required under Sections 356g,
15
356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
16
356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
17
356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
18
356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
19
356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
20
356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
21
356z.67, 356z.68, 356z.70, 356z.71, 356z.74,
and
356z.77,
22
356z.79,

and
356z.80
, 356z.81, 356z.82, 356z.83, 356z.84,
23
356z.85, 356z.88, and 356z.89
of the Illinois Insurance Code.
24
The coverage shall comply with Sections 155.22a, 355b,
25
356z.19, 370c, and 370c.4 of the Illinois Insurance Code. The

SB2762 Enrolled
- 7 -
LRB104 16499 BAB 29895 b
1
Department of Insurance shall enforce the requirements of this
2
Section. The requirement that health benefits be covered as
3
provided in this
Section
is an exclusive power and function of
4
the State and is a denial and limitation under Article VII,
5
Section 6, subsection (h) of the Illinois Constitution. A home
6
rule municipality to which this Section applies must comply
7
with every provision of this Section.
8

Rulemaking authority to implement Public Act 95-1045, if
9
any, is conditioned on the rules being adopted in accordance
10
with all provisions of the Illinois Administrative Procedure
11
Act and all rules and procedures of the Joint Committee on
12
Administrative Rules; any purported rule not so adopted, for
13
whatever reason, is unauthorized.
14
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
15
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
16
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
17
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
18
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
19
6-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
20
1-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
21
eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26;
22
revised 1-8-26.)

23

Section 15.
The School Code is amended by changing Section
24
10-22.3f as follows:

SB2762 Enrolled
- 8 -
LRB104 16499 BAB 29895 b
1

(105 ILCS 5/10-22.3f)
2

(Text of Section before amendment by P.A. 104-446
)
3

Sec. 10-22.3f.
Required health benefits.
Insurance
4
protection and benefits for employees shall provide the
5
post-mastectomy care benefits required to be covered by a
6
policy of accident and health insurance under Section 356t and
7
the coverage required under Sections 356g, 356g.5, 356g.5-1,
8
356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
9
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
10
356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
11
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
12
356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
13
356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71,
14
356z.74,
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82,
15
356z.83, 356z.84, 356z.85, 356z.88, and 356z.89
of the
16
Illinois Insurance Code. Insurance policies shall comply with
17
Section 356z.19 of the Illinois Insurance Code. The coverage
18
shall comply with Sections 155.22a, 355b, and 370c and Article
19
XXXIIB of the Illinois Insurance Code. The Department of
20
Insurance shall enforce the requirements of this Section.
21

Rulemaking authority to implement Public Act 95-1045, if
22
any, is conditioned on the rules being adopted in accordance
23
with all provisions of the Illinois Administrative Procedure
24
Act and all rules and procedures of the Joint Committee on
25
Administrative Rules; any purported rule not so adopted, for
26
whatever reason, is unauthorized.

SB2762 Enrolled
- 9 -
LRB104 16499 BAB 29895 b
1
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
2
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
3
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
4
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
5
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
6
6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff.
7
1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
8
eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
9
revised 1-8-26.)

10

(Text of Section after amendment by P.A. 104-446
)
11

Sec. 10-22.3f.
Required health benefits.
Insurance
12
protection and benefits for employees shall provide the
13
post-mastectomy care benefits required to be covered by a
14
policy of accident and health insurance under Section 356t and
15
the coverage required under Sections 356g, 356g.5, 356g.5-1,
16
356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
17
356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
18
356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
19
356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
20
356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
21
356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71,
22
356z.74,
and
356z.77,
356z.79,

and
356z.80
, 356z.81, 356z.82,
23
356z.83, 356z.84, 356z.85, 356z.88, and 356z.89
of the
24
Illinois Insurance Code. Insurance policies shall comply with
25
Section 356z.19 of the Illinois Insurance Code. The coverage

SB2762 Enrolled
- 10 -
LRB104 16499 BAB 29895 b
1
shall comply with Sections 155.22a, 355b, 370c, and 370c.4 and
2
Article XXXIIB of the Illinois Insurance Code. The Department
3
of Insurance shall enforce the requirements of this Section.
4

Rulemaking authority to implement Public Act 95-1045, if
5
any, is conditioned on the rules being adopted in accordance
6
with all provisions of the Illinois Administrative Procedure
7
Act and all rules and procedures of the Joint Committee on
8
Administrative Rules; any purported rule not so adopted, for
9
whatever reason, is unauthorized.
10
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
11
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
12
8-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
13
eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
14
103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
15
6-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff.
16
1-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
17
eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
18
104-446, eff. 6-1-26; revised 1-8-26.)

19

Section 20.
The Illinois Insurance Code is amended by
20
adding Sections 356z.88 and 356z.89 as follows:

21

(215 ILCS 5/356z.88 new)
22

Sec. 356z.88.
Coverage for seizure detection devices.
23

(a) For the purposes of this Section, "seizure detection
24
device" means a monitoring device cleared by the United States

SB2762 Enrolled
- 11 -
LRB104 16499 BAB 29895 b
1
Food and Drug Administration, and any related technology,
2
application, service, or subscription supporting the
3
prescribed use of the device, that provides the following:
4

(1) individual monitoring and alert services relating
5

to seizure activity;
6

(2) detection or prediction of seizure activity and
7

transmission of notification of the seizure activity to
8

the individual or a caregiver for appropriate medical
9

response; or
10

(3) collection of data of the seizure activity of the
11

individual that can be used by a health care provider to
12

diagnose or appropriately treat a health care condition
13

that causes the seizure activity.
14

(b) A group or individual plan of accident and health
15
insurance or managed care plan amended, delivered, issued, or
16
renewed on or after January 1, 2029 shall provide coverage for
17
medically prescribed seizure detection devices.
18

(c) All seizure detection devices covered under this
19
Section shall be approved for use by individuals, and the
20
choice of device shall be made based upon the individual's
21
circumstances and medical needs in consultation with the
22
individual's medical provider.
23

(d) Any individual who has been prescribed a seizure
24
detection device shall not be required to obtain prior
25
authorization for coverage for a seizure detection device, and
26
coverage shall be continuous once the seizure detection device

SB2762 Enrolled
- 12 -
LRB104 16499 BAB 29895 b
1
is prescribed.
2

(e) A group or individual policy of accident and health
3
insurance or a managed care plan that is amended, delivered,
4
issued, or renewed on or after January 1, 2029 shall not impose
5
a deductible, coinsurance, copayment, or any other
6
cost-sharing requirement of more than $50 on the coverage of a
7
seizure detection device per plan year. The provisions of this
8
subsection do not apply to coverage under this Section to the
9
extent that the coverage would disqualify a high-deductible
10
health plan from eligibility for a health savings account.

11

(215 ILCS 5/356z.89 new)
12

Sec. 356z.89.
Coverage for preeclampsia biomarker testing.
13
Any group or individual policy of accident and health
14
insurance or managed care plan amended, delivered, issued, or
15
renewed on or after January 1, 2028 shall cover, without
16
imposing a deductible, coinsurance, copayment, or any other
17
cost-sharing requirement upon the insured, preeclampsia
18
biomarker testing for predictive screening in asymptomatic
19
individuals, or for diagnosis and management when symptoms are
20
present.

21

Section 25.
The Health Maintenance Organization Act is
22
amended by changing Section 5-3 as follows:

23

(215 ILCS 125/5-3)

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

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1

Sec. 5-3.
Illinois Insurance Code provisions.
2

(a) Health Maintenance Organizations shall be subject to
3
the provisions of Sections 133, 134, 136, 137, 139, 140,
4
141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
5
152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
6
155.49, 352c, 355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f,
7
356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
8
356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
9
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
10
356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
11
356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
12
356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
13
356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
14
356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
15
356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
16
356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
17
356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
18
356z.76, 356z.77, 356z.78,
356z.79,
356z.80,
356z.81, 356z.82,
19
356z.83, 356z.84, 356z.85, 356z.88, 356z.89,
364, 364.01,
20
364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e,
21
370a, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2,
22
409, 412, 444, and 444.1, paragraph (c) of subsection (2) of
23
Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
24
XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance
25
Code.
26

(b) For purposes of the Illinois Insurance Code, except

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LRB104 16499 BAB 29895 b
1
for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
2
Health Maintenance Organizations in the following categories
3
are deemed to be "domestic companies":
4

(1) a corporation authorized under the Dental Service
5

Plan Act or the Voluntary Health Services Plans Act;
6

(2) a corporation organized under the laws of this
7

State; or
8

(3) a corporation organized under the laws of another
9

state, 30% or more of the enrollees of which are residents
10

of this State, except a corporation subject to
11

substantially the same requirements in its state of
12

organization as is a "domestic company" under Article VIII
13

1/2 of the Illinois Insurance Code.
14

(c) In considering the merger, consolidation, or other
15
acquisition of control of a Health Maintenance Organization
16
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
17

(1) the Director shall give primary consideration to
18

the continuation of benefits to enrollees and the
19

financial conditions of the acquired Health Maintenance
20

Organization after the merger, consolidation, or other
21

acquisition of control takes effect;
22

(2)(i) the criteria specified in subsection (1)(b) of
23

Section 131.8 of the Illinois Insurance Code shall not
24

apply and (ii) the Director, in making his determination
25

with respect to the merger, consolidation, or other
26

acquisition of control, need not take into account the

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LRB104 16499 BAB 29895 b
1

effect on competition of the merger, consolidation, or
2

other acquisition of control;
3

(3) the Director shall have the power to require the
4

following information:
5

(A) certification by an independent actuary of the
6

adequacy of the reserves of the Health Maintenance
7

Organization sought to be acquired;
8

(B) pro forma financial statements reflecting the
9

combined balance sheets of the acquiring company and
10

the Health Maintenance Organization sought to be
11

acquired as of the end of the preceding year and as of
12

a date 90 days prior to the acquisition, as well as pro
13

forma financial statements reflecting projected
14

combined operation for a period of 2 years;
15

(C) a pro forma business plan detailing an
16

acquiring party's plans with respect to the operation
17

of the Health Maintenance Organization sought to be
18

acquired for a period of not less than 3 years; and
19

(D) such other information as the Director shall
20

require.
21

(d) The provisions of Article VIII 1/2 of the Illinois
22
Insurance Code and this Section 5-3 shall apply to the sale by
23
any health maintenance organization of greater than 10% of its
24
enrollee population (including, without limitation, the health
25
maintenance organization's right, title, and interest in and
26
to its health care certificates).

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1

(e) In considering any management contract or service
2
agreement subject to Section 141.1 of the Illinois Insurance
3
Code, the Director (i) shall, in addition to the criteria
4
specified in Section 141.2 of the Illinois Insurance Code,
5
take into account the effect of the management contract or
6
service agreement on the continuation of benefits to enrollees
7
and the financial condition of the health maintenance
8
organization to be managed or serviced, and (ii) need not take
9
into account the effect of the management contract or service
10
agreement on competition.
11

(f) Except for small employer groups as defined in the
12
Small Employer Rating, Renewability and Portability Health
13
Insurance Act and except for medicare supplement policies as
14
defined in Section 363 of the Illinois Insurance Code, a
15
Health Maintenance Organization may by contract agree with a
16
group or other enrollment unit to effect refunds or charge
17
additional premiums under the following terms and conditions:
18

(i) the amount of, and other terms and conditions with
19

respect to, the refund or additional premium are set forth
20

in the group or enrollment unit contract agreed in advance
21

of the period for which a refund is to be paid or
22

additional premium is to be charged (which period shall
23

not be less than one year); and
24

(ii) the amount of the refund or additional premium
25

shall not exceed 20% of the Health Maintenance
26

Organization's profitable or unprofitable experience with

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LRB104 16499 BAB 29895 b
1

respect to the group or other enrollment unit for the
2

period (and, for purposes of a refund or additional
3

premium, the profitable or unprofitable experience shall
4

be calculated taking into account a pro rata share of the
5

Health Maintenance Organization's administrative and
6

marketing expenses, but shall not include any refund to be
7

made or additional premium to be paid pursuant to this
8

subsection (f)). The Health Maintenance Organization and
9

the group or enrollment unit may agree that the profitable
10

or unprofitable experience may be calculated taking into
11

account the refund period and the immediately preceding 2
12

plan years.
13

The Health Maintenance Organization shall include a
14
statement in the evidence of coverage issued to each enrollee
15
describing the possibility of a refund or additional premium,
16
and upon request of any group or enrollment unit, provide to
17
the group or enrollment unit a description of the method used
18
to calculate (1) the Health Maintenance Organization's
19
profitable experience with respect to the group or enrollment
20
unit and the resulting refund to the group or enrollment unit
21
or (2) the Health Maintenance Organization's unprofitable
22
experience with respect to the group or enrollment unit and
23
the resulting additional premium to be paid by the group or
24
enrollment unit.
25

In no event shall the Illinois Health Maintenance
26
Organization Guaranty Association be liable to pay any

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LRB104 16499 BAB 29895 b
1
contractual obligation of an insolvent organization to pay any
2
refund authorized under this Section.
3

(g) Rulemaking authority to implement Public Act 95-1045,
4
if any, is conditioned on the rules being adopted in
5
accordance with all provisions of the Illinois Administrative
6
Procedure Act and all rules and procedures of the Joint
7
Committee on Administrative Rules; any purported rule not so
8
adopted, for whatever reason, is unauthorized.
9
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
10
103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
11
1-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
12
eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
13
103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.
14
1-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
15
eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
16
103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff.
17
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28,
18
eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73,
19
eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
20
104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff.
21
1-1-26; 104-417, eff. 8-15-25; revised 11-21-25.)

22

Section 30.
The Limited Health Service Organization Act is
23
amended by changing Section 4003 as follows:

24

(215 ILCS 130/4003)

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

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1

Sec. 4003.
Illinois Insurance Code provisions.
Limited
2
health service organizations shall be subject to the
3
provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
4
141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
5
154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
6
355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
7
356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
8
356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
9
356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
10
356z.73, 356z.74, 356z.75, 356z.79, 356z.80,
356z.81, 356z.83,
11
356z.84, 356z.85, 356z.88, 356z.89,
364.3, 368a, 370a, 401,
12
401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and
13
Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV,
14
XXVI, and XXXIIB of the Illinois Insurance Code. Nothing in
15
this Section shall require a limited health care plan to cover
16
any service that is not a limited health service. For purposes
17
of the Illinois Insurance Code, except for Sections 444 and
18
444.1 and Articles XIII and XIII 1/2, limited health service
19
organizations in the following categories are deemed to be
20
domestic companies:
21

(1) a corporation under the laws of this State; or
22

(2) a corporation organized under the laws of another
23

state, 30% or more of the enrollees of which are residents
24

of this State, except a corporation subject to
25

substantially the same requirements in its state of
26

organization as is a domestic company under Article VIII

SB2762 Enrolled
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LRB104 16499 BAB 29895 b
1

1/2 of the Illinois Insurance Code.
2
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
3
103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
4
1-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
5
eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
6
103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
7
1-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
8
eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26;
9
104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff.
10
8-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised
11
11-21-25.)

12

Section 35.
The Voluntary Health Services Plans Act is
13
amended by changing Section 10 as follows:

14

(215 ILCS 165/10)

(from Ch. 32, par. 604)
15

Sec. 10.
Application of Illinois Insurance Code
16
provisions.
Health services plan corporations and all persons
17
interested therein or dealing therewith shall be subject to
18
the provisions of Articles IIA and XII 1/2 and Sections 3.1,
19
133, 136, 139, 140, 143, 143.31, 143c, 149, 155.22a, 155.37,
20
354, 355.2, 355.3, 355.7, 355b, 355d, 356g, 356g.5, 356g.5-1,
21
356m, 356q, 356r, 356t, 356u, 356u.10, 356v, 356w, 356x, 356y,
22
356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
23
356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
24
356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26,

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LRB104 16499 BAB 29895 b
1
356z.29, 356z.30, 356z.32, 356z.32a, 356z.33, 356z.40,
2
356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56,
3
356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67,
4
356z.68, 356z.71, 356z.72, 356z.74, 356z.75, 356z.77,
356z.79,

5
356z.80,
356z.81, 356z.83, 356z.84, 356z.85, 356z.88, 356z.89,

6
364.01, 364.3, 367.2, 368a, 370a, 401, 401.1, 402, 403, 403A,
7
408, 408.2, and 412, and paragraphs (7) and (15) of Section 367
8
of the Illinois Insurance Code.
9

Rulemaking authority to implement Public Act 95-1045, if
10
any, is conditioned on the rules being adopted in accordance
11
with all provisions of the Illinois Administrative Procedure
12
Act and all rules and procedures of the Joint Committee on
13
Administrative Rules; any purported rule not so adopted, for
14
whatever reason, is unauthorized.
15
(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
16
103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-551, eff.
17
8-11-23; 103-605, eff. 7-1-24; 103-656, eff. 1-1-25; 103-718,
18
eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, eff. 8-2-24;
19
103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 103-914, eff.
20
1-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1,
21
eff. 6-9-25; 104-28, eff. 1-1-26; 104-42, eff. 8-1-25; 104-73,
22
eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
23
104-324, eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff.
24
8-15-25; revised 11-21-25.)

25

Section 95.
No acceleration or delay.
Where this Act makes

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LRB104 16499 BAB 29895 b
1
changes in a statute that is represented in this Act by text
2
that is not yet or no longer in effect (for example, a Section
3
represented by multiple versions), the use of that text does
4
not accelerate or delay the taking effect of (i) the changes
5
made by this Act or (ii) provisions derived from any other
6
Public Act.

7

Section 99.
Effective date.
This Act takes effect upon
8
becoming law.

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