SB 2762

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Full Text of SB2762
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	SB2762 - 104th General Assembly
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		Public Act
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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,
3represented in the General Assembly:
4    Section 5. The Counties Code is amended by changing
5Section 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,
9including a home rule county, is a self-insurer for purposes
10of providing health insurance coverage for its employees, the
11coverage shall include coverage for the post-mastectomy care
12benefits required to be covered by a policy of accident and
13health insurance under Section 356t and the coverage required
14under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
15356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
16356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
17356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
18356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
19356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
20356z.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, 
22356z.84, 356z.85, 356z.88, and 356z.89 of the Illinois
23Insurance Code. The coverage shall comply with Sections
		SB2762 Enrolled	- 2 -	LRB104 16499 BAB 29895 b
1155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
2Code. The Department of Insurance shall enforce the
3requirements of this Section. The requirement that health
4benefits be covered as provided in this Section is an
5exclusive power and function of the State and is a denial and
6limitation under Article VII, Section 6, subsection (h) of the
7Illinois Constitution. A home rule county to which this
8Section applies must comply with every provision of this
9Section.
10    Rulemaking authority to implement Public Act 95-1045, if
11any, is conditioned on the rules being adopted in accordance
12with all provisions of the Illinois Administrative Procedure
13Act and all rules and procedures of the Joint Committee on
14Administrative Rules; any purported rule not so adopted, for
15whatever reason, is unauthorized.
16(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
17103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
188-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
19eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
20103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
216-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
221-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
23eff. 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
1including a home rule county, is a self-insurer for purposes
2of providing health insurance coverage for its employees, the
3coverage shall include coverage for the post-mastectomy care
4benefits required to be covered by a policy of accident and
5health insurance under Section 356t and the coverage required
6under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u,
7356u.10, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9,
8356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
9356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 356z.36,
10356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
11356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61,
12356z.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, 
14356z.84, 356z.85, 356z.88, and 356z.89 of the Illinois
15Insurance Code. The coverage shall comply with Sections
16155.22a, 355b, 356z.19, 370c, and 370c.4 of the Illinois
17Insurance Code. The Department of Insurance shall enforce the
18requirements of this Section. The requirement that health
19benefits be covered as provided in this Section is an
20exclusive power and function of the State and is a denial and
21limitation under Article VII, Section 6, subsection (h) of the
22Illinois Constitution. A home rule county to which this
23Section applies must comply with every provision of this
24Section.
25    Rulemaking authority to implement Public Act 95-1045, if
26any, is conditioned on the rules being adopted in accordance
		SB2762 Enrolled	- 4 -	LRB104 16499 BAB 29895 b
1with all provisions of the Illinois Administrative Procedure
2Act and all rules and procedures of the Joint Committee on
3Administrative Rules; any purported rule not so adopted, for
4whatever reason, is unauthorized.
5(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
6103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
78-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
8eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
9103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
106-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
111-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
12eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26;
13revised 1-7-26.)
14    Section 10. The Illinois Municipal Code is amended by
15changing 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
19municipality, including a home rule municipality, is a
20self-insurer for purposes of providing health insurance
21coverage for its employees, the coverage shall include
22coverage for the post-mastectomy care benefits required to be
23covered by a policy of accident and health insurance under
24Section 356t and the coverage required under Sections 356g,
		SB2762 Enrolled	- 5 -	LRB104 16499 BAB 29895 b
1356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
2356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
3356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
4356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
5356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
6356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
7356z.67, 356z.68, 356z.70, 356z.71, 356z.74, [and] 356z.77,
8356z.79, [and] 356z.80, 356z.81, 356z.82, 356z.83, 356z.84, 
9356z.85, 356z.88, and 356z.89 of the Illinois Insurance Code.
10The coverage shall comply with Sections 155.22a, 355b,
11356z.19, and 370c of the Illinois Insurance Code. The
12Department of Insurance shall enforce the requirements of this
13Section. The requirement that health benefits be covered as
14provided in this Section is an exclusive power and function of
15the State and is a denial and limitation under Article VII,
16Section 6, subsection (h) of the Illinois Constitution. A home
17rule municipality to which this Section applies must comply
18with every provision of this Section.
19    Rulemaking authority to implement Public Act 95-1045, if
20any, is conditioned on the rules being adopted in accordance
21with all provisions of the Illinois Administrative Procedure
22Act and all rules and procedures of the Joint Committee on
23Administrative Rules; any purported rule not so adopted, for
24whatever reason, is unauthorized.
25(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
26103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
		SB2762 Enrolled	- 6 -	LRB104 16499 BAB 29895 b
18-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
2eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
3103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
46-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
51-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
6eff. 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
9municipality, including a home rule municipality, is a
10self-insurer for purposes of providing health insurance
11coverage for its employees, the coverage shall include
12coverage for the post-mastectomy care benefits required to be
13covered by a policy of accident and health insurance under
14Section 356t and the coverage required under Sections 356g,
15356g.5, 356g.5-1, 356m, 356q, 356u, 356u.10, 356w, 356x,
16356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
17356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
18356z.29, 356z.30, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
19356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
20356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64,
21356z.67, 356z.68, 356z.70, 356z.71, 356z.74, [and] 356z.77,
22356z.79, [and] 356z.80, 356z.81, 356z.82, 356z.83, 356z.84, 
23356z.85, 356z.88, and 356z.89 of the Illinois Insurance Code.
24The coverage shall comply with Sections 155.22a, 355b,
25356z.19, 370c, and 370c.4 of the Illinois Insurance Code. The
		SB2762 Enrolled	- 7 -	LRB104 16499 BAB 29895 b
1Department of Insurance shall enforce the requirements of this
2Section. The requirement that health benefits be covered as
3provided in this Section is an exclusive power and function of
4the State and is a denial and limitation under Article VII,
5Section 6, subsection (h) of the Illinois Constitution. A home
6rule municipality to which this Section applies must comply
7with every provision of this Section.
8    Rulemaking authority to implement Public Act 95-1045, if
9any, is conditioned on the rules being adopted in accordance
10with all provisions of the Illinois Administrative Procedure
11Act and all rules and procedures of the Joint Committee on
12Administrative Rules; any purported rule not so adopted, for
13whatever reason, is unauthorized.
14(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
15103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
168-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
17eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
18103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
196-9-25; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73, eff.
201-1-26; 104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-379,
21eff. 1-1-26; 104-417, eff. 8-15-25; 104-446, eff. 6-1-26;
22revised 1-8-26.)
23    Section 15. The School Code is amended by changing Section
2410-22.3f 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
4protection and benefits for employees shall provide the
5post-mastectomy care benefits required to be covered by a
6policy of accident and health insurance under Section 356t and
7the coverage required under Sections 356g, 356g.5, 356g.5-1,
8356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
9356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
10356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
11356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
12356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
13356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71,
14356z.74, [and] 356z.77, 356z.79, [and] 356z.80, 356z.81, 356z.82, 
15356z.83, 356z.84, 356z.85, 356z.88, and 356z.89 of the
16Illinois Insurance Code. Insurance policies shall comply with
17Section 356z.19 of the Illinois Insurance Code. The coverage
18shall comply with Sections 155.22a, 355b, and 370c and Article
19XXXIIB of the Illinois Insurance Code. The Department of
20Insurance shall enforce the requirements of this Section.
21    Rulemaking authority to implement Public Act 95-1045, if
22any, is conditioned on the rules being adopted in accordance
23with all provisions of the Illinois Administrative Procedure
24Act and all rules and procedures of the Joint Committee on
25Administrative Rules; any purported rule not so adopted, for
26whatever 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;
2103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
38-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
4eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
5103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
66-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff.
71-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
8eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
9revised 1-8-26.)
10    (Text of Section after amendment by P.A. 104-446)
11    Sec. 10-22.3f. Required health benefits. Insurance
12protection and benefits for employees shall provide the
13post-mastectomy care benefits required to be covered by a
14policy of accident and health insurance under Section 356t and
15the coverage required under Sections 356g, 356g.5, 356g.5-1,
16356m, 356q, 356u, 356u.10, 356w, 356x, 356z.4, 356z.4a,
17356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14,
18356z.15, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32,
19356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47,
20356z.51, 356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60,
21356z.61, 356z.62, 356z.64, 356z.67, 356z.68, 356z.70, 356z.71,
22356z.74, [and] 356z.77, 356z.79, [and] 356z.80, 356z.81, 356z.82, 
23356z.83, 356z.84, 356z.85, 356z.88, and 356z.89 of the
24Illinois Insurance Code. Insurance policies shall comply with
25Section 356z.19 of the Illinois Insurance Code. The coverage
		SB2762 Enrolled	- 10 -	LRB104 16499 BAB 29895 b
1shall comply with Sections 155.22a, 355b, 370c, and 370c.4 and
2Article XXXIIB of the Illinois Insurance Code. The Department
3of Insurance shall enforce the requirements of this Section.
4    Rulemaking authority to implement Public Act 95-1045, if
5any, is conditioned on the rules being adopted in accordance
6with all provisions of the Illinois Administrative Procedure
7Act and all rules and procedures of the Joint Committee on
8Administrative Rules; any purported rule not so adopted, for
9whatever reason, is unauthorized.
10(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
11103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff.
128-11-23; 103-551, eff. 8-11-23; 103-605, eff. 7-1-24; 103-718,
13eff. 7-19-24; 103-751, eff. 8-2-24; 103-914, eff. 1-1-25;
14103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1, eff.
156-9-25; 104-27, eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff.
161-1-26; 104-73, eff. 1-1-26; 104-289, eff. 1-1-26; 104-324,
17eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25;
18104-446, eff. 6-1-26; revised 1-8-26.)
19    Section 20. The Illinois Insurance Code is amended by
20adding 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 
24device" means a monitoring device cleared by the United States 
		SB2762 Enrolled	- 11 -	LRB104 16499 BAB 29895 b
1Food and Drug Administration, and any related technology, 
2application, service, or subscription supporting the 
3prescribed 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 
15insurance or managed care plan amended, delivered, issued, or 
16renewed on or after January 1, 2029 shall provide coverage for 
17medically prescribed seizure detection devices.
18    (c) All seizure detection devices covered under this 
19Section shall be approved for use by individuals, and the 
20choice of device shall be made based upon the individual's 
21circumstances and medical needs in consultation with the 
22individual's medical provider.
23    (d) Any individual who has been prescribed a seizure 
24detection device shall not be required to obtain prior 
25authorization for coverage for a seizure detection device, and 
26coverage shall be continuous once the seizure detection device 
		SB2762 Enrolled	- 12 -	LRB104 16499 BAB 29895 b
1is prescribed.
2    (e) A group or individual policy of accident and health 
3insurance or a managed care plan that is amended, delivered, 
4issued, or renewed on or after January 1, 2029 shall not impose 
5a deductible, coinsurance, copayment, or any other 
6cost-sharing requirement of more than $50 on the coverage of a 
7seizure detection device per plan year. The provisions of this 
8subsection do not apply to coverage under this Section to the 
9extent that the coverage would disqualify a high-deductible 
10health plan from eligibility for a health savings account.
11    (215 ILCS 5/356z.89 new)
12    Sec. 356z.89. Coverage for preeclampsia biomarker testing. 
13Any group or individual policy of accident and health 
14insurance or managed care plan amended, delivered, issued, or 
15renewed on or after January 1, 2028 shall cover, without 
16imposing a deductible, coinsurance, copayment, or any other 
17cost-sharing requirement upon the insured, preeclampsia 
18biomarker testing for predictive screening in asymptomatic 
19individuals, or for diagnosis and management when symptoms are 
20present.
21    Section 25. The Health Maintenance Organization Act is
22amended by changing Section 5-3 as follows:
23    (215 ILCS 125/5-3)  (from Ch. 111 1/2, par. 1411.2)
		SB2762 Enrolled	- 13 -	LRB104 16499 BAB 29895 b
1    Sec. 5-3. Illinois Insurance Code provisions.
2    (a) Health Maintenance Organizations shall be subject to
3the provisions of Sections 133, 134, 136, 137, 139, 140,
4141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
5152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
6155.49, 352c, 355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f,
7356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
8356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
9356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
10356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
11356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
12356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
13356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
14356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
15356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
16356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
17356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
18356z.76, 356z.77, 356z.78, 356z.79, 356z.80, 356z.81, 356z.82, 
19356z.83, 356z.84, 356z.85, 356z.88, 356z.89, 364, 364.01,
20364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e,
21370a, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2,
22409, 412, 444, and 444.1, paragraph (c) of subsection (2) of
23Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
24XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance
25Code.
26    (b) For purposes of the Illinois Insurance Code, except
		SB2762 Enrolled	- 14 -	LRB104 16499 BAB 29895 b
1for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
2Health Maintenance Organizations in the following categories
3are 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
15acquisition of control of a Health Maintenance Organization
16pursuant 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
		SB2762 Enrolled	- 15 -	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
22Insurance Code and this Section 5-3 shall apply to the sale by
23any health maintenance organization of greater than 10% of its
24enrollee population (including, without limitation, the health
25maintenance organization's right, title, and interest in and
26to its health care certificates).
		SB2762 Enrolled	- 16 -	LRB104 16499 BAB 29895 b
1    (e) In considering any management contract or service
2agreement subject to Section 141.1 of the Illinois Insurance
3Code, the Director (i) shall, in addition to the criteria
4specified in Section 141.2 of the Illinois Insurance Code,
5take into account the effect of the management contract or
6service agreement on the continuation of benefits to enrollees
7and the financial condition of the health maintenance
8organization to be managed or serviced, and (ii) need not take
9into account the effect of the management contract or service
10agreement on competition.
11    (f) Except for small employer groups as defined in the
12Small Employer Rating, Renewability and Portability Health
13Insurance Act and except for medicare supplement policies as
14defined in Section 363 of the Illinois Insurance Code, a
15Health Maintenance Organization may by contract agree with a
16group or other enrollment unit to effect refunds or charge
17additional 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
		SB2762 Enrolled	- 17 -	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
14statement in the evidence of coverage issued to each enrollee
15describing the possibility of a refund or additional premium,
16and upon request of any group or enrollment unit, provide to
17the group or enrollment unit a description of the method used
18to calculate (1) the Health Maintenance Organization's
19profitable experience with respect to the group or enrollment
20unit and the resulting refund to the group or enrollment unit
21or (2) the Health Maintenance Organization's unprofitable
22experience with respect to the group or enrollment unit and
23the resulting additional premium to be paid by the group or
24enrollment unit.
25    In no event shall the Illinois Health Maintenance
26Organization Guaranty Association be liable to pay any
		SB2762 Enrolled	- 18 -	LRB104 16499 BAB 29895 b
1contractual obligation of an insolvent organization to pay any
2refund authorized under this Section.
3    (g) Rulemaking authority to implement Public Act 95-1045,
4if any, is conditioned on the rules being adopted in
5accordance with all provisions of the Illinois Administrative
6Procedure Act and all rules and procedures of the Joint
7Committee on Administrative Rules; any purported rule not so
8adopted, for whatever reason, is unauthorized.
9(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
10103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
111-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
12eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
13103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.
141-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
15eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
16103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff.
171-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28,
18eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73,
19eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
20104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff.
211-1-26; 104-417, eff. 8-15-25; revised 11-21-25.)
22    Section 30. The Limited Health Service Organization Act is
23amended by changing Section 4003 as follows:
24    (215 ILCS 130/4003)  (from Ch. 73, par. 1504-3)
		SB2762 Enrolled	- 19 -	LRB104 16499 BAB 29895 b
1    Sec. 4003. Illinois Insurance Code provisions. Limited
2health service organizations shall be subject to the
3provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
4141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
5154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 352c,
6355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
7356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
8356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
9356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
10356z.73, 356z.74, 356z.75, 356z.79, 356z.80, 356z.81, 356z.83, 
11356z.84, 356z.85, 356z.88, 356z.89, 364.3, 368a, 370a, 401,
12401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1 and
13Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV,
14XXVI, and XXXIIB of the Illinois Insurance Code. Nothing in
15this Section shall require a limited health care plan to cover
16any service that is not a limited health service. For purposes
17of the Illinois Insurance Code, except for Sections 444 and
18444.1 and Articles XIII and XIII 1/2, limited health service
19organizations in the following categories are deemed to be
20domestic 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	- 20 -	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;
3103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
41-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
5eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
6103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
71-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
8eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26;
9104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff.
108-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised
1111-21-25.)
12    Section 35. The Voluntary Health Services Plans Act is
13amended by changing Section 10 as follows:
14    (215 ILCS 165/10)  (from Ch. 32, par. 604)
15    Sec. 10. Application of Illinois Insurance Code
16provisions. Health services plan corporations and all persons
17interested therein or dealing therewith shall be subject to
18the provisions of Articles IIA and XII 1/2 and Sections 3.1,
19133, 136, 139, 140, 143, 143.31, 143c, 149, 155.22a, 155.37,
20354, 355.2, 355.3, 355.7, 355b, 355d, 356g, 356g.5, 356g.5-1,
21356m, 356q, 356r, 356t, 356u, 356u.10, 356v, 356w, 356x, 356y,
22356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
23356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
24356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26,
		SB2762 Enrolled	- 21 -	LRB104 16499 BAB 29895 b
1356z.29, 356z.30, 356z.32, 356z.32a, 356z.33, 356z.40,
2356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.56,
3356z.57, 356z.59, 356z.60, 356z.61, 356z.62, 356z.64, 356z.67,
4356z.68, 356z.71, 356z.72, 356z.74, 356z.75, 356z.77, 356z.79,
5356z.80, 356z.81, 356z.83, 356z.84, 356z.85, 356z.88, 356z.89,
6364.01, 364.3, 367.2, 368a, 370a, 401, 401.1, 402, 403, 403A,
7408, 408.2, and 412, and paragraphs (7) and (15) of Section 367
8of the Illinois Insurance Code.
9    Rulemaking authority to implement Public Act 95-1045, if
10any, is conditioned on the rules being adopted in accordance
11with all provisions of the Illinois Administrative Procedure
12Act and all rules and procedures of the Joint Committee on
13Administrative Rules; any purported rule not so adopted, for
14whatever reason, is unauthorized.
15(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
16103-420, eff. 1-1-24; 103-445, eff. 1-1-24; 103-551, eff.
178-11-23; 103-605, eff. 7-1-24; 103-656, eff. 1-1-25; 103-718,
18eff. 7-19-24; 103-751, eff. 8-2-24; 103-753, eff. 8-2-24;
19103-758, eff. 1-1-25; 103-832, eff. 1-1-25; 103-914, eff.
201-1-25; 103-918, eff. 1-1-25; 103-1024, eff. 1-1-25; 104-1,
21eff. 6-9-25; 104-28, eff. 1-1-26; 104-42, eff. 8-1-25; 104-73,
22eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
23104-324, eff. 1-1-26; 104-379, eff. 1-1-26; 104-417, eff.
248-15-25; revised 11-21-25.)
25    Section 95. No acceleration or delay. Where this Act makes
		SB2762 Enrolled	- 22 -	LRB104 16499 BAB 29895 b
1changes in a statute that is represented in this Act by text
2that is not yet or no longer in effect (for example, a Section
3represented by multiple versions), the use of that text does
4not accelerate or delay the taking effect of (i) the changes
5made by this Act or (ii) provisions derived from any other
6Public Act.
7    Section 99. Effective date. This Act takes effect upon
8becoming law.