Chapter 215, INSURANCE

(215 ILCS 5/356z.4b) Sec. 356z.4b. Billing for long-acting reversible contraceptives. (a) In this Section, "long-acting reversible contraceptive device" means any intrauterine device or contraceptive implant. (b) Any individual or group policy of accident and health insurance or …

(215 ILCS 5/356z.5) Sec. 356z.5. Prescription inhalers. (a) In this Section, "prescription inhaler" means a prescribed medical device that delivers inhaled medications used to treat breathing for persons suffering from asthma or other life-threatening bronchial ailments. "Prescri…

(215 ILCS 5/356z.50) Sec. 356z.50. Comprehensive cancer testing. (a) As used in this Section: "Comprehensive cancer testing" includes, but is not limited to, the following forms of testing: (1) Targeted cancer gene panels. (2) Whole-exome genome testing. (3) Whole-genome sequenci…

(215 ILCS 5/356z.51) Sec. 356z.51. Coverage for port-wine stain treatment. (a) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2022 shall provide coverage for treatment to eliminate o…

(215 ILCS 5/356z.53) Sec. 356z.53. Coverage for home health services. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2024 shall provide coverage for access to home health s…

(215 ILCS 5/356z.54) Sec. 356z.54. Coverage for breast reduction surgery. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2024 shall provide coverage for medically necessary…

(215 ILCS 5/356z.55) Sec. 356z.55. Coverage for cleft lip and cleft palate. (a) As used in this Section, "medically necessary care and treatment" to address congenital anomalies associated with a cleft lip or palate, or both, includes: (1) oral and facial surgery, including recon…

(215 ILCS 5/356z.56) (Text of Section before amendment by P.A. 104-793) Sec. 356z.56. Coverage for hormonal and non-hormonal therapy to treat menopause. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or ren…

(215 ILCS 5/356z.57) Sec. 356z.57. Pediatric palliative care. (a) A group or individual policy of accident and health insurance or a managed care plan amended, delivered, issued, or renewed on or after January 1, 2024 shall provide coverage for community-based pediatric palliativ…

(215 ILCS 5/356z.58) Sec. 356z.58. Prenatal vitamins coverage. A group or individual policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2024 that provides coverage for prescription drugs shall provide coverage for prenata…

(215 ILCS 5/356z.59) Sec. 356z.59. Coverage for continuous glucose monitors. (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed before January 1, 2026 shall provide coverage for medically necessa…

(215 ILCS 5/356z.6) Sec. 356z.6. Bone mass measurement; osteoporosis. A group or individual policy of accident and health insurance amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 93rd General Assembly must provide coverage for medica…

(215 ILCS 5/356z.60) Sec. 356z.60. Coverage for abortifacients, hormonal therapy, and human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis. (a) As used in this Section: "Abortifacients" means any medication administered to terminate a pregnancy as p…

(215 ILCS 5/356z.61) Sec. 356z.61. Coverage for liver disease screening. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide coverage for preventative liver d…

(215 ILCS 5/356z.62) Sec. 356z.62. Coverage of preventive health services. (a) A policy of group health insurance coverage or individual health insurance coverage as defined in Section 5 of the Illinois Health Insurance Portability and Accountability Act shall, at a minimum, prov…

(215 ILCS 5/356z.63) Sec. 356z.63. Coverage of pharmacy testing, screening, vaccinations, and treatment. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide c…

(215 ILCS 5/356z.64) Sec. 356z.64. Coverage for compression sleeves. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide coverage for compression sleeves that…

(215 ILCS 5/356z.65) Sec. 356z.65. Coverage for reconstructive services. (a) As used in this Section, "reconstructive services" means treatments performed on structures of the body damaged by trauma to restore physical appearance. (b) A group or individual policy of accident and …

(215 ILCS 5/356z.66) Sec. 356z.66. Proton beam therapy. (a) As used in this Section: "Medically necessary" has the meaning given to that term in the Prior Authorization Reform Act. "Proton beam therapy" means a type of radiation therapy treatment that utilizes protons as the radi…

(215 ILCS 5/356z.67) Sec. 356z.67. Coverage of prescription estrogen. (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 and that provides coverage for prescription dr…

(215 ILCS 5/356z.68) Sec. 356z.68. Home saliva cancer screening. (a) As used in this Section, "home saliva cancer screening" means an outpatient test that utilizes an individual's saliva to detect biomarkers for early-stage cancer. (b) An individual or group policy of accident an…

(215 ILCS 5/356z.69) Sec. 356z.69. Coverage for children with neuromuscular, neurological, or cognitive impairment. A group or individual policy of accident and health insurance amended, delivered, issued, or renewed on or after January 1, 2025 shall provide coverage for therapy,…

(215 ILCS 5/356z.7) (was 215 ILCS 5/370r) Sec. 356z.7. Prescription drugs; cancer treatment. No group policy of accident or health insurance that provides coverage for prescribed drugs approved by the federal Food and Drug Administration for the treatment of certain types of canc…

(215 ILCS 5/356z.70) Sec. 356z.70. Coverage of no-cost mental health prevention and wellness visits. (a) A group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide cov…

(215 ILCS 5/356z.71) Sec. 356z.71. Coverage for mobile integrated health care services. (a) In this Section: "Eligible recipient" means an individual who has received hospital emergency department services 3 or more times in a period of 4 consecutive months in the past 12 months …

(215 ILCS 5/356z.72) Sec. 356z.72. Wigs and hair prostheses. A group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed after January 1, 2026 must provide coverage, no less than once every 12 months, for one wig or othe…

(215 ILCS 5/356z.73) Sec. 356z.73. Insurance coverage for dependent parents. (a) A group or individual policy of accident and health insurance issued, amended, delivered, or renewed on or after January 1, 2026 that provides dependent coverage shall make that dependent coverage av…

(215 ILCS 5/356z.74) (Text of Section before amendment by P.A. 104-793) Sec. 356z.74. Coverage for annual menopause health visit. A group or individual policy of accident and health insurance providing coverage for more than 25 employees that is amended, delivered, issued, or ren…

(215 ILCS 5/356z.75) Sec. 356z.75. Coverage during a generic drug shortage. (a) As used in this Section: "Eligible prescription drug" means a prescription drug approved under 21 U.S.C. 355(c) that is not under patent. "Generic drug" means a drug that is approved pursuant to an ap…

(215 ILCS 5/356z.76) Sec. 356z.76. Coverage for at-home pregnancy tests. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 shall provide coverage for at-home, urine-based…

(215 ILCS 5/356z.77) Sec. 356z.77. Coverage of vaccination administration fees. (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 shall provide coverage for vaccinati…

(215 ILCS 5/356z.78) Sec. 356z.78. Coverage for medically necessary care and treatment to address a major injury to the jaw either through an accident or disease. (a) In this Section, "medically necessary care and treatment to address a major injury to the jaw either through an a…

(215 ILCS 5/356z.79) Sec. 356z.79. Coverage for treatments to slow the progression of Alzheimer's disease and related dementias. (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after Jan…

(215 ILCS 5/356z.8) Sec. 356z.8. Multiple sclerosis preventative physical therapy. A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 94th General Assembl…

(215 ILCS 5/356z.80) Sec. 356z.80. Coverage for testing for Klinefelter syndrome. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for a karyotype…

(215 ILCS 5/356z.81) Sec. 356z.81. Coverage for anesthesia services. (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 shall provide coverage for medically necessary …

(215 ILCS 5/356z.82) Sec. 356z.82. Coverage for hippotherapy and therapeutic riding. (a) As used in this Section, "hippotherapy" means the use by a licensed occupational therapist, physical therapist, or speech-language pathologist, in conjunction with a professional horse handle…

(215 ILCS 5/356z.83) Sec. 356z.83. Laser hair removal. Any group or individual policy of accident or health insurance or a managed care plan that is amended, delivered, issued, or renewed after January 1, 2027 shall provide coverage for medically necessary laser hair removal if t…

(215 ILCS 5/356z.84) Sec. 356z.84. Coverage for complex wheelchair service and repair. (a) As used in this Section: "Complex rehabilitation technology" means a medically necessary complex wheelchair and associated accessories that is individually configured for an individual to m…

(215 ILCS 5/356z.85) Sec. 356z.85. Coverage for peripheral artery disease screening test. A group or individual plan of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2027 shall provide medically necessary coverage…

(215 ILCS 5/356z.88) (Text of Section from P.A. 104-531) Sec. 356z.88. Durable medical equipment. An individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2028 that provides coverage …

(215 ILCS 5/356z.89) Sec. 356z.89. Coverage for preeclampsia biomarker testing. Any group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2028 shall cover, without imposing a deductible, coin…

(215 ILCS 5/356z.9) Sec. 356z.9. Human papillomavirus vaccine. A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 95th General Assembly must provide cover…

(215 ILCS 5/357.1) (from Ch. 73, par. 969.1) Sec. 357.1. Accident and health policy provisions required. Except as provided in section 357.26 of this article each accident and health policy delivered or issued for delivery to any person in this State shall contain the provisions …

(215 ILCS 5/357.10) (from Ch. 73, par. 969.10) Sec. 357.10. "PAYMENT OF CLAIMS: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment…

(215 ILCS 5/357.11) (from Ch. 73, par. 969.11) Sec. 357.11. "PHYSICAL EXAMINATIONS AND AUTOPSY: The company at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pendency of a claim h…

(215 ILCS 5/357.12) (from Ch. 73, par. 969.12) Sec. 357.12. "LEGAL ACTIONS: No civil action shall be brought to recover on this policy prior to the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of this policy. No such act…

(215 ILCS 5/357.13) (from Ch. 73, par. 969.13) Sec. 357.13. "CHANGE OF BENEFICIARY: Unless the insured makes an irrevocable designation of beneficiary, the right to change of beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be r…

(215 ILCS 5/357.14) (from Ch. 73, par. 969.14) Sec. 357.14. Except as provided in section 357.26, no such policy delivered or issued for delivery to any person in this State shall contain provisions respecting the matters set forth in sections 357.15 through 357.24 unless such pr…

(215 ILCS 5/357.15) (from Ch. 73, par. 969.15) Sec. 357.15. "CHANGE OF OCCUPATION: If the insured be injured or contract sickness after having changed his occupation to one classified by the company as more hazardous than that stated in this policy or while doing for compensation…