SB 2757

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Full Text of SB2757
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	SB2757 - 104th General Assembly
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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,
3represented in the General Assembly:
4    Section 5. The Illinois Insurance Code is amended by
5changing 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
8delivered in other State-Transactions in this State. With the
9exception of insurance transactions authorized under Sections
10230.2 or 367.3 of this Code [or transactions described under ]
11[Section 352c], transactions in this State involving group
12legal, group life and group accident and health or blanket
13accident and health insurance or group annuities where the
14master policy of such groups was lawfully issued and delivered
15in, and under the laws of, a State in which the insurer was
16authorized to do an insurance business, to a group properly
17established pursuant to law or regulation, and where the
18policyholder 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;
22discretionary groups.
		SB2757	- 2 -	LRB104 16590 BAB 29989 b
1    (a) No group health insurance offered to a resident of
2this State under a policy issued to a group, other than one
3specifically described in Section 367(1), shall be delivered
4or issued for delivery in this State unless the Director
5determines 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
13State under a policy issued in another state unless this State
14or the state in which the group policy is issued has made a
15determination that the requirements of subsection (a) have
16been met.
17    Where insurance is to be offered in this State under a
18policy described in this subsection, the insurer shall file
19for 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	- 3 -	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
10information required under subsection (b) and after finding
11that the standards of subsection (a) have not been met, order
12the insurer to cease the issuance or marketing of that
13coverage in this State.
14    (d) Notwithstanding subsections (a) and (b), group
15accident and health insurance subject to the provisions of
16this 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
22accident and health insurance providing excepted benefits, as
23defined in 42 U.S.C. 300gg-91 and implementing regulations
24[Section 352c], that covers special groups of persons as
25enumerated in one of the following paragraphs (a) to (g),
		SB2757	- 4 -	LRB104 16590 BAB 29989 b
1inclusive:
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	- 5 -	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
20health insurance in this state shall have the power to issue
21blanket accident and health insurance. No such blanket policy
22may be issued or delivered in this State unless a copy of the
23form thereof shall have been filed in accordance with Section
24355, and it contains in substance such of those provisions
25contained in Sections 357.1 through 357.30 as may be
26applicable to blanket accident and health insurance and the
		SB2757	- 6 -	LRB104 16590 BAB 29989 b
1following 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
13person covered under a blanket accident or health policy or
14contract, nor shall it be necessary for the insurer to furnish
15each person a certificate.
16    (3.5) Subsection (3) does not apply to major medical
17insurance, or to any excepted benefits or short-term,
18limited-duration health insurance coverage for which an
19insured individual pays premiums or contributions. In those
20cases, the insurer shall require an individual application or
21enrollment form and shall furnish each insured individual a
22certificate, which shall have been approved by the Director
23under Section 355 of this Code.
24    (4) All benefits under any blanket accident and health
25policy shall be payable to the person insured, or to his
26designated beneficiary or beneficiaries, or to his or her
		SB2757	- 7 -	LRB104 16590 BAB 29989 b
1estate, except that if the person insured be a minor or person
2under legal disability, such benefits may be made payable to
3his or her parent, guardian, or other person actually
4supporting him or her. Provided further, however, that the
5policy may provide that all or any portion of any indemnities
6provided by any such policy on account of hospital, nursing,
7medical or surgical services may, at the insurer's option, be
8paid directly to the hospital or person rendering such
9services; but the policy may not require that the service be
10rendered by a particular hospital or person. Payment so made
11shall discharge the insurer's obligation with respect to the
12amount of insurance so paid.
13    (5) Nothing contained in this Section shall be deemed to
14affect the legal liability of policyholders for the death of
15or injury to, any such member of such group.
16(Source: P.A. 103-649, eff. 1-1-25; 103-718, eff. 1-1-25;
17104-417, eff. 8-15-25.)
18    (215 ILCS 5/352c rep.)
19    Section 7. The Illinois Insurance Code is amended by
20repealing Section 352c.
21    Section 10. 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)
		SB2757	- 8 -	LRB104 16590 BAB 29989 b
1    (Text of Section before amendment by P.A. 103-808, 104-28,
2104-68, 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
5the provisions of Sections 133, 134, 136, 137, 139, 140,
6141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
7152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
8155.49, [352c,] 355.2, 355.3, 355.6, 355b, 355c, 356f, 356g.5-1,
9356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2, 356z.3a,
10356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10,
11356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18,
12356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24, 356z.25,
13356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32, 356z.33,
14356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39, 356z.40,
15356z.40a, 356z.41, 356z.44, 356z.45, 356z.46, 356z.47,
16356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54, 356z.55,
17356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61, 356z.62,
18356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68, 356z.69,
19356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75, 356z.76,
20356z.77, 356z.78, 356z.79, 356z.81, [356z.80,] 364, 364.01,
21364.3, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e,
22370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 409,
23412, 444, and 444.1, paragraph (c) of subsection (2) of
24Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
25XIII 1/2, XXV, XXVI, and XXXIIB of the Illinois Insurance
26Code. Section 356z.81 [365z.80] of the Illinois Insurance Code
		SB2757	- 9 -	LRB104 16590 BAB 29989 b
1is not applicable to health care plans under contract with the
2Department of Healthcare and Family Services.
3    (b) For purposes of the Illinois Insurance Code, except
4for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
5Health Maintenance Organizations in the following categories
6are 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
18acquisition of control of a Health Maintenance Organization
19pursuant 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	- 10 -	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
25Insurance Code and this Section 5-3 shall apply to the sale by
26any health maintenance organization of greater than 10% of its
		SB2757	- 11 -	LRB104 16590 BAB 29989 b
1enrollee population (including, without limitation, the health
2maintenance organization's right, title, and interest in and
3to its health care certificates).
4    (e) In considering any management contract or service
5agreement subject to Section 141.1 of the Illinois Insurance
6Code, the Director (i) shall, in addition to the criteria
7specified in Section 141.2 of the Illinois Insurance Code,
8take into account the effect of the management contract or
9service agreement on the continuation of benefits to enrollees
10and the financial condition of the health maintenance
11organization to be managed or serviced, and (ii) need not take
12into account the effect of the management contract or service
13agreement on competition.
14    (f) Except for small employer groups as defined in the
15Small Employer Rating, Renewability and Portability Health
16Insurance Act and except for medicare supplement policies as
17defined in Section 363 of the Illinois Insurance Code, a
18Health Maintenance Organization may by contract agree with a
19group or other enrollment unit to effect refunds or charge
20additional 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	- 12 -	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
17statement in the evidence of coverage issued to each enrollee
18describing the possibility of a refund or additional premium,
19and upon request of any group or enrollment unit, provide to
20the group or enrollment unit a description of the method used
21to calculate (1) the Health Maintenance Organization's
22profitable experience with respect to the group or enrollment
23unit and the resulting refund to the group or enrollment unit
24or (2) the Health Maintenance Organization's unprofitable
25experience with respect to the group or enrollment unit and
26the resulting additional premium to be paid by the group or
		SB2757	- 13 -	LRB104 16590 BAB 29989 b
1enrollment unit.
2    In no event shall the Illinois Health Maintenance
3Organization Guaranty Association be liable to pay any
4contractual obligation of an insolvent organization to pay any
5refund authorized under this Section.
6    (g) Rulemaking authority to implement Public Act 95-1045,
7if any, is conditioned on the rules being adopted in
8accordance with all provisions of the Illinois Administrative
9Procedure Act and all rules and procedures of the Joint
10Committee on Administrative Rules; any purported rule not so
11adopted, for whatever reason, is unauthorized.
12(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
13103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
141-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
15eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
16103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.
171-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
18eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
19103-914, eff. 1-1-25; 103-918, eff. 1-1-25; 103-1024, eff.
201-1-25; 104-1, eff. 6-9-25; 104-42, eff. 8-1-25; 104-334, eff.
218-15-25; 104-417, eff. 8-15-25; revised 10-3-25.)
22    (Text of Section after amendment by P.A. 103-808, 104-28,
23104-68, 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	- 14 -	LRB104 16590 BAB 29989 b
1the provisions of Sections 133, 134, 136, 137, 139, 140,
2141.1, 141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151,
3152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a,
4155.49, [352c,] 355.2, 355.3, 355.6, 355.7, 355b, 355c, 356f,
5356g, 356g.5-1, 356m, 356q, 356u.10, 356v, 356w, 356x, 356z.2,
6356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9,
7356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17,
8356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.23, 356z.24,
9356z.25, 356z.26, 356z.28, 356z.29, 356z.30, 356z.31, 356z.32,
10356z.33, 356z.34, 356z.35, 356z.36, 356z.37, 356z.38, 356z.39,
11356z.40, 356z.40a, 356z.41, 356z.44, 356z.45, 356z.46,
12356z.47, 356z.48, 356z.49, 356z.50, 356z.51, 356z.53, 356z.54,
13356z.55, 356z.56, 356z.57, 356z.58, 356z.59, 356z.60, 356z.61,
14356z.62, 356z.63, 356z.64, 356z.65, 356z.66, 356z.67, 356z.68,
15356z.69, 356z.70, 356z.71, 356z.72, 356z.73, 356z.74, 356z.75,
16356z.76, 356z.77, 356z.78, 356z.79, 356z.80, 356z.81, 356z.82, 
17356z.83, 356z.84, 356z.85, 364, 364.01, 364.3, 367.2, 367.2-5,
18367i, 368a, 368b, 368c, 368d, 368e, 370a, 370c, 370c.1, 401,
19401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
20paragraph (c) of subsection (2) of Section 367, and Articles
21IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
22XXXIIB of the Illinois Insurance Code.
23    (b) For purposes of the Illinois Insurance Code, except
24for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
25Health Maintenance Organizations in the following categories
26are deemed to be "domestic companies":
		SB2757	- 15 -	LRB104 16590 BAB 29989 b
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
12acquisition of control of a Health Maintenance Organization
13pursuant 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
		SB2757	- 16 -	LRB104 16590 BAB 29989 b
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
19Insurance Code and this Section 5-3 shall apply to the sale by
20any health maintenance organization of greater than 10% of its
21enrollee population (including, without limitation, the health
22maintenance organization's right, title, and interest in and
23to its health care certificates).
24    (e) In considering any management contract or service
25agreement subject to Section 141.1 of the Illinois Insurance
26Code, the Director (i) shall, in addition to the criteria
		SB2757	- 17 -	LRB104 16590 BAB 29989 b
1specified in Section 141.2 of the Illinois Insurance Code,
2take into account the effect of the management contract or
3service agreement on the continuation of benefits to enrollees
4and the financial condition of the health maintenance
5organization to be managed or serviced, and (ii) need not take
6into account the effect of the management contract or service
7agreement on competition.
8    (f) Except for small employer groups as defined in the
9Small Employer Rating, Renewability and Portability Health
10Insurance Act and except for medicare supplement policies as
11defined in Section 363 of the Illinois Insurance Code, a
12Health Maintenance Organization may by contract agree with a
13group or other enrollment unit to effect refunds or charge
14additional 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
		SB2757	- 18 -	LRB104 16590 BAB 29989 b
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
11statement in the evidence of coverage issued to each enrollee
12describing the possibility of a refund or additional premium,
13and upon request of any group or enrollment unit, provide to
14the group or enrollment unit a description of the method used
15to calculate (1) the Health Maintenance Organization's
16profitable experience with respect to the group or enrollment
17unit and the resulting refund to the group or enrollment unit
18or (2) the Health Maintenance Organization's unprofitable
19experience with respect to the group or enrollment unit and
20the resulting additional premium to be paid by the group or
21enrollment unit.
22    In no event shall the Illinois Health Maintenance
23Organization Guaranty Association be liable to pay any
24contractual obligation of an insolvent organization to pay any
25refund authorized under this Section.
26    (g) Rulemaking authority to implement Public Act 95-1045,
		SB2757	- 19 -	LRB104 16590 BAB 29989 b
1if any, is conditioned on the rules being adopted in
2accordance with all provisions of the Illinois Administrative
3Procedure Act and all rules and procedures of the Joint
4Committee on Administrative Rules; any purported rule not so
5adopted, for whatever reason, is unauthorized.
6(Source: P.A. 103-84, eff. 1-1-24; 103-91, eff. 1-1-24;
7103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-420, eff.
81-1-24; 103-426, eff. 8-4-23; 103-445, eff. 1-1-24; 103-551,
9eff. 8-11-23; 103-605, eff. 7-1-24; 103-618, eff. 1-1-25;
10103-649, eff. 1-1-25; 103-656, eff. 1-1-25; 103-700, eff.
111-1-25; 103-718, eff. 7-19-24; 103-751, eff. 8-2-24; 103-753,
12eff. 8-2-24; 103-758, eff. 1-1-25; 103-777, eff. 8-2-24;
13103-808, eff. 1-1-26; 103-914, eff. 1-1-25; 103-918, eff.
141-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-28,
15eff. 1-1-26; 104-42, eff. 8-1-25; 104-68, eff. 1-1-26; 104-73,
16eff. 1-1-26; 104-98, eff. 1-1-26; 104-289, eff. 1-1-26;
17104-324, eff. 1-1-26; 104-334, eff. 8-15-25; 104-379, eff.
181-1-26; 104-417, eff. 8-15-25; revised 10-3-25.)
19    Section 15. The Limited Health Service Organization Act is
20amended 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,
23104-289, 104-324, and 104-379)
24    Sec. 4003. Illinois Insurance Code provisions. Limited
		SB2757	- 20 -	LRB104 16590 BAB 29989 b
1health service organizations shall be subject to the
2provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
3141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
4154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, [352c,]
5355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
6356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
7356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
8356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
9356z.73, 356z.74, 356z.75, 356z.79, 356z.81, [356z.80,] 364.3,
10368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444,
11and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII
121/2, XXV, XXVI, and XXXIIB of the Illinois Insurance Code.
13Nothing in this Section shall require a limited health care
14plan to cover any service that is not a limited health service.
15For purposes of the Illinois Insurance Code, except for
16Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited
17health service organizations in the following categories are
18deemed 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;
		SB2757	- 21 -	LRB104 16590 BAB 29989 b
1103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
21-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
3eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
4103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
51-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
6eff. 8-1-25; 104-334, eff. 8-15-25; 104-417, eff. 8-15-25;
7revised 10-3-25.)
8    (Text of Section after amendment by P.A. 104-73, 104-98,
9104-289, 104-324, and 104-379)
10    Sec. 4003. Illinois Insurance Code provisions. Limited
11health service organizations shall be subject to the
12provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
13141.2, 141.3, 143, 143.31, 143c, 147, 148, 149, 151, 152, 153,
14154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, [352c,]
15355.2, 355.3, 355b, 355d, 356m, 356q, 356v, 356z.4, 356z.4a,
16356z.10, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.32,
17356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
18356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68, 356z.71,
19356z.73, 356z.74, 356z.75, 356z.79, 356z.80, 356z.81, 356z.83, 
20356z.84, 356z.85, 364.3, 368a, 370a, 401, 401.1, 402, 403,
21403A, 408, 408.2, 409, 412, 444, and 444.1 and Articles IIA,
22VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB
23of the Illinois Insurance Code. Nothing in this Section shall
24require a limited health care plan to cover any service that is
25not a limited health service. For purposes of the Illinois
		SB2757	- 22 -	LRB104 16590 BAB 29989 b
1Insurance Code, except for Sections 444 and 444.1 and Articles
2XIII and XIII 1/2, limited health service organizations in the
3following 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;
12103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445, eff.
131-1-24; 103-605, eff. 7-1-24; 103-649, eff. 1-1-25; 103-656,
14eff. 1-1-25; 103-700, eff. 1-1-25; 103-718, eff. 7-19-24;
15103-751, eff. 8-2-24; 103-758, eff. 1-1-25; 103-832, eff.
161-1-25; 103-1024, eff. 1-1-25; 104-1, eff. 6-9-25; 104-42,
17eff. 8-1-25; 104-73, eff. 1-1-26; 104-98, eff. 1-1-26;
18104-289, eff. 1-1-26; 104-324, eff. 1-1-26; 104-334, eff.
198-15-25; 104-379, eff. 1-1-26; 104-417, eff. 8-15-25; revised
2010-3-25.)
21    Section 20. The Short-Term, Limited-Duration Health
22Insurance Coverage Act is reenacted as follows:
23    (215 ILCS 190/Act title)
24    An Act concerning regulation.
		SB2757	- 23 -	LRB104 16590 BAB 29989 b
1    (215 ILCS 190/1)
2    Sec. 1. Short title. This Act may be cited as the
3Short-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
9term in the Illinois Health Insurance Portability and
10Accountability Act.
11    "Health insurance issuer" has the meaning given to that
12term in the Illinois Health Insurance Portability and
13Accountability Act.
14    "Fraud" means an intentional misrepresentation of a
15material fact in connection with the coverage.
16    "Short-term, limited-duration health insurance coverage"
17means health insurance coverage provided pursuant to a policy
18with an issuer, regardless of the situs of the delivery of the
19policy, that is less than 365 days after the effective date of
20the policy.
21(Source: P.A. 100-1118, eff. 11-27-18.)
22    (215 ILCS 190/10)
23    Sec. 10. Application; scope; duration of coverage.
		SB2757	- 24 -	LRB104 16590 BAB 29989 b
1    (a) This Act applies to health insurance issuers that
2offer short-term, limited-duration health insurance coverage
3to individuals in this State and to short-term,
4limited-duration health insurance coverage that is delivered
5or issued for delivery in this State, including coverage
6issued outside of this State that covers individuals in this
7State.
8    (b) A short-term, limited-duration health insurance
9coverage policy may not be issued or delivered to any person
10residing in this State unless the policy, when delivered or
11issued for delivery in this State, complies with the
12provisions of this Act.
13    (c) Any short-term, limited-duration health insurance
14coverage policy that is delivered or issued for delivery in
15this State must have an expiration date in the policy that is
16less than 181 days after the effective date and shall not be
17renewable or extendable within a period of 365 days after the
18individual's coverage under the policy ends, either at the
19option of the issuer or the individual. Renewal of a
20short-term, limited-duration health insurance coverage policy
21includes the issuance of a new short-term, limited-duration
22health insurance policy by an issuer to a policyholder within
2360 days after the expiration of a policy previously issued by
24the issuer to the policyholder.
25    (d) Any short-term, limited-duration health insurance
26coverage policy that is delivered or issued for delivery in
		SB2757	- 25 -	LRB104 16590 BAB 29989 b
1this State may not be rescinded before the expiration date in
2the policy, except in cases of nonpayment of premiums, fraud,
3or as provided in subsection (e).
4    (e) Any short-term, limited-duration health insurance
5coverage policy that is delivered or issued for delivery in
6this State shall contain an option for an individual to cancel
7coverage after any 30-day interval during the term of the
8plan.
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,
13limited-duration health insurance coverage to be delivered or
14issued for delivery in this State shall, in addition to all
15other documents required, including, but not limited to, the
16policy, the certificate, the membership booklet, and a
17description of appeal and external review rights, deliver an
18outline of coverage to an applicant for or an enrollee in
19short-term, limited-duration health insurance coverage
20delivered or issued for delivery in this State.
21    (b) Any short-term, limited-duration health insurance
22coverage policy that is delivered or issued for delivery in
23the State shall display prominently in the policy, any
24application, sales, and marketing materials provided in
25connection with enrollment in such coverage, and the outline
		SB2757	- 26 -	LRB104 16590 BAB 29989 b
1of coverage for such coverage, in at least 14-point, bold
2type, the following: "NOTICE: THE SHORT-TERM, LIMITED-DURATION
3INSURANCE BENEFITS UNDER THIS COVERAGE DO NOT MEET ALL FEDERAL
4REQUIREMENTS TO QUALIFY AS "MINIMUM ESSENTIAL COVERAGE" FOR
5HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. THIS PLAN OF
6COVERAGE DOES NOT INCLUDE ALL ESSENTIAL HEALTH BENEFITS AS
7REQUIRED BY THE AFFORDABLE CARE ACT. PREEXISTING CONDITIONS
8ARE NOT COVERED UNDER THIS PLAN OF COVERAGE. BE SURE TO CHECK
9YOUR POLICY CAREFULLY TO MAKE SURE YOU UNDERSTAND WHAT THE
10POLICY DOES AND DOES NOT COVER. IF THIS COVERAGE EXPIRES OR YOU
11LOSE ELIGIBILITY FOR THIS COVERAGE, YOU MIGHT HAVE TO WAIT
12UNTIL THE NEXT OPEN ENROLLMENT PERIOD TO GET OTHER HEALTH
13INSURANCE COVERAGE. YOU MAY BE ABLE TO GET LONGER TERM
14INSURANCE THAT QUALIFIES AS "MINIMUM ESSENTIAL COVERAGE" FOR
15HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT NOW AND HELP TO
16PAY FOR IT AT WWW.HEALTHCARE.GOV.".
17    (c) Any individual selling a short-term, limited-duration
18health insurance coverage policy in this State in face-to-face
19or telephonic sales interactions must read out loud the
20disclosure in subsection (b) to a prospective purchaser. An
21entity selling a short-term, limited-duration health insurance
22coverage policy in Illinois must display the disclosure in
23subsection (b) on the webpage where a prospective purchaser
24would purchase coverage.
25    (d) Nothing in this Section precludes an insurer from
26providing disclosures in addition to those required in
		SB2757	- 27 -	LRB104 16590 BAB 29989 b
1subsections (b) and (c). Nothing in this Section precludes an
2insurer from providing disclosures intended to clarify those
3required in subsections (b) and (c) if approved by the
4Department.
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
9issued for delivery in this State unless the policy evidencing
10such coverage has been filed with and been approved by the
11Department.
12    (b) A health insurance issuer who intends to deliver or
13issue for delivery a short-term, limited-duration health
14insurance coverage policy in this State shall file with the
15Department:
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
22carry out the provisions of this Act.
23(Source: P.A. 100-1118, eff. 11-27-18.)
24    (215 ILCS 190/99)
		SB2757	- 28 -	LRB104 16590 BAB 29989 b
1    Sec. 99. Effective date. This Act takes effect upon
2becoming law, except that the provisions changing Sections
3456, 457, and 458 of the Illinois Insurance Code and the
4provisions repealing Section 460 of the Illinois Insurance
5Code 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
8changes in a statute that is represented in this Act by text
9that is not yet or no longer in effect (for example, a Section
10represented by multiple versions), the use of that text does
11not accelerate or delay the taking effect of (i) the changes
12made by this Act or (ii) provisions derived from any other
13Public Act.