SB 2878

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Full Text of SB2878
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	SB2878 - 104th General Assembly
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			Senate Amendment 001
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		Introduced
		Senate Amendment 001
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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB2878
Introduced 1/16/2026, by Sen. Julie A. Morrison
SYNOPSIS AS INTRODUCED:
215 ILCS 5/355.5
Amends the Illinois Insurance Code. Prohibits an insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any other company or its contracted vendor that amends, delivers, issues, or renews an individual or group policy of accident and health insurance on or after the effective date of the amendatory Act from requiring a dental care provider to only accept payment from a credit card or electronic funds transfer, in addition to the existing prohibition on incurred fees to access and obtain payment or reimbursement for services provided. Provides that any insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any other company or its contracted vendor that amends, delivers, issues, or renews an individual or group policy of accident and health insurance may initiate or change payment methodology to a dental care provider using electronic funds transfer payments, including virtual credit card payments, if the specified conditions are met. Sets forth provisions concerning claim payment methodologies and fees for transmitting payments. Provides that the specified dental coverage reimbursement provisions shall not be waived by contract. Effective January 1, 2027.
LRB104 16882 BAB 30292 b
A BILL FOR
		SB2878		LRB104 16882 BAB 30292 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 Section 355.5 as follows:
6    (215 ILCS 5/355.5)
7    Sec. 355.5. Dental coverage reimbursement; prohibitions.
8    (a) No insurer, dental service plan corporation,
9professional service corporation, insurance network leasing
10company, or any other company or its contracted vendor that
11amends, delivers, issues, or renews an individual or group
12policy of accident and health insurance on or after the 
13effective date of this amendatory Act of the 104th General 
14Assembly [the effective date of this amendatory Act of the ]
15[103rd General Assembly] shall require a dental care provider to
16only accept payment from a credit card or electronic funds 
17transfer or to incur a fee to access and obtain payment or
18reimbursement for services provided.
19    (b) Any insurer, dental service plan corporation, 
20professional service corporation, insurance network leasing 
21company, or any other company or its contracted vendor that 
22amends, delivers, issues, or renews an individual or group 
23policy of accident and health insurance [A dental plan carrier]
		SB2878	- 2 -	LRB104 16882 BAB 30292 b
1shall provide a dental care provider with 100% of the
2contracted amount of the payment or reimbursement.
3    (c) In this subsection, "express acceptance" means a clear 
4and direct agreement to the terms of payment method, 
5communicated explicitly by the dental plan to the dental care 
6provider, in writing, signifying acceptance of the payment 
7method without any ambiguity or implied actions. Any insurer, 
8dental service plan corporation, professional service 
9corporation, insurance network leasing company, or any other 
10company or its contracted vendor that amends, delivers, 
11issues, or renews an individual or group policy of accident 
12and health insurance may initiate or change payment 
13methodology to a dental care provider using electronic funds 
14transfer payments, including virtual credit card payments, if:
15        (1) the dental care provider is notified of any fees 
16    associated with a particular payment method;
17        (2) the insurer, dental service plan corporation, 
18    professional service corporation, insurance network 
19    leasing company, or other company or its contracted vendor 
20    advises the dental care provider of the available methods 
21    of payment and provides clear instructions to the dentist 
22    as to how to select an alternative payment method that 
23    does not impose fees or similar charges on the provider; 
24    and
25        (3) the dental care provider or a designee of the 
26    provider elects, through express acceptance, to accept a 
		SB2878	- 3 -	LRB104 16882 BAB 30292 b
1    payment of the claim using the credit card or electronic 
2    funds transfer payment method. Violation of express 
3    acceptance nullifies an election on claim payment 
4    methodology until the express agreement is executed.
5    (d) A dental care provider's selected form of claim 
6payment methodology remains effective until the dental care 
7provider chooses an alternative method of payment or a new 
8contract is executed.
9    (e) If a dental care provider requests a change in the 
10available payment methodology, then the insurer, dental 
11service plan corporation, professional service corporation, 
12insurance network leasing company, or other company or its 
13contracted vendor that amends, delivers, issues, or renews an 
14individual or group policy of accident and health insurance 
15shall implement the change within 30 business days after the 
16request.
17    (f) An insurer or managed care plan shall not use a dental 
18care provider's preferred method of payment as a factor when 
19deciding whether to provide credentials to a dentist.
20    (g) A dental benefit plan or its contracted vendor or 
21health maintenance organization that initiates or changes 
22payments to a dentist through the Automated Clearing House 
23Network in accordance with 45 CFR 162.1601 and 45 CFR 162.1602 
24shall not charge a fee solely to transmit the payment to the 
25dental care provider unless the dental care provider has 
26consented to the fee. A dental care provider agent may charge 
		SB2878	- 4 -	LRB104 16882 BAB 30292 b
1reasonable fees when transmitting an Automated Clearing House 
2Network payment related to transaction management, data 
3management, portal services, and other value-added services, 
4in addition to bank transmittal.
5    (h) The requirements of this Section shall not be waived 
6by contract, and any contractual clause in conflict with the 
7requirements of this Section or that purports to waive any 
8requirements of this Section is void. [Fees incurred directly ]
9[by a dental care provider from third parties related to ]
10[transmitting an automated clearing house network claim, ]
11[transaction management, data management, or portal services ]
12[and other fees charged by third parties that are not in the ]
13[control of the dental plan carrier shall not be prohibited by ]
14[this Section.]
15(Source: P.A. 103-24, eff. 1-1-24.)
16    Section 99. Effective date. This Act takes effect January
171, 2027.