Insurance

Amends the Illinois Insurance Code. Creates the Vision Benefit Managers Article. Beginning on July 1, 2026, requires a vision benefit manager to be registered with the Department of Insurance, as specified, to conduct business in the State. Requires amounts collected under provisions concerning vision benefit manager registration requirements to be deposited into the Low-Income Student Vision Examination Fund, which is created as a special fund in the State treasury. Grants the Director or the Director's designee the authority to examine a registered vision benefit manager related to all of its lines of business. Amends the Vision Care Plan Regulation Act. Changes the name of the Act to the Vision Benefit Manager Regulation Act. Establishes the legislative intent of the Act. Makes changes to defined terms. Throughout the Act, replaces references to vision care plans with vision benefit plans and vision benefit discount plans and vision care organizations with vision benefit managers. Sets forth provisions concerning required actions for noncovered services; fee schedules for eye care providers; reimbursement paid by a vision benefit manager to an eye care provider; application of the Act to a specified limited health service organization; an eye care provider's choice of vendors and affiliations; the modification of a plan; audits of an eye care provider; prohibited conduct impacting patient access and choice; credentialing; termination of agreements; prohibition on security interests; arbitration costs; nonretaliation; and private rights of action. Amends the Consumer Fraud and Deceptive Business Practices Act and the State Finance Act to make conforming changes. Effective January 1, 2027.

Amends the Illinois Insurance Code. Provides that every automobile insurance policy issued, renewed, or delivered in Illinois that includes first-party coverage for physical damage shall contain a provision granting either the insured or the insurer the right to invoke appraisal in the event of a dispute over (i) the actual cash value or amount of a loss, including repairable or total loss amounts; or (ii) the value of a settlement offer made to a third-party claimant. Sets forth provisions concerning the selection of appraisers; appointment of an umpire in the event of a disagreement between appraisers; issuance of the award following the appraisal; the binding effect of an agreement between appraisers or one appraiser and the umpire; cost allocation and consumer protections; the right of appraisal for third-party claimants; and enforcement and penalties. Creates the Automotive Appraisal Standards Advisory Board to provide guidance on rulemaking, enforcement priorities, and best practices. Sets forth membership provisions and provides that the Board shall meet no less than quarterly and may issue nonbinding recommendations to the Department of Insurance regarding updates to rules and emerging trends impacting fair claim resolution. Requires the Department to publish meeting summaries and any formal recommendations on its public website. Provides that the Department may adopt rules necessary to implement and enforce provisions concerning the right to appraisal. Effective 90 days after becoming law.

Amends the Illinois Insurance Code. Requires every insurer to provide in each group or individual policy, contract, or certificate of insurance issued or renewed for persons who are residents of the State, coverage for screening by low-dose mammography for all patients 30 (instead of 35) years of age or older for the presence of occult breast cancer within the provisions of the policy, contract, or certificate. Requires coverage for a baseline mammogram for patients 30 to 34 (instead of 35 to 39) years of age and an annual mammogram for patients 35 (instead of 40) years of age or older. Effective January 1, 2027.

Amends the Illinois Insurance Code. In provisions concerning the payment of nonparticipating ground ambulance service providers, makes changes to defined term, removes jurisdictional provisions, and provides that, for nonparticipating ground ambulance service providers owned and operated by (instead of subject to) a unit of local government, a rate shall be paid that is equal to the rate established or approved by the governing body of the unit of local government providing the ground ambulance service. Establishes a rate of pay for nonparticipating ground ambulance service providers that are not owned and operated by (instead of subject to the jurisdiction of) a unit of local government. Amends the Health Maintenance Organization Act. Replaces provisions concerning coverage for emergency transportation by ambulance with provisions concerning coverage for ground ambulance service.

Amends the Illinois Administrative Procedure Act. Provides that, for any law implementing the federal Patient Protection and Affordable Care Act, the Department of Insurance may adopt rules that include incorporations by reference of federal rules and regulations without identifying the incorporated matter by date and without including a statement that the incorporation does not include later amendments. Amends the Illinois Insurance Code. Makes changes concerning the assignment or transfer of property and casualty policies; formatting requirements for the insurance company supplier diversity report; and insurance coverage for dependent parents. Provides that the Director of Insurance shall maintain as confidential any records or information received from the National Association of Insurance Commissioners or other state, federal, and international regulatory agencies (instead of insurance regulatory officials of other states) that are confidential in that other jurisdiction. Provides that the Department may waive registration and course certification fees if the pre-licensing or continuing education course is provided by a government entity free of charge. Amends the Network Adequacy and Transparency Act. In applicability provisions, removes language concerning exemptions for short-term, limited-duration health insurance coverage with a network plan. Repeals the Health Care Purchasing Group Act. Effective immediately.