HB3019: DENTAL PRACTICE ACT EXTENSION

Legislative Summary

Amends the Illinois Insurance Code. Establishes reporting requirements for a health insurance issuer offering group or individual health insurance coverage concerning the ratio of the incurred loss or incurred claims plus the loss adjustment expense or change in contract reserves to earned premiums. Requires compliance under federal reporting regulations. Requires supplemental reports to be filed with the Director of Insurance or supplemental rebate payments to be made, as provided, if specified federal regulation are amended to repeal the reporting or rebate requirements. In provisions concerning benefits for treatment services for inpatient and outpatient treatment of substance use disorders or conditions, provides that, except to the extent prohibited by provisions concerning mental, emotional, nervous, or substance use disorder or condition parity with respect to treatment limitations in a benefit classification or subclassification, the insurer may require the substance use disorder treatment provider or facility to notify the insurer of the initiation of treatment. In provisions concerning requirements, beginning January 1, 2026, for coverage for medically necessary treatment of mental, emotional, or nervous disorders or conditions, establishes prohibitions on prior authorization. Makes changes in provisions concerning treatment for autism spectrum disorders; pregnancy and postpartum coverage; and mental, emotional, nervous, or substance use disorders or conditions to reflect the specified prohibition on prior authorization. Makes other changes. Amends the Network Adequacy and Transparency Act. Makes changes in provisions concerning the description of services to be offered through a network plan. Sets forth requirements for the plan or policy years beginning on or after January 1, 2026, regarding reimbursement to a beneficiary for costs including food, lodging, and travel. Provides that the requirements do not apply to policies issued or delivered in the State that provide medical assistance under the Illinois Public Aid Code or the Children's Health Insurance Program Act. Amends the Health Maintenance Organization Act and the Voluntary Health Services Plans Act to make corresponding changes. Amends the Illinois Public Aid Code. Provides rulemaking authority to the Department of Healthcare and Family Services to implement the applicable provisions of the amendatory Act. Effective January 1, 2026.