Amendment vs bill Senate Amendment 001 vs Enrolled

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SB3707 Enrolled LRB104 20689 JDS 34188 b AN ACT concerning regulation.
*LRB10420689BAB37738a* Sen.
Be it enacted by the People of the State of Illinois, represented in the General Assembly:
Cristina Castro Filed:
Section 5.
5/15/2026 10400SB3707sam001 LRB104 20689 BAB 37738 a AMENDMENT TO SENATE BILL 3707 AMENDMENT NO.
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Amend Senate Bill 3707 by replacing everything after the enacting clause with the following:
"Section 5.
"Covered materials" means materials for which reimbursement from an enrollee's the vision care plan is provided to an eye care provider or for which reimbursement is provided to by an enrollee under a vision care enrollee's plan contract or for which a reimbursement would be available but for the application of the enrollee's plan contractual limitation of deductibles, copayments, or coinsurance.
"Covered materials" means materials for which reimbursement from an enrollee's the vision care plan is provided to an eye care provider or for which reimbursement is 10400SB3707sam001 -2- LRB104 20689 BAB 37738 a provided to by an enrollee under a vision care enrollee's plan contract or for which a reimbursement would be available but for the application of the enrollee's plan contractual limitation of deductibles, copayments, or coinsurance.
SB3707 Enrolled - 2 - LRB104 20689 JDS 34188 b "Covered services" means services for which reimbursement from an enrollee's the vision care plan is provided to an eye care provider or for which reimbursement is provided to by an enrollee under a vision care enrollee's plan contract or for which a reimbursement would be available but for the application of the enrollee's contractual plan limitation of deductibles, copayments, or coinsurance regardless of how the benefits are listed in an enrollee's benefit plan's definition of benefits.
"Covered services" means services for which reimbursement from an enrollee's the vision care plan is provided to an eye care provider or for which reimbursement is provided to by an enrollee under a vision care enrollee's plan contract or for which a reimbursement would be available but for the application of the enrollee's contractual plan limitation of deductibles, copayments, or coinsurance regardless of how the benefits are listed in an enrollee's benefit plan's definition of benefits.
"Eye care provider" means a doctor of optometry licensed pursuant to the Illinois Optometric Practice Act of 1987 or a physician licensed to practice medicine in all of its branches pursuant to the Medical Practice Act of 1987.
"Eye care provider" means a doctor of optometry licensed pursuant to the Illinois Optometric Practice Act of 1987 or a physician licensed to practice medicine in all of its branches 10400SB3707sam001 -3- LRB104 20689 BAB 37738 a pursuant to the Medical Practice Act of 1987.
"Health insurance coverage" has the meaning given to that term in Section 5 of the Illinois Health Insurance Portability SB3707 Enrolled - 3 - LRB104 20689 JDS 34188 b and Accountability Act.
"Health insurance coverage" has the meaning given to that term in Section 5 of the Illinois Health Insurance Portability and Accountability Act.
"Provider agreement" means the contractual relationship between a vision care organization and an eye care provider setting forth the terms and conditions under which covered services and covered materials are provided to an enrollee under the vision care plan, including but not limited to, provider manuals, policies and procedures, fee schedules, dispute resolution processes, and any documents incorporated by reference.
"Provider agreement" means the contractual relationship between a vision care organization and an eye care provider setting forth the terms and conditions under which covered services and covered materials are provided to an enrollee under the vision care plan, including but not limited to, 10400SB3707sam001 -4- LRB104 20689 BAB 37738 a provider manuals, policies and procedures, fee schedules, dispute resolution processes, and any documents incorporated by reference.
"Subcontractor" means any company, group, affiliate, or third-party entity, including agents or , servants, that SB3707 Enrolled - 4 - LRB104 20689 JDS 34188 b performs or administers functions or services on behalf of the vision care organization to execute or, partially owned or wholly owned subsidiaries and controlled organizations, that the vision care plan contracts with to supply services or materials for an eye care provider or enrollee to fulfill the benefit plan of a vision care plan or a vision care discount plan.
"Subcontractor" means any company, group, affiliate, or third-party entity, including agents or , servants, that performs or administers functions or services on behalf of the vision care organization to execute or, partially owned or wholly owned subsidiaries and controlled organizations, that the vision care plan contracts with to supply services or materials for an eye care provider or enrollee to fulfill the benefit plan of a vision care plan or a vision care discount plan.
"Vision care plan" means a policy, certificate, contract, or other plan of health insurance coverage, whether excepted benefits or any other coverage that creates, promotes, sells, provides, advertises, or administers an integrated or stand-alone plan that provides coverage for covered services and covered materials.
"Vision care plan" means a policy, certificate, contract, or other plan of health insurance coverage, whether excepted benefits or any other coverage that creates, promotes, sells, 10400SB3707sam001 -5- LRB104 20689 BAB 37738 a provides, advertises, or administers an integrated or stand-alone plan that provides coverage for covered services and covered materials.
SB3707 Enrolled - 5 - LRB104 20689 JDS 34188 b (a) No vision care organization that issues, delivers, amends, or renews a provider agreement vision care plan on or after the effective date of this amendatory Act of the 104th General Assembly shall issue a contract that requires an eye care provider, as a condition of participation in the vision care plan, to provide services or materials to an enrollee at a fee set by the vision care plan unless the services or materials are covered services or covered materials under the vision care plan.
(a) No vision care organization that issues, delivers, amends, or renews a provider agreement vision care plan on or after the effective date of this amendatory Act of the 104th General Assembly shall issue a contract that requires an eye care provider, as a condition of participation in the vision care plan, to provide services or materials to an enrollee at a fee set by the vision care plan unless the services or materials are covered services or covered materials under the vision care plan.
In accordance with State law, this This eye care provider may choose does not to accept discounts the fee schedule set by your insurer for noncovered vision care services and noncovered vision care materials that are not covered benefits under your plan and instead charges his or her normal fee for those services and materials.
In accordance with State law, this This eye care provider may choose does not to accept discounts the fee schedule set by your insurer for noncovered vision care services and noncovered vision care materials that are not 10400SB3707sam001 -6- LRB104 20689 BAB 37738 a covered benefits under your plan and instead charges his or her normal fee for those services and materials.
8-4-23.) SB3707 Enrolled - 6 - LRB104 20689 JDS 34188 b (215 ILCS 161/15) Sec.
8-4-23.) (215 ILCS 161/15) Sec.
(c) A vision care organization shall make an updated copy of a fee schedule available to the eye care provider every calendar quarter.
(c) A vision care organization shall make an updated copy of a fee schedule available to the eye care provider every 10400SB3707sam001 -7- LRB104 20689 BAB 37738 a calendar quarter.
8-4-23.) (215 ILCS 161/17 new) SB3707 Enrolled - 7 - LRB104 20689 JDS 34188 b Sec.
8-4-23.) (215 ILCS 161/17 new) Sec.
(a) A vision care organization and its officers, directors, agents, and employees are subject to the provisions of Sections 149, and 154.6, and 424 of the Illinois Insurance Code.
(a) A vision care organization and its officers, 10400SB3707sam001 -8- LRB104 20689 BAB 37738 a directors, agents, and employees are subject to the provisions of Sections 149, and 154.6, and 424 of the Illinois Insurance Code.
(c) (b) Incorporation by reference in this Act to specific SB3707 Enrolled - 8 - LRB104 20689 JDS 34188 b laws of this State shall not be construed to exempt a vision care organization or vision care plan from otherwise applicable laws that are not specifically referenced in this Act.
(c) (b) Incorporation by reference in this Act to specific laws of this State shall not be construed to exempt a vision care organization or vision care plan from otherwise applicable laws that are not specifically referenced in this Act.
(b) Notification of any proposed changes to the provider agreement, and the details in the provider agreement, shall be sent to the eye care provider by electronic communication with verification upon receipt, or upon request of the eye care provider, through certified mail.
10400SB3707sam001 -9- LRB104 20689 BAB 37738 a (b) Notification of any proposed changes to the provider agreement, and the details in the provider agreement, shall be sent to the eye care provider by electronic communication with verification upon receipt, or upon request of the eye care provider, through certified mail.
(c) A vision care organization shall provide to the eye care provider reasonable access to agreement terms, policy SB3707 Enrolled - 9 - LRB104 20689 JDS 34188 b manuals, fee schedules, and any other policies and procedures referenced in the agreement or proposed amendments to the agreement.
(c) A vision care organization shall provide to the eye care provider reasonable access to agreement terms, policy manuals, fee schedules, and any other policies and procedures referenced in the agreement or proposed amendments to the agreement.
(a) No vision care organization that issues, delivers, amends, or renews a provider agreement vision care plan on or after the effective date of this amendatory Act of the 104th General Assembly shall issue a provider agreement vision care plan contract that requires:
(a) No vision care organization that issues, delivers, amends, or renews a provider agreement vision care plan on or after the effective date of this amendatory Act of the 104th 10400SB3707sam001 -10- LRB104 20689 BAB 37738 a General Assembly shall issue a provider agreement vision care plan contract that requires:
or SB3707 Enrolled - 10 - LRB104 20689 JDS 34188 b (2) an eye care provider to participate in contract with a vision care plan as a condition to participation in a medical plan or in-network.
or (2) an eye care provider to participate in contract with a vision care plan as a condition to participation in a medical plan or in-network.
(215 ILCS 161/50 new) Sec.
(215 ILCS 161/50 new) 10400SB3707sam001 -11- LRB104 20689 BAB 37738 a Sec.
(215 ILCS 161/55 new) SB3707 Enrolled - 11 - LRB104 20689 JDS 34188 b Sec.
(215 ILCS 161/55 new) Sec.
This Act takes effect January 1, 2027.
This Act takes effect January 1, 2027.".