Illinois 95th Regular Session Status: Passed Senate

SB 2486 — INS CD-WELLNESS COVERAGE

Last action — Session Sine Die

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 95th Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Amends the State Employees Group Insurance Act of 1971, the Illinois Insurance Code, and the Health Maintenance Organization Act. Provides that a policy or plan that provides coverage for hospital or medical treatment on an expense incurred basis, may offer wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan. Provides that "wellness coverage" means health care coverage with the primary purpose to engage and motivate the insured or enrollee through: incentives; provision of health education, counseling, and self-management skills; identification of modifiable health risks; and other activities to influence health behavior changes. Makes other changes. Effective January 1, 2009.

Bill Text

What changed in the latest version

155 added · 179 removed

Plain-language change summary

The updated version of Bill SB 2486 includes new provisions that allow health insurers to offer various incentives, such as reduced premiums or contributions to health spending accounts, for participants in approved wellness programs. This means that if individuals engage in health improvement activities, they may receive financial benefits that help lower their medical costs. This change emphasizes the importance of proactive health management and aims to encourage people to adopt healthier lifestyles. Overall, it seeks to make healthcare more affordable and accessible while promoting wellness among insured individuals.

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*LRB09517334KBJ43404b* SB2486 95TH GENERAL ASSEMBLY State of Illinois and 2008 SB2486 Introduced 2/15/2008, by Sen.
SB2486 Engrossed LRB095 17334 KBJ 43404 b AN ACT concerning regulation.
Dan Kotowski SYNOPSIS AS INTRODUCED:
ILCS 375/6.11 ILCS 5/356z.11 new ILCS 125/5-3 from Ch.
111 1/2, par.
1411.2 Amends the State Employees Group Insurance Act of 1971, the Illinois Insurance Code, and the Health Maintenance Organization Act.
Provides that a policy or plan that provides coverage for hospital or medical treatment on an expense incurred basis, may offer wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan.
Provides that "wellness coverage" means health care coverage with the primary purpose to engage and motivate the insured or enrollee through:
incentives;
provision of health education, counseling, and self-management skills;
identification of modifiable health risks;
and other activities to influence health behavior changes.
Makes other changes.
Effective January 1, 2009.
LRB095 17334 KBJ 43404 b FISCAL NOTE ACT STATE MANDATES MAY APPLY ACT MAY REQUIRE REIMBURSEMENT A BILL FOR SB2486 LRB095 17334 KBJ 43404 b AN ACT concerning regulation.
(215 ILCS 5/356z.11 new) SB2486 - 2 - LRB095 17334 KBJ 43404 b Sec.
(215 ILCS 5/356z.11 new) SB2486 Engrossed - 2 - LRB095 17334 KBJ 43404 b Sec.
(a) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 95th General Assembly that provides coverage for hospital or medical treatment on an expense incurred basis may offer wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan.
(a) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 95th General Assembly that provides coverage for hospital or medical treatment on an expense incurred basis may offer a reasonably designed program for wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug, or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan.
The insured or enrollee may be required to provide evidence of participation in a program, demonstrative maintenance, or improvement of the individual’s or dependent’s health behaviors as determined by assessments of agreed-upon health status indicators between the insured or enrollee and the health insurer or managed care plan.
The insured or enrollee may be required to provide evidence of participation in a program, demonstrative compliance with treatment recommendations, or improvement of the individual’s or dependent’s health behaviors as determined by the health insurer or managed care plan.
(c) Incentives as outlined in this Section are specific and unique to the offering of wellness coverage and have no SB2486 - 3 - LRB095 17334 KBJ 43404 b application to any other required or optional health care benefit.
(c) Incentives as outlined in this Section are specific and unique to the offering of wellness coverage and have no SB2486 Engrossed - 3 - LRB095 17334 KBJ 43404 b application to any other required or optional health care benefit.
(d) A reward, health spending account contribution, or reduction established under this Section does not violate Section 151 of this Code.
(d) Such wellness coverage shall satisfy the requirements for an exception from the general prohibition against discrimination based on a health factor under the federal Health Insurance Portability and Accountability Act of 1996 (P.L.
104-191;
110 Stat.
1936), including any federal regulations that are adopted pursuant to that Act.
(e) A reward, health spending account contribution, or reduction established under this Section does not violate Section 151 of this Code.
(a) Health Maintenance Organizations shall be subject to the provisions of Sections 133, 134, 137, 140, 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11 356z.9, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370c, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection (2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
(a) Health Maintenance Organizations shall be subject to the provisions of Sections 133, 134, 137, 140, 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 355.2, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11 356z.9, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370c, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection (2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, SB2486 Engrossed - 4 - LRB095 17334 KBJ 43404 b XXV, and XXVI of the Illinois Insurance Code.
(1) a corporation authorized under the Dental Service SB2486 - 4 - LRB095 17334 KBJ 43404 b Plan Act or the Voluntary Health Services Plans Act;
(1) a corporation authorized under the Dental Service Plan Act or the Voluntary Health Services Plans Act;
(2)(i) the criteria specified in subsection (1)(b) of Section 131.8 of the Illinois Insurance Code shall not apply and (ii) the Director, in making his determination with respect to the merger, consolidation, or other acquisition of control, need not take into account the effect on competition of the merger, consolidation, or other acquisition of control;
(2)(i) the criteria specified in subsection (1)(b) of Section 131.8 of the Illinois Insurance Code shall not apply and (ii) the Director, in making his determination SB2486 Engrossed - 5 - LRB095 17334 KBJ 43404 b with respect to the merger, consolidation, or other acquisition of control, need not take into account the effect on competition of the merger, consolidation, or other acquisition of control;
SB2486 - 5 - LRB095 17334 KBJ 43404 b (A) certification by an independent actuary of the adequacy of the reserves of the Health Maintenance Organization sought to be acquired;
(A) certification by an independent actuary of the adequacy of the reserves of the Health Maintenance Organization sought to be acquired;
(d) The provisions of Article VIII 1/2 of the Illinois Insurance Code and this Section 5-3 shall apply to the sale by any health maintenance organization of greater than 10% of its enrollee population (including without limitation the health maintenance organization’s right, title, and interest in and to its health care certificates).
(d) The provisions of Article VIII 1/2 of the Illinois Insurance Code and this Section 5-3 shall apply to the sale by any health maintenance organization of greater than 10% of its enrollee population (including without limitation the health SB2486 Engrossed - 6 - LRB095 17334 KBJ 43404 b maintenance organization’s right, title, and interest in and to its health care certificates).
(e) In considering any management contract or service agreement subject to Section 141.1 of the Illinois Insurance Code, the Director (i) shall, in addition to the criteria specified in Section 141.2 of the Illinois Insurance Code, take SB2486 - 6 - LRB095 17334 KBJ 43404 b into account the effect of the management contract or service agreement on the continuation of benefits to enrollees and the financial condition of the health maintenance organization to be managed or serviced, and (ii) need not take into account the effect of the management contract or service agreement on competition.
(e) In considering any management contract or service agreement subject to Section 141.1 of the Illinois Insurance Code, the Director (i) shall, in addition to the criteria specified in Section 141.2 of the Illinois Insurance Code, take into account the effect of the management contract or service agreement on the continuation of benefits to enrollees and the financial condition of the health maintenance organization to be managed or serviced, and (ii) need not take into account the effect of the management contract or service agreement on competition.
and (ii) the amount of the refund or additional premium shall not exceed 20% of the Health Maintenance Organization’s profitable or unprofitable experience with respect to the group or other enrollment unit for the period (and, for purposes of a refund or additional premium, the profitable or unprofitable experience shall be calculated taking into account a pro rata share of the SB2486 - 7 - LRB095 17334 KBJ 43404 b Health Maintenance Organization’s administrative and marketing expenses, but shall not include any refund to be made or additional premium to be paid pursuant to this subsection (f)).
and (ii) the amount of the refund or additional premium SB2486 Engrossed - 7 - LRB095 17334 KBJ 43404 b shall not exceed 20% of the Health Maintenance Organization’s profitable or unprofitable experience with respect to the group or other enrollment unit for the period (and, for purposes of a refund or additional premium, the profitable or unprofitable experience shall be calculated taking into account a pro rata share of the Health Maintenance Organization’s administrative and marketing expenses, but shall not include any refund to be made or additional premium to be paid pursuant to this subsection (f)).
In no event shall the Illinois Health Maintenance Organization Guaranty Association be liable to pay any contractual obligation of an insolvent organization to pay any refund authorized under this Section.
SB2486 Engrossed - 8 - LRB095 17334 KBJ 43404 b In no event shall the Illinois Health Maintenance Organization Guaranty Association be liable to pay any contractual obligation of an insolvent organization to pay any refund authorized under this Section.
revised 12-4-07.) SB2486 - 8 - LRB095 17334 KBJ 43404 b Section 99.
revised 12-4-07.) Section 99.
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Action History

  1. Session Sine Die

  2. Rule 19(b) / Re-referred to Rules Committee

  3. House Committee Amendment No. 1 Motion Refuse to Recede Rep. Sidney H. Mathias; MOTION #2

  4. House Committee Amendment No. 1 Motion to Recede Referred to Rules Committee; MOTION #1

  5. House Committee Amendment No. 1 Motion to Recede Rep. Sidney H. Mathias; MOTION #1

  6. Placed on Calendar Order of Non-Concurrence House Amendment(s) 1

  7. Senate Non-Concurs 01

  8. House Committee Amendment No. 1 Motion to Non-Concur Filed with Secretary Sen. Dan Kotowski

  9. Placed on Calendar Order of Concurrence House Amendment(s) 01-May 21, 2008

  10. Secretary's Desk - Concurrence House Amendment(s) 01

  11. Third Reading - Short Debate - Passed 098-000-000

  12. Added Alternate Chief Co-Sponsor Rep. Fred Crespo

  13. Added Alternate Chief Co-Sponsor Rep. Elizabeth Coulson

  14. Placed on Calendar Order of 3rd Reading - Short Debate

  15. Second Reading - Short Debate

  16. Placed on Calendar 2nd Reading - Short Debate

  17. Do Pass as Amended / Short Debate Health Care Availability and Access Committee; 012-000-000

  18. House Committee Amendment No. 1 Adopted in Health Care Availability and Access Committee; by Voice Vote

  19. House Committee Amendment No. 1 Filed with Clerk by Health Care Availability and Access Committee

  20. Committee Deadline Extended-Rule 9(b) May 23, 2008

  21. Assigned to Health Care Availability and Access Committee

  22. Added Alternate Chief Co-Sponsor Rep. Robert W. Pritchard

  23. Referred to Rules Committee

  24. First Reading

  25. Added Alternate Chief Co-Sponsor Rep. Frank J. Mautino

  26. Chief House Sponsor Rep. Sidney H. Mathias

  27. Placed on Calendar Order of First Reading

  28. Arrived in House

  29. Senate Floor Amendment No. 1 Tabled Pursuant to Rule 5-4(a)

  30. Third Reading - Passed; 046-000-000

  31. Placed on Calendar Order of 3rd Reading

  32. Senate Floor Amendment No. 2 Adopted; Kotowski

  33. Recalled to Second Reading

  34. Added as Co-Sponsor Sen. Michael Bond

  35. Senate Floor Amendment No. 2 Recommend Do Adopt Insurance; 007-000-000

  36. Senate Floor Amendment No. 2 Rules Refers to Insurance

  37. Added as Co-Sponsor Sen. Gary G. Dahl

  38. Senate Floor Amendment No. 2 Referred to Rules

  39. Senate Floor Amendment No. 2 Filed with Secretary by Sen. Dan Kotowski

  40. Added as Co-Sponsor Sen. Jeffrey M. Schoenberg

  41. Added as Co-Sponsor Sen. Frank C. Watson

  42. Added as Co-Sponsor Sen. Tim Bivins

  43. Senate Floor Amendment No. 1 Referred to Rules

  44. Senate Floor Amendment No. 1 Filed with Secretary by Sen. Dan Kotowski

  45. Added as Co-Sponsor Sen. Carole Pankau

  46. Added as Co-Sponsor Sen. Larry K. Bomke

  47. Added as Co-Sponsor Sen. John O. Jones

  48. Added as Chief Co-Sponsor Sen. Pamela J. Althoff

  49. Added as Chief Co-Sponsor Sen. Bill Brady

  50. Added as Chief Co-Sponsor Sen. Heather Steans

  51. Placed on Calendar Order of 3rd Reading March 13, 2008

  52. Second Reading

  53. Placed on Calendar Order of 2nd Reading March 11, 2008

  54. Do Pass Insurance; 007-000-000

  55. Added as Chief Co-Sponsor Sen. Matt Murphy

  56. Assigned to Insurance

  57. Referred to Rules

  58. First Reading

  59. Filed with Secretary by Sen. Dan Kotowski

Sponsors

  • Dan Kotowski · Cosponsor

Sponsorship breakdown

Export CSV (upgrade) →

0 sponsors · 1 co-sponsors · 182 not signed on

Sponsors (0)

None.

Co-sponsors (1)

  • Dan Kotowski

Not signed on (182)

182 members have not signed on to this bill.

Show all 182 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Third Reading

Passed 98 Yea · 0 Nay · 20 Other
Party YeaNayPresentNot Voting
Unaffiliated 880017
Democrat 6003
Republican 4000
Total 980020
% of votes cast 83%0%0%17%
How each member voted (118)
Member Party Vote
Graham — Not Voting
Hassert — Yea
Jakobsson — Yea
Nekritz — Yea
Jefferies — Yea
Jefferson — Yea
Lang — Yea
Lindner — Yea
Reitz — Yea
Dunkin — Yea
Dunn — Yea
Eddy — Yea
Madigan — Yea
Mautino — Yea
May — Yea
McAuliffe — Yea
McCarthy — Yea
Mendoza — Yea
McGuire — Yea
Moffitt — Yea
Molaro — Yea
Munson — Yea
Bradley, John — Yea
Myers — Yea
Brady — Yea
Mitchell, Bill — Yea
Phelps — Yea
Poe — Yea
Schock — Yea
Sommer — Yea
Sullivan — Yea
Turner — Yea
Hannig — Yea
Verschoore — Yea
Harris — Yea
Wait — Yea
Winters — Yea
Hernandez — Yea
Yarbrough — Yea
Younge — Yea
Howard — Yea
Coladipietro — Yea
Cole — Yea
Coulson — Yea
Cross — Yea
Cultra — Yea
Currie — Yea
D'Amico — Yea
Flider — Yea
Flowers — Yea
Fortner — Yea
Franks — Yea
Froehlich — Yea
Golar — Yea
Granberg — Yea
Hamos — Yea
Holbrook — Yea
Davis, Monique — Yea
Lyons — Not Voting
Bradley, Richard — Not Voting
Mitchell, Jerry — Not Voting
Osterman — Not Voting
Burke — Not Voting
Watson — Not Voting
Scully — Not Voting
Tryon — Not Voting
Washington — Not Voting
Colvin — Not Voting
Dugan — Not Voting
Durkin — Not Voting
Kosel — Yea
Osmond — Yea
Patterson — Not Voting
Pihos — Yea
Pritchard — Yea
Ramey — Yea
Reboletti — Yea
Reis — Yea
Riley — Yea
Ryg — Yea
Sacia — Not Voting
Saviano — Yea
Schmitz — Yea
Soto — Yea
Leitch — Yea
Krause — Yea
Acevedo — Yea
Arroyo — Yea
Bassi — Yea
Beaubien — Yea
Beiser — Yea
Bellock — Yea
Mathias — Yea
Berrios — Yea
Biggins — Yea
Black — Not Voting
Boland — Not Voting
Bost — Yea
Brauer — Yea
Brosnahan — Yea
Meyer — Yea
Mulligan — Yea
Fritchey — Yea
Gordon — Yea
Chapa LaVia — Yea
Fred Crespo Democrat Yea
Jay Hoffman Democrat Yea
La Shawn K. Ford Democrat Not Voting
Lakesia Collins Democrat Not Voting
Nicholas K. Smith Democrat Yea
Patrick J. Joyce Democrat Yea
Robert "Bob" Rita Democrat Yea
Sara Feigenholtz Democrat Not Voting
William "Will" Davis Democrat Yea
Brad Stephens Republican Yea
Chapin Rose Republican Yea
Chris Miller Republican Yea
Jil Tracy Republican Yea

Official roll call →

Third Reading

Passed 46 Yea · 0 Nay · 13 Other
Party YeaNayPresentNot Voting
Unaffiliated 370012
Democrat 9000
Republican 0001
Total 460013
% of votes cast 78%0%0%22%
How each member voted (59)
Member Party Vote
Halvorson — Yea
Hultgren — Yea
Forby — Yea
Frerichs — Yea
Luechtefeld — Not Voting
Sullivan — Yea
Meeks — Yea
Munoz — Yea
Millner — Not Voting
Noland — Yea
Pankau — Yea
Peterson — Yea
Cullerton — Yea
Watson — Yea
Jacobs — Yea
Radogno — Yea
Jones, J. — Yea
Schoenberg — Not Voting
Demuzio — Yea
Silverstein — Yea
Steans — Yea
Brady — Not Voting
Trotter — Yea
Viverito — Yea
Wilhelmi — Yea
Clayborne — Yea
Cronin — Not Voting
Crotty — Yea
Dahl — Yea
DeLeo — Yea
Dillard — Not Voting
Haine — Yea
Hendon — Yea
Kotowski — Yea
Raoul — Yea
Righter — Not Voting
Risinger — Yea
Rutherford — Not Voting
Sandoval — Not Voting
Lauzen — Not Voting
Link — Yea
Maloney — Yea
Althoff — Yea
Martinez — Yea
Bivins — Yea
Bomke — Yea
Bond — Not Voting
Burzynski — Yea
Garrett — Not Voting
David Koehler Democrat Yea
Don Harmon Democrat Yea
Emil Jones, III Democrat Yea
Eva-Dina Delgado Democrat Yea
Kimberly A. Lightford Democrat Yea
Lakesia Collins Democrat Yea
Laura M. Murphy Democrat Yea
Linda Holmes Democrat Yea
Mattie Hunter Democrat Yea
Dave Syverson Republican Not Voting

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 2486 do?
Amends the State Employees Group Insurance Act of 1971, the Illinois Insurance Code, and the Health Maintenance Organization Act. Provides that a policy or plan that provides coverage for hospital or medical treatment on an expense incurred basis, may offer wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan. Provides that "wellness coverage" means health care coverage with the primary purpose to engage and motivate the insured or enrollee through: incentives; provision of health education, counseling, and self-management skills; identification of modifiable health risks; and other activities to influence health behavior changes. Makes other changes. Effective January 1, 2009.
Who sponsors SB 2486?
SB 2486 is sponsored by Dan Kotowski.
What is the current status of SB 2486?
This bill died with 95th Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 2486?
Track SB 2486 free on One Click Politics — get push/email alerts when it moves.

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