summary
Introduced
01/09/2025
01/09/2025
In Committee
04/23/2025
04/23/2025
Crossed Over
04/09/2025
04/09/2025
Passed
Dead
Introduced Session
Potential new amendment
104th General Assembly
Bill Summary
Creates the Artificial Intelligence Systems Use in Health Insurance Act. Provides that the Department of Insurance's regulatory oversight of insurers includes oversight of an insurer's use of AI systems to make or support adverse determinations that affect consumers. Provides that any insurer authorized to operate in the State is subject to review by the Department in an investigation or market conduct action regarding the development, implementation, and use of AI systems or predictive models and the outcomes from the use of those AI systems or predictive models. Provides that an insurer authorized to do business in Illinois shall not issue an adverse consumer outcome with regard to the denial, reduction, or termination of insurance plans or benefits that result solely from the use or application of any AI system or predictive model. Provides that any decision-making process for the denial, reduction, or termination of insurance plans or benefits that results from the use of AI systems or predictive models shall be meaningfully reviewed, in accordance with review procedures determined by Department rules, by an individual with authority to override the AI systems and determinations. Authorizes the Department to adopt emergency rules to implement the Act and to adopt rules concerning standards for full and fair disclosure of an insurer's use of AI systems. Makes a conforming change in the Illinois Administrative Procedure Act.
AI Summary
This bill establishes the Artificial Intelligence Systems Use in Health Insurance Act, which creates comprehensive regulations for how health insurance companies can use AI systems. The legislation gives the Illinois Department of Insurance expanded oversight authority to review and investigate how insurers develop, implement, and use AI systems and predictive models in making decisions about insurance coverage. Specifically, the bill prohibits insurers from making adverse consumer decisions (like denying, reducing, or terminating insurance plans or benefits) solely based on AI system outputs. Any AI-driven decision-making process must be meaningfully reviewed by a human with the authority to override the AI's determination, and in cases involving medical determinations, this reviewer must be a clinical peer. The bill also requires health insurance issuers to develop AI systems programs that include governance, risk management, and internal audit functions, and mandates full disclosure of how AI systems might impact consumers. The legislation aims to ensure that AI systems used in health insurance are transparent, fair, and do not discriminate against consumers, while still allowing innovative technology to support insurance decision-making. All health insurance issuers authorized to do business in Illinois must comply with these new regulations, which are designed to protect consumer rights and prevent potential algorithmic bias.
Committee Categories
Business and Industry, Government Affairs
Sponsors (9)
Laura Fine (D)*,
Bob Morgan (D)*,
Jen Gong-Gershowitz (D),
Nicolle Grasse (D),
Graciela Guzmán (D),
Hoan Huynh (D),
Lilian Jiménez (D),
Curtis Tarver (D),
Janet Yang Rohr (D),
Last Action
Added as Alternate Co-Sponsor Sen. Graciela Guzmán (on 05/27/2025)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.ilga.gov/legislation/BillStatus.asp?DocNum=35&GAID=18&DocTypeID=HB&SessionID=114&GA=104 |
| Senate Amendment 001 | https://www.ilga.gov/legislation/104/HB/10400HB0035sam001.htm |
| BillText | https://www.ilga.gov/legislation/104/HB/10400HB0035eng.htm |
| House Amendment 001 | https://www.ilga.gov/legislation/104/HB/10400HB0035ham001.htm |
| BillText | https://www.ilga.gov/legislation/104/HB/10400HB0035.htm |
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