Bill > HB5393

This bill amends the Limited Health Service Organization Act, which governs organizations that provide or arrange for specific health services like dental or vision care, often on a prepaid basis. Key changes include removing a previous requirement for Limited Health Service Organizations (LHSOs) to set an annual maximum benefit allowance of $2,500 for out-of-plan services offered through a "point-of-service" (POS) contract, which allows members to receive care both within and outside the LHSO's network. Instead, if an LHSO spends more than 20% of its total expenditures on out-of-plan services in a quarter, certain limitations on offering POS contracts will not apply, provided the LHSO meets minimum capital and surplus requirements similar to those for life, accident, and health insurance companies. The bill also expands the definition of "limited health service" to explicitly include services for substance use disorders and clarifies that "enrollee" now includes dependents.

https://www.ilga.gov/Legislation/BillStatus?DocNum=5393&GAID=18&DocTypeID=HB&SessionID=114&GA=104