Amends the Illinois Insurance Code. Makes changes to defined terms. Provides that a group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after January 1, 2026 shall provide coverage for evidence-based cancer imaging for individuals with an increased risk of cancer as recommended by the current National Comprehensive Cancer Network clinical practice guidelines. Provides that this coverage shall be provided without cost-sharing, and the requirements of the Act shall not apply to the extent that providing coverage would disqualify a high-deductible health plan from eligibility for a health savings account.
House Floor Amendment No. 4: Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that the coverage required under provisions concerning genetic testing and evidence-based screenings for an inherited gene mutation shall be provided without cost sharing, except as specified. Changes the date of coverage to January 1, 2028 (rather than January 1, 2026) and provides that the coverage requirements apply to an individual or group policy (rather than only a group policy) of accident and health insurance or managed care plan. Excludes the State Employees Group Insurance Program or any other health care plan established or maintained under the State Employees Group Insurance Act of 1971 from the coverage requirements. Amends the State Employees Group Insurance Act of 1971. Requires the State Employees Group Insurance Program to provide coverage for clinical genetic testing for an inherited gene mutation for individuals with a personal or family history of cancer, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines. For individuals with a genetic test that is positive for an inherited mutation associated with an increased risk of cancer, requires the coverage to include any evidence-based screenings, as recommended by a health care professional in accordance with current evidence-based clinical practice guidelines, to the extent that the management recommendation is not already covered by the policy. Provides that the coverage is subject to specified cost sharing requirements.
Senate Committee Amendment No. 1: Replaces a reference to the State Employees Group Insurance Program with the program of health benefits provided under the State Employees Group Insurance Act of 1971 in provisions requiring coverage for genetic testing under that Act.

Statutes affected:
Introduced: 215 ILCS 5/356
Engrossed: 5 ILCS 375/6, 215 ILCS 5/356