Amends the Illinois Insurance Code. Sets forth provisions requiring an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State on or after January 1, 2028 to provide coverage for up to a 12-month supply of prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within the provider's scope of practice and dispensed at one time for an enrollee by a provider or pharmacist, or at a location licensed or otherwise authorized to dispense drugs or supplies. Amends the Pharmacy Practice Act. Provides that, notwithstanding any other provision of law, a dispensing provider or pharmacist shall dispense, at a patient's request, up to a 12-month supply of a prescription hormone therapy and the necessary supplies for self-administration pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, except as specified. Amends the State Employees Group Insurance Act of 1971 and the Illinois Public Aid Code to require coverage under the provisions of those Acts.
House Floor Amendment No. 1: Replaces everything after the enacting clause. Reinserts the provisions of the introduced bill with the following changes. Removes provisions concerning out-of-network coverage and provisions amending the Pharmacy Practice Act. Amends the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage for prescription hormone therapy under the provisions of those Acts.
Senate Floor Amendment No. 2: Provides that an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State on or after January 1, 2028 shall provide coverage for up to a 6-month (rather than 12-month) supply of prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a provider (rather than a network provider) within the provider's scope of practice and dispensed at one time for an enrollee by a provider or pharmacist, or at a location licensed or otherwise authorized to dispense drugs or supplies. Changes the supply amount of prescription hormone therapy to 6 months (rather than 12 months) in subsequent provisions within the bill. Provides that, if the prescription hormone therapy is a controlled substance, the policy shall provide coverage for the maximum supply allowed under State and federal law to be obtained at one time by the insured. Specifies that provisions concerning refill limits for prescription hormone therapy apply, except as otherwise provided in the Illinois Insurance Code.

Statutes affected:
Introduced: 5 ILCS 375/6, 215 ILCS 5/356, 225 ILCS 85/45, 305 ILCS 5/5
Engrossed: 5 ILCS 375/6, 55 ILCS 5/5, 65 ILCS 5/10, 105 ILCS 5/10, 215 ILCS 5/356, 215 ILCS 125/5, 215 ILCS 130/4003, 215 ILCS 165/10, 305 ILCS 5/5
Enrolled: 5 ILCS 375/6, 55 ILCS 5/5, 65 ILCS 5/10, 105 ILCS 5/10, 215 ILCS 5/356, 215 ILCS 125/5, 215 ILCS 130/4003, 215 ILCS 165/10, 305 ILCS 5/5