INSURANCE-VARIOUS

Amends the Illinois Insurance Code. Provides that beginning with the operation of a State-based exchange in plan year 2026, a pregnant individual has the right to enroll in a qualified health plan through a special enrollment period at any time after a qualified health care professional certifies that the individual is pregnant. Amends the Illinois Health Insurance Portability and Accountability Act. Provides that notice of a health insurance issuer's election to uniformly modify coverage, uniformly terminate coverage, or discontinue coverage in a marketplace shall be sent by certified mail to the Department of Insurance 45 days (instead of 90 days) in advance of any notification of the company's actions sent to plan sponsors, participants, beneficiaries, and covered individuals. Makes conforming changes. Amends the Managed Care Reform and Patient Rights Act. Makes changes in provisions concerning flat-dollar copayment structures for prescription drug benefits. Amends the Network Adequacy and Transparency Act. Provides that the Act does not apply to an individual or group policy for excepted benefits or short-term, limited-duration health insurance coverage (instead of an individual or group policy for dental or vision insurance or a limited health service organization) with a network plan, except to the extent that federal law establishes network adequacy and transparency standards for stand-alone dental plans, which the Department shall enforce. Provides that if the Centers for Medicare and Medicaid Services establishes minimum provider ratios for stand-alone dental plans in the type of exchange in use in this State for a given plan year, the Department shall enforce those standards for stand-alone dental plans for that plan year. Requires the Department of Insurance to enforce certain appointment wait-time standards, time and distance standards, and other standards if the Centers for Medicare and Medicaid Services establishes those standards for plans in the type of exchange in use in this State. Makes other changes.