SB3067 Summary

• Amends the Illinois Insurance Code to require coverage for treatment of cleft lip and cleft palate as part of congenital defect coverage for newborn infants.

• Requires individual and group accident and health insurance policies amended, delivered, issued, or renewed on or after January 1, 2024 to provide coverage for medically necessary care and treatment of cleft lip and palate for children under age 19.

• Defines medically necessary care and treatment to include oral and facial surgery, prosthetic treatment, orthodontic treatment, prosthodontic treatment, and otolaryngology treatment, but excludes cosmetic surgery.

• Allows insurers to impose the same deductible, coinsurance, or cost-sharing limitations on cleft lip and palate coverage as other related surgical benefits under the policy.

• Exempts dental-only policies from the coverage requirements and makes conforming changes to the State Employees Group Insurance Act of 1971.