SB3130 Summary

• Creates a 2-year term for the Marketplace Director of the Illinois Health Benefits Exchange, with the first director's term expiring on the third Monday in January 2027, and removes the provision allowing the director to have other duties.

• Establishes pregnancy as a qualifying life event for health plan enrollment, allowing pregnant individuals to enroll in qualified health plans within 60 days of certification by a health care professional, effective plan year 2026.

• Reduces the advance notice period for health insurers to notify the Department of Insurance regarding coverage modifications or discontinuances from 90 days to 45 days, and allows electronic notification via email or online platform instead of certified mail.

• Expands the Network Adequacy and Transparency Act to include enforcement of federal network adequacy and transparency standards for stand-alone dental plans where established by the Centers for Medicare and Medicaid Services.

• Modifies prescription drug benefit requirements for individual plans to increase from 10% to 25% of plans offering flat-dollar copayment structures beginning January 1, 2024, and requires small group plans to offer at least 2 plans with flat-dollar copayment structures.