INS-HEARING CARE PLAN

From the Legislature

Amends the Illinois Insurance Code. Prohibits a hearing care organization that is an issuer or administrator of a hearing care plan or discounted hearing care plan issued, delivered, amended, or renewed on or after the effective date of the amendatory Act from issuing or renewing a contract that requires a hearing instrument professional, as a condition of participation in the hearing care plan or discounted hearing care plan, to provide items or services to an enrollee at a fee set by the hearing care plan or discounted hearing care plan unless the items and services are covered items or covered services under the hearing care plan or discounted hearing care plan. Provides that a hearing instrument professional who chooses not to accept as payment an amount set by a hearing care plan or discounted hearing care plan for items and services that are not covered by the hearing care plan or discounted hearing care plan shall comply with the specified notification requirements. Requires hearing care benefits to be communicated in writing by the hearing care organization to an enrollee, prospective enrollee, and the hearing instrument professional. Provides that no hearing care organization or its officers, directors, agents, and employees may represent a discount hearing care benefit as a funded hearing care benefit. Allows a hearing care plan or discounted hearing care plan to provide hearing care benefits that include routine hearing care services and medically necessary diagnostic hearing services in accordance with guidance promulgated by the Centers for Medicare and Medicaid Services. Makes other changes. Amends the Health Maintenance Organization Act and the Limited Health Service Organization Act to conform with the requirements for hearing care plans and discounted hearing care plans. Effective January 1, 2027.