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IDOI reminds health insurers of women’s reproductive healthcare access protection

IDOI reminds health insurers to protect women’s access to coverage, including abortion and contraceptives

The Illinois Department of Insurance (IDOI) has issued Company Bulletin 2022-15 to reaffirm guidance for Illinois-licensed health insurance issuers about the coverage of reproductive health care services for state-regulated private health insurance plans.

“We’re putting health insurers on notice that Illinois law remains unchanged regarding coverage for abortion services and contraceptives,” said IDOI Director Dana Popish Severinghaus. “We want people in our state to know that their right to make decisions about their reproductive health is protected, and we expect insurers regulated by the Department to continue complying with all state and federal laws related to nondiscrimination in health care services.”

The Reproductive Health Act requires state-regulated private health insurance plans that offer pregnancy-related benefits to cover abortion. The requirement includes plans purchased on the ACA (Affordable Care Act) Health Insurance Marketplace and coverage through an employer that offers a fully insured plan. *

In addition to noting the Reproductive Health Act, Company Bulletin 2022-15 refers to the federal No Surprises Act which, in addition to broad protections from surprise billing, also provides protections for individuals who may inadvertently or unknowingly receive abortion services from a provider that is out-of-network under their health insurance plan. The protections afforded under the federal No Surprises Act apply to plan years beginning on or after January 1, 2022, for all group health plans and all group or individual health insurance coverage.

“IDOI stands ready to assist Illinoisans with guidance related to insurance coverage and filing complaints against any state-regulated insurer they believe may have violated their rights related to coverage,” said Director Popish Severinghaus.

Consumers can visit the IDOI website to file a complaint or find related FAQs for Company Bulletin 2022-15.

Consumers who have questions about their health insurance policies, their policyholder rights, or how to file appeals, complaints, and external review requests for denied services can call the IDOI Office of Consumer Health Insurance at 877-527-9431.

For information about ACA Marketplace health insurance plans, visit Getcoveredillinois.gov.

* This requirement does not apply to employers that provide self-funded group health plans, which are preempted from state regulation.

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