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HB 3561

Relating to financial assistance for the cost of health care services.

2025 Regular Session Introduced by Pam Marsh

Illinois health plans must cover at no cost at least one early egg and one early peanut allergen introduction supplement, expanding access across public and private plans.

In committee upon adjournment.
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Bill Summary · HB 3561

Summary — HB 3561 (Avelar) — Relating to financial assistance for the cost of health care services

Status: In committee upon adjournment (introduced Feb 18, 2025)
Primary sponsor: Rep. Dagmara Avelar

Purpose / Intent

HB 3561 requires private and public health coverage in Illinois to cover at least one early egg-allergen introduction dietary supplement and one early peanut-allergen introduction dietary supplement. The goal is to increase access to products intended for early allergen introduction (a strategy to reduce food allergy risk in infants) by removing or limiting cost barriers.

Key provisions

  • Insurance coverage requirement:
    • Group and individual accident & health insurance policies and managed care plans must cover at least one early egg allergen introduction dietary supplement and one early peanut allergen introduction dietary supplement.
    • Coverage must be provided at no cost to the covered individual, including both deductible payments and any cost-sharing amounts that would otherwise apply after a deductible is met.
  • Exceptions and federal-law limitations:
    • The coverage requirement does not apply to accident-only, specified-disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited-benefit health insurance products.
    • The no-cost/cost-sharing limitation does not apply to catastrophic health plans or high-deductible health plans (HDHPs) to the extent applying it would cause the plan to lose its federal status (e.g., catastrophic plan status or HSA-eligible HDHP status).
    • If applying the cost-sharing limit would make an enrollee ineligible for a health savings account (HSA) under federal law, the no-cost requirement for an HDHP applies only after the enrollee’s deductible has been met.
  • Scope — amendments across multiple Illinois laws:
    • The bill amends the Illinois Insurance Code and adds parallel requirements to the State Employees Group Insurance Act, Counties Code, Illinois Municipal Code, School Code, Health Maintenance Organization Act, Limited Health Service Organization Act, Voluntary Health Services Plans Act, and the Illinois Public Aid Code — extending the requirement to state and many local governmental plans and Medicaid where applicable.
  • Enforcement:
    • Enforcement responsibilities are allocated among state agencies in the existing statutes (e.g., Department of Insurance; Department of Central Management Services for state employee plans), consistent with prior statutory enforcement structures.

Who is affected

  • Insurers offering individual and group accident & health coverage and managed care plans in Illinois.
  • Covered individuals and families (particularly infants and caregivers seeking early allergen introduction products).
  • State, county, municipal, school, and other governmental self-insured plans (statutory amendments extend requirements to these plans).
  • Medicaid/Illinois Public Aid recipients as modified by the Public Aid Code change.

Procedural / timeline notes

  • Filed/First reading: Feb 18, 2025. Referred to Rules, Insurance Committee, and subcommittees. Latest status: In committee upon adjournment (June 28, 2025).
  • No fiscal estimates or effective dates are specified in the introduced text.

Potential impacts

  • Likely increases access and reduces out-of-pocket costs for early allergen introduction supplements, potentially supporting public-health allergy-prevention strategies.
  • Insurers and public plans may incur additional costs; potential downstream premium or budgetary effects depend on utilization and product pricing.
  • Federal HSA and plan-status constraints limit application for certain HDHPs and catastrophic plans.

Compiled from official sources — confirm details with the bill’s official record.

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