HB5393 - Limited Health Service Organization Act Amendments
Illinois Legislative Events
Summary
Illinois HB5393 passed the House on April 9, 2026, amending the Limited Health Service Organization Act. The bill removes a provision requiring limited health service organizations to include an annual maximum benefit allowance not exceeding $2,500 per year. It also modifies rules so that if an LHSO expends more than 20% of total limited health services expenditures on out-of-plan covered services in any calendar quarter, specified limitations do not apply subject to minimum capital and surplus requirements.
What changed
HB5393 amends the Limited Health Service Organization Act by removing the $2,500 annual maximum benefit allowance requirement that LHSOs were required to include in point-of-sale contracts. The bill also introduces a 20% threshold trigger: if an LHSO expends more than 20% of total limited health services expenditures on out-of-plan covered services in any calendar quarter, specified limitations are waived, subject to applicable life, accident, and health insurance company capital and surplus requirements.
Healthcare organizations and insurers operating as LHSOs in Illinois should monitor this bill as it progresses through the Senate. The removal of the benefit cap may increase financial exposure, while the out-of-plan spending threshold provides flexibility for organizations exceeding that limit. Compliance and actuarial teams should begin assessing the operational and financial implications of these changes.
What to do next
- Monitor HB5393 for Senate passage and governor signature
- Review benefit allowance and out-of-plan service policies
- Assess capital and surplus requirement implications
Archived snapshot
Apr 10, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
ChangeBridge / Illinois / HB5393 Passed HB5393 House Bill Passed 2026-04-09
LIMITED HEALTH SERVICE ORGS
Amends the Limited Health Service Organization Act. Makes changes to defined terms. In provisions concerning the offering of a point-of-sale contract by a limited health service organization (LHSO), removes a provision requiring the LHSO to include an annual maximum benefit allowance not to exceed $2,500 per year that is separate from any limits or allowances applied to in-plan services. Provides that, if an LHSO expends in any calendar quarter more than 20% of its total limited health services expenditures for all its members for out-of-plan covered services, then specified limitations shall not apply subject to the LHSO minimum capital and surplus requirements applicable to a life, accident, and health insurance company. Makes other changes.
Bill Details
State Illinois
Session 104th General Assembly
Chamber House
Official Source www.ilga.gov/Legislation/BillStatus?DocNum...
LegiScan View on LegiScan
Sponsors
Ann Williams (Rep - D) Daniel Didech (Rep - D)
Action History
2026-04-09 H Third Reading - Short Debate - Passed 098-000-000 2026-04-07 H Placed on Calendar Order of 3rd Reading - Short Debate 2026-04-07 H Second Reading - Short Debate 2026-03-25 H Placed on Calendar 2nd Reading - Short Debate 2026-03-24 H Do Pass / Short Debate Insurance Committee; 015-000-000 2026-03-24 H Added Chief Co-Sponsor Rep. Daniel Didech 2026-03-18 H Assigned to Insurance Committee 2026-02-10 H Referred to Rules Committee 2026-02-10 H First Reading 2026-02-06 H Filed with the Clerk by Rep. Ann M. Williams
Committee Referrals
2026-02-10 H Rules 2026-03-18 H Insurance
Bill Text Versions
2026-02-06 Introduced 2026-04-07 Engrossed Legislative data powered by LegiScan (CC BY 4.0)
Named provisions
Related changes
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