Coverage of COVID-19 Vaccines

Springfield Office 320 W. Washington Street Springfield, Illinois 62767 (217) 782-4515 Chicago Office 122 S. Michigan Ave., 19th Floor Chicago, Illinois 60603 (312) 814-2420 Illinois Department of Insurance JB PRITZKER Governor DANA POPISH SEVERINGHAUS Director MEMORANDUM TO: ALL COMPANIES WRITING ACCIDENT AND HEALTH INSURANCE AND MANAGED CARE PLANS IN ILLINOIS FROM: Dana Popish Severinghaus, Director of Insurance DATE: September 22, 2023 RE: Company Bulletin 2023-11 Coverage of COVID-19 Vaccines _____________________________________________________________________________ The Illinois Department of Insurance (“IDOI”) is reminding companies of their obligation to provide coverage of COVID-19 vaccines, including the recently updated mRNA COVID-19 vaccine recommended by Advisory Committee on Immunization Practices (“ACIP”) on September 12, 2023. Pursuant to Section 3203 of the CARES Act, vaccines received from a network provider must be covered without cost-sharing within 15 business days after the date on which an applicable recommendation is made by U.S. Preventive Services Task Force (“USPSTF”) with an effective rating of “A” or “B” or ACIP regarding the qualifying coronavirus preventive service. However, IDOI urges issuers to act as expeditiously as possible and take the necessary measures to streamline any claim system, billing, coding, or overall coverage issues prior to the 15 business days, but no later than October 3, 2023. To avoid any potential disruption or delays experienced by insureds seeking to obtain the updated COVID- 19 vaccine. IDOI is committed to ensuring that all insureds receive the benefits of the insurance that they pay for, including access to vaccines that mitigate potential hospitalizations and death. Questions about this bulletin may be directed to DOI.InfoDesk@illinois.gov.