HB5228, introduced in the 104th General Assembly (2025–2026), is a Work Compensation–State Licensure bill that amends both the Workers’ Compensation Act and the Illinois Insurance Code to strengthen oversight of businesses that require state licensure and must prove they have workers’ compensation insurance.

Key Provisions

1. Civil Penalties for Non‑Compliance

The bill requires that any corporation, limited liability company, or partnership engaged in activities requiring a state agency license — and for which proof of workers’ compensation insurance is a licensure requirement — must meet specified insurance requirements. If such an entity fails to satisfy these requirements, it can face civil penalties under the Workers’ Compensation Act, unless it can prove by clear and convincing evidence that it was not operating during the period its license was active Illinois General Assembly.

2. Insurance Code Amendments – Surcharge on Annual Payments

• The Illinois Insurance Code is amended to require, starting July 1, 2026 (or 15 days after the effective date of the amendatory Act, whichever is later), and annually thereafter, that the Director of the Illinois Department of Insurance charge an additional amount to companies’ obligations for the Illinois Workers’ Compensation Commission Operations Fund Surcharge.

• The additional amount is calculated and must be approved by the Department of Insurance before collection.

• It is deposited into the Commission’s Operations Fund.

• Special procedures apply if a company survives, is formed by merger/consolidation/reorganization, or reincorporates Illinois General Assembly.

3. Burial Expense Payments

The Workers’ Compensation Act is amended to increase the employer‑paid burial expense amount for accidental death from $8,000 to $10,000 for the widow, widower, other dependent, next of kin, or person incurring burial expenses Illinois General Assembly.

4. Utilization Review Standards

• The bill sets standards for utilization review processes:

• Adverse determinations must be made by a physician if the services are physician‑delivered or recommended.

• Certifications from the review process are valid for three months from the date received by the employee and provider, or for the length of treatment as determined by the provider Illinois General Assembly.

5. Appeal Process

Procedures for appealing a non‑certification decision are also established LegiScan.

HB5228 aims to:

• Ensure that state‑licensed businesses are properly insured for workers’ compensation liabilities.

• Increase funding for the Workers’ Compensation Commission’s operations.

• Provide higher burial expense payments to beneficiaries.

• Standardize and clarify utilization review and appeal processes.

In short, it strengthens enforcement, expands funding, and improves benefits for workers’ compensation in Illinois.

https://ilga.gov/Legislation/BillStatus/FullText?LegDocId=211343&DocName=10400HB5228sam002&DocNum=5228&DocTypeID=HB&LegID=166905&GAID=18&SessionID=114&SpecSess=&Session=