|
|||||||
| |||||||
| |||||||
1 | AN ACT concerning insurance.
| ||||||
2 | Be it enacted by the People of the State of Illinois,
| ||||||
3 | represented in the General Assembly:
| ||||||
4 | Section 5. The Illinois Insurance Code is amended by | ||||||
5 | changing Section 367e as follows:
| ||||||
6 | (215 ILCS 5/367e) (from Ch. 73, par. 979e)
| ||||||
7 | Sec. 367e. Continuation of Group Hospital, Surgical and | ||||||
8 | Major Medical
Coverage After Termination of Employment or | ||||||
9 | Membership.
A group policy delivered, issued for delivery, | ||||||
10 | renewed or amended in this
state which insures employees or | ||||||
11 | members
for hospital, surgical or major medical insurance on an | ||||||
12 | expense incurred
or service basis, other than for specific | ||||||
13 | diseases or for accidental injuries
only, shall provide that | ||||||
14 | employees or members whose insurance under the
group policy | ||||||
15 | would otherwise terminate because of termination of employment
| ||||||
16 | or membership or because of a reduction in hours below the | ||||||
17 | minimum required
by the group plan shall be entitled to | ||||||
18 | continue their hospital, surgical and
major medical insurance | ||||||
19 | under that group policy, for themselves and their
eligible | ||||||
20 | dependents, subject to all of the group policy's terms and | ||||||
21 | conditions
applicable to those forms of insurance and to the | ||||||
22 | following conditions:
| ||||||
23 | 1. Continuation shall only be available to an employee |
| |||||||
| |||||||
1 | or member who has
been continuously insured under the group | ||||||
2 | policy (and for similar benefits
under any group policy | ||||||
3 | which it replaced) during the entire 3 months period
ending | ||||||
4 | with such termination
or reduction in hours below the | ||||||
5 | minimum required by the group plan. With respect to an | ||||||
6 | employee or member who is involuntarily terminated between | ||||||
7 | September 1, 2008 and December 31, 2009, continuation shall | ||||||
8 | be available if the employee or member was insured under | ||||||
9 | the group policy on the day prior to the termination.
| ||||||
10 | 2. Continuation shall not be available for any person | ||||||
11 | who is covered by
Medicare, except for those individuals | ||||||
12 | who have been covered under a
group Medicare supplement | ||||||
13 | policy. Neither shall continuation be
available for any | ||||||
14 | person who is
covered by any other insured or uninsured | ||||||
15 | plan
which provides hospital, surgical or medical coverage | ||||||
16 | for individuals in
a group and under which the person was | ||||||
17 | not
covered immediately prior to such termination
or | ||||||
18 | reduction in hours below the minimum required by the group | ||||||
19 | plan
or who exercises his conversion
privilege under the | ||||||
20 | group policy.
| ||||||
21 | 3. Continuation need not include dental, vision care, | ||||||
22 | prescription drug
benefits, disability income, specified | ||||||
23 | disease, or similar supplementary
benefits which are | ||||||
24 | provided under the group policy in addition to its | ||||||
25 | hospital,
surgical or major medical benefits.
| ||||||
26 | 4. Within 10 days after the employee's or member's Upon |
| |||||||
| |||||||
1 | termination
or reduction in hours below the minimum | ||||||
2 | required by the group plan
written notice of continuation | ||||||
3 | shall be presented
to the employee or member by the | ||||||
4 | employer . If the employee or member is unavailable, written | ||||||
5 | notice shall be or mailed by the employer to the
last known | ||||||
6 | address of the employee or member within 10 days after the | ||||||
7 | employee's or member's termination or reduction in hours | ||||||
8 | below the minimum required by the group plan . The employer | ||||||
9 | shall also send a copy of the notice to the insurer. An | ||||||
10 | employee or member who wishes
continuation
of coverage must | ||||||
11 | request such continuation in writing within the 30 day | ||||||
12 | ten-day
period following the later of: (i) the date of such | ||||||
13 | termination
or reduction in hours below the minimum | ||||||
14 | required by the group plan, or (ii)
the date the employee | ||||||
15 | is presented or mailed given written notice of the right of | ||||||
16 | continuation
by either the employer or the
group | ||||||
17 | policyholder. In no event, however, may the employee or | ||||||
18 | member elect
continuation more than 60 days after the date | ||||||
19 | of such termination
or reduction in hours below the minimum | ||||||
20 | required by the group plan.
Written notice of continuation | ||||||
21 | presented to the employee or member by the
policyholder, or | ||||||
22 | mailed by the policyholder to the last known address of
the | ||||||
23 | employee, shall constitute the giving of notice for the | ||||||
24 | purpose of this
provision.
| ||||||
25 | The insurer shall not deny coverage to the employee or | ||||||
26 | member due to the employer's failure to provide notice |
| |||||||
| |||||||
1 | pursuant to this Section to the employee or member. Until | ||||||
2 | January 1, 2010, in the event the employee or member | ||||||
3 | contacts the insurer regarding continuation rights and | ||||||
4 | advises that notice has not been provided by the employer | ||||||
5 | or group policyholder, the insurer shall provide a written | ||||||
6 | explanation to the employee or member of the employee's or | ||||||
7 | member's continuation rights pursuant to this Section. | ||||||
8 | 4a. Unless contrary to the provisions of, or any rules | ||||||
9 | promulgated pursuant to, Section 3001(a)(7) of Title III of | ||||||
10 | Division B of the federal American Recovery and | ||||||
11 | Reinvestment Act of 2009, with respect to employees or | ||||||
12 | members of health plans that are subject solely to State | ||||||
13 | continuation coverage and who are terminated or whose | ||||||
14 | reduction in hours below the minimum required by the group | ||||||
15 | occurs between the effective date of this amendatory Act of | ||||||
16 | the 96th General Assembly and December 31, 2009, the notice | ||||||
17 | requirements of this Section are not satisfied unless | ||||||
18 | notice is presented or mailed to the employee or member by | ||||||
19 | the insurer informing the employee or member of the | ||||||
20 | availability of premium reduction with respect to such | ||||||
21 | coverage under the American Recovery and Reinvestment Act | ||||||
22 | of 2009. Such written notice shall conform to all | ||||||
23 | applicable requirements set forth in Section 3001(a)(7) of | ||||||
24 | Title III of Division B of the federal American Recovery | ||||||
25 | and Reinvestment Act of 2009. The Department shall publish | ||||||
26 | models for the notification that shall be provided by |
| |||||||
| |||||||
1 | insurers pursuant to this paragraph 4a. | ||||||
2 | 4b. Unless contrary to the provisions of, or any rules | ||||||
3 | promulgated pursuant to, Section 3001(a)(7) of Title III of | ||||||
4 | Division B of the federal American Recovery and | ||||||
5 | Reinvestment Act of 2009, with respect to employees or | ||||||
6 | members of health plans that are subject solely to State | ||||||
7 | continuation coverage who were terminated or whose | ||||||
8 | reduction in hours below the minimum required by the group | ||||||
9 | occurred between September 1, 2008 and the effective date | ||||||
10 | of this amendatory Act of the 96th General Assembly and who | ||||||
11 | have an election of continuation of coverage pursuant to | ||||||
12 | this Section in effect, notice shall be presented or mailed | ||||||
13 | to the employee or member by the insurer informing the | ||||||
14 | employee or member of the availability of premium reduction | ||||||
15 | with respect to such coverage under the federal American | ||||||
16 | Recovery and Reinvestment Act of 2009. Such written notice | ||||||
17 | shall conform to all applicable requirements set forth in | ||||||
18 | Section 3001(a)(7) of Title III of Division B of the | ||||||
19 | federal American Recovery and Reinvestment Act of 2009 and | ||||||
20 | shall be presented or mailed to the employee or member | ||||||
21 | within 14 days of the effective date of this amendatory Act | ||||||
22 | of the 96th General Assembly. The Department shall publish | ||||||
23 | models for the notification that shall be provided by | ||||||
24 | insurers pursuant to this paragraph 4b.
| ||||||
25 | 5. An employee or member electing continuation must pay | ||||||
26 | to the group
policyholder
or his employer, on a monthly |
| |||||||
| |||||||
1 | basis in advance, the total amount of premium
required by | ||||||
2 | the insurer, including that portion of the premium | ||||||
3 | contributed
by the policyholder or employer, if any, but | ||||||
4 | not more than the group rate
for the insurance being | ||||||
5 | continued with appropriate reduction in premium
for any | ||||||
6 | supplementary benefits which have been discontinued under | ||||||
7 | paragraph
(3) of this Section. The premium rate required by | ||||||
8 | the insurer shall be
the applicable premium required on the | ||||||
9 | due date of each payment.
| ||||||
10 | 6. Continuation of insurance under the group policy for
| ||||||
11 | any person shall terminate when he becomes eligible for | ||||||
12 | Medicare or is covered
by any other insured or uninsured | ||||||
13 | plan which provides hospital, surgical
or medical coverage | ||||||
14 | for individuals in a group and under which
the person was | ||||||
15 | not covered immediately prior to such termination
or | ||||||
16 | reduction in hours below the minimum required by the group | ||||||
17 | plan
as provided
in condition
2 above or, if earlier, at | ||||||
18 | the first to occur of the following:
| ||||||
19 | (a) The date 12 9 months after the date the | ||||||
20 | employee's or member's
insurance
under the policy | ||||||
21 | would otherwise have terminated because of termination
| ||||||
22 | of employment or membership
or reduction in hours below | ||||||
23 | the minimum required by the group plan.
| ||||||
24 | (b) If the employee or member fails to make timely | ||||||
25 | payment of a required
contribution, the end of the | ||||||
26 | period for which contributions were made.
|
| |||||||
| |||||||
1 | (c) The date on which the group policy is | ||||||
2 | terminated or, in the case of
an employee, the date his | ||||||
3 | employer terminates participation under the group
| ||||||
4 | policy. However, if this (c) applies and the coverage | ||||||
5 | ceasing by reason of
such
termination is replaced by | ||||||
6 | similar coverage under another group policy,
the | ||||||
7 | following shall apply:
| ||||||
8 | (i) The employee or member shall have the right | ||||||
9 | to become covered
under
that other group policy, | ||||||
10 | for the balance of the period that he would have
| ||||||
11 | remained covered under the prior group policy in | ||||||
12 | accordance with condition
6 had a termination | ||||||
13 | described in this (c) not occurred.
| ||||||
14 | (ii) The prior group policy shall continue to | ||||||
15 | provide benefits to the
extent of its accrued | ||||||
16 | liabilities and extensions of benefits as if the
| ||||||
17 | replacement
had not occurred.
| ||||||
18 | 7. A notification of the continuation privilege shall | ||||||
19 | be included in each
certificate of coverage.
| ||||||
20 | 8. Continuation shall not be available for any employee | ||||||
21 | who was
discharged because of the commission of a felony in | ||||||
22 | connection with his
work, or because of theft in connection | ||||||
23 | with his work, for which the
employer was in no way | ||||||
24 | responsible; provided the employee admitted his
commission | ||||||
25 | of the felony or theft or such act has resulted in a | ||||||
26 | conviction
or order of supervision by a court of competent |
| |||||||
| |||||||
1 | jurisdiction.
| ||||||
2 | 9. An employee or member without an election of | ||||||
3 | continuation of coverage pursuant to this Section in effect | ||||||
4 | on the effective date of this amendatory Act of the 96th | ||||||
5 | General Assembly may elect continuation pursuant to this | ||||||
6 | paragraph 9 if the employee or member: (i) would be an | ||||||
7 | assistance eligible individual as defined in Section | ||||||
8 | 3001(a)(3) of Title III of Division B of the federal | ||||||
9 | American Recovery and Reinvestment Act of 2009, if such an | ||||||
10 | election were in effect and (ii) at the time of termination | ||||||
11 | was eligible for continuation pursuant to paragraphs 1 and | ||||||
12 | 2 of this Section. | ||||||
13 | Unless contrary to the provisions of, or any rules | ||||||
14 | promulgated pursuant to, Section 3001(a)(7) of Title III of | ||||||
15 | Division B of the federal American Recovery and | ||||||
16 | Reinvestment Act of 2009, written notice of continuation | ||||||
17 | pursuant to this paragraph 9 shall be presented to the | ||||||
18 | employee or member by the insurer or mailed by the insurer | ||||||
19 | to the last known address of the employee or member within | ||||||
20 | 30 days after the effective date of this amendatory Act of | ||||||
21 | the 96th General Assembly. Such written notice shall | ||||||
22 | conform to all applicable requirements set forth in Section | ||||||
23 | 3001(a)(7) of Title III of Division B of the federal | ||||||
24 | American Recovery and Reinvestment Act of 2009. The | ||||||
25 | Department shall publish models for the notification that | ||||||
26 | shall be provided by insurers pursuant to this paragraph 9. |
| |||||||
| |||||||
1 | An employee or member electing continuation of | ||||||
2 | coverage under this paragraph 9 must request such | ||||||
3 | continuation in writing within 60 days after the date the | ||||||
4 | employee or member receives written notice of the right of | ||||||
5 | continuation by the insurer. | ||||||
6 | Continuation of coverage elected pursuant to this | ||||||
7 | paragraph 9 shall commence with the first period of | ||||||
8 | coverage beginning on or after February 17, 2009, the | ||||||
9 | effective date of the federal American Recovery and | ||||||
10 | Reinvestment Act of 2009, and shall not extend beyond the | ||||||
11 | period of continuation that would have been required if the | ||||||
12 | coverage had been elected pursuant to paragraph 4 of this | ||||||
13 | Section. | ||||||
14 | With respect to an employee or member who elects | ||||||
15 | continuation of coverage under this paragraph 9, the period | ||||||
16 | beginning on the date of the employee's or member's | ||||||
17 | involuntary termination of employment and ending on the | ||||||
18 | date of the first period of coverage on or after February | ||||||
19 | 17, 2009 shall be disregarded for purposes of determining | ||||||
20 | the 63-day period referred to in Section 20 of the Illinois | ||||||
21 | Health Insurance Portability and Accountability Act. | ||||||
22 | The requirements of this amendatory Act of 1983 shall apply | ||||||
23 | to any group
policy as defined in this Section, delivered or | ||||||
24 | issued for delivery on or after
180 days following the | ||||||
25 | effective date of this amendatory Act of 1983.
| ||||||
26 | The requirements of this amendatory Act of 1985 shall apply |
| |||||||
| |||||||
1 | to any
group policy as defined in this Section, delivered, | ||||||
2 | issued for delivery,
renewed or amended on or after 180 days | ||||||
3 | following the effective date of
this amendatory Act of 1985.
| ||||||
4 | (Source: P.A. 93-477, eff. 1-1-04.)
| ||||||
5 | Section 10. The Health Maintenance Organization Act is | ||||||
6 | amended by changing Section 4-9.2 as follows:
| ||||||
7 | (215 ILCS 125/4-9.2) (from Ch. 111 1/2, par. 1409.2-2)
| ||||||
8 | Sec. 4-9.2. Continuation of group HMO coverage after | ||||||
9 | termination of
employee or membership. A group contract | ||||||
10 | delivered, issued for delivery,
renewed, or amended in this | ||||||
11 | State that covers employees or members for health
care services | ||||||
12 | shall provide that employees or members whose coverage under
| ||||||
13 | the group contract would otherwise terminate because of | ||||||
14 | termination of
employment or membership or because of a | ||||||
15 | reduction in hours below the minimum
required by the group | ||||||
16 | contract shall be entitled to continue their coverage
under
| ||||||
17 | that group contract, for themselves and their eligible | ||||||
18 | dependents, subject
to all of the group contract's terms and | ||||||
19 | conditions applicable to those
forms of coverage and to the | ||||||
20 | following conditions:
| ||||||
21 | (1) Continuation shall only be available to an employee | ||||||
22 | or member who has
been continuously covered under the group | ||||||
23 | contract (and for similar
benefits under any group contract | ||||||
24 | that it replaced) during the entire 3
month period ending |
| |||||||
| |||||||
1 | with the termination of employment or membership or
| ||||||
2 | reduction in hours below the minimum required by the group | ||||||
3 | contract. With respect to an employee or member who is | ||||||
4 | involuntarily terminated between September 1, 2008 and | ||||||
5 | December 31, 2009, continuation shall be available if the | ||||||
6 | employee or member was covered under the group contract the | ||||||
7 | day prior to such termination.
| ||||||
8 | (2) Continuation shall not be available for any | ||||||
9 | enrollee who is
covered by Medicare, except for those | ||||||
10 | individuals who have been covered
under a group Medicare | ||||||
11 | supplement policy. Continuation shall not be
available for | ||||||
12 | any enrollee who is covered by any other insured or | ||||||
13 | uninsured
plan that provides hospital, surgical, or | ||||||
14 | medical coverage for individuals
in a group and under which | ||||||
15 | the enrollee was not covered immediately
before | ||||||
16 | termination or reduction in hours below the minimum | ||||||
17 | required by the
group contract or who exercises his or her | ||||||
18 | conversion privilege under
the group policy.
| ||||||
19 | (3) Continuation need not include dental, vision care, | ||||||
20 | prescription
drug, or similar supplementary benefits that | ||||||
21 | are provided under
the group contract in addition to its | ||||||
22 | basic health care services.
| ||||||
23 | (4) Within 10 days after the employee's or member's | ||||||
24 | Upon termination or reduction in hours below the minimum | ||||||
25 | required by
the group contract, written notice of | ||||||
26 | continuation shall be presented
to the employee or member |
| |||||||
| |||||||
1 | by the employer . If the employee or member is unavailable, | ||||||
2 | written notice shall be or mailed by the employer to the | ||||||
3 | last
known address of the employee or member within 10 days | ||||||
4 | after the employee's or member's termination or reduction | ||||||
5 | in hours below the minimum required by the group plan . The | ||||||
6 | employer shall also send a copy of the notice to the HMO. | ||||||
7 | An employee or member who wishes
continuation of coverage | ||||||
8 | must request continuation in writing within
the 30 10 day | ||||||
9 | period following the later of (i) the date of termination | ||||||
10 | or
reduction in hours below the minimum required by the | ||||||
11 | group contract or (ii)
the date the employee is presented | ||||||
12 | or mailed given written notice of the right of continuation | ||||||
13 | by
either the employer or the group policyholder. In no | ||||||
14 | event, however, shall the
employee or member elect | ||||||
15 | continuation more than 60 days after the date of
| ||||||
16 | termination
or reduction in hours below the minimum | ||||||
17 | required by the group contract.
Written notice of | ||||||
18 | continuation presented to the employee or member
by the | ||||||
19 | policyholder, or mailed by the policyholder to the last | ||||||
20 | known address of
the employee, shall constitute the giving | ||||||
21 | of notice for the purpose of this
paragraph. | ||||||
22 | The HMO shall not deny coverage to the employee or | ||||||
23 | member due to the employer's failure to provide notice | ||||||
24 | pursuant to this Section to the employee or member. Until | ||||||
25 | January 1, 2010, in the event the employee or member | ||||||
26 | contacts the HMO regarding continuation rights and advises |
| |||||||
| |||||||
1 | that notice has not been provided by the employer or group | ||||||
2 | policyholder, the HMO shall provide a written explanation | ||||||
3 | to the employee or member of the employee's or member's | ||||||
4 | continuation rights pursuant to this Section. | ||||||
5 | (4a) Unless contrary to the provisions of, or any rules | ||||||
6 | promulgated pursuant to, Section 3001(a)(7) of Title III of | ||||||
7 | Division B of the federal American Recovery and | ||||||
8 | Reinvestment Act of 2009, with respect to employees or | ||||||
9 | members of health plans that are subject solely to State | ||||||
10 | continuation coverage and who are terminated or whose | ||||||
11 | reduction in hours below the minimum required by the group | ||||||
12 | occurs between the effective date of this amendatory Act of | ||||||
13 | the 96th General Assembly and December 31, 2009, the notice | ||||||
14 | requirements of this Section are not satisfied unless | ||||||
15 | notice is presented or mailed to the employee or member by | ||||||
16 | the HMO informing the employee or member of the | ||||||
17 | availability of premium reduction with respect to such | ||||||
18 | coverage under the federal American Recovery and | ||||||
19 | Reinvestment Act of 2009. Such written notice shall conform | ||||||
20 | to all applicable requirements set forth in Section | ||||||
21 | 3001(a)(7) of Title III of Division B of the federal | ||||||
22 | American Recovery and Reinvestment Act of 2009. The | ||||||
23 | Department shall publish models for the notification that | ||||||
24 | shall be provided by HMOs pursuant to this paragraph (4a). | ||||||
25 | (4b) Unless contrary to the provisions of, or any rules | ||||||
26 | promulgated pursuant to, Section 3001(a)(7) of Title III of |
| |||||||
| |||||||
1 | Division B of the federal American Recovery and | ||||||
2 | Reinvestment Act of 2009, with respect to employees or | ||||||
3 | members of health plans that are subject solely to State | ||||||
4 | continuation coverage who were terminated or whose | ||||||
5 | reduction in hours below the minimum required by the group | ||||||
6 | occurred between September 1, 2008, and the effective date | ||||||
7 | of this amendatory Act of the 96th General Assembly and who | ||||||
8 | have an election of continuation of coverage pursuant to | ||||||
9 | this Section in effect, notice shall be presented or mailed | ||||||
10 | to the employee or member by the HMO informing the employee | ||||||
11 | or member of the availability of premium reduction with | ||||||
12 | respect to such coverage under the federal American | ||||||
13 | Recovery and Reinvestment Act of 2009. Such written notice | ||||||
14 | shall conform to all applicable requirements set forth in | ||||||
15 | Section 3001(a)(7) of Title III of Division B of the | ||||||
16 | federal American Recovery and Reinvestment Act of 2009 and | ||||||
17 | shall be presented or mailed to the employee or member | ||||||
18 | within 14 days of the effective date of this amendatory Act | ||||||
19 | of the 96th General Assembly. The Department shall publish | ||||||
20 | models for the notification that shall be provided by HMOs | ||||||
21 | pursuant to this paragraph (4b).
| ||||||
22 | (5) An employee or member electing continuation must | ||||||
23 | pay to the group
policyholder or his employer, on a monthly | ||||||
24 | basis in advance, the total
amount of premium required by | ||||||
25 | the HMO, including that portion of the
premium contributed | ||||||
26 | by the policyholder or employer, if any, but not more
than |
| |||||||
| |||||||
1 | the group rate for the coverage being continued with | ||||||
2 | appropriate
reduction in premium for any supplementary | ||||||
3 | benefits that have been
discontinued under paragraph (3) of | ||||||
4 | this Section. The premium rate required
by the HMO shall be | ||||||
5 | the applicable premium required on the due date of each
| ||||||
6 | payment.
| ||||||
7 | (6) Continuation of coverage under the group contract | ||||||
8 | for any person
shall terminate when the person becomes | ||||||
9 | eligible for Medicare or is covered by
any other insured or | ||||||
10 | uninsured plan that provides hospital, surgical, or
| ||||||
11 | medical coverage for individuals in a group and under which | ||||||
12 | the person was not
covered immediately before termination
| ||||||
13 | or reduction in hours below the minimum required by the | ||||||
14 | group contract
as provided in paragraph (2) of this
Section | ||||||
15 | or, if earlier, at the first to occur of the following:
| ||||||
16 | (a) The expiration of 12 9 months after the | ||||||
17 | employee's or member's coverage
because of termination | ||||||
18 | of employment or membership
or reduction in hours below | ||||||
19 | the minimum required by the group contract.
| ||||||
20 | (b) If the employee or member fails to make timely | ||||||
21 | payment of a
required contribution, the end of the | ||||||
22 | period for which contributions were made.
| ||||||
23 | (c) The date on which the group contract is | ||||||
24 | terminated or, in the
case of an employee, the date his | ||||||
25 | or her employer terminates participation
under the | ||||||
26 | group contract. If, however, this paragraph applies |
| |||||||
| |||||||
1 | and the coverage
ceasing by reason of termination is | ||||||
2 | replaced by similar coverage under another
group | ||||||
3 | contract, then (i) the employee or member shall have | ||||||
4 | the right to become
covered under the replacement group | ||||||
5 | contract for the balance of the period that
he or she | ||||||
6 | would have remained covered under the prior group | ||||||
7 | contract in
accordance with paragraph (6) had a | ||||||
8 | termination described in this item (c) not
occurred and | ||||||
9 | (ii) the prior group contract shall continue to provide | ||||||
10 | benefits
to the extent of its accrued liabilities and | ||||||
11 | extensions of benefits as if the
replacement had not | ||||||
12 | occurred.
| ||||||
13 | (7) A notification of the continuation privilege shall | ||||||
14 | be included in
each evidence of coverage.
| ||||||
15 | (8) Continuation shall not be available for any | ||||||
16 | employee who was
discharged because of the commission of a | ||||||
17 | felony in connection with his or her
work, or because of | ||||||
18 | theft in connection with his or her work, for which the
| ||||||
19 | employer was in no way responsible if the employee (i) | ||||||
20 | admitted to
committing the felony or theft or (ii) was | ||||||
21 | convicted or placed under
supervision by a court of | ||||||
22 | competent jurisdiction.
| ||||||
23 | (9) An employee or member without an election of | ||||||
24 | continuation of coverage pursuant to this Section in effect | ||||||
25 | on the effective date of this amendatory Act of the 96th | ||||||
26 | General Assembly may elect continuation pursuant to this |
| |||||||
| |||||||
1 | paragraph (9) if the employee or member: (i) would be an | ||||||
2 | assistance eligible individual as defined in Section | ||||||
3 | 3001(a)(3) of Title III of Division B of the federal | ||||||
4 | American Recovery and Reinvestment Act of 2009 if such an | ||||||
5 | election were in effect and (ii) at the time of termination | ||||||
6 | was eligible for continuation pursuant to paragraphs (1) | ||||||
7 | and (2) of this Section. | ||||||
8 | Unless contrary to the provisions of, or any rules | ||||||
9 | promulgated pursuant to, Section 3001(a)(7) of Title III of | ||||||
10 | Division B of the federal American Recovery and | ||||||
11 | Reinvestment Act of 2009, written notice of continuation | ||||||
12 | pursuant to this paragraph (9) shall be presented to the | ||||||
13 | employee or member by the HMO or mailed by the HMO to the | ||||||
14 | last known address of the employee or member within 30 days | ||||||
15 | after the effective date of this amendatory Act of the 96th | ||||||
16 | General Assembly. The written notice shall conform to all | ||||||
17 | applicable requirements set forth in Section 3001(a)(7) of | ||||||
18 | Title III of Division B of the federal American Recovery | ||||||
19 | and Reinvestment Act of 2009. The Department shall publish | ||||||
20 | models for the notification that shall be provided by HMOs | ||||||
21 | pursuant to this paragraph (9). | ||||||
22 | An employee or member electing continuation of | ||||||
23 | coverage under this paragraph (9) must request such | ||||||
24 | continuation in writing within 60 days after the date the | ||||||
25 | employee or member receives written notice of the right of | ||||||
26 | continuation by the HMO. |
| |||||||
| |||||||
1 | Continuation of coverage elected pursuant to this | ||||||
2 | paragraph (9) shall commence with the first period of | ||||||
3 | coverage beginning on or after February 17, 2009, the | ||||||
4 | effective date of the federal American Recovery and | ||||||
5 | Reinvestment Act of 2009, and shall not extend beyond the | ||||||
6 | period of continuation that would have been required if the | ||||||
7 | coverage had been elected pursuant to paragraph (4) of this | ||||||
8 | Section. | ||||||
9 | With respect to an employee or member who elects | ||||||
10 | continuation of coverage under this paragraph (9), the | ||||||
11 | period beginning on the date of the employee or member's | ||||||
12 | involuntary termination of employment and ending on the | ||||||
13 | date of the first period of coverage on or after February | ||||||
14 | 17, 2009 shall be disregarded for purposes of determining | ||||||
15 | the 63-day period referred to in Section 20 of the Illinois | ||||||
16 | Health Insurance Portability and Accountability Act. | ||||||
17 | The requirements of this amendatory Act of 1992 shall apply | ||||||
18 | to any
group contract, as defined in this Section, delivered or | ||||||
19 | issued for
delivery on or after 180 days following the | ||||||
20 | effective date of this
amendatory Act of 1992.
| ||||||
21 | (Source: P.A. 93-477, eff. 1-1-04.)
| ||||||
22 | Section 99. Effective date. This Act takes effect upon | ||||||
23 | becoming law.
|