Sen. Heather A. Steans

Filed: 5/16/2018

 

 


 

 


 
10000HB2624sam002LRB100 07415 SMS 40247 a

1
AMENDMENT TO HOUSE BILL 2624

2    AMENDMENT NO. ______. Amend House Bill 2624 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Short-Term, Limited-Duration Health Insurance Coverage Act.
 
6    Section 5. Definitions. In this Act:
7    "Department" means the Department of Insurance.
8    "Group health insurance coverage" means, in connection
9with a group health plan, health insurance coverage offered in
10connection with the plan.
11    "Group health plan" means an employee welfare benefit plan
12(as defined in Section 3(1) of the federal Employee Retirement
13Income Security Act of 1974) to the extent that the plan
14provides medical care (as defined in paragraph (2) of that
15Section and including items and services paid for as medical
16care) to employees or their dependents (as defined under the

 

 

10000HB2624sam002- 2 -LRB100 07415 SMS 40247 a

1terms of the plan) directly or through insurance,
2reimbursement, or otherwise.
3    "Health insurance coverage" means benefits consisting of
4medical care (provided directly, through insurance or
5reimbursement, or otherwise and including items and services
6paid for as medical care) under any hospital or medical service
7policy or certificate, hospital or medical service plan
8contract, or health maintenance organization contract offered
9by a health insurance issuer.
10    "Health insurance issuer" means an insurance company,
11insurance service, or insurance organization (including a
12health maintenance organization) that is licensed to engage in
13the business of insurance in a state and that is subject to
14Illinois law that regulates insurance (within the meaning of
15Section 514(b)(2) of the federal Employee Retirement Income
16Security Act of 1974). "Health insurance issuer" does not
17include a group health plan.
18    "Fraud" means an intentional misrepresentation of a
19material fact in connection with the coverage.
20    "Individual health insurance coverage" means health
21insurance coverage offered to individuals in the individual
22market, including short-term, limited-duration health
23insurance coverage.
24    "Short-term, limited-duration health insurance coverage"
25means individual health insurance coverage provided under a
26contract offered by a licensed health insurance issuer,

 

 

10000HB2624sam002- 3 -LRB100 07415 SMS 40247 a

1regardless of the situs of the delivery of the policy or
2contract that has a specified, limited-duration.
 
3    Section 10. Application; scope; duration of coverage.
4    (a) This Act applies to health insurance issuers that offer
5short-term, limited-duration health insurance coverage to
6individuals in this State and to short-term, limited-duration
7health insurance coverage that is delivered or issued for
8delivery in this State, including coverage issued outside of
9this State that covers individuals in this State.
10    (b) A short-term, limited-duration health insurance
11coverage policy (even where issued outside of this State) may
12not cover any person residing in this State or be delivered or
13issued for delivery in this State unless the policy complies
14with the provisions of this Act.
15    (c) Any short-term, limited-duration health insurance
16coverage policy that is delivered or issued for delivery in
17this State must have an expiration date in the contract that is
18less than 91 days and shall not be renewable within a period of
19365 days, beginning the day after the contract ends, either at
20the option of the issuer or the individual. Renewal of a
21short-term, limited-duration health insurance coverage policy
22includes the issuance of a new short-term, limited-duration
23health insurance policy by an issuer to a policyholder within
2460 days after the expiration of a policy previously issued by
25the issuer to the policyholder.

 

 

10000HB2624sam002- 4 -LRB100 07415 SMS 40247 a

1    (d) Any short-term, limited-duration health insurance
2coverage policy that is delivered or issued for delivery in
3this State may not be rescinded before the expiration date in
4the contract, except in cases of nonpayment of premiums, fraud,
5or as provided in subsection (e).
6    (e) Any short-term, limited-duration health insurance
7coverage policy that is delivered or issued for delivery in
8this State shall contain an option for an individual to cancel
9coverage after any 30-day interval during the term of the plan.
 
10    Section 15. Disclosure requirements.
11    (a) A health insurance issuer that offers short-term,
12limited-duration health insurance coverage shall, in addition
13to all other documents required, including, but not limited to,
14the policy, the certificate, the membership booklet, and a
15description of appeal and external review rights, deliver an
16outline of coverage to an applicant for or an enrollee in
17short-term, limited-duration health insurance coverage
18delivered or issued for delivery in this State.
19    (b) Any short-term, limited-duration health insurance
20coverage policy that is delivered or issued for delivery in the
21State shall display prominently in the contract, any
22application, sales, and marketing materials provided in
23connection with enrollment in such coverage, and the outline of
24coverage for such coverage, in at least 14-point, bold type,
25the following: "NOTICE: THE SHORT-TERM, LIMITED-DURATION

 

 

10000HB2624sam002- 5 -LRB100 07415 SMS 40247 a

1INSURANCE BENEFITS UNDER THIS COVERAGE DO NOT MEET ALL FEDERAL
2REQUIREMENTS TO QUALIFY AS "MINIMUM ESSENTIAL COVERAGE" FOR
3HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. THIS PLAN OF
4COVERAGE DOES NOT INCLUDE ALL ESSENTIAL HEALTH BENEFITS AS
5REQUIRED BY THE AFFORDABLE CARE ACT. PREEXISTING CONDITIONS ARE
6NOT COVERED UNDER THIS PLAN OF COVERAGE. BE SURE TO CHECK YOUR
7POLICY CAREFULLY TO MAKE SURE YOU UNDERSTAND WHAT THE POLICY
8DOES AND DOES NOT COVER. IF THIS COVERAGE EXPIRES OR YOU LOSE
9ELIGIBILITY FOR THIS COVERAGE, YOU MIGHT HAVE TO WAIT UNTIL THE
10NEXT OPEN ENROLLMENT PERIOD TO GET OTHER HEALTH INSURANCE
11COVERAGE. YOU MAY BE ABLE TO GET LONGER TERM INSURANCE THAT
12QUALIFIES AS "MINIMUM ESSENTIAL COVERAGE" FOR HEALTH INSURANCE
13UNDER THE AFFORDABLE CARE ACT NOW AND HELP TO PAY FOR IT AT
14WWW.HEALTHCARE.GOV.".
15    (c) Any individual selling a short-term, limited-duration
16health insurance coverage policy in this State must read out
17loud the disclosure in subsection (b) to a prospective
18purchaser.
19    (d) Nothing in this Section precludes an insurer from
20providing disclosures in addition to those required in
21subsections (b) and (c).
 
22    Section 20. Filing and approval.
23    (a) Coverage subject to this Act may not be delivered or
24issued for delivery unless it has been approved by the
25Department.

 

 

10000HB2624sam002- 6 -LRB100 07415 SMS 40247 a

1    (b) A health insurance issuer who intends to deliver or
2issue for delivery a short-term, limited-duration health
3insurance coverage policy in this State shall file with the
4Department:
5        (1) all paperwork required by health insurance issuers
6    of individual health insurance coverage;
7        (2) all sales and marketing materials provided in
8    connection with enrollment in such coverage; and
9        (3) the outline of such coverage.
10    (c) The Department shall adopt any rules necessary to carry
11out the provisions of this Act.
 
12    Section 99. Effective date. This Act takes effect January
131, 2019.".