101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB5533

 

Introduced , by Rep. Mary Edly-Allen

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356z.12

    Amends the Illinois Insurance Code. Provides that an insurer shall provide notice to an insured's dependent at least 30 days before the termination of the dependent's coverage if the insured no longer elects to cover the dependent, unless the dependent's coverage is terminated because the dependent is 26 years of age or older.


LRB101 18903 BMS 68362 b

 

 

A BILL FOR

 

HB5533LRB101 18903 BMS 68362 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 356z.12 as follows:
 
6    (215 ILCS 5/356z.12)
7    Sec. 356z.12. Dependent coverage.
8    (a) A group or individual policy of accident and health
9insurance or managed care plan that provides coverage for
10dependents and that is amended, delivered, issued, or renewed
11after the effective date of this amendatory Act of the 95th
12General Assembly shall not terminate coverage or deny the
13election of coverage for an unmarried dependent by reason of
14the dependent's age before the dependent's 26th birthday.
15    (b) A policy or plan subject to this Section shall, upon
16amendment, delivery, issuance, or renewal, establish an
17initial enrollment period of not less than 90 days during which
18an insured may make a written election for coverage of an
19unmarried person as a dependent under this Section. After the
20initial enrollment period, enrollment by a dependent pursuant
21to this Section shall be consistent with the enrollment terms
22of the plan or policy.
23    (c) A policy or plan subject to this Section shall allow

 

 

HB5533- 2 -LRB101 18903 BMS 68362 b

1for dependent coverage during the annual open enrollment date
2or the annual renewal date if the dependent, as of the date on
3which the insured elects dependent coverage under this
4subsection, has:
5        (1) a period of continuous creditable coverage of 90
6    days or more; and
7        (2) not been without creditable coverage for more than
8    63 days.
9An insured may elect coverage for a dependent who does not meet
10the continuous creditable coverage requirements of this
11subsection (c) and that dependent shall not be denied coverage
12due to age.
13    For purposes of this subsection (c), "creditable coverage"
14shall have the meaning provided under subsection (C)(1) of
15Section 20 of the Illinois Health Insurance Portability and
16Accountability Act.
17    (d) Military personnel. A group or individual policy of
18accident and health insurance or managed care plan that
19provides coverage for dependents and that is amended,
20delivered, issued, or renewed after the effective date of this
21amendatory Act of the 95th General Assembly shall not terminate
22coverage or deny the election of coverage for an unmarried
23dependent by reason of the dependent's age before the
24dependent's 30th birthday if the dependent (i) is an Illinois
25resident, (ii) served as a member of the active or reserve
26components of any of the branches of the Armed Forces of the

 

 

HB5533- 3 -LRB101 18903 BMS 68362 b

1United States, and (iii) has received a release or discharge
2other than a dishonorable discharge. To be eligible for
3coverage under this subsection (d), the eligible dependent
4shall submit to the insurer a form approved by the Illinois
5Department of Veterans' Affairs stating the date on which the
6dependent was released from service.
7    (e) Calculation of the cost of coverage provided to an
8unmarried dependent under this Section shall be identical.
9    (f) Nothing in this Section shall prohibit an employer from
10requiring an employee to pay all or part of the cost of
11coverage provided under this Section.
12    (g) No exclusions or limitations may be applied to coverage
13elected pursuant to this Section that do not apply to all
14dependents covered under the policy.
15    (h) A policy or plan subject to this Section shall not
16condition eligibility for dependent coverage provided pursuant
17to this Section on enrollment in any educational institution.
18    (i) Notice regarding coverage for a dependent as provided
19pursuant to this Section shall be provided to an insured by the
20insurer:
21        (1) upon application or enrollment;
22        (2) in the certificate of coverage or equivalent
23    document prepared for an insured and delivered on or about
24    the date on which the coverage commences; and
25        (3) (blank).
26    (j) An insurer shall provide notice to an insured's

 

 

HB5533- 4 -LRB101 18903 BMS 68362 b

1dependent at least 30 days before the termination of the
2dependent's coverage if the insured no longer elects to cover
3the dependent, unless the dependent's coverage is terminated
4because the dependent is 26 years of age or older.
5(Source: P.A. 98-226, eff. 1-1-14.)