Full Text of HB0415 95th General Assembly
HB0415 95TH GENERAL ASSEMBLY
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95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008 HB0415
Introduced 01/26/07, by Rep. Deborah L. Graham SYNOPSIS AS INTRODUCED: |
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215 ILCS 5/356a |
from Ch. 73, par. 968a |
215 ILCS 5/367.2-5 |
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Amends the Illinois Insurance Code. Raises the maximum age of a dependent child that a policy of accident and health insurance may
insure, originally or by subsequent amendment, upon the application of an
adult member of a family who shall be deemed the policyholder, from 19 to 24. Provides that if the limiting age under the policy is less than 25 years of age, then the insurer shall, upon application of the dependent child, provide coverage after that specific age, until the dependent child is 25 years of age.
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A BILL FOR
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HB0415 |
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LRB095 04041 KBJ 24078 b |
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| AN ACT concerning insurance.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Insurance Code is amended by | 5 |
| changing Sections 356a and 367.2-5 as follows:
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| (215 ILCS 5/356a) (from Ch. 73, par. 968a)
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| Sec. 356a. Form of
policy.
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| (1) No policy of accident and health insurance shall be | 9 |
| delivered or
issued for delivery to any person in this state | 10 |
| unless:
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| (a) the entire money and other considerations therefor are | 12 |
| expressed
therein; and
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| (b) the time at which the insurance takes effect and | 14 |
| terminates is
expressed therein; and
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| (c) it purports to insure only one person, except that a | 16 |
| policy may
insure, originally or by subsequent amendment, upon | 17 |
| the application of an
adult member of a family who shall be | 18 |
| deemed the policyholder, any two or
more eligible members of | 19 |
| that family, including husband, wife, dependent
children or any | 20 |
| children under a specified age which shall not exceed 24
19
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| years and any other person dependent upon the policyholder; and
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| (d) the style, arrangement and over-all appearance of the | 23 |
| policy give no
undue prominence to any portion of the text, and |
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| unless every printed
portion of the text of the policy and of | 2 |
| any endorsements or attached
papers is plainly printed in | 3 |
| light-faced type of a style in general use,
the size of which | 4 |
| shall be uniform and not less than ten-point with a
lower-case | 5 |
| unspaced alphabet length not less than one hundred and
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| twenty-point (the "text" shall include all printed matter | 7 |
| except the name
and address of the insurer, name or title of | 8 |
| the policy, the brief
description if any, and captions and | 9 |
| subcaptions); and
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| (e) the exceptions and reductions of indemnity are set | 11 |
| forth in the
policy and, except those which are set forth in | 12 |
| Sections 357.1 through
357.30 of this act, are printed, at the | 13 |
| insurer's option, either included
with the benefit provision to | 14 |
| which they apply, or under an appropriate
caption such as | 15 |
| "EXCEPTIONS", or "EXCEPTIONS AND REDUCTIONS", provided that
if | 16 |
| an exception or reduction specifically applies only to a | 17 |
| particular
benefit of the policy, a statement of such exception | 18 |
| or reduction shall be
included with the benefit provision to | 19 |
| which it applies; and
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| (f) each such form, including riders and endorsements, | 21 |
| shall be
identified by a form number in the lower left-hand | 22 |
| corner of the first page
thereof; and
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| (g) it contains no provision purporting to make any portion | 24 |
| of the
charter, rules, constitution, or by-laws of the insurer | 25 |
| a part of the
policy unless such portion is set forth in full | 26 |
| in the policy, except in
the case of the incorporation of, or |
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| reference to, a statement of rates or
classification of risks, | 2 |
| or short-rate table filed with the Director.
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| (2) If any policy is issued by an insurer domiciled in this | 4 |
| state for
delivery to a person residing in another state, and | 5 |
| if the official having
responsibility for the administration of | 6 |
| the insurance laws of such other
state shall have advised the | 7 |
| Director that any such policy is not subject
to approval or | 8 |
| disapproval by such official, the Director may by ruling
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| require that such policy meet the standards set forth in | 10 |
| subsection (1) of
this section and in Sections 357.1 through | 11 |
| 357.30.
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| (Source: P.A. 76-860.)
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| (215 ILCS 5/367.2-5)
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| Sec. 367.2-5. Dependent child continuation privilege; | 15 |
| group contracts.
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| (a) No policy of group accident or health insurance, nor | 17 |
| any certificate
thereunder
shall be amended, renewed, | 18 |
| delivered, or issued for delivery in this State
after
July 1,
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| 2004, unless the policy provides for a continuation of the | 20 |
| existing insurance
benefits for
an employee's dependent child | 21 |
| who is insured under the provisions of that group
policy
or | 22 |
| certificate in the event of the death of the employee and the | 23 |
| child is not
eligible for
coverage as a dependent under the | 24 |
| provisions of Section 367.2 or the dependent
child has
attained | 25 |
| the limiting age under the policy. If the limiting age under |
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| the policy is less than 25 years of age, then the insurer | 2 |
| shall, upon application of the dependent child as set forth in | 3 |
| subsection (c) of this Section, provide coverage after that | 4 |
| specific age, until the dependent child is 25 years of age.
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| (b) In the event of the death of the employee, if | 6 |
| continuation coverage is
desired,
the dependent child or a | 7 |
| responsible adult acting on behalf of the dependent
child shall
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| give the employer or the insurer written notice of the death of | 9 |
| employee within
30 days of
the date the coverage terminates. | 10 |
| The employer, within 15 days of receipt of
the notice,
shall | 11 |
| give written notice to the insurance company issuing the policy | 12 |
| of the
death of the
employee and the dependent child's | 13 |
| residence. The employer shall immediately
send a
copy of the | 14 |
| notice to the dependent child or responsible adult at the | 15 |
| dependent
child's
residence.
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| (c) In the event of the dependent child attaining the | 17 |
| limiting age under the
policy,
if continuation coverage is | 18 |
| desired, the dependent child shall give the
employer or the
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| insurer written notice of the attainment of the limiting age | 20 |
| within 30 days of
the date the
coverage terminates. The | 21 |
| employer, within 15 days of receipt of the notice,
shall give
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| written notice to the insurance company issuing the policy of | 23 |
| the attainment
of the
limiting age by the dependent child and | 24 |
| of the dependent child's residence.
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| (d) Within 30 days after the date of receipt of a notice | 26 |
| from the employer,
dependent child, or responsible adult acting |
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| on behalf of the dependent child,
or of the
initiation of a new | 2 |
| group policy, the insurance company, by certified mail,
return | 3 |
| receipt
requested, shall notify the dependent child or | 4 |
| responsible adult at the
dependent child's
residence that the | 5 |
| policy may be continued for the dependent child. The
notice | 6 |
| shall
include:
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| (1) a form for election to continue the insurance | 8 |
| coverage;
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| (2) the amount of periodic premiums to be charged for | 10 |
| continuation
coverage and
the
method and place of payment; | 11 |
| and
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| (3) instructions for returning the election form | 13 |
| within 30 days after the
date
it is received
from the | 14 |
| insurance company.
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| Failure of the dependent child or the responsible adult | 16 |
| acting on behalf of
the dependent
child to exercise the | 17 |
| election to continue insurance coverage by notifying the
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| insurance
company in writing within such 30 day period shall | 19 |
| terminate the continuation
of benefits
and the right to | 20 |
| continuation.
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| If the insurance company fails to notify the dependent | 22 |
| child or responsible
adult acting on
behalf of the dependent | 23 |
| child as provided for in this subsection (d), all
premiums | 24 |
| shall
be waived from the date the notice was required until | 25 |
| notice was sent, and the
benefits shall
continue under the | 26 |
| terms and provisions of the policy, from the date the notice
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| was
required until the notice was sent, notwithstanding any | 2 |
| other provision hereof,
except where
the benefits in existence | 3 |
| at the time the company's notice was to be sent
pursuant to
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| this subsection (d) are terminated as to all employees.
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| (e) The monthly premium for continuation shall be computed | 6 |
| as follows:
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| (1) an amount, if any, that would be charged an | 8 |
| employee if the dependent
child were a
current employee of | 9 |
| the employer, plus;
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| (2) an amount, if any, that the employer would | 11 |
| contribute toward the
premium if
the
dependent child were a | 12 |
| current employee.
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| Failure to pay the initial monthly premium within 30 days | 14 |
| after the date of
receipt of
notice required in subsection (d) | 15 |
| of this Section terminates the continuation
benefits and
the | 16 |
| right to continuation benefits.
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| Continuation coverage provided under this Act shall | 18 |
| terminate upon the
earliest to happen
of the following:
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| (1) the failure to pay premiums when due, including any | 20 |
| grace period
allowed by the
policy;
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| (2) when coverage would terminate under the terms of | 22 |
| the existing policy
if the
dependent child was still an | 23 |
| eligible dependent of the employee;
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| (3) the date on which the dependent child first | 25 |
| becomes, after the date of
election, an
insured employee | 26 |
| under any other group health plan; or
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| (4) the expiration of 2 years from the date | 2 |
| continuation coverage began.
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| Upon the termination of continuation coverage, the | 4 |
| dependent child shall be
entitled to
convert the coverage to an | 5 |
| individual policy.
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| (f) The renewal, amendment, or extension of any group | 7 |
| policy affected by
this
Section shall be deemed to be delivery | 8 |
| or issuance for delivery of a new policy
or
contract of | 9 |
| insurance in this State.
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| (g) If (1) the policy is cancelled, and (2) another | 11 |
| insurance company
contracts to
provide group health and | 12 |
| accident insurance to the employer, and (3)
continuation
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| coverage is in effect for the dependent child at the time of | 14 |
| cancellation, and
(4) the
employee is or would have been | 15 |
| included under the new group policy, then the
new
insurer must | 16 |
| also offer continuation coverage to the dependent child under | 17 |
| the
same
terms and conditions as contained in this Section.
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| (h) This Section shall not limit the right of any dependent | 19 |
| child to
exercise the
privilege to convert to an individual | 20 |
| policy as contained in this Code.
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| (i) No person who obtains coverage under this Section shall | 22 |
| be required to
pay a
rate greater than that applicable to any | 23 |
| employee or member covered under that
group.
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| (Source: P.A. 93-477, eff. 1-1-04.)
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