Full Text of HB4830 95th General Assembly
HB4830 95TH GENERAL ASSEMBLY
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95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008 HB4830
Introduced , by Rep. Karen May SYNOPSIS AS INTRODUCED: |
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215 ILCS 5/367e |
from Ch. 73, par. 979e |
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Amends the Illinois Insurance Code. Provides that an employee or member or the
eligible dependent of an employee or member is eligible for continuing coverage under a group insurance policy for up to 12 months (instead of 9 months) after the date the employee's or member's
insurance
under the policy would otherwise have terminated because of termination
of employment or membership
or reduction in hours below the minimum required by the group plan. Provides that employer must give written notice of the employee's option to elect continuation coverage directly to the employee or send the notice to the employee via certified mail within 10 days after the employee's termination or reduction in hours below the minimum required by the group plan. Provides that an employee or member who wishes
continuation
of coverage must request such continuation in writing within the 30 day (instead of ten-day)
period following the later of: (i) the date of such termination
or reduction in hours below the minimum required by the group plan, or (ii)
the date the employee is given written notice of the right of continuation
by either the employer or the
group policyholder. Provides that the written notice provided to an employee must include an explanation that his or her option for continuation coverage will expire within the 30 day period following the later of (i) the date of such termination of employment or reduction in hours below the minimum required by the group plan, or (ii) the date the employee is given written notice of the right of continuation by either the employer or group policyholder. Provides that any employer who fails to provide the notice required in the provision is guilty of a petty offense and shall be fined $500. Effective immediately.
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| FISCAL NOTE ACT MAY APPLY | |
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A BILL FOR
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HB4830 |
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LRB095 17861 KBJ 43941 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 Section 367e as follows:
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| (215 ILCS 5/367e) (from Ch. 73, par. 979e)
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| 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
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| 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:
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| 1. Continuation shall only be available to an employee |
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HB4830 |
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LRB095 17861 KBJ 43941 b |
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| 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.
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| 2. Continuation shall not be available for any person | 7 |
| who is covered by
Medicare, except for those individuals | 8 |
| who have been covered under a
group Medicare supplement | 9 |
| policy. Neither shall continuation be
available for any | 10 |
| person who is
covered by any other insured or uninsured | 11 |
| plan
which provides hospital, surgical or medical coverage | 12 |
| for individuals in
a group and under which the person was | 13 |
| not
covered immediately prior to such termination
or | 14 |
| reduction in hours below the minimum required by the group | 15 |
| plan
or who exercises his conversion
privilege under the | 16 |
| group policy.
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| 3. Continuation need not include dental, vision care, | 18 |
| prescription drug
benefits, disability income, specified | 19 |
| disease, or similar supplementary
benefits which are | 20 |
| provided under the group policy in addition to its | 21 |
| hospital,
surgical or major medical benefits.
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| 4. Upon termination
or reduction in hours below the | 23 |
| minimum required by the group plan
written notice of | 24 |
| continuation shall be presented
to the employee or member | 25 |
| by the employer or mailed by the employer to the
last known | 26 |
| address of the employee. This written notice must be given |
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HB4830 |
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LRB095 17861 KBJ 43941 b |
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| directly to the employee or sent via certified mail within | 2 |
| 10 days after the employee's termination or reduction in | 3 |
| hours below the minimum required by the group plan. An | 4 |
| employee or member who wishes
continuation
of coverage must | 5 |
| request such continuation in writing within the 30 | 6 |
| day ten-day
period following the later of: (i) the date of | 7 |
| such termination
or reduction in hours below the minimum | 8 |
| required by the group plan, or (ii)
the date the employee | 9 |
| is given written notice of the right of continuation
by | 10 |
| either the employer or the
group policyholder. In no event, | 11 |
| however, may the employee or member elect
continuation more | 12 |
| than 60 days after the date of such termination
or | 13 |
| reduction in hours below the minimum required by the group | 14 |
| plan. The written notice provided to an employee must | 15 |
| include an explanation that his or her option for | 16 |
| continuation coverage will expire within the 30 day period | 17 |
| following the later of (i) the date of such termination of | 18 |
| employment or reduction in hours below the minimum required | 19 |
| by the group plan, or (ii) the date the employee is given | 20 |
| written notice of the right of continuation by either the | 21 |
| employer or group policyholder.
Written notice of | 22 |
| continuation presented to the employee or member by the
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| policyholder, or mailed by the policyholder to the last | 24 |
| known address of
the employee, shall constitute the giving | 25 |
| of notice for the purpose of this
provision.
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| Any employer who fails to provide the notice required in |
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LRB095 17861 KBJ 43941 b |
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| this subsection 4. is guilty of a petty offense and shall be | 2 |
| fined $500.
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| 5. An employee or member electing continuation must pay | 4 |
| to the group
policyholder
or his employer, on a monthly | 5 |
| basis in advance, the total amount of premium
required by | 6 |
| the insurer, including that portion of the premium | 7 |
| contributed
by the policyholder or employer, if any, but | 8 |
| not more than the group rate
for the insurance being | 9 |
| continued with appropriate reduction in premium
for any | 10 |
| supplementary benefits which have been discontinued under | 11 |
| paragraph
(3) of this Section. The premium rate required by | 12 |
| the insurer shall be
the applicable premium required on the | 13 |
| due date of each payment.
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| 6. Continuation of insurance under the group policy for
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| any person shall terminate when he becomes eligible for | 16 |
| Medicare or is covered
by any other insured or uninsured | 17 |
| plan which provides hospital, surgical
or medical coverage | 18 |
| for individuals in a group and under which
the person was | 19 |
| not covered immediately prior to such termination
or | 20 |
| reduction in hours below the minimum required by the group | 21 |
| plan
as provided
in condition
2 above or, if earlier, at | 22 |
| the first to occur of the following:
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| (a) The date 12 9 months after the date the | 24 |
| employee's or member's
insurance
under the policy | 25 |
| would otherwise have terminated because of termination
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| of employment or membership
or reduction in hours below |
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LRB095 17861 KBJ 43941 b |
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| the minimum required by the group plan.
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| (b) If the employee or member fails to make timely | 3 |
| payment of a required
contribution, the end of the | 4 |
| period for which contributions were made.
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| (c) The date on which the group policy is | 6 |
| terminated or, in the case of
an employee, the date his | 7 |
| employer terminates participation under the group
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| policy. However, if this (c) applies and the coverage | 9 |
| ceasing by reason of
such
termination is replaced by | 10 |
| similar coverage under another group policy,
the | 11 |
| following shall apply:
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| (i) The employee or member shall have the right | 13 |
| to become covered
under
that other group policy, | 14 |
| for the balance of the period that he would have
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| remained covered under the prior group policy in | 16 |
| accordance with condition
6 had a termination | 17 |
| described in this (c) not occurred.
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| (ii) The prior group policy shall continue to | 19 |
| provide benefits to the
extent of its accrued | 20 |
| liabilities and extensions of benefits as if the
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| replacement
had not occurred.
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| 7. A notification of the continuation privilege shall | 23 |
| be included in each
certificate of coverage.
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| 8. Continuation shall not be available for any employee | 25 |
| who was
discharged because of the commission of a felony in | 26 |
| connection with his
work, or because of theft in connection |
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| with his work, for which the
employer was in no way | 2 |
| responsible; provided the employee admitted his
commission | 3 |
| of the felony or theft or such act has resulted in a | 4 |
| conviction
or order of supervision by a court of competent | 5 |
| jurisdiction.
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| The requirements of this amendatory Act of 1983 shall apply | 7 |
| to any group
policy as defined in this Section, delivered or | 8 |
| issued for delivery on or after
180 days following the | 9 |
| effective date of this amendatory Act of 1983.
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| The requirements of this amendatory Act of 1985 shall apply | 11 |
| to any
group policy as defined in this Section, delivered, | 12 |
| issued for delivery,
renewed or amended on or after 180 days | 13 |
| following the effective date of
this amendatory Act of 1985.
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| (Source: P.A. 93-477, eff. 1-1-04.)
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| Section 99. Effective date. This Act takes effect upon | 16 |
| becoming law.
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