Full Text of SB0005 95th General Assembly
SB0005sam004 95TH GENERAL ASSEMBLY
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Sen. Carol Ronen
Filed: 5/24/2007
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LRB095 08883 DRJ 36949 a |
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| AMENDMENT TO SENATE BILL 5
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| AMENDMENT NO. ______. Amend Senate Bill 5, AS AMENDED, with | 3 |
| reference to page and line numbers of Senate Amendment No. 1, | 4 |
| on page 68, after line 23, by inserting the following:
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| "Section 15-15. The State Employees Group Insurance Act of | 6 |
| 1971 is amended by adding Section 6.16 as follows: | 7 |
| (5 ILCS 375/6.16 new) | 8 |
| Sec. 6.16. Coverage of dependents until age 30. | 9 |
| (a) A group health insurance policy that provides coverage | 10 |
| for a dependent of a State member, as defined in this Act, | 11 |
| under which coverage of a dependent terminates at a specific | 12 |
| age before the dependent's 30th birthday, and is delivered, | 13 |
| issued, executed, or renewed in this State after January 1, | 14 |
| 2008, shall, upon application of the dependent as set forth in | 15 |
| subsection (c) of this Section, provide health insurance | 16 |
| coverage, excluding dental, life, and vision coverage, to the |
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| dependent after that specific age until the
dependent's 30th | 2 |
| birthday. As used in this Section, "dependent" means any State | 3 |
| member's child by blood or by law who: | 4 |
| (1) is less than 30 years of age; | 5 |
| (2) is unmarried; | 6 |
| (3) is a resident of this State or is enrolled as a | 7 |
| full-time student at an accredited public or private | 8 |
| institution of higher education; and | 9 |
| (4) is not actually provided coverage as a named | 10 |
| subscriber, insured, enrollee, or covered person under any | 11 |
| other group or individual health benefits plan, group | 12 |
| health plan, church plan, or health benefits plan, or | 13 |
| entitled to benefits under Title XVIII of the Social | 14 |
| Security Act, Pub.L. 89-97 (42 U.S.C. 1395 et seq.). | 15 |
| (b) Nothing in this Section shall be construed to require | 16 |
| that: | 17 |
| (1)
coverage for services be provided to dependents | 18 |
| before January 1,
2008; or | 19 |
| (2) an insurer pay all or part of the cost of coverage | 20 |
| for
dependents as provided pursuant to this Section. | 21 |
| (c) Application for dependent coverage. | 22 |
| (1) A dependent covered by any health insurance policy, | 23 |
| which coverage under the policy terminates at a specific | 24 |
| age before the dependent's 30th birthday, may make
a | 25 |
| written election for coverage as a dependent pursuant to | 26 |
| this Section, until the dependent's 30th birthday, at any |
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| of the following times: | 2 |
| (A) within 30 days prior to the termination of | 3 |
| coverage at the specific age provided in the policy; | 4 |
| (B) within 30 days after meeting the requirements | 5 |
| for dependent status as set forth in subsection (a) of | 6 |
| this Section, when coverage for the dependent under the | 7 |
| policy previously terminated; or | 8 |
| (C) during an open enrollment period, as provided | 9 |
| pursuant to the policy, if the dependent meets the | 10 |
| requirements for dependent status as set forth in | 11 |
| subsection (a) of this Section during the open | 12 |
| enrollment period. | 13 |
| (2) For 12 months after January 1, 2008, a dependent | 14 |
| who qualifies for dependent status as set forth in | 15 |
| subsection (a) of this Section, but whose coverage as a | 16 |
| dependent terminated under the terms of the policy prior to | 17 |
| January 1, 2008, may make a written election to reinstate | 18 |
| coverage under the policy as a dependent pursuant to this | 19 |
| subsection. | 20 |
| (3) Coverage for a dependent who makes a written | 21 |
| election for coverage pursuant to this subsection shall | 22 |
| consist of coverage that is identical to the health | 23 |
| insurance coverage provided to that dependent prior to the | 24 |
| termination of coverage at the specific age provided in the | 25 |
| policy. If the health insurance coverage was modified under | 26 |
| the policy for any similarly situated dependents prior to |
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| their termination of coverage at the specific age provided | 2 |
| in the policy, the health insurance coverage shall also be | 3 |
| modified in the same manner for the dependent seeking | 4 |
| reinstatement. | 5 |
| (4) Coverage for a dependent who makes a written | 6 |
| election for coverage pursuant to this subsection shall not | 7 |
| be conditioned upon, or discriminate on the basis of, lack | 8 |
| of evidence of insurability. | 9 |
| (d) Premium payments. | 10 |
| (1) The policy of insurance pursuant to this Section | 11 |
| shall require payment of a premium by the State member or | 12 |
| dependent, as appropriate, for any period of coverage | 13 |
| relating to a dependent's written election for coverage | 14 |
| pursuant to subsection (c). The
premium shall be no less | 15 |
| than 100% and shall not exceed 105% of the cost of such | 16 |
| coverage as determined by the Department of Healthcare and | 17 |
| Family Services. | 18 |
| (2) Payments of the premium may, at the election of the | 19 |
| State member, be made in monthly or semi-monthly | 20 |
| installments through payroll deduction or direct payment. | 21 |
| (e) Coverage for a dependent provided pursuant to this
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| Section shall be provided until the earlier of the following: | 23 |
| (1) the dependent is disqualified for dependent status | 24 |
| as set forth in subsection (a) of this Section; | 25 |
| (2) the date on which coverage ceases under the policy | 26 |
| by reason of a failure to make a timely payment of any |
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| premium required under the policy by the State member or | 2 |
| dependent for coverage provided pursuant to this Section; | 3 |
| the payment of any premium shall be considered to be timely | 4 |
| if made within 30 days after the due date or within a | 5 |
| longer period as may be provided for by the policy; or | 6 |
| (3) the date upon which the insurer ceases to provide | 7 |
| coverage to the State member. | 8 |
| Nothing in this subsection (e) shall be construed to permit | 9 |
| the insurer to refuse a written election for coverage by a | 10 |
| dependent pursuant to subsection (c) of this Section, based | 11 |
| upon the dependent's prior disqualification pursuant to | 12 |
| paragraph (1) of this subsection (e). | 13 |
| (f) Notice regarding coverage for a dependent as provided | 14 |
| pursuant
to this Section shall be provided by the insurer: | 15 |
| (1) on or before the coverage of a State member's | 16 |
| dependent terminates at the specific age as provided in the | 17 |
| policy; | 18 |
| (2) at the time coverage of the dependent is no longer | 19 |
| provided pursuant to this Section because the dependent is | 20 |
| disqualified for dependent status as set forth in | 21 |
| subsection (a) of this Section, except that this notice | 22 |
| shall not be required when a dependent no longer qualifies | 23 |
| based upon paragraph
(1) or (3) of subsection (a) of this | 24 |
| Section; | 25 |
| (3) before any open enrollment period permitting a | 26 |
| dependent to make a written election for coverage pursuant |
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| to subsection (c) of this Section; and | 2 |
| (4) immediately following January 1, 2008, prior to any | 3 |
| subsequent open enrollment period, as provided for by the | 4 |
| policy, to make a written election to reinstate coverage | 5 |
| under the policy pursuant to paragraph (2) of subsection | 6 |
| (c) of this Section. ".
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