Full Text of HB5018 96th General Assembly
HB5018 96TH GENERAL ASSEMBLY
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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010 HB5018
Introduced 1/21/2010, by Rep. Karen May SYNOPSIS AS INTRODUCED: |
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215 ILCS 5/367e |
from Ch. 73, par. 979e |
215 ILCS 125/4-9.2 |
from Ch. 111 1/2, par. 1409.2-2 |
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Amends the Illinois Insurance Code and the Health Maintenance Organization Act. Provides that continuation of and notice concerning group hospital, surgical, and major medical
coverage and group HMO coverage, with respect to an employee or member who is involuntarily terminated between September 1, 2008 and the end of the period set forth in the federal American Recovery and Reinvestment Act of 2009 (instead of December 31, 2009), shall be available if the employee or member was insured under the group policy or group contract on the day prior to the termination. Makes other changes. Effective immediately.
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A BILL FOR
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HB5018 |
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LRB096 18816 RPM 34202 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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| 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. With respect to an | 6 |
| employee or member who is involuntarily terminated between | 7 |
| September 1, 2008 and the end of the period set forth in | 8 |
| Section 3001(a)(3)(A) of Title III of Division B of the | 9 |
| federal American Recovery and Reinvestment Act of 2009, as | 10 |
| now or hereafter amended December 31, 2009 , continuation | 11 |
| shall be available if the employee or member was insured | 12 |
| under the group policy on the day prior to the termination.
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| 2. Continuation shall not be available for any person | 14 |
| who is covered by
Medicare, except for those individuals | 15 |
| who have been covered under a
group Medicare supplement | 16 |
| policy. Neither shall continuation be
available for any | 17 |
| person who is
covered by any other insured or uninsured | 18 |
| plan
which provides hospital, surgical or medical coverage | 19 |
| for individuals in
a group and under which the person was | 20 |
| not
covered immediately prior to such termination
or | 21 |
| reduction in hours below the minimum required by the group | 22 |
| plan
or who exercises his conversion
privilege under the | 23 |
| group policy.
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| 3. Continuation need not include dental, vision care, | 25 |
| prescription drug
benefits, disability income, specified | 26 |
| disease, or similar supplementary
benefits which are |
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| provided under the group policy in addition to its | 2 |
| hospital,
surgical or major medical benefits.
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| 4. Within 10 days after the employee's or member's | 4 |
| termination
or reduction in hours below the minimum | 5 |
| required by the group plan
written notice of continuation | 6 |
| shall be presented
to the employee or member by the | 7 |
| employer. If the employee or member is unavailable, written | 8 |
| notice shall be mailed by the employer to the
last known | 9 |
| address of the employee or member within 10 days after the | 10 |
| employee's or member's termination or reduction in hours | 11 |
| below the minimum required by the group plan. The employer | 12 |
| shall also send a copy of the notice to the insurer. An | 13 |
| employee or member who wishes
continuation
of coverage must | 14 |
| request such continuation in writing within the 30 day
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| period following the later of: (i) the date of such | 16 |
| termination
or reduction in hours below the minimum | 17 |
| required by the group plan, or (ii)
the date the employee | 18 |
| is presented or mailed written notice of the right of | 19 |
| continuation
by either the employer or the
group | 20 |
| policyholder. In no event, however, may the employee or | 21 |
| member elect
continuation more than 60 days after the date | 22 |
| of such termination
or reduction in hours below the minimum | 23 |
| required by the group plan.
Written notice of continuation | 24 |
| presented to the employee or member by the
policyholder, or | 25 |
| mailed by the policyholder to the last known address of
the | 26 |
| employee, shall constitute the giving of notice for the |
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| purpose of this
provision.
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| The insurer shall not deny coverage to the employee or | 3 |
| member due to the employer's failure to provide notice | 4 |
| pursuant to this Section to the employee or member. Until | 5 |
| the end of the period set forth in Section 3001(a)(3)(A) of | 6 |
| Title III of Division B of the federal American Recovery | 7 |
| and Reinvestment Act of 2009, as now or hereafter amended | 8 |
| January 1, 2010 , in the event the employee or member | 9 |
| contacts the insurer regarding continuation rights and | 10 |
| advises that notice has not been provided by the employer | 11 |
| or group policyholder, the insurer shall provide a written | 12 |
| explanation to the employee or member of the employee's or | 13 |
| member's continuation rights pursuant to this Section. | 14 |
| 4a. Unless contrary to the provisions of, or any rules | 15 |
| promulgated pursuant to , Section 3001(a)(7) of Title III of | 16 |
| Division B of the federal American Recovery and | 17 |
| Reinvestment Act of 2009, with respect to employees or | 18 |
| members of health plans that are subject solely to State | 19 |
| continuation coverage and who are terminated or whose | 20 |
| reduction in hours below the minimum required by the group | 21 |
| occurs between the effective date of this amendatory Act of | 22 |
| the 96th General Assembly and the end of the period set | 23 |
| forth in Section 3001(a)(3)(A) of Title III of Division B | 24 |
| of the federal American Recovery and Reinvestment Act of | 25 |
| 2009, as now or hereafter amended December 31, 2009 , the | 26 |
| notice requirements of this Section are not satisfied |
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| unless notice is presented or mailed to the employee or | 2 |
| member by the insurer informing the employee or member of | 3 |
| the availability of premium reduction with respect to such | 4 |
| coverage under the American Recovery and Reinvestment Act | 5 |
| of 2009. Such written notice shall conform to all | 6 |
| applicable requirements set forth in Section 3001(a)(7) of | 7 |
| Title III of Division B of the federal American Recovery | 8 |
| and Reinvestment Act of 2009. The Department shall publish | 9 |
| models for the notification that shall be provided by | 10 |
| insurers pursuant to this paragraph 4a. | 11 |
| 4b. Unless contrary to the provisions of, or any rules | 12 |
| promulgated pursuant to, Section 3001(a)(7) of Title III of | 13 |
| Division B of the federal American Recovery and | 14 |
| Reinvestment Act of 2009, with respect to employees or | 15 |
| members of health plans that are subject solely to State | 16 |
| continuation coverage who were terminated or whose | 17 |
| reduction in hours below the minimum required by the group | 18 |
| occurred between September 1, 2008 and the effective date | 19 |
| of this amendatory Act of the 96th General Assembly and who | 20 |
| have an election of continuation of coverage pursuant to | 21 |
| this Section in effect, notice shall be presented or mailed | 22 |
| to the employee or member by the insurer informing the | 23 |
| employee or member of the availability of premium reduction | 24 |
| with respect to such coverage under the federal American | 25 |
| Recovery and Reinvestment Act of 2009. Such written notice | 26 |
| shall conform to all applicable requirements set forth in |
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| Section 3001(a)(7) of Title III of Division B of the | 2 |
| federal American Recovery and Reinvestment Act of 2009 and | 3 |
| shall be presented or mailed to the employee or member | 4 |
| within 14 days of the effective date of this amendatory Act | 5 |
| of the 96th General Assembly. The Department shall publish | 6 |
| models for the notification that shall be provided by | 7 |
| insurers pursuant to this paragraph 4b.
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| 5. An employee or member electing continuation must pay | 9 |
| to the group
policyholder
or his employer, on a monthly | 10 |
| basis in advance, the total amount of premium
required by | 11 |
| the insurer, including that portion of the premium | 12 |
| contributed
by the policyholder or employer, if any, but | 13 |
| not more than the group rate
for the insurance being | 14 |
| continued with appropriate reduction in premium
for any | 15 |
| supplementary benefits which have been discontinued under | 16 |
| paragraph
(3) of this Section. The premium rate required by | 17 |
| the insurer shall be
the applicable premium required on the | 18 |
| 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 | 21 |
| Medicare or is covered
by any other insured or uninsured | 22 |
| plan which provides hospital, surgical
or medical coverage | 23 |
| for individuals in a group and under which
the person was | 24 |
| not covered immediately prior to such termination
or | 25 |
| reduction in hours below the minimum required by the group | 26 |
| plan
as provided
in condition
2 above or, if earlier, at |
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| the first to occur of the following:
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| (a) The date 12 months after the date the | 3 |
| employee's or member's
insurance
under the policy | 4 |
| would otherwise have terminated because of termination
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| of employment or membership
or reduction in hours below | 6 |
| the minimum required by the group plan or, with respect | 7 |
| to an employee or member who is an assistance eligible | 8 |
| individual as defined in Section 3001(a)(3) of Title | 9 |
| III of Division B of the federal American Recovery and | 10 |
| Reinvestment Act of 2009, the date that the individual | 11 |
| ceases to be eligible for premium assistance under | 12 |
| Section 3001(a)(2)(A)(ii)(I) of Title III of Division | 13 |
| B of the federal American Recovery and Reinvestment Act | 14 |
| of 2009, as now or hereafter amended .
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| (b) If the employee or member fails to make timely | 16 |
| payment of a required
contribution, the end of the | 17 |
| period for which contributions were made.
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| (c) The date on which the group policy is | 19 |
| terminated or, in the case of
an employee, the date his | 20 |
| employer terminates participation under the group
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| policy. However, if this (c) applies and the coverage | 22 |
| ceasing by reason of
such
termination is replaced by | 23 |
| similar coverage under another group policy,
the | 24 |
| following shall apply:
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| (i) The employee or member shall have the right | 26 |
| to become covered
under
that other group policy, |
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| for the balance of the period that he would have
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| remained covered under the prior group policy in | 3 |
| accordance with condition
6 had a termination | 4 |
| described in this (c) not occurred.
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| (ii) The prior group policy shall continue to | 6 |
| provide benefits to the
extent of its accrued | 7 |
| 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 | 10 |
| be included in each
certificate of coverage.
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| 8. Continuation shall not be available for any employee | 12 |
| who was
discharged because of the commission of a felony in | 13 |
| connection with his
work, or because of theft in connection | 14 |
| with his work, for which the
employer was in no way | 15 |
| responsible; provided the employee admitted his
commission | 16 |
| of the felony or theft or such act has resulted in a | 17 |
| conviction
or order of supervision by a court of competent | 18 |
| jurisdiction.
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| 9. An employee or member without an election of | 20 |
| continuation of coverage pursuant to this Section in effect | 21 |
| on the effective date of this amendatory Act of the 96th | 22 |
| General Assembly may elect continuation pursuant to this | 23 |
| paragraph 9 if the employee or member: (i) would be an | 24 |
| assistance eligible individual as defined in Section | 25 |
| 3001(a)(3) of Title III of Division B of the federal | 26 |
| American Recovery and Reinvestment Act of 2009, if such an |
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| election were in effect and (ii) at the time of termination | 2 |
| was eligible for continuation pursuant to paragraphs 1 and | 3 |
| 2 of this Section. | 4 |
| Unless contrary to the provisions of, or any rules | 5 |
| promulgated pursuant to, Section 3001(a)(7) of Title III of | 6 |
| Division B of the federal American Recovery and | 7 |
| Reinvestment Act of 2009, written notice of continuation | 8 |
| pursuant to this paragraph 9 shall be presented to the | 9 |
| employee or member by the insurer or mailed by the insurer | 10 |
| to the last known address of the employee or member within | 11 |
| 30 days after the effective date of this amendatory Act of | 12 |
| the 96th General Assembly. Such written notice shall | 13 |
| conform to all applicable requirements set forth in Section | 14 |
| 3001(a)(7) of Title III of Division B of the federal | 15 |
| American Recovery and Reinvestment Act of 2009. The | 16 |
| Department shall publish models for the notification that | 17 |
| shall be provided by insurers pursuant to this paragraph 9. | 18 |
| An employee or member electing continuation of | 19 |
| coverage under this paragraph 9 must request such | 20 |
| continuation in writing within 60 days after the date the | 21 |
| employee or member receives written notice of the right of | 22 |
| continuation by the insurer. | 23 |
| Continuation of coverage elected pursuant to this | 24 |
| paragraph 9 shall commence with the first period of | 25 |
| coverage beginning on or after February 17, 2009, the | 26 |
| effective date of the federal American Recovery and |
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| Reinvestment Act of 2009, and shall not extend beyond the | 2 |
| period of continuation that would have been required if the | 3 |
| coverage had been elected pursuant to paragraph 4 of this | 4 |
| Section. | 5 |
| With respect to an employee or member who elects | 6 |
| continuation of coverage under this paragraph 9, the period | 7 |
| beginning on the date of the employee's or member's | 8 |
| involuntary termination of employment and ending on the | 9 |
| date of the first period of coverage on or after February | 10 |
| 17, 2009 shall be disregarded for purposes of determining | 11 |
| the 63-day period referred to in Section 20 of the Illinois | 12 |
| Health Insurance Portability and Accountability Act. | 13 |
| The requirements of this amendatory Act of 1983 shall apply | 14 |
| to any group
policy as defined in this Section, delivered or | 15 |
| issued for delivery on or after
180 days following the | 16 |
| effective date of this amendatory Act of 1983.
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| The requirements of this amendatory Act of 1985 shall apply | 18 |
| to any
group policy as defined in this Section, delivered, | 19 |
| issued for delivery,
renewed or amended on or after 180 days | 20 |
| following the effective date of
this amendatory Act of 1985.
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| (Source: P.A. 96-13, eff. 6-18-09.)
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| Section 10. The Health Maintenance Organization Act is | 23 |
| amended by changing Section 4-9.2 as follows:
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| (215 ILCS 125/4-9.2) (from Ch. 111 1/2, par. 1409.2-2)
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| Sec. 4-9.2. Continuation of group HMO coverage after | 2 |
| termination of
employee or membership. A group contract | 3 |
| delivered, issued for delivery,
renewed, or amended in this | 4 |
| State that covers employees or members for health
care services | 5 |
| shall provide that employees or members whose coverage under
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| the group contract would otherwise terminate because of | 7 |
| termination of
employment or membership or because of a | 8 |
| reduction in hours below the minimum
required by the group | 9 |
| contract shall be entitled to continue their coverage
under
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| that group contract, for themselves and their eligible | 11 |
| dependents, subject
to all of the group contract's terms and | 12 |
| conditions applicable to those
forms of coverage and to the | 13 |
| following conditions:
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| (1) Continuation shall only be available to an employee | 15 |
| or member who has
been continuously covered under the group | 16 |
| contract (and for similar
benefits under any group contract | 17 |
| that it replaced) during the entire 3
month period ending | 18 |
| with the termination of employment or membership or
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| reduction in hours below the minimum required by the group | 20 |
| contract. With respect to an employee or member who is | 21 |
| involuntarily terminated between September 1, 2008 and the | 22 |
| end of the period set forth in Section 3001(a)(3)(A) of | 23 |
| Title III of Division B of the federal American Recovery | 24 |
| and Reinvestment Act of 2009, as now or hereafter amended | 25 |
| December 31, 2009 , continuation shall be available if the | 26 |
| employee or member was covered under the group contract the |
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| day prior to such termination.
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| (2) Continuation shall not be available for any | 3 |
| enrollee who is
covered by Medicare, except for those | 4 |
| individuals who have been covered
under a group Medicare | 5 |
| supplement policy. Continuation shall not be
available for | 6 |
| any enrollee who is covered by any other insured or | 7 |
| uninsured
plan that provides hospital, surgical, or | 8 |
| medical coverage for individuals
in a group and under which | 9 |
| the enrollee was not covered immediately
before | 10 |
| termination or reduction in hours below the minimum | 11 |
| required by the
group contract or who exercises his or her | 12 |
| conversion privilege under
the group policy.
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| (3) Continuation need not include dental, vision care, | 14 |
| prescription
drug, or similar supplementary benefits that | 15 |
| are provided under
the group contract in addition to its | 16 |
| basic health care services.
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| (4) Within 10 days after the employee's or member's | 18 |
| termination or reduction in hours below the minimum | 19 |
| required by
the group contract, written notice of | 20 |
| continuation shall be presented
to the employee or member | 21 |
| by the employer. If the employee or member is unavailable, | 22 |
| written notice shall be mailed by the employer to the last
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| known address of the employee or member within 10 days | 24 |
| after the employee's or member's termination or reduction | 25 |
| in hours below the minimum required by the group plan. The | 26 |
| employer shall also send a copy of the notice to the HMO. |
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| An employee or member who wishes
continuation of coverage | 2 |
| must request continuation in writing within
the 30 day | 3 |
| period following the later of (i) the date of termination | 4 |
| or
reduction in hours below the minimum required by the | 5 |
| group contract or (ii)
the date the employee is presented | 6 |
| or mailed written notice of the right of continuation by
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| either the employer or the group policyholder. In no event, | 8 |
| however, shall the
employee or member elect continuation | 9 |
| more than 60 days after the date of
termination
or | 10 |
| reduction in hours below the minimum required by the group | 11 |
| contract.
Written notice of continuation presented to the | 12 |
| employee or member
by the policyholder, or mailed by the | 13 |
| policyholder to the last known address of
the employee, | 14 |
| shall constitute the giving of notice for the purpose of | 15 |
| this
paragraph. | 16 |
| The HMO shall not deny coverage to the employee or | 17 |
| member due to the employer's failure to provide notice | 18 |
| pursuant to this Section to the employee or member. Until | 19 |
| the end of the period set forth in Section 3001(a)(3)(A) of | 20 |
| Title III of Division B of the federal American Recovery | 21 |
| and Reinvestment Act of 2009, as now or hereafter amended | 22 |
| January 1, 2010 , in the event the employee or member | 23 |
| contacts the HMO regarding continuation rights and advises | 24 |
| that notice has not been provided by the employer or group | 25 |
| policyholder, the HMO shall provide a written explanation | 26 |
| to the employee or member of the employee's or member's |
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| continuation rights pursuant to this Section. | 2 |
| (4a) Unless contrary to the provisions of, or any rules | 3 |
| promulgated pursuant to, Section 3001(a)(7) of Title III of | 4 |
| Division B of the federal American Recovery and | 5 |
| Reinvestment Act of 2009, with respect to employees or | 6 |
| members of health plans that are subject solely to State | 7 |
| continuation coverage and who are terminated or whose | 8 |
| reduction in hours below the minimum required by the group | 9 |
| occurs between the effective date of this amendatory Act of | 10 |
| the 96th General Assembly and the end of the period set | 11 |
| forth in Section 3001(a)(3)(A) of Title III of Division B | 12 |
| of the federal American Recovery and Reinvestment Act of | 13 |
| 2009, as now or hereafter amended December 31, 2009 , the | 14 |
| notice requirements of this Section are not satisfied | 15 |
| unless notice is presented or mailed to the employee or | 16 |
| member by the HMO informing the employee or member of the | 17 |
| availability of premium reduction with respect to such | 18 |
| coverage under the federal American Recovery and | 19 |
| Reinvestment Act of 2009. Such written notice shall conform | 20 |
| to all applicable requirements set forth in Section | 21 |
| 3001(a)(7) of Title III of Division B of the federal | 22 |
| American Recovery and Reinvestment Act of 2009. The | 23 |
| Department shall publish models for the notification that | 24 |
| shall be provided by HMOs pursuant to this paragraph (4a). | 25 |
| (4b) Unless contrary to the provisions of, or any rules | 26 |
| promulgated pursuant to, Section 3001(a)(7) of Title III of |
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| Division B of the federal American Recovery and | 2 |
| Reinvestment Act of 2009, with respect to employees or | 3 |
| members of health plans that are subject solely to State | 4 |
| continuation coverage who were terminated or whose | 5 |
| reduction in hours below the minimum required by the group | 6 |
| occurred between September 1, 2008, and the effective date | 7 |
| of this amendatory Act of the 96th General Assembly and who | 8 |
| have an election of continuation of coverage pursuant to | 9 |
| this Section in effect, notice shall be presented or mailed | 10 |
| to the employee or member by the HMO informing the employee | 11 |
| or member of the availability of premium reduction with | 12 |
| respect to such coverage under the federal American | 13 |
| Recovery and Reinvestment Act of 2009. Such written notice | 14 |
| shall conform to all applicable requirements set forth in | 15 |
| Section 3001(a)(7) of Title III of Division B of the | 16 |
| federal American Recovery and Reinvestment Act of 2009 and | 17 |
| shall be presented or mailed to the employee or member | 18 |
| within 14 days of the effective date of this amendatory Act | 19 |
| of the 96th General Assembly. The Department shall publish | 20 |
| models for the notification that shall be provided by HMOs | 21 |
| pursuant to this paragraph (4b).
| 22 |
| (5) An employee or member electing continuation must | 23 |
| pay to the group
policyholder or his employer, on a monthly | 24 |
| basis in advance, the total
amount of premium required by | 25 |
| the HMO, including that portion of the
premium contributed | 26 |
| by the policyholder or employer, if any, but not more
than |
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| the group rate for the coverage being continued with | 2 |
| appropriate
reduction in premium for any supplementary | 3 |
| benefits that have been
discontinued under paragraph (3) of | 4 |
| this Section. The premium rate required
by the HMO shall be | 5 |
| the applicable premium required on the due date of each
| 6 |
| payment.
| 7 |
| (6) Continuation of coverage under the group contract | 8 |
| for any person
shall terminate when the person becomes | 9 |
| eligible for Medicare or is covered by
any other insured or | 10 |
| uninsured plan that provides hospital, surgical, or
| 11 |
| medical coverage for individuals in a group and under which | 12 |
| the person was not
covered immediately before termination
| 13 |
| or reduction in hours below the minimum required by the | 14 |
| group contract
as provided in paragraph (2) of this
Section | 15 |
| or, if earlier, at the first to occur of the following:
| 16 |
| (a) The expiration of 12 months after the | 17 |
| employee's or member's coverage
because of termination | 18 |
| of employment or membership
or reduction in hours below | 19 |
| the minimum required by the group contract.
| 20 |
| (b) If the employee or member fails to make timely | 21 |
| payment of a
required contribution, the end of the | 22 |
| period for which contributions were made or, with | 23 |
| respect to an employee or member who is an assistance | 24 |
| eligible individual as defined in Section 3001(a)(3) | 25 |
| of Title III of Division B of the federal American | 26 |
| Recovery and Reinvestment Act of 2009, the date that |
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| the individual ceases to be eligible for premium | 2 |
| assistance under Section 3001(a)(2)(A)(ii)(I) of Title | 3 |
| III of Division B of the federal American Recovery and | 4 |
| Reinvestment Act of 2009, as now or hereafter amended .
| 5 |
| (c) The date on which the group contract is | 6 |
| terminated or, in the
case of an employee, the date his | 7 |
| or her employer terminates participation
under the | 8 |
| group contract. If, however, this paragraph applies | 9 |
| and the coverage
ceasing by reason of termination is | 10 |
| replaced by similar coverage under another
group | 11 |
| contract, then (i) the employee or member shall have | 12 |
| the right to become
covered under the replacement group | 13 |
| contract for the balance of the period that
he or she | 14 |
| would have remained covered under the prior group | 15 |
| contract in
accordance with paragraph (6) had a | 16 |
| termination described in this item (c) not
occurred and | 17 |
| (ii) the prior group contract shall continue to provide | 18 |
| benefits
to the extent of its accrued liabilities and | 19 |
| extensions of benefits as if the
replacement had not | 20 |
| occurred.
| 21 |
| (7) A notification of the continuation privilege shall | 22 |
| be included in
each evidence of coverage.
| 23 |
| (8) Continuation shall not be available for any | 24 |
| employee who was
discharged because of the commission of a | 25 |
| felony in connection with his or her
work, or because of | 26 |
| theft in connection with his or her work, for which the
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| 1 |
| employer was in no way responsible if the employee (i) | 2 |
| admitted to
committing the felony or theft or (ii) was | 3 |
| convicted or placed under
supervision by a court of | 4 |
| competent jurisdiction.
| 5 |
| (9) An employee or member without an election of | 6 |
| continuation of coverage pursuant to this Section in effect | 7 |
| on the effective date of this amendatory Act of the 96th | 8 |
| General Assembly may elect continuation pursuant to this | 9 |
| paragraph (9) if the employee or member: (i) would be an | 10 |
| assistance eligible individual as defined in Section | 11 |
| 3001(a)(3) of Title III of Division B of the federal | 12 |
| American Recovery and Reinvestment Act of 2009 if such an | 13 |
| election were in effect and (ii) at the time of termination | 14 |
| was eligible for continuation pursuant to paragraphs (1) | 15 |
| and (2) of this Section. | 16 |
| Unless contrary to the provisions of, or any rules | 17 |
| promulgated pursuant to, Section 3001(a)(7) of Title III of | 18 |
| Division B of the federal American Recovery and | 19 |
| Reinvestment Act of 2009, written notice of continuation | 20 |
| pursuant to this paragraph (9) shall be presented to the | 21 |
| employee or member by the HMO or mailed by the HMO to the | 22 |
| last known address of the employee or member within 30 days | 23 |
| after the effective date of this amendatory Act of the 96th | 24 |
| General Assembly. The written notice shall conform to all | 25 |
| applicable requirements set forth in Section 3001(a)(7) of | 26 |
| Title III of Division B of the federal American Recovery |
|
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LRB096 18816 RPM 34202 b |
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| 1 |
| and Reinvestment Act of 2009. The Department shall publish | 2 |
| models for the notification that shall be provided by HMOs | 3 |
| pursuant to this paragraph (9). | 4 |
| An employee or member electing continuation of | 5 |
| coverage under this paragraph (9) must request such | 6 |
| continuation in writing within 60 days after the date the | 7 |
| employee or member receives written notice of the right of | 8 |
| continuation by the HMO. | 9 |
| Continuation of coverage elected pursuant to this | 10 |
| paragraph (9) shall commence with the first period of | 11 |
| coverage beginning on or after February 17, 2009, the | 12 |
| effective date of the federal American Recovery and | 13 |
| Reinvestment Act of 2009, and shall not extend beyond the | 14 |
| period of continuation that would have been required if the | 15 |
| coverage had been elected pursuant to paragraph (4) of this | 16 |
| Section. | 17 |
| With respect to an employee or member who elects | 18 |
| continuation of coverage under this paragraph (9), the | 19 |
| period beginning on the date of the employee or member's | 20 |
| involuntary termination of employment and ending on the | 21 |
| date of the first period of coverage on or after February | 22 |
| 17, 2009 shall be disregarded for purposes of determining | 23 |
| the 63-day period referred to in Section 20 of the Illinois | 24 |
| Health Insurance Portability and Accountability Act. | 25 |
| The requirements of this amendatory Act of 1992 shall apply | 26 |
| to any
group contract, as defined in this Section, delivered or |
|
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| 1 |
| issued for
delivery on or after 180 days following the | 2 |
| effective date of this
amendatory Act of 1992.
| 3 |
| (Source: P.A. 96-13, eff. 6-18-09.)
| 4 |
| Section 99. Effective date. This Act takes effect upon | 5 |
| becoming law.
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|