Section 125.260  Adding Children to the Program and Changes in Participation

a)         Families may add eligible children to the Program during the 12-month eligibility period, without eligibility being reviewed by the Department. Coverage for children added shall be prospective from the effective date determined according to Section 125.240(e) and shall continue for the remainder of the family's original 12-month eligibility period and may also include any prior coverage established pursuant to Section 125.240(f).

b)         Premium amounts under the KidCare Health Plan and Rebates under KidCare Rebate will be adjusted to reflect adding or removing a child from the Program.

c)         A child who would otherwise be terminated from KidCare Rebate because of losing private or employer-sponsored health insurance may change coverage to the KidCare Health Plan without eligibility being reviewed by the Department if there is no unpaid Rebate overpayment.  Coverage under the KidCare Health Plan shall be prospective from the effective date determined according to Section 125.240(e) and shall continue for the remainder of the existing 12-month eligibility period.  However, at the time of the change in coverage, a family may choose to have the KidCare Share or/Premium coverage retroactive to the first day of the first month following the last month of coverage under the private or employer sponsored insurance if the family refunds within 30 days after the Department's notice that the child's coverage has been changed to KidCare Health Plan any Rebate payment received for a month in which there was no private or employer based insurance coverage, notwithstanding Section 125.445(c).

d)         A child with significant health insurance may choose to change coverage from the KidCare Health Plan to KidCare Rebate without eligibility being reviewed by the Department if the family returns a Rebate form and there are no unpaid premiums owed to the Department. Coverage under KidCare Rebate shall be prospective from the effective date determined according to Section 125.240(e), following receipt by the Department of a completed Rebate Form and shall continue for the remainder of the existing 12-month eligibility period.

(Source:  Amended at 30 Ill. Reg. 10328, effective May 26, 2006)