Full Text of HB2624 100th General Assembly
HB2624sam001 100TH GENERAL ASSEMBLY | Sen. Heather A. Steans Filed: 5/9/2018
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| 1 | | AMENDMENT TO HOUSE BILL 2624
| 2 | | AMENDMENT NO. ______. Amend House Bill 2624 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Short-Term, Limited-Duration Health Insurance Coverage Act. | 6 | | Section 5. Definitions. In this Act: | 7 | | "Department" means the Department of Insurance. | 8 | | "Group health insurance coverage" means, in connection | 9 | | with a group health plan, health insurance coverage offered in | 10 | | connection with the plan. | 11 | | "Group health plan" means an employee welfare benefit plan | 12 | | (as defined in Section 3(1) of the federal Employee Retirement | 13 | | Income Security Act of 1974) to the extent that the plan | 14 | | provides medical care (as defined in paragraph (2) of that | 15 | | Section and including items and services paid for as medical | 16 | | care) to employees or their dependents (as defined under the |
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| 1 | | terms of the plan) directly or through insurance, | 2 | | reimbursement, or otherwise. | 3 | | "Health insurance coverage" means benefits consisting of | 4 | | medical care (provided directly, through insurance or | 5 | | reimbursement, or otherwise and including items and services | 6 | | paid for as medical care) under any hospital or medical service | 7 | | policy or certificate, hospital or medical service plan | 8 | | contract, or health maintenance organization contract offered | 9 | | by a health insurance issuer. | 10 | | "Health insurance issuer" means an insurance company, | 11 | | insurance service, or insurance organization (including a | 12 | | health maintenance organization) that is licensed to engage in | 13 | | the business of insurance in a state and that is subject to | 14 | | Illinois law that regulates insurance (within the meaning of | 15 | | Section 514(b)(2) of the federal Employee Retirement Income | 16 | | Security Act of 1974). "Health insurance issuer" does not | 17 | | include a group health plan. | 18 | | "Fraud" means an intentional misrepresentation of a | 19 | | material fact in connection with the coverage. | 20 | | "Individual health insurance coverage" means health | 21 | | insurance coverage offered to individuals in the individual | 22 | | market, including short-term, limited-duration health | 23 | | insurance coverage. | 24 | | "Short-term, limited-duration health insurance coverage" | 25 | | means individual health insurance coverage provided under a | 26 | | contract offered by a licensed health insurance issuer, |
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| 1 | | regardless of the situs of the delivery of the policy or | 2 | | contract that has a specified, limited-duration. | 3 | | Section 10. Application; scope; duration of coverage. | 4 | | (a) This Act applies to health insurance issuers that offer | 5 | | short-term, limited-duration health insurance coverage to | 6 | | individuals in this State and to short-term, limited-duration | 7 | | health insurance coverage that is delivered or issued for | 8 | | delivery in this State, including coverage issued outside of | 9 | | this State that covers individuals in this State. | 10 | | (b) A short-term, limited-duration health insurance | 11 | | coverage policy (even where issued outside of this State) may | 12 | | not cover any person residing in this State or be delivered or | 13 | | issued for delivery in this State unless the policy complies | 14 | | with the provisions of this Act. | 15 | | (c) Any short-term, limited-duration health insurance | 16 | | coverage policy that is delivered or issued for delivery in | 17 | | this State must have an expiration date in the contract that is | 18 | | less than 91 days and shall not be renewable within a period of | 19 | | 365 days, beginning the day after the contract ends, either at | 20 | | the option of the issuer or the individual. Renewal of a | 21 | | short-term, limited-duration health insurance coverage policy | 22 | | includes the issuance of a new short-term, limited-duration | 23 | | health insurance policy by an issuer to a policyholder within | 24 | | 60 days after the expiration of a policy previously issued by | 25 | | the issuer to the policyholder. |
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| 1 | | (d) Any short-term, limited-duration health insurance | 2 | | coverage policy that is delivered or issued for delivery in | 3 | | this State may not be rescinded before the expiration date in | 4 | | the contract, except in cases of nonpayment of premiums or | 5 | | fraud. | 6 | | Section 15. Disclosure requirements. | 7 | | (a) A health insurance issuer that offers short-term, | 8 | | limited-duration health insurance coverage shall, in addition | 9 | | to all other documents required, including, but not limited to, | 10 | | the policy, the certificate, the membership booklet, and a | 11 | | description of appeal and external review rights, deliver an | 12 | | outline of coverage to an applicant for or an enrollee in | 13 | | short-term, limited-duration health insurance coverage | 14 | | delivered or issued for delivery in this State. | 15 | | (b) Any short-term, limited-duration health insurance | 16 | | coverage policy that is delivered or issued for delivery in the | 17 | | State shall display prominently in the contract, any | 18 | | application, sales, and marketing materials provided in | 19 | | connection with enrollment in such coverage, and the outline of | 20 | | coverage for such coverage, in at least 14-point, bold type, | 21 | | the following: "WARNING! This plan may not cover all of the | 22 | | health care you need and may leave you with very high medical | 23 | | bills. If you buy this plan, you may not be able to get more | 24 | | complete insurance when this contract ends. You may be able to | 25 | | get more complete insurance now and help to pay for it at |
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| 1 | | www.healthcare.gov.". | 2 | | (c) Any short-term, limited-duration health insurance | 3 | | coverage policy that is delivered or issued for delivery in | 4 | | this State shall display prominently in the footer on every | 5 | | page of the contract, in any application, sales, and marketing | 6 | | materials provided in connection with enrollment in such | 7 | | coverage, and in the outline of coverage for such coverage, in | 8 | | at least 14-point, bold type, the following: "WARNING! This is | 9 | | temporary coverage. This policy provides limited benefits.". | 10 | | (d) Any identification card for short-term, | 11 | | limited-duration health insurance coverage that is delivered | 12 | | or issued for delivery in this State must prominently display | 13 | | the following in bold type: "WARNING! This is temporary | 14 | | coverage. This policy provides limited benefits.". | 15 | | (e) Any individual selling a short-term, limited-duration | 16 | | health insurance coverage policy in this State must read out | 17 | | loud the disclosure in subsection (b) to a prospective | 18 | | purchaser. | 19 | | Section 20. Filing and approval. | 20 | | (a) Coverage subject to this Act may not be delivered or | 21 | | issued for delivery unless it has been approved by the | 22 | | Department. | 23 | | (b) A health insurance issuer who intends to deliver or | 24 | | issue for delivery a short-term, limited-duration health | 25 | | insurance coverage policy in this State shall file with the |
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| 1 | | Department: | 2 | | (1) all paperwork required by health insurance issuers | 3 | | of individual health insurance coverage; | 4 | | (2) all sales and marketing materials provided in | 5 | | connection with enrollment in such coverage; and | 6 | | (3) the outline of such coverage. | 7 | | (c) The Department shall adopt any rules necessary to carry | 8 | | out the provisions of this Act. | 9 | | (d) The Department shall adopt any rules necessary to | 10 | | protect Illinois consumers and promote the stability of | 11 | | Illinois' health insurance markets. | 12 | | Section 25. Illinois Insurance Code and benefit | 13 | | requirements. | 14 | | (a) Short-term, limited-duration coverage shall be subject | 15 | | to Sections 143c, 155.36, 355, 356a, 356b, 356c, 356e, 356f, | 16 | | 356g, 356g.5, 356g.5-1, 356h, 356i, 356k, 356L, 356m, 356n, | 17 | | 356p, 356q, 356r, 356s, 356t, 356u, 356v, 356w, 356x, 356z.1, | 18 | | 356z.2, 356z.3a, 356z.4, 356z.5, 356z.6, 356z.7, 356z.8, | 19 | | 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, | 20 | | 356z.17, 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.24, | 21 | | 356z.25, 356z.25, 364, 364.01, 367b, 367k, 370a, and 370c, | 22 | | subsections (7) and (8) of Section 367, and subsection (a) of | 23 | | Section 370i of the Illinois Insurance Code. | 24 | | (b) Short-term, limited-duration coverage shall also be | 25 | | subject to the provisions of the Network Adequacy and |
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| 1 | | Transparency Act, the Managed Care Reform and Patients Rights | 2 | | Act, the Topical Eye Medication Prescription Act, the Organ | 3 | | Transplant Medication Notification Act, and the Health Carrier | 4 | | External Review Act. | 5 | | Section 90. The Illinois Insurance Code is amended by | 6 | | changing Section 356z.16 and by changing and renumbering | 7 | | Section 356z.25 (as added by Public Act 100-386) as follows: | 8 | | (215 ILCS 5/356z.16) | 9 | | Sec. 356z.16. Applicability of mandated benefits to | 10 | | supplemental policies. Unless specified otherwise, the | 11 | | following Sections of the Illinois Insurance Code do not apply | 12 | | to short-term travel, disability income, long-term care, | 13 | | accident only, or limited (excluding short-term, | 14 | | limited-duration health insurance coverage policies as defined | 15 | | in the Short-Term, Limited-Duration Health Insurance Coverage | 16 | | Act) or specified disease policies: 355b, 356b, 356c, 356d, | 17 | | 356g, 356k, 356m, 356n, 356p, 356q, 356r, 356t, 356u, 356w, | 18 | | 356x, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.12, | 19 | | 356z.14, 356z.19, 356z.21, 356z.25, 356z.27, 364.01, 367.2-5, | 20 | | and 367e.
| 21 | | (Source: P.A. 100-386, eff. 1-1-18 .) | 22 | | (215 ILCS 5/356z.27) | 23 | | Sec. 356z.27 356z.25 . Preexisting condition exclusion. No |
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| 1 | | policy of individual or group accident and health insurance | 2 | | issued, amended, delivered, or renewed on or after January 1, | 3 | | 2018 ( the effective date of Public Act 100-386) this amendatory | 4 | | Act of the 100th General Assembly may impose any preexisting | 5 | | condition exclusion, as defined in the Illinois Health | 6 | | Insurance Portability and Accountability Act, with respect to | 7 | | such plan or coverage. | 8 | | No policy of short-term, limited-duration health insurance | 9 | | coverage as defined in the Short-Term, Limited-Duration Health | 10 | | Insurance Coverage Act issued, amended, delivered, or renewed | 11 | | on or after the effective date of this amendatory Act of the | 12 | | 100th General Assembly may impose any preexisting condition | 13 | | exclusion, as defined in the Illinois Health Insurance | 14 | | Portability and Accountability Act, with respect to such plan | 15 | | or coverage.
| 16 | | (Source: P.A. 100-386, eff. 1-1-18; revised 9-15-17.)
| 17 | | Section 99. Effective date. This Act takes effect January | 18 | | 1, 2019.".
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