(215 ILCS 125/4-8)
(from Ch. 111 1/2, par. 1409.1)
(1) No contract or evidence of coverage
issued by a Health Maintenance Organization which provides for coverage of
dependents of the principal enrollee shall contain any disclaimer, waiver
or other limitation relative to the eligibility or coverage of newborn
infants of a principal enrollee from and after the moment of birth.
(2) Each such contract or evidence of coverage shall contain a provision
stating that benefits shall be granted immediately with respect to newborn
infants from the moment of birth and that such coverage shall include
illness, injury, congenital defects, birth abnormalities and premature birth.
(3) If payment of a specific premium is required under the terms of a
contract to provide coverage for a child, there may be requirements that
notification of birth of a newly born infant be given to the Health
Maintenance Organization within the 31 days following the birth in order to
have coverage continued beyond such 31 day period and that such specific
premium be paid within 30 days following receipt of such notice.
(4) In the event that no other members of the enrollee's immediate
family are covered, immediate coverage for the first newborn infant shall
be provided if the enrollee applies for dependent's coverage within 31 days
of the newborn's birth. Such coverage shall be contingent upon payment of
the additional premium.
(5) The requirements of this Section shall apply, on or after the
sixtieth day following the effective date of this amendatory Act of 1989,
(a) to all such evidences of coverage delivered or issued for delivery, and
(b) to all such group contracts delivered, issued for delivery, renewed or
amended. The health maintenance organizations which issue such evidences
of coverage that are in effect on the sixtieth day following the effective
date of this amendatory Act of 1989 shall extend to owners of such
contracts, on or before the first contract anniversary following such date,
the opportunity to apply for the addition to their contracts of a provision
as set forth in subsection (2) above, with, at the option of the health
maintenance organization, payment of a premium appropriate thereto.
(Source: P.A. 86-620.)