Public Act 93-0622

SB783 Enrolled                       LRB093 03237 JLS 03254 b

    AN ACT in relation to insurance.

    Be it  enacted  by  the  People  of  the  State  of  Illinois,
represented in the General Assembly:

    Section 5.  The Comprehensive Health Insurance  Plan  Act
is amended by changing Sections 2, 3, and 15 as follows:

    (215 ILCS 105/2) (from Ch. 73, par. 1302)
    Sec.  2.  Definitions.   As  used in this Act, unless the
context otherwise requires:
    "Plan administrator" means the  insurer  or  third  party
administrator designated under Section 5 of this Act.
    "Benefits  plan"  means the coverage to be offered by the
Plan to eligible persons and federally  eligible  individuals
pursuant to this Act.
    "Board" means the Illinois Comprehensive Health Insurance
Board.
    "Church plan" has the same meaning given that term in the
federal  Health  Insurance Portability and Accountability Act
of 1996.
    "Continuation coverage" means  continuation  of  coverage
under  a group health plan or other health insurance coverage
for former employees or dependents of former  employees  that
would  otherwise  have  terminated  under  the  terms of that
coverage  pursuant  to  any  continuation  provisions   under
federal  or  State  law,  including  the Consolidated Omnibus
Budget  Reconciliation  Act  of  1985  (COBRA),  as  amended,
Sections 367.2, 367e, and 367e.1 of  the  Illinois  Insurance
Code, or any other similar requirement in another State.
    "Covered  person"  means a person who is and continues to
remain eligible for Plan coverage and is covered under one of
the benefit plans offered by the Plan.
    "Creditable coverage" means, with respect to a  federally
eligible  individual, coverage of the individual under any of
the following:
         (A)  A group health plan.
         (B)  Health  insurance  coverage  (including   group
    health insurance coverage).
         (C)  Medicare.
         (D)  Medical assistance.
         (E)  Chapter 55 of title 10, United States Code.
         (F)  A  medical  care  program  of the Indian Health
    Service or of a tribal organization.
         (G)  A state health benefits risk pool.
         (H)  A health plan offered under Chapter 89 of title
    5, United States Code.
         (I)  A public health plan (as defined in regulations
    consistent  with  Section  104   of   the   Health   Care
    Portability  and  Accountability  Act of 1996 that may be
    promulgated by the Secretary of the  U.S.  Department  of
    Health and Human Services).
         (J)  A health benefit plan under Section 5(e) of the
    Peace Corps Act (22 U.S.C. 2504(e)).
         (K)  Any  other  qualifying coverage required by the
    federal Health Insurance Portability  and  Accountability
    Act  of  1996, as it may be amended, or regulations under
    that Act.
    "Creditable   coverage"   does   not   include   coverage
consisting  solely  of  coverage  of  excepted  benefits,  as
defined in Section 2791(c)  of  title  XXVII  of  the  Public
Health Service Act (42 U.S.C. 300 gg-91), nor does it include
any  period  of  coverage  under any of items (A) through (K)
that occurred before a break of more  than  90  days  or,  if
after  September  30,  2003,  the  individual has either been
certified as eligible pursuant to the federal  Trade  Act  of
2002  or initially been paid a benefit by the Pension Benefit
Guaranty Corporation, a break of more than 63 days during all
of which the individual was not covered under  any  of  items
(A) through (K) above.
    For  an  individual  who  between  December  1,  2002 and
September 30, 2003 has either (1) been certified as  eligible
pursuant to the federal Trade Act of 2002, (2) initially been
paid  a  benefit by the Pension Benefit Guaranty Corporation,
or (3) as of December 1, 2002, been receiving  benefits  from
the   Pension   Benefit  Guaranty  Corporation  and  who  has
qualified health insurance, as defined by the  federal  Trade
Act  of  2002,  "creditable  coverage" includes any period of
coverage aggregating 3 or more months under any of items  (A)
through (K), irrespective of the length of a break during all
of  which  the  individual was not covered under any of items
(A) through (K).
    Any period that an individual is in a waiting period  for
any  coverage  under a group health plan (or for group health
insurance coverage) or is in an affiliation period under  the
terms  of  health  insurance  coverage  offered  by  a health
maintenance organization shall not be taken into  account  in
determining if there has been a break of more than 90 days in
any creditable coverage.
    "Department" means the Illinois Department of Insurance.
    "Dependent"  means an Illinois resident: who is a spouse;
or who is claimed as a dependent by the principal insured for
purposes of filing a federal income tax return and resides in
the  principal  insured's  household,  and  is   a   resident
unmarried  child  under  the  age  of  19 years; or who is an
unmarried child who also is a full-time student under the age
of 23  years  and  who  is  financially  dependent  upon  the
principal  insured;  or  who is a child of any age and who is
disabled  and  financially  dependent  upon   the   principal
insured.
    "Direct  Illinois premiums" means, for Illinois business,
an insurer's direct premium income for the kinds of  business
described  in  clause (b) of Class 1 or clause (a) of Class 2
of Section 4 of  the  Illinois  Insurance  Code,  and  direct
premium  income  of  a  health  maintenance organization or a
voluntary health services plan, except it shall  not  include
credit  health  insurance as defined in Article IX 1/2 of the
Illinois Insurance Code.
    "Director" means the Director of the Illinois  Department
of Insurance.
    "Eligible  person"  means  a  resident  of this State who
qualifies for Plan coverage under Section 7 of this Act.
    "Employee" means a resident of this State who is employed
by an employer or has entered into the employment of or works
under contract  or  service  of  an  employer  including  the
officers,  managers and employees of subsidiary or affiliated
corporations and the  individual  proprietors,  partners  and
employees  of  affiliated  individuals  and  firms  when  the
business  of the subsidiary or affiliated corporations, firms
or individuals is controlled by  a  common  employer  through
stock ownership, contract, or otherwise.
    "Employer"    means    any    individual,    partnership,
association,  corporation,  business  trust, or any person or
group  of  persons  acting  directly  or  indirectly  in  the
interest of an employer in relation to an employee, for which
one or more persons is gainfully employed.
    "Family" coverage means the coverage provided by the Plan
for the covered person and his or her eligible dependents who
also are covered persons.
    "Federally  eligible  individual"  means  an   individual
resident of this State:
         (1)(A)  for  whom,  as  of  the  date  on  which the
    individual seeks Plan coverage under Section 15  of  this
    Act,  the aggregate of the periods of creditable coverage
    is 18 or more months or, if the individual has either (i)
    been certified as eligible pursuant to the federal  Trade
    Act  of  2002,  (ii) initially been paid a benefit by the
    Pension Benefit Guaranty  Corporation,  or  (iii)  as  of
    December  1,  2002,  been  receiving  benefits  from  the
    Pension  Benefit  Guaranty  Corporation and has qualified
    health insurance, as defined by the federal Trade Act  of
    2002,  3  or more months, and (B) whose most recent prior
    creditable coverage  was  under  group  health  insurance
    coverage  offered  by  a health insurance issuer, a group
    health plan, a governmental plan, or a  church  plan  (or
    health  insurance coverage offered in connection with any
    such plans) or any other type of creditable coverage that
    may  be  required  by  the   federal   Health   Insurance
    Portability  and Accountability Act of 1996, as it may be
    amended, or the regulations under that Act;
         (2)  who is not eligible for coverage  under  (A)  a
    group  health plan (other than an individual who has been
    certified as eligible pursuant to the federal  Trade  Act
    of  2002),  (B)  part  A or part B of Medicare due to age
    (other than an  individual  who  has  been  certified  as
    eligible  pursuant  to the federal Trade Act of 2002), or
    (C) medical assistance, and does not  have  other  health
    insurance coverage (other than an individual who has been
    certified  as  eligible pursuant to the federal Trade Act
    of 2002);
         (3)  with respect to whom (other than an  individual
    who  has  been  certified  as  eligible  pursuant  to the
    federal Trade Act  of  2002)  the  most  recent  coverage
    within  the coverage period described in paragraph (1)(A)
    of this definition was not terminated based upon a factor
    relating to nonpayment of premiums or fraud;
         (4)  if the individual (other than an individual who
    has either (A) been certified as eligible pursuant to the
    federal Trade Act of 2002,  (B)  initially  been  paid  a
    benefit  by  the Pension Benefit Guaranty Corporation, or
    (C) as of December 1, 2002, been receiving benefits  from
    the  Pension  Benefit  Guaranty  Corporation  and who has
    qualified health insurance, as  defined  by  the  federal
    Trade  Act  of  2002)  had  been  offered  the  option of
    continuation  coverage   under   a   COBRA   continuation
    provision  or  under a similar State program, who elected
    such coverage; and
         (5)  who,   if   the   individual    elected    such
    continuation  coverage,  has  exhausted such continuation
    coverage under such provision or program.
    However, an individual who has either been  certified  as
eligible  pursuant  to  the  federal  Trade  Act  of  2002 or
initially been paid a benefit by the Pension Benefit Guaranty
Corporation shall  not  be  required  to  elect  continuation
coverage  under  a  COBRA  continuation  provision or under a
similar state program.
    "Group health insurance coverage"  means,  in  connection
with  a  group health plan, health insurance coverage offered
in connection with that plan.
    "Group health plan" has the same meaning given that  term
in    the    federal   Health   Insurance   Portability   and
Accountability Act of 1996.
    "Governmental plan" has the same meaning given that  term
in    the    federal   Health   Insurance   Portability   and
Accountability Act of 1996.
    "Health insurance coverage" means benefits consisting  of
medical   care   (provided  directly,  through  insurance  or
reimbursement, or otherwise and including items and  services
paid  for  as  medical  care)  under any hospital and medical
expense-incurred policy, certificate, or contract provided by
an insurer, non-profit health  care  service  plan  contract,
health maintenance organization or other subscriber contract,
or any other health care plan or arrangement that pays for or
furnishes   medical   or  health  care  services  whether  by
insurance or otherwise.  Health insurance coverage shall  not
include   short   term,  accident  only,  disability  income,
hospital confinement or fixed indemnity, dental only,  vision
only,  limited  benefit, or credit insurance, coverage issued
as a supplement to liability insurance, insurance arising out
of  a  workers'  compensation  or  similar  law,   automobile
medical-payment  insurance, or insurance under which benefits
are payable with or without regard  to  fault  and  which  is
statutorily   required  to  be  contained  in  any  liability
insurance policy or equivalent self-insurance.
    "Health insurance issuer"  means  an  insurance  company,
insurance  service,  or  insurance  organization (including a
health  maintenance  organization  and  a  voluntary   health
services   plan)   that  is  authorized  to  transact  health
insurance business in this State.  Such term does not include
a group health plan.
    "Health Maintenance Organization" means  an  organization
as defined in the Health Maintenance Organization Act.
    "Hospice"  means  a  program  as  defined in and licensed
under the Hospice Program Licensing Act.
    "Hospital" means a duly licensed institution  as  defined
in  the Hospital Licensing Act, an institution that meets all
comparable conditions and requirements in effect in the state
in which  it  is  located,  or  the  University  of  Illinois
Hospital  as  defined  in the University of Illinois Hospital
Act.
    "Individual  health  insurance  coverage"  means   health
insurance  coverage  offered to individuals in the individual
market, but does  not  include  short-term,  limited-duration
insurance.
    "Insured" means any individual resident of this State who
is  eligible  to receive benefits from any insurer (including
health insurance coverage offered in connection with a  group
health  plan)  or  health insurance issuer as defined in this
Section.
    "Insurer"  means  any  insurance  company  authorized  to
transact health insurance business  in  this  State  and  any
corporation  that  provides medical services and is organized
under the Voluntary Health Services Plans Act or  the  Health
Maintenance Organization Act.
    "Medical  assistance"  means the State medical assistance
or medical assistance no grant (MANG) programs provided under
Title XIX of the Social Security Act and Articles V  (Medical
Assistance)  and  VI  (General  Assistance)  of  the Illinois
Public Aid Code (or  any  successor  program)  or  under  any
similar program of health care benefits in a state other than
Illinois.
    "Medically  necessary"  means  that  a  service, drug, or
supply is necessary and  appropriate  for  the  diagnosis  or
treatment  of  an  illness or injury in accord with generally
accepted standards  of  medical  practice  at  the  time  the
service,  drug,  or  supply  is  provided.  When specifically
applied to a confinement it further means that the  diagnosis
or  treatment  of  the  covered  person's medical symptoms or
condition cannot be safely provided  to  that  person  as  an
outpatient. A service, drug, or supply shall not be medically
necessary if it: (i) is investigational, experimental, or for
research  purposes;  or  (ii)  is  provided  solely  for  the
convenience  of the patient, the patient's family, physician,
hospital, or any other provider; or (iii) exceeds  in  scope,
duration,  or  intensity that level of care that is needed to
provide  safe,  adequate,  and   appropriate   diagnosis   or
treatment;  or (iv) could have been omitted without adversely
affecting the covered person's condition or  the  quality  of
medical  care;  or  (v) involves the use of a medical device,
drug, or substance not formally approved by the United States
Food and Drug Administration.
    "Medical care" means the ordinary and usual  professional
services  rendered by a physician or other specified provider
during a professional visit for treatment of  an  illness  or
injury.
    "Medicare" means coverage under both Part A and Part B of
Title  XVIII of the Social Security Act, 42 U.S.C. Sec. 1395,
et seq.
    "Minimum premium plan" means  an  arrangement  whereby  a
specified  amount  of  health care claims is self-funded, but
the insurance company  assumes  the  risk  that  claims  will
exceed that amount.
    "Participating   transplant   center"  means  a  hospital
designated by the Board as a preferred or exclusive  provider
of  services  for one or more specified human organ or tissue
transplants for which the hospital has  signed  an  agreement
with  the  Board to accept a transplant payment allowance for
all expenses related to the transplant  during  a  transplant
benefit period.
    "Physician"  means a person licensed to practice medicine
pursuant to the Medical Practice Act of 1987.
    "Plan" means  the  Comprehensive  Health  Insurance  Plan
established by this Act.
    "Plan  of  operation"  means the plan of operation of the
Plan, including articles, bylaws and operating rules, adopted
by the board pursuant to this Act.
    "Provider" means any hospital, skilled nursing  facility,
hospice, home health agency, physician, registered pharmacist
acting  within  the  scope of that registration, or any other
person or entity licensed  in  Illinois  to  furnish  medical
care.
    "Qualified  high  risk  pool"  has the same meaning given
that term in the federal  Health  Insurance  Portability  and
Accountability Act of 1996.
    "Resident"  means  a  person  who  is and continues to be
legally domiciled and physically residing on a permanent  and
full-time  basis  in  a place of permanent habitation in this
State that remains that person's principal residence and from
which that person is absent only for temporary or  transitory
purpose.
    "Skilled  nursing  facility"  means  a  facility  or that
portion of a  facility  that  is  licensed  by  the  Illinois
Department  of  Public Health under the Nursing Home Care Act
or a comparable  licensing  authority  in  another  state  to
provide skilled nursing care.
    "Stop-loss  coverage"  means  an  arrangement  whereby an
insurer insures against the risk  that  any  one  claim  will
exceed  a specific dollar amount or that the entire loss of a
self-insurance plan will exceed a specific amount.
    "Third party administrator"  means  an  administrator  as
defined in Section 511.101 of the Illinois Insurance Code who
is licensed under Article XXXI 1/4 of that Code.
(Source:  P.A.  92-153,  eff.  7-25-01;  93-33, eff. 6-23-03;
93-34, eff. 6-23-03; 93-477, eff. 8-8-03; revised 8-21-03.)

    (215 ILCS 105/3) (from Ch. 73, par. 1303)
    Sec. 3.  Operation of the Plan.
    a.  There is hereby  created  an  Illinois  Comprehensive
Health Insurance Plan.
    b.  The Plan shall operate subject to the supervision and
control  of  the  board.  The board is created as a political
subdivision and body politic and corporate and, as  such,  is
not  a  State  agency.   The board shall consist of 10 public
members, appointed  by  the  Governor  with  the  advice  and
consent of the Senate.
    Initial  members  shall  be appointed to the Board by the
Governor as follows: 2 members to serve until July  1,  1988,
and  until  their  successors  are appointed and qualified; 2
members  to  serve  until  July  1,  1989,  and  until  their
successors are appointed and qualified; 3  members  to  serve
until  July 1, 1990, and until their successors are appointed
and qualified; and 3 members to serve until July 1, 1991, and
until their successors are appointed and qualified. As  terms
of   initial   members  expire,  their  successors  shall  be
appointed for terms to expire the first day in July  3  years
thereafter,  and  until  their  successors  are appointed and
qualified.
    Any vacancy in the Board occurring for any  reason  other
than  the  expiration  of  a  term  shall  be  filled for the
unexpired  term  in  the  same   manner   as   the   original
appointment.
    Any  member  of  the Board may be removed by the Governor
for neglect of duty, misfeasance, malfeasance, or nonfeasance
in office.
    In addition, a representative of the Governor's Office of
Management and Budget Bureau of the Budget, a  representative
of the Office of the Attorney General and the Director or the
Director's  designated representative shall be members of the
board.  Four  members  of  the  General  Assembly,  one  each
appointed  by the President and Minority Leader of the Senate
and by the Speaker  and  Minority  Leader  of  the  House  of
Representatives,  shall  serve  as  nonvoting  members of the
board.  At least 2 of the public members shall be individuals
reasonably expected to qualify for coverage under  the  Plan,
the  parent  or  spouse of such an individual, or a surviving
family member of an individual who could have  qualified  for
the  plan  during  his  lifetime.  The Director or Director's
representative  shall  be  the  chairperson  of  the   board.
Members of the board shall receive no compensation, but shall
be   reimbursed  for  reasonable  expenses  incurred  in  the
necessary performance of their duties.
    c.  The board shall make an annual  report  in  September
and  shall  file  the report with the Secretary of the Senate
and the Clerk of the House of  Representatives.   The  report
shall  summarize  the activities of the Plan in the preceding
calendar year, including net written and earned premiums, the
expense of administration, the paid and incurred  losses  for
the  year  and  other  information as may be requested by the
General Assembly. The report shall also include analysis  and
recommendations   regarding   utilization   review,   quality
assurance and access to cost effective quality health care.
    d.  In its plan of operation the board shall:
         (1)  Establish   procedures  for  selecting  a  plan
    administrator in accordance with Section 5 of this Act.
         (2)  Establish procedures for the operation  of  the
    board.
         (3)  Create  a  Plan  fund,  under management of the
    board, to fund administrative, claim, and other  expenses
    of the Plan.
         (4)  Establish   procedures  for  the  handling  and
    accounting of assets and monies of the Plan.
         (5)  Develop and implement a  program  to  publicize
    the  existence  of the Plan, the eligibility requirements
    and procedures for  enrollment  and  to  maintain  public
    awareness of the Plan.
         (6)  Establish procedures under which applicants and
    participants  may have grievances reviewed by a grievance
    committee appointed by the board.  The  grievances  shall
    be  reported to the board immediately after completion of
    the review.  The Department and the  board  shall  retain
    all  written complaints regarding the Plan for at least 3
    years.  Oral complaints shall be reduced to written  form
    and maintained for at least 3 years.
         (7)  Provide  for  other matters as may be necessary
    and proper for the execution of its  powers,  duties  and
    obligations under the Plan.
    e.  No later than 5 years after the Plan is operative the
board  and the Department shall conduct cooperatively a study
of the Plan and the persons insured by the Plan to determine:
(1)  claims  experience  including  a  breakdown  of  medical
conditions  for  which  claims   were   paid;   (2)   whether
availability  of  the  Plan affected employment opportunities
for  participants;  (3)  whether  availability  of  the  Plan
affected the receipt of medical assistance benefits  by  Plan
participants;  (4) whether a change occurred in the number of
personal bankruptcies due to medical or other health  related
costs;  (5)  data regarding all complaints received about the
Plan including its operation and services; (6) and any  other
significant  observations  regarding utilization of the Plan.
The study shall culminate in a written report to be presented
to the Governor, the President of the Senate, the Speaker  of
the  House  and  the  chairpersons  of  the  House and Senate
Insurance Committees.  The report shall  be  filed  with  the
Secretary  of  the  Senate  and  the  Clerk  of  the House of
Representatives.  The  report  shall  also  be  available  to
members of the general public upon request.
    f.  The board may:
         (1)  Prepare    and    distribute   certificate   of
    eligibility forms and  enrollment  instruction  forms  to
    insurance  producers  and  to  the general public in this
    State.
         (2)  Provide for reinsurance of  risks  incurred  by
    the  Plan  and  enter  into  reinsurance  agreements with
    insurers to establish a reinsurance  plan  for  risks  of
    coverage  described  in  the  Plan,  or obtain commercial
    reinsurance to reduce the risk of loss through the Plan.
         (3)  Issue  additional  types  of  health  insurance
    policies to provide optional coverages as  are  otherwise
    permitted  by  this  Act  including a Medicare supplement
    policy designed to supplement Medicare.
         (4)  Provide  for  and   employ   cost   containment
    measures  and requirements including, but not limited to,
    preadmission  certification,  second  surgical   opinion,
    concurrent  utilization  review  programs, and individual
    case management for the purpose of making the  pool  more
    cost effective.
         (5)  Design, utilize, contract, or otherwise arrange
    for  the delivery of cost effective health care services,
    including  establishing  or  contracting  with  preferred
    provider organizations, health maintenance organizations,
    and other limited network provider arrangements.
         (6)  Adopt bylaws, rules, regulations, policies  and
    procedures  as  may  be  necessary  or convenient for the
    implementation of the Act and the operation of the Plan.
         (7)  Administer separate pools,  separate  accounts,
    or other plans or arrangements as required by this Act to
    separate  federally  eligible  individuals  or  groups of
    federally  eligible  individuals  who  qualify  for  plan
    coverage under Section  15  of  this  Act  from  eligible
    persons  or  groups  of  eligible persons who qualify for
    plan coverage under Section 7 of this Act  and  apportion
    the  costs  of  the  administration  among  such separate
    pools, separate accounts, or other plans or arrangements.
    g.  The  Director  may,  by  rule,  establish  additional
powers and duties of the board and may adopt  rules  for  any
other  purposes,  including the operation of the Plan, as are
necessary or proper to implement this Act.
    h.  The board is not liable for  any  obligation  of  the
Plan.   There  is  no  liability on the part of any member or
employee of the board or the  Department,  and  no  cause  of
action  of  any nature may arise against them, for any action
taken or omission made by them in the  performance  of  their
powers  and  duties  under  this  Act,  unless  the action or
omission constitutes willful or wanton misconduct. The  board
may  provide  in  its bylaws or rules for indemnification of,
and legal representation for, its members and employees.
    i.  There is no liability on the part  of  any  insurance
producer  for  the failure of any applicant to be accepted by
the Plan unless the failure of the applicant to  be  accepted
by  the  Plan  is  due to an act or omission by the insurance
producer which constitutes willful or wanton misconduct.
(Source: P.A. 92-597, eff. 6-28-02; revised 8-23-03.)

    (215 ILCS 105/15)
    Sec. 15.  Alternative  portable  coverage  for  federally
eligible individuals.
    (a)  Notwithstanding the requirements of subsection a. of
Section  7  and except as otherwise provided in this Section,
any  federally  eligible   individual   for   whom   a   Plan
application, and such enclosures and supporting documentation
as  the Board may require, is received by the Board within 90
days after the termination of prior creditable coverage shall
qualify  to  enroll  in  the  Plan  under   the   portability
provisions of this Section.
    A  federally eligible person who between December 1, 2002
and September 30, 2003  has  either  (1)  been  certified  as
eligible  pursuant  to  the  federal  Trade  Act of 2002, (2)
initially been paid a benefit by the Pension Benefit Guaranty
Corporation, or (3) as of December 1,  2002,  been  receiving
benefits  from  the Pension Benefit Guaranty Corporation, who
has qualified health insurance, as  defined  by  the  federal
Trade  Act of 2002, and whose Plan application and enclosures
and supporting documentation, as the Board  may  require,  is
received  by  the  Board  after  the  termination of previous
creditable coverage shall qualify to enroll in the Plan under
the portability provisions of this Section.
    A federally eligible  person  who,  after  September  30,
2003,  has  either been certified as eligible pursuant to the
federal Trade Act of 2002 or initially been paid a benefit by
the Pension  Benefit  Guaranty  Corporation  and  whose  Plan
application  and  enclosures  and supporting documentation as
the Board may require is received by the Board within 63 days
after the termination of previous creditable  coverage  shall
qualify   to   enroll  in  the  Plan  under  the  portability
provisions of this Section.
    (b)  Any  federally  eligible  individual  seeking   Plan
coverage  under  this  Section  must  submit  with his or her
application   evidence,    including    acceptable    written
certification  of  previous  creditable  coverage,  that will
establish to the Board's satisfaction, that he or  she  meets
all of the requirements to be a federally eligible individual
and  is  currently and permanently residing in this State (as
of the date his  or  her  application  was  received  by  the
Board).
    (c)  Except  as  otherwise  provided  in  this Section, a
period of creditable coverage  shall  not  be  counted,  with
respect  to  qualifying  an  applicant for Plan coverage as a
federally eligible individual under this  Section,  if  after
such  period and before the application for Plan coverage was
received by the Board, there was at least  a  90  day  period
during  all of which the individual was not covered under any
creditable coverage.
    For a federally eligible person who between  December  1,
2002  and September 30, 2003 has either (1) been certified as
eligible pursuant to the  federal  Trade  Act  of  2002,  (2)
initially been paid a benefit by the Pension Benefit Guaranty
Corporation,  or  (3)  as of December 1, 2002, been receiving
benefits from the Pension Benefit  Guaranty  Corporation  and
who has qualified health insurance, as defined by the federal
Trade  Act  of 2002, a period of creditable coverage shall be
counted, with respect to qualifying  an  applicant  for  Plan
coverage  as  a  federally  eligible  individual  under  this
Section,  when the application for Plan coverage was received
by the Board.
    For a federally eligible person who, after September  30,
2003,  has  either been certified as eligible pursuant to the
federal Trade Act of 2002 or initially been paid a benefit by
the  Pension  Benefit  Guaranty  Corporation,  a  period   of
creditable  coverage  shall  not  be counted, with respect to
qualifying an applicant for  Plan  coverage  as  a  federally
eligible  individual under this Section, if after such period
and before the application for Plan coverage was received  by
the  Board,  there was at least a 63 day period during all of
which the individual was not  covered  under  any  creditable
coverage.
    (d)  Any  federally  eligible  individual  who  the Board
determines qualifies for Plan  coverage  under  this  Section
shall  be  offered  his  or her choice of enrolling in one of
alternative portability health benefit plans which the  Board
is  authorized  under  this  Section  to  establish for these
federally eligible individuals and their dependents.
    (e)  The Board  shall  offer  a  choice  of  health  care
coverages  consistent  with  major medical coverage under the
alternative health benefit plans authorized by  this  Section
to  every  federally eligible individual. The coverages to be
offered  under  the  plans,   the   schedule   of   benefits,
deductibles,  co-payments,  exclusions, and other limitations
shall be  approved  by  the  Board.   One  optional  form  of
coverage   shall   be   comparable  to  comprehensive  health
insurance coverage offered in the individual market  in  this
State  or  a  standard option of coverage available under the
group or individual health insurance laws of the State.   The
standard benefit plan that is authorized by Section 8 of this
Act may be used for this purpose.  The Board may also offer a
preferred provider option and such other options as the Board
determines  may  be  appropriate for these federally eligible
individuals who qualify for Plan coverage  pursuant  to  this
Section.
    (f)  Notwithstanding the requirements of subsection f. of
Section  8,  any  plan  coverage  that is issued to federally
eligible individuals who qualify for the Plan pursuant to the
portability provisions of this Section shall not  be  subject
to  any  preexisting conditions exclusion, waiting period, or
other similar limitation on coverage.
    (g)  Federally  eligible  individuals  who  qualify   and
enroll in the Plan pursuant to this Section shall be required
to  pay  such  premium rates as the Board shall establish and
approve in accordance with the requirements of Section 7.1 of
this Act.
    (h)  A federally eligible individual  who  qualifies  and
enrolls  in the Plan pursuant to this Section must satisfy on
an ongoing basis all of the other eligibility requirements of
this Act to the extent  not  inconsistent  with  the  federal
Health  Insurance  Portability and Accountability Act of 1996
in order to maintain continued eligibility for coverage under
the Plan.
(Source: P.A. 92-153,  eff.  7-25-01;  93-33,  eff.  6-23-03;
93-34, eff. 6-23-03.)

    Section  99.  Effective date.  This Act takes effect upon
becoming law.

Effective Date: 12/18/2003