98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB0137

 

Introduced 1/14/2013, by Rep. Jil Tracy

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 170/20

    Amends the Covering ALL KIDS Health Insurance Act. Adds to the criteria for eligibility for the Covering ALL KIDS Health Insurance Program that a person must be a child who does not have access to affordable employer-sponsored dependent health insurance coverage that is comparable to the coverage of the existing Program as determined by the administering agency's rules. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning insurance.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Covering ALL KIDS Health Insurance Act is
5amended by changing Section 20 as follows:
 
6    (215 ILCS 170/20)
7    (Section scheduled to be repealed on July 1, 2016)
8    Sec. 20. Eligibility.
9    (a) To be eligible for the Program, a person must be a
10child:
11        (1) who is a resident of the State of Illinois;
12        (2) who is ineligible for medical assistance under the
13    Illinois Public Aid Code or benefits under the Children's
14    Health Insurance Program Act;
15        (3) either (i) who has been without health insurance
16    coverage for 12 months, (ii) whose parent has lost
17    employment that made available affordable dependent health
18    insurance coverage, until such time as affordable
19    employer-sponsored dependent health insurance coverage is
20    again available for the child as set forth by the
21    Department in rules, (iii) who is a newborn whose
22    responsible relative does not have available affordable
23    private or employer-sponsored health insurance, or (iv)

 

 

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1    who, within one year of applying for coverage under this
2    Act, lost medical benefits under the Illinois Public Aid
3    Code or the Children's Health Insurance Program Act; and
4        (3.5) whose household income, as determined by the
5    Department, is at or below 300% of the federal poverty
6    level; . this This item (3.5) is effective July 1, 2011; and
7    .
8        (4) who does not have access to affordable
9    employer-sponsored dependent health insurance coverage
10    that is comparable to the coverage of the existing Program
11    as determined by the administering agency's rules.
12    An entity that provides health insurance coverage (as
13defined in Section 2 of the Comprehensive Health Insurance Plan
14Act) to Illinois residents shall provide health insurance data
15match to the Department of Healthcare and Family Services as
16provided by and subject to Section 5.5 of the Illinois
17Insurance Code.
18    The Department of Healthcare and Family Services, in
19collaboration with the Department of Insurance, shall adopt
20rules governing the exchange of information under this Section.
21The rules shall be consistent with all laws relating to the
22confidentiality or privacy of personal information or medical
23records, including provisions under the Federal Health
24Insurance Portability and Accountability Act (HIPAA).
25    (b) The Department shall monitor the availability and
26retention of employer-sponsored dependent health insurance

 

 

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1coverage and shall modify the period described in subdivision
2(a)(3) if necessary to promote retention of private or
3employer-sponsored health insurance and timely access to
4healthcare services, but at no time shall the period described
5in subdivision (a)(3) be less than 6 months.
6    (c) The Department, at its discretion, may take into
7account the affordability of dependent health insurance when
8determining whether employer-sponsored dependent health
9insurance coverage is available upon reemployment of a child's
10parent as provided in subdivision (a)(3).
11    (d) A child who is determined to be eligible for the
12Program shall remain eligible for 12 months, provided that the
13child maintains his or her residence in this State, has not yet
14attained 19 years of age, and is not excluded under subsection
15(e).
16    (e) A child is not eligible for coverage under the Program
17if:
18        (1) the premium required under Section 40 has not been
19    timely paid; if the required premiums are not paid, the
20    liability of the Program shall be limited to benefits
21    incurred under the Program for the time period for which
22    premiums have been paid; re-enrollment shall be completed
23    before the next covered medical visit, and the first
24    month's required premium shall be paid in advance of the
25    next covered medical visit; or
26        (2) the child is an inmate of a public institution or

 

 

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1    an institution for mental diseases.
2    (f) The Department may adopt rules, including, but not
3limited to: rules regarding annual renewals of eligibility for
4the Program in conformance with Section 7 of this Act; rules
5providing for re-enrollment, grace periods, notice
6requirements, and hearing procedures under subdivision (e)(1)
7of this Section; and rules regarding what constitutes
8availability and affordability of private or
9employer-sponsored health insurance, with consideration of
10such factors as the percentage of income needed to purchase
11children or family health insurance, the availability of
12employer subsidies, and other relevant factors.
13    (g) Each child enrolled in the Program as of July 1, 2011
14whose family income, as established by the Department, exceeds
15300% of the federal poverty level may remain enrolled in the
16Program for 12 additional months commencing July 1, 2011.
17Continued enrollment pursuant to this subsection shall be
18available only if the child continues to meet all eligibility
19criteria established under the Program as of the effective date
20of this amendatory Act of the 96th General Assembly without a
21break in coverage. Nothing contained in this subsection shall
22prevent a child from qualifying for any other health benefits
23program operated by the Department.
24(Source: P.A. 96-1272, eff. 1-1-11; 96-1501, eff. 1-25-11.)
 
25    Section 99. Effective date. This Act takes effect upon
26becoming law.