Rep. Laura Fine

Filed: 4/20/2018





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2    AMENDMENT NO. ______. Amend House Bill 1337 by replacing
3everything after the enacting clause with the following:
4    "Section 1. Short title. This Act may be cited as the
5Short-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
9with a group health plan, health insurance coverage offered in
10connection 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
13Income Security Act of 1974) to the extent that the plan
14provides medical care (as defined in paragraph (2) of that
15Section and including items and services paid for as medical
16care) to employees or their dependents (as defined under the



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1terms of the plan) directly or through insurance,
2reimbursement, or otherwise.
3    "Health insurance coverage" means benefits consisting of
4medical care (provided directly, through insurance or
5reimbursement, or otherwise and including items and services
6paid for as medical care) under any hospital or medical service
7policy or certificate, hospital or medical service plan
8contract, or health maintenance organization contract offered
9by a health insurance issuer.
10    "Health insurance issuer" means an insurance company,
11insurance service, or insurance organization (including a
12health maintenance organization) that is licensed to engage in
13the business of insurance in a state and that is subject to
14Illinois law that regulates insurance (within the meaning of
15Section 514(b)(2) of the federal Employee Retirement Income
16Security Act of 1974). "Health insurance issuer" does not
17include a group health plan.
18    "Fraud" means an intentional misrepresentation of a
19material fact in connection with the coverage.
20    "Individual health insurance coverage" means health
21insurance coverage offered to individuals in the individual
22market, including short-term, limited-duration health
23insurance coverage.
24    "Short-term, limited-duration health insurance coverage"
25means individual health insurance coverage provided under a
26contract offered by a licensed health insurance issuer,



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1regardless of the situs of the delivery of the policy or
2contract 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
5short-term, limited-duration health insurance coverage to
6individuals in this State and to short-term, limited-duration
7health insurance coverage that is delivered or issued for
8delivery in this State, including coverage issued outside of
9this State that covers individuals in this State.
10    (b) A short-term, limited-duration health insurance
11coverage policy (even where issued outside of this State) may
12not cover any person residing in this State or be delivered or
13issued for delivery in this State unless the policy complies
14with the provisions of this Act.
15    (c) Any short-term, limited-duration health insurance
16coverage policy that is delivered or issued for delivery in
17this State must have an expiration date in the contract that is
18less than 91 days and shall not be renewable within a period of
19365 days, beginning the day after the contract ends, either at
20the option of the issuer or the individual. Renewal of a
21short-term, limited-duration health insurance coverage policy
22includes the issuance of a new short-term, limited-duration
23health insurance policy by an issuer to a policyholder within
2460 days after the expiration of a policy previously issued by
25the issuer to the policyholder.



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1    (d) Any short-term, limited-duration health insurance
2coverage policy that is delivered or issued for delivery in
3this State may not be rescinded before the expiration date in
4the contract, except in cases of nonpayment of premiums or
6    Section 15. Disclosure requirements.
7    (a) A health insurance issuer that offers short-term,
8limited-duration health insurance coverage shall, in addition
9to all other documents required, including, but not limited to,
10the policy, the certificate, the membership booklet, and a
11description of appeal and external review rights, deliver an
12outline of coverage to an applicant for or an enrollee in
13short-term, limited-duration health insurance coverage
14delivered or issued for delivery in this State.
15    (b) Any short-term, limited-duration health insurance
16coverage policy that is delivered or issued for delivery in the
17State shall display prominently in the contract, any
18application, sales, and marketing materials provided in
19connection with enrollment in such coverage, and the outline of
20coverage for such coverage, in at least 14-point, bold type,
21the following: "WARNING! This plan may not cover all of the
22health care you need and may leave you with very high medical
23bills. If you buy this plan, you may not be able to get more
24complete insurance when this contract ends. You may be able to
25get more complete insurance now and help to pay for it at



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2    (c) Any short-term, limited-duration health insurance
3coverage policy that is delivered or issued for delivery in
4this State shall display prominently in the footer on every
5page of the contract, in any application, sales, and marketing
6materials provided in connection with enrollment in such
7coverage, and in the outline of coverage for such coverage, in
8at least 14-point, bold type, the following: "WARNING! This is
9temporary coverage. This policy provides limited benefits.".
10    (d) Any identification card for short-term,
11limited-duration health insurance coverage that is delivered
12or issued for delivery in this State must prominently display
13the following in bold type: "WARNING! This is temporary
14coverage. This policy provides limited benefits.".
15    (e) Any individual selling a short-term, limited-duration
16health insurance coverage policy in this State must read out
17loud the disclosure in subsection (b) to a prospective
19    Section 20. Filing and approval.
20    (a) Coverage subject to this Act may not be delivered or
21issued for delivery unless it has been approved by the
23    (b) A health insurance issuer who intends to deliver or
24issue for delivery a short-term, limited-duration health
25insurance coverage policy in this State shall file with the



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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
8out the provisions of this Act.
9    (d) The Department shall adopt any rules necessary to
10protect Illinois consumers and promote the stability of
11Illinois' health insurance markets.
12    Section 25. Illinois Insurance Code and benefit
14    (a) Short-term, limited-duration coverage shall be subject
15to Sections 143c, 155.36, 355, 356a, 356b, 356c, 356e, 356f,
16356g, 356g.5, 356g.5-1, 356h, 356i, 356k, 356L, 356m, 356n,
17356p, 356q, 356r, 356s, 356t, 356u, 356v, 356w, 356x, 356z.1,
18356z.2, 356z.3a, 356z.4, 356z.5, 356z.6, 356z.7, 356z.8,
19356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15,
20356z.17, 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, 356z.24,
21356z.25, 356z.25, 364, 364.01, 367b, 367k, 370a, and 370c,
22subsections (7) and (8) of Section 367, and subsection (a) of
23Section 370i of the Illinois Insurance Code.
24    (b) Short-term, limited-duration coverage shall also be
25subject to the provisions of the Network Adequacy and



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1Transparency Act, the Managed Care Reform and Patients Rights
2Act, the Topical Eye Medication Prescription Act, the Organ
3Transplant Medication Notification Act, and the Health Carrier
4External Review Act.
5    Section 90. The Illinois Insurance Code is amended by
6changing Section 356z.16 and by changing and renumbering
7Section 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
10supplemental policies. Unless specified otherwise, the
11following Sections of the Illinois Insurance Code do not apply
12to short-term travel, disability income, long-term care,
13accident only, or limited (excluding short-term,
14limited-duration health insurance coverage policies as defined
15in the Short-Term, Limited-Duration Health Insurance Coverage
16Act) or specified disease policies: 355b, 356b, 356c, 356d,
17356g, 356k, 356m, 356n, 356p, 356q, 356r, 356t, 356u, 356w,
18356x, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.12,
19356z.14, 356z.19, 356z.21, 356z.25, 364.01, 367.2-5, and 367e.
20(Source: P.A. 100-386, eff. 1-1-18.)
21    (215 ILCS 5/356z.27)
22    Sec. 356z.27 356z.25. Preexisting condition exclusion. No
23policy of individual or group accident and health insurance,



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1including short-term, limited-duration health insurance
2coverage as defined in the Short-Term, Limited-Duration Health
3Insurance Coverage Act issued, amended, delivered, or renewed
4on or after January 1, 2018 (the effective date of Public Act
5100-386) this amendatory Act of the 100th General Assembly may
6impose any preexisting condition exclusion, as defined in the
7Illinois Health Insurance Portability and Accountability Act,
8with respect to such plan or coverage.
9(Source: P.A. 100-386, eff. 1-1-18; revised 9-15-17.)
10    Section 99. Effective date. This Act takes effect January
111, 2019.".