Illinois General Assembly - Full Text of HB3259
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Full Text of HB3259  97th General Assembly


Rep. Jil Tracy

Filed: 4/13/2011





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2    AMENDMENT NO. ______. Amend House Bill 3259 by replacing
3everything after the enacting clause with the following:
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7    (Section scheduled to be repealed on July 1, 2016)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
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



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1    employment that made available affordable dependent health
2    insurance coverage, until such time as affordable
3    employer-sponsored dependent health insurance coverage is
4    again available for the child as set forth by the
5    Department in rules, (iii) who is a newborn whose
6    responsible relative does not have available affordable
7    private or employer-sponsored health insurance, or (iv)
8    who, within one year of applying for coverage under this
9    Act, lost medical benefits under the Illinois Public Aid
10    Code or the Children's Health Insurance Program Act; and
11        (3.5) whose household income, as determined by the
12    Department, is at or below 300% of the federal poverty
13    level; . this This item (3.5) is effective July 1, 2011; and
14    .
15        (4) who does not have access to affordable
16    employer-sponsored dependent health insurance coverage
17    that is comparable to the coverage of the existing Program
18    as determined by the administering agency's rules.
19    An entity that provides health insurance coverage (as
20defined in Section 2 of the Comprehensive Health Insurance Plan
21Act) to Illinois residents shall provide health insurance data
22match to the Department of Healthcare and Family Services as
23provided by and subject to Section 5.5 of the Illinois
24Insurance Code.
25    The Department of Healthcare and Family Services, in
26collaboration with the Department of Insurance, shall adopt



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1rules governing the exchange of information under this Section.
2The rules shall be consistent with all laws relating to the
3confidentiality or privacy of personal information or medical
4records, including provisions under the Federal Health
5Insurance Portability and Accountability Act (HIPAA).
6    (b) The Department shall monitor the availability and
7retention of employer-sponsored dependent health insurance
8coverage and shall modify the period described in subdivision
9(a)(3) if necessary to promote retention of private or
10employer-sponsored health insurance and timely access to
11healthcare services, but at no time shall the period described
12in subdivision (a)(3) be less than 6 months.
13    (c) The Department, at its discretion, may take into
14account the affordability of dependent health insurance when
15determining whether employer-sponsored dependent health
16insurance coverage is available upon reemployment of a child's
17parent as provided in subdivision (a)(3).
18    (d) A child who is determined to be eligible for the
19Program shall remain eligible for 12 months, provided that the
20child maintains his or her residence in this State, has not yet
21attained 19 years of age, and is not excluded under subsection
23    (e) A child is not eligible for coverage under the Program
25        (1) the premium required under Section 40 has not been
26    timely paid; if the required premiums are not paid, the



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1    liability of the Program shall be limited to benefits
2    incurred under the Program for the time period for which
3    premiums have been paid; re-enrollment shall be completed
4    before the next covered medical visit, and the first
5    month's required premium shall be paid in advance of the
6    next covered medical visit; or
7        (2) the child is an inmate of a public institution or
8    an institution for mental diseases.
9    (f) The Department may adopt rules, including, but not
10limited to: rules regarding annual renewals of eligibility for
11the Program in conformance with Section 7 of this Act; rules
12providing for re-enrollment, grace periods, notice
13requirements, and hearing procedures under subdivision (e)(1)
14of this Section; and rules regarding what constitutes
15availability and affordability of private or
16employer-sponsored health insurance, with consideration of
17such factors as the percentage of income needed to purchase
18children or family health insurance, the availability of
19employer subsidies, and other relevant factors.
20    (g) Each child enrolled in the Program as of July 1, 2011
21whose family income, as established by the Department, exceeds
22300% of the federal poverty level may remain enrolled in the
23Program for 12 additional months commencing July 1, 2011.
24Continued enrollment pursuant to this subsection shall be
25available only if the child continues to meet all eligibility
26criteria established under the Program as of the effective date



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1of this amendatory Act of the 96th General Assembly without a
2break in coverage. Nothing contained in this subsection shall
3prevent a child from qualifying for any other health benefits
4program operated by the Department.
5(Source: P.A. 96-1272, eff. 1-1-11; 96-1501, eff. 1-25-11.)
6    Section 99. Effective date. This Act takes effect upon
7becoming law.".