Full Text of HB2624 100th General Assembly
HB2624sam002 100TH GENERAL ASSEMBLY | Sen. Heather A. Steans Filed: 5/16/2018
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| 1 | | AMENDMENT TO HOUSE BILL 2624
| 2 | | AMENDMENT NO. ______. Amend House Bill 2624 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Short-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 | 9 | | with a group health plan, health insurance coverage offered in | 10 | | connection 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 | 13 | | Income Security Act of 1974) to the extent that the plan | 14 | | provides medical care (as defined in paragraph (2) of that | 15 | | Section and including items and services paid for as medical | 16 | | care) to employees or their dependents (as defined under the |
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| 1 | | terms of the plan) directly or through insurance, | 2 | | reimbursement, or otherwise. | 3 | | "Health insurance coverage" means benefits consisting of | 4 | | medical care (provided directly, through insurance or | 5 | | reimbursement, or otherwise and including items and services | 6 | | paid for as medical care) under any hospital or medical service | 7 | | policy or certificate, hospital or medical service plan | 8 | | contract, or health maintenance organization contract offered | 9 | | by a health insurance issuer. | 10 | | "Health insurance issuer" means an insurance company, | 11 | | insurance service, or insurance organization (including a | 12 | | health maintenance organization) that is licensed to engage in | 13 | | the business of insurance in a state and that is subject to | 14 | | Illinois law that regulates insurance (within the meaning of | 15 | | Section 514(b)(2) of the federal Employee Retirement Income | 16 | | Security Act of 1974). "Health insurance issuer" does not | 17 | | include a group health plan. | 18 | | "Fraud" means an intentional misrepresentation of a | 19 | | material fact in connection with the coverage. | 20 | | "Individual health insurance coverage" means health | 21 | | insurance coverage offered to individuals in the individual | 22 | | market, including short-term, limited-duration health | 23 | | insurance coverage. | 24 | | "Short-term, limited-duration health insurance coverage" | 25 | | means individual health insurance coverage provided under a | 26 | | contract offered by a licensed health insurance issuer, |
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| 1 | | regardless of the situs of the delivery of the policy or | 2 | | contract 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 | 5 | | short-term, limited-duration health insurance coverage to | 6 | | individuals in this State and to short-term, limited-duration | 7 | | health insurance coverage that is delivered or issued for | 8 | | delivery in this State, including coverage issued outside of | 9 | | this State that covers individuals in this State. | 10 | | (b) A short-term, limited-duration health insurance | 11 | | coverage policy (even where issued outside of this State) may | 12 | | not cover any person residing in this State or be delivered or | 13 | | issued for delivery in this State unless the policy complies | 14 | | with the provisions of this Act. | 15 | | (c) Any short-term, limited-duration health insurance | 16 | | coverage policy that is delivered or issued for delivery in | 17 | | this State must have an expiration date in the contract that is | 18 | | less than 91 days and shall not be renewable within a period of | 19 | | 365 days, beginning the day after the contract ends, either at | 20 | | the option of the issuer or the individual. Renewal of a | 21 | | short-term, limited-duration health insurance coverage policy | 22 | | includes the issuance of a new short-term, limited-duration | 23 | | health insurance policy by an issuer to a policyholder within | 24 | | 60 days after the expiration of a policy previously issued by | 25 | | the issuer to the policyholder. |
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| 1 | | (d) Any short-term, limited-duration health insurance | 2 | | coverage policy that is delivered or issued for delivery in | 3 | | this State may not be rescinded before the expiration date in | 4 | | the contract, except in cases of nonpayment of premiums, fraud, | 5 | | or as provided in subsection (e). | 6 | | (e) Any short-term, limited-duration health insurance | 7 | | coverage policy that is delivered or issued for delivery in | 8 | | this State shall contain an option for an individual to cancel | 9 | | coverage after any 30-day interval during the term of the plan. | 10 | | Section 15. Disclosure requirements. | 11 | | (a) A health insurance issuer that offers short-term, | 12 | | limited-duration health insurance coverage shall, in addition | 13 | | to all other documents required, including, but not limited to, | 14 | | the policy, the certificate, the membership booklet, and a | 15 | | description of appeal and external review rights, deliver an | 16 | | outline of coverage to an applicant for or an enrollee in | 17 | | short-term, limited-duration health insurance coverage | 18 | | delivered or issued for delivery in this State. | 19 | | (b) Any short-term, limited-duration health insurance | 20 | | coverage policy that is delivered or issued for delivery in the | 21 | | State shall display prominently in the contract, any | 22 | | application, sales, and marketing materials provided in | 23 | | connection with enrollment in such coverage, and the outline of | 24 | | coverage for such coverage, in at least 14-point, bold type, | 25 | | the following: "NOTICE: THE SHORT-TERM, LIMITED-DURATION |
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| 1 | | INSURANCE BENEFITS UNDER THIS COVERAGE DO NOT MEET ALL FEDERAL | 2 | | REQUIREMENTS TO QUALIFY AS "MINIMUM ESSENTIAL COVERAGE" FOR | 3 | | HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. THIS PLAN OF | 4 | | COVERAGE DOES NOT INCLUDE ALL ESSENTIAL HEALTH BENEFITS AS | 5 | | REQUIRED BY THE AFFORDABLE CARE ACT. PREEXISTING CONDITIONS ARE | 6 | | NOT COVERED UNDER THIS PLAN OF COVERAGE. BE SURE TO CHECK YOUR | 7 | | POLICY CAREFULLY TO MAKE SURE YOU UNDERSTAND WHAT THE POLICY | 8 | | DOES AND DOES NOT COVER. IF THIS COVERAGE EXPIRES OR YOU LOSE | 9 | | ELIGIBILITY FOR THIS COVERAGE, YOU MIGHT HAVE TO WAIT UNTIL THE | 10 | | NEXT OPEN ENROLLMENT PERIOD TO GET OTHER HEALTH INSURANCE | 11 | | COVERAGE. YOU MAY BE ABLE TO GET LONGER TERM INSURANCE THAT | 12 | | QUALIFIES AS "MINIMUM ESSENTIAL COVERAGE" FOR HEALTH INSURANCE | 13 | | UNDER THE AFFORDABLE CARE ACT NOW AND HELP TO PAY FOR IT AT | 14 | | WWW.HEALTHCARE.GOV.". | 15 | | (c) Any individual selling a short-term, limited-duration | 16 | | health insurance coverage policy in this State must read out | 17 | | loud the disclosure in subsection (b) to a prospective | 18 | | purchaser. | 19 | | (d) Nothing in this Section precludes an insurer from | 20 | | providing disclosures in addition to those required in | 21 | | subsections (b) and (c). | 22 | | Section 20. Filing and approval. | 23 | | (a) Coverage subject to this Act may not be delivered or | 24 | | issued for delivery unless it has been approved by the | 25 | | Department. |
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| 1 | | (b) A health insurance issuer who intends to deliver or | 2 | | issue for delivery a short-term, limited-duration health | 3 | | insurance coverage policy in this State shall file with the | 4 | | Department: | 5 | | (1) all paperwork required by health insurance issuers | 6 | | of individual health insurance coverage; | 7 | | (2) all sales and marketing materials provided in | 8 | | connection with enrollment in such coverage; and | 9 | | (3) the outline of such coverage. | 10 | | (c) The Department shall adopt any rules necessary to carry | 11 | | out the provisions of this Act.
| 12 | | Section 99. Effective date. This Act takes effect January | 13 | | 1, 2019.".
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