Full Text of HB3781 98th General Assembly
HB3781 98TH GENERAL ASSEMBLY |
| | 98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014 HB3781 Introduced , by Rep. Jil Tracy SYNOPSIS AS INTRODUCED: |
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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 regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Covering ALL KIDS Health Insurance Act is | 5 | | amended by changing Section 20 as follows: | 6 | | (215 ILCS 170/20) | 7 | | (Section scheduled to be repealed on July 1, 2016)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 | 10 | | child:
| 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 ; | 7 | | and . | 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 | 13 | | defined in Section 2 of the Comprehensive Health Insurance Plan | 14 | | Act) to Illinois residents shall provide health insurance data | 15 | | match to the Department of Healthcare and Family Services as | 16 | | provided by and subject to Section 5.5 of the Illinois | 17 | | Insurance Code. The Department of Healthcare and Family | 18 | | Services may impose an administrative penalty as provided under | 19 | | Section 12-4.45 of the Illinois Public Aid Code on entities | 20 | | that have established a pattern of failure to provide the | 21 | | information required under this Section. | 22 | | The Department of Healthcare and Family Services, in | 23 | | collaboration with the Department of Insurance, shall adopt | 24 | | rules governing the exchange of information under this Section. | 25 | | The rules shall be consistent with all laws relating to the | 26 | | confidentiality or privacy of personal information or medical |
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| 1 | | records, including provisions under the Federal Health | 2 | | Insurance Portability and Accountability Act (HIPAA). | 3 | | (b) The Department shall monitor the availability and | 4 | | retention of employer-sponsored dependent health insurance | 5 | | coverage and shall modify the period described in subdivision | 6 | | (a)(3) if necessary to promote retention of private or | 7 | | employer-sponsored health insurance and timely access to | 8 | | healthcare services, but at no time shall the period described | 9 | | in subdivision (a)(3) be less than 6 months.
| 10 | | (c) The Department, at its discretion, may take into | 11 | | account the affordability of dependent health insurance when | 12 | | determining whether employer-sponsored dependent health | 13 | | insurance coverage is available upon reemployment of a child's | 14 | | parent as provided in subdivision (a)(3). | 15 | | (d) A child who is determined to be eligible for the | 16 | | Program shall remain eligible for 12 months, provided that the | 17 | | child maintains his or her residence in this State, has not yet | 18 | | attained 19 years of age, and is not excluded under subsection | 19 | | (e). | 20 | | (e) A child is not eligible for coverage under the Program | 21 | | if: | 22 | | (1) the premium required under Section 40 has not been | 23 | | timely paid; if the required premiums are not paid, the | 24 | | liability of the Program shall be limited to benefits | 25 | | incurred under the Program for the time period for which | 26 | | premiums have been paid; re-enrollment shall be completed |
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| 1 | | before the next covered medical visit, and the first | 2 | | month's required premium shall be paid in advance of the | 3 | | next covered medical visit; or | 4 | | (2) the child is an inmate of a public institution or | 5 | | an institution for mental diseases.
| 6 | | (f) The Department may adopt rules, including, but not | 7 | | limited to: rules regarding annual renewals of eligibility for | 8 | | the Program in conformance with Section 7 of this Act; rules | 9 | | providing for re-enrollment, grace periods, notice | 10 | | requirements, and hearing procedures under subdivision (e)(1) | 11 | | of this Section; and rules regarding what constitutes | 12 | | availability and affordability of private or | 13 | | employer-sponsored health insurance, with consideration of | 14 | | such factors as the percentage of income needed to purchase | 15 | | children or family health insurance, the availability of | 16 | | employer subsidies, and other relevant factors.
| 17 | | (g) Each child enrolled in the Program as of July 1, 2011 | 18 | | whose family income, as established by the Department, exceeds | 19 | | 300% of the federal poverty level may remain enrolled in the | 20 | | Program for 12 additional months commencing July 1, 2011. | 21 | | Continued enrollment pursuant to this subsection shall be | 22 | | available only if the child continues to meet all eligibility | 23 | | criteria established under the Program as of the effective date | 24 | | of this amendatory Act of the 96th General Assembly without a | 25 | | break in coverage. Nothing contained in this subsection shall | 26 | | prevent a child from qualifying for any other health benefits |
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| 1 | | program operated by the Department. | 2 | | (Source: P.A. 98-130, eff. 8-2-13.)
| 3 | | Section 99. Effective date. This Act takes effect upon | 4 | | becoming law.
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