Bill Amendment: IL HB2624 | 2017-2018 | 100th General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: HEALTH INS RATE REVIEW ACT
Status: 2018-11-28 - Total Veto Stands - No Positive Action Taken [HB2624 Detail]
Download: Illinois-2017-HB2624-Senate_Amendment_002.html
Bill Title: HEALTH INS RATE REVIEW ACT
Status: 2018-11-28 - Total Veto Stands - No Positive Action Taken [HB2624 Detail]
Download: Illinois-2017-HB2624-Senate_Amendment_002.html
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1 | AMENDMENT TO HOUSE BILL 2624
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2 | AMENDMENT NO. ______. Amend House Bill 2624 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 1. Short title. This Act may be cited as the | ||||||
5 | Short-Term, Limited-Duration Health Insurance Coverage Act.
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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.
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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.
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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).
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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.
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12 | Section 99. Effective date. This Act takes effect January | ||||||
13 | 1, 2019.".
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