Bill Text: IL HB3093 | 2011-2012 | 97th General Assembly | Introduced

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Bill Title: Amends the Covering ALL KIDS Health Insurance Act. In the provision concerning eligibility, provides that the Department of Healthcare and Family Services, in cooperation with the Department of Human Services, shall develop and implement procedures in administration of the Covering ALL KIDS Health Insurance Program to require certain proofs of eligibility from applicants; cross reference income reported by applicants; and require the termination of coverage if certain premiums have not been paid pursuant to a grace period. Effective immediately.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2013-01-08 - Session Sine Die [HB3093 Detail]

Download: Illinois-2011-HB3093-Introduced.html

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97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 HB3093 Introduced , by Rep. Michael W. Tryon SYNOPSIS AS INTRODUCED:
215 ILCS 170/20
Amends the Covering ALL KIDS Health Insurance Act. In the provision concerning eligibility, provides that the Department of Healthcare and Family Services, in cooperation with the Department of Human Services, shall develop and implement procedures in administration of the Covering ALL KIDS Health Insurance Program to require certain proofs of eligibility from applicants; cross reference income reported by applicants; and require the termination of coverage if certain premiums have not been paid pursuant to a grace period. Effective immediately.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning insurance.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Covering ALL KIDS Health Insurance Act is
amended by changing Section 20 as follows:
(215 ILCS 170/20)
(Section scheduled to be repealed on July 1, 2016)
Sec. 20. Eligibility.
(a) To be eligible for the Program, a person must be a
child:
(1) who is a resident of the State of Illinois;
(2) who is ineligible for medical assistance under the
Illinois Public Aid Code or benefits under the Children's
Health Insurance Program Act;
(3) either (i) who has been without health insurance
coverage for 12 months, (ii) whose parent has lost
employment that made available affordable dependent health
insurance coverage, until such time as affordable
employer-sponsored dependent health insurance coverage is
again available for the child as set forth by the
Department in rules, (iii) who is a newborn whose
responsible relative does not have available affordable
private or employer-sponsored health insurance, or (iv)

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who, within one year of applying for coverage under this
Act, lost medical benefits under the Illinois Public Aid
Code or the Children's Health Insurance Program Act; and
(3.5) whose household income, as determined by the
Department, is at or below 300% of the federal poverty
level. This item (3.5) is effective July 1, 2011.
An entity that provides health insurance coverage (as
defined in Section 2 of the Comprehensive Health Insurance Plan
Act) to Illinois residents shall provide health insurance data
match to the Department of Healthcare and Family Services as
provided by and subject to Section 5.5 of the Illinois
Insurance Code.
The Department of Healthcare and Family Services, in
collaboration with the Department of Insurance, shall adopt
rules governing the exchange of information under this Section.
The rules shall be consistent with all laws relating to the
confidentiality or privacy of personal information or medical
records, including provisions under the Federal Health
Insurance Portability and Accountability Act (HIPAA).
(b) The Department shall monitor the availability and
retention of employer-sponsored dependent health insurance
coverage and shall modify the period described in subdivision
(a)(3) if necessary to promote retention of private or
employer-sponsored health insurance and timely access to
healthcare services, but at no time shall the period described
in subdivision (a)(3) be less than 6 months.

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(c) The Department, at its discretion, may take into
account the affordability of dependent health insurance when
determining whether employer-sponsored dependent health
insurance coverage is available upon reemployment of a child's
parent as provided in subdivision (a)(3).
(d) A child who is determined to be eligible for the
Program shall remain eligible for 12 months, provided that the
child maintains his or her residence in this State, has not yet
attained 19 years of age, and is not excluded under subsection
(e).
(e) A child is not eligible for coverage under the Program
if:
(1) the premium required under Section 40 has not been
timely paid; if the required premiums are not paid, the
liability of the Program shall be limited to benefits
incurred under the Program for the time period for which
premiums have been paid; re-enrollment shall be completed
before the next covered medical visit, and the first
month's required premium shall be paid in advance of the
next covered medical visit; or
(2) the child is an inmate of a public institution or
an institution for mental diseases.
(f) The Department may adopt rules, including, but not
limited to: rules regarding annual renewals of eligibility for
the Program in conformance with Section 7 of this Act; rules
providing for re-enrollment, grace periods, notice

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requirements, and hearing procedures under subdivision (e)(1)
of this Section; and rules regarding what constitutes
availability and affordability of private or
employer-sponsored health insurance, with consideration of
such factors as the percentage of income needed to purchase
children or family health insurance, the availability of
employer subsidies, and other relevant factors.
(f-5) Within 90 days after the effective date of this
amendatory Act of the 97th General Assembly, the Department, in
cooperation with the Department of Human Services, shall
develop and implement procedures in administration of the
Program to do all of the following:
(1) Require applicants to provide proof of the
applicant's date of birth, including, but not limited to,
by providing a birth certificate to prove the age of the
applicant.
(2) Require applicants to provide documentation to
prove the identity of the applicant.
(3) Require applicants to provide documentation to
prove that the applicant is a resident of Illinois.
(4) Address or other contact information of the
applicant's parent or guardian.
(5) For documented immigrants, provide for applicants
to supply information to prove the documented status of the
applicant.
(6) Cross reference income reported by applicants, at

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the time of original application or renewal, to other State
records, including the Department of Employment Security
data or tax records.
(7) Require all enrollees to return an annual
redetermination to verify that there were no changes to
their eligibility information.
(8) Require the termination of coverage if the premium
for an enrollee in All Kids Premium Level 2 through Premium
Level 8 has not been paid pursuant to a grace period
through the end of the month of coverage. When termination
of coverage is recorded by the 15th day of the month, the
termination is effective the first day of the following
month. When termination of coverage is recorded after the
15th day of the month, the termination is effective no
later than the first day of the second month following that
determination.
(g) Each child enrolled in the Program as of July 1, 2011
whose family income, as established by the Department, exceeds
300% of the federal poverty level may remain enrolled in the
Program for 12 additional months commencing July 1, 2011.
Continued enrollment pursuant to this subsection shall be
available only if the child continues to meet all eligibility
criteria established under the Program as of the effective date
of this amendatory Act of the 96th General Assembly without a
break in coverage. Nothing contained in this subsection shall
prevent a child from qualifying for any other health benefits

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program operated by the Department.
(Source: P.A. 96-1272, eff. 1-1-11; 96-1501, eff. 1-25-11.)
Section 99. Effective date. This Act takes effect upon
becoming law.