Bill Text: IL HB3259 | 2011-2012 | 97th General Assembly | Amended

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Bill Title: Amends the Covering ALL KIDS Health Insurance Act. Provides that a child who is determined to be eligible shall remain eligible for 12 months, provided that the child has not gained access to affordable employer-sponsored dependent health insurance. Provides that the parent, guardian, or legal custodian of an enrolled child shall report promptly those changes in income and other circumstances that affect eligibility within 30 days after the occurrence of the change. Provides that the eligibility of a child may be redetermined based on the information reported or may be terminated based on the failure to report or failure to report accurately. Effective immediately.

Sponsorship: Partisan Bill (Republican 2)

Status: (Failed) 2013-01-08 - Session Sine Die [HB3259 Detail]

Download: Illinois-2011-HB3259-Amended.html

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Rep. Jil Tracy

Filed: 4/13/2011

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(Section scheduled to be repealed on July 1, 2016)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

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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)
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 This item (3.5) is effective July 1, 2011; and
.
(4) 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.
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

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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.
(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

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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
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.
(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

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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
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.".