(215 ILCS 105/15)
Sec. 15. Alternative portable coverage for federally eligible individuals.
(a) Notwithstanding the requirements of subsection a of Section 7 and
except as otherwise provided in this Section, any
federally eligible individual for whom a Plan
application, and such enclosures and supporting documentation as the Board may
require, is received by the Board within 90 days after the
termination of prior
creditable coverage shall qualify to enroll in the Plan under the
portability provisions of this Section.
A federally eligible person who has
been certified as eligible pursuant to the federal Trade
Act of 2002
and whose Plan application and enclosures and supporting
documentation as the Board may require is received by the Board within 63 days
after the termination of previous creditable coverage shall qualify to enroll
in the Plan under the portability provisions of this Section.
(b) Any federally eligible individual seeking Plan coverage under this
Section must submit with his or her application evidence, including acceptable
written certification of previous creditable coverage, that will establish to
the Board's satisfaction, that he or she meets all of the requirements to be a
federally eligible individual and is currently and
permanently residing in this State (as of the date his or her application was
received by the Board).
(c) Except as otherwise provided in this Section, a period of creditable
coverage shall not be counted, with respect to
qualifying an applicant for Plan coverage as a federally eligible individual
under this Section, if after such period and before the application for Plan
coverage was received by the Board, there was at least a 90-day
period during
all of which the individual was not covered under any creditable coverage.
For a federally eligible person who has
been certified as eligible
pursuant to the federal Trade Act of 2002, a period of creditable
coverage shall not be counted, with respect to qualifying an applicant for Plan
coverage as a federally eligible individual under this Section, if after such
period and before the application for Plan coverage was received by the Board,
there was at
least a 63-day period during all of which the individual was not covered under
any creditable coverage.
(d) Any federally eligible individual who the Board determines qualifies for
Plan coverage under this Section shall be offered his or her choice of
enrolling in one of alternative portability health benefit plans which the
Board
is authorized under this Section to establish for these federally eligible
individuals
and their dependents.
(e) The Board shall offer a choice of health care coverages consistent with
major medical coverage under the alternative health benefit plans authorized by
this Section to every federally eligible individual.
The coverages to be offered under the plans, the schedule of
benefits, deductibles, co-payments, exclusions, and other limitations shall be
approved by the Board. One optional form of coverage shall be comparable to
comprehensive health insurance coverage offered in the individual market in
this State or a standard option of coverage available under the group or
individual health insurance laws of the State. The standard benefit plan that
is
authorized by Section 8 of this Act may be used for this purpose. The Board
may also offer a preferred provider option and such other options as the Board
determines may be appropriate for these federally eligible individuals who
qualify for Plan coverage pursuant to this Section.
(f) Notwithstanding the requirements of subsection f of Section 8, any
Plan coverage
that is issued to federally eligible individuals who qualify for the Plan
pursuant
to the portability provisions of this Section shall not be subject to any
preexisting conditions exclusion, waiting period, or other similar limitation
on coverage.
(g) Federally eligible individuals who qualify and enroll in the Plan
pursuant
to this Section shall be required to pay such premium rates as the Board shall
establish and approve in accordance with the requirements of Section 7.1 of
this Act.
(h) A federally eligible individual who qualifies and enrolls in the Plan
pursuant to this Section must satisfy on an ongoing basis all of the other
eligibility requirements of this Act to the extent not inconsistent with the
federal Health Insurance Portability and Accountability Act of 1996 in order to
maintain continued eligibility
for coverage under the Plan.
(i) New enrollment and policy renewals are discontinued on December 31, 2021. (Source: P.A. 102-159, eff. 7-23-21.)
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