(215 ILCS 125/4-9.1) (from Ch. 111 1/2, par. 1409.2-1)
Sec. 4-9.1. Dependent Coverage Termination.
(a) The attainment of a limiting age under a group contract or
evidence of coverage which provides that coverage of a dependent person of
an enrollee shall terminate upon attainment of the limiting age for
dependent persons does
not operate to terminate the coverage of a person who, because
of a disabling condition that occurred before attainment of the limiting age,
is incapable of self-sustaining employment and is dependent on his
or her
parents or other care providers for lifetime care and supervision.
(b) For purposes of subsection (a), "dependent on other care providers" is
defined as requiring a Community Integrated Living Arrangement, group home,
supervised apartment, or other residential services licensed or certified by
the Department of Human Services (as successor to the Department of Mental
Health and Developmental Disabilities), the Department
of Public Health, or the Department of Healthcare and Family Services (formerly Department of Public Aid).
(c) Proof of such incapacity and dependency shall be furnished to the health
maintenance organization by the enrollee within
31 days of a request for the
information by the health maintenance organization and subsequently as may
be required by the health maintenance organization, but not more frequently
than annually. In the absence of proof submitted within 31 days of such
inquiry that such dependent is a person who has a disability and is a dependent, the health
maintenance organization may terminate coverage of such person at or
after attainment of the limiting age. In the absence of such inquiry,
coverage of any person who has a disability and is a dependent shall continue through the
term of the group contract or evidence of coverage or any extension or
renewal thereof.
(Source: P.A. 99-143, eff. 7-27-15.)
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