|
United States Veteran
honorably discharged or a person |
on active military duty;
|
(B) refugees under Section 207 of the Immigration |
and
Nationality Act;
|
(C) asylees under Section 208 of the Immigration |
and
Nationality Act;
|
(D) persons for whom deportation has been withheld |
under
Section 243(h) of the Immigration and |
Nationality Act;
|
(E) persons granted conditional entry under |
Section 203(a)(7) of the
Immigration and Nationality |
Act as in effect prior to April 1, 1980;
|
(F) persons lawfully admitted for permanent |
residence under
the Immigration and Nationality Act; |
and
|
(G) parolees, for at least one year, under Section |
212(d)(5)
of the Immigration and Nationality Act.
|
Those children who are in the categories set forth in |
subdivisions
(4)(F) and (4)(G) of this subsection, who enter |
the United States on or
after August 22, 1996, shall not be |
eligible for 5 years beginning on the
date the child entered |
the United States.
|
(b) A child who is determined to be eligible for assistance |
may remain
eligible for 12 months, provided the child maintains |
his or
her residence in the State, has not yet attained 19 |
years of age, and is not
excluded pursuant to subsection (c). A |
|
child who has been determined to
be eligible for assistance |
must reapply or otherwise establish eligibility
at least |
annually.
An eligible child shall be required, as determined by |
the
Department by rule, to report promptly those changes in |
income and other
circumstances that affect eligibility. 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. A child's |
responsible
relative or caretaker may also be held liable to |
the Department for any
payments made by the Department on such |
child's behalf that were inappropriate.
An applicant shall be |
provided with notice of these obligations.
|
(c) A child shall not be eligible for coverage under this |
Program if:
|
(1) the premium required pursuant to
Section 30 of this |
Act has not been 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 had been paid. If
the required monthly |
premium is not paid, the child shall be ineligible for
|
re-enrollment for a minimum period of 3 months. |
Re-enrollment shall be
completed prior to the next covered |
medical visit and the first month's
required premium shall |
be paid in advance of the next covered medical visit.
The |
Department shall promulgate rules regarding grace periods, |
notice
requirements, and hearing procedures pursuant to |
|
this subsection;
|
(2) the child is an inmate of a public institution or a |
patient in an
institution for mental diseases; or
|
(3) the child is a member of a family that is eligible |
for health benefits
covered under the State of Illinois |
health benefits plan on the basis of a
member's employment |
with a public agency.
|
(Source: P.A. 92-597, eff. 6-28-02; 93-63, eff. 6-30-03.)
|
Section 10. 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, 2011)
|
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; and
|
(2) who is ineligible for medical assistance under the |
Illinois Public Aid Code or benefits under the Children's |
Health Insurance Program Act; and
|
(3) either (i) who has been without health insurance |
coverage for a period set forth by the Department in rules, |
but not less than 6 months during the first month of |
operation of the Program, 7 months during the second month |
of operation, 8 months during the third month of operation, |
|
9 months during the fourth month of operation, 10 months |
during the fifth month of operation, 11 months during the |
sixth month of operation, and 12 months thereafter, (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) 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. |
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 for |
the purpose of determining eligibility for the Program under |
this Act. |
The Department of Healthcare and Family Services, in |
collaboration with the Department of Financial and |
Professional Regulation, Division 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.
|
(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; if the required monthly premium is |
not paid, the child is ineligible for re-enrollment for a |
|
minimum period of 3 months; 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 shall adopt eligibility rules, |
including, but not limited to: rules regarding annual renewals |
of eligibility for the Program; 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.
|
(Source: P.A. 94-693, eff. 7-1-06.)
|