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90_SB1919
215 ILCS 125/4-8 from Ch. 111 1/2, par. 1409.1
Amends the Health Maintenance Organization Act. Makes a
technical change in a Section concerning coverage of newborn
infants.
LRB9011427JSgc
LRB9011427JSgc
1 AN ACT to amend the Health Maintenance Organization Act
2 by changing Section 4-8.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Health Maintenance Organization Act is
6 amended by changing Section 4-8 as follows:
7 (215 ILCS 125/4-8) (from Ch. 111 1/2, par. 1409.1)
8 Sec. 4-8. Newborn infants.
9 (1) No contract or evidence of coverage issued by a
10 Health Maintenance Organization that which provides for
11 coverage of dependents of the principal enrollee shall
12 contain any disclaimer, waiver or other limitation relative
13 to the eligibility or coverage of newborn infants of a
14 principal enrollee from and after the moment of birth.
15 (2) Each such contract or evidence of coverage shall
16 contain a provision stating that benefits shall be granted
17 immediately with respect to newborn infants from the moment
18 of birth and that such coverage shall include illness,
19 injury, congenital defects, birth abnormalities and premature
20 birth.
21 (3) If payment of a specific premium is required under
22 the terms of a contract to provide coverage for a child,
23 there may be requirements that notification of birth of a
24 newly born infant be given to the Health Maintenance
25 Organization within the 31 days following the birth in order
26 to have coverage continued beyond such 31 day period and that
27 such specific premium be paid within 30 days following
28 receipt of such notice.
29 (4) In the event that no other members of the enrollee's
30 immediate family are covered, immediate coverage for the
31 first newborn infant shall be provided if the enrollee
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1 applies for dependent's coverage within 31 days of the
2 newborn's birth. Such coverage shall be contingent upon
3 payment of the additional premium.
4 (5) The requirements of this Section shall apply, on or
5 after the sixtieth day following the effective date of this
6 amendatory Act of 1989, (a) to all such evidences of coverage
7 delivered or issued for delivery, and (b) to all such group
8 contracts delivered, issued for delivery, renewed or amended.
9 The health maintenance organizations which issue such
10 evidences of coverage that are in effect on the sixtieth day
11 following the effective date of this amendatory Act of 1989
12 shall extend to owners of such contracts, on or before the
13 first contract anniversary following such date, the
14 opportunity to apply for the addition to their contracts of a
15 provision as set forth in subsection (2) above, with, at the
16 option of the health maintenance organization, payment of a
17 premium appropriate thereto.
18 (Source: P.A. 86-620.)