80 Ill. Adm. Code 2210.430
Continuation of Coverage
Section
2210.430 Continuation of Coverage
a) Election of Continuation
Coverage.
1) Eligible Members who
lose coverage due an event identified in subsection (b) may elect to continue
coverage for a specified period of time in accordance with the requirements of
federal law and sections 367.2, 367e, and 367e.1 of the Illinois Insurance Code
[215 ILCS 5].
2) A Member electing
continuation coverage must make a written election to continue coverage within
60 calendar days after the later of the date coverage is terminated due to a
qualifying event or the date the Member or Dependent is sent notice of the
right to elect continuation coverage.
3) A Member electing to
enroll in continuation coverage must submit payment of all premiums due for
such coverage within 45 calendar days of the date of election.
4) A Member who timely
elects continuation coverage and submits payment of all premiums due will not
have a gap in coverage and will have coverage reinstated retroactive to the
date of termination.
5) The Agency shall
establish the monthly premium rates to be paid by Members for continuation
coverage. These rates are published in the CMS Benefit Program Books available
at https://cms.illinois.gov/benefits/stateemployee/benefitsbooks.html
b) Qualifying Events for
Continuation Coverage.
1) An Employee may elect
continuation coverage under the Program upon the occurrence of any of the
following events:
A) Termination of Employee’s
employment with the State for any reason other than gross misconduct;
B) Termination of Employee’s
disability benefits;
C) Expiration of Employee’s
maximum leave of absence period; or
D) Loss of eligibility to
participate in the Program due to a reduction in work hours.
2) A Dependent will be
eligible to elect continuation coverage under the Program upon the occurrence
of any of the following events:
A) Employee’s termination of
employment with the State;
B) Employee’s termination of
disability benefits;
C) Expiration of the
Employee’s maximum leave of absence period;
D) Employee’s loss of
eligibility to participate in the Program due to a reduction in work hours;
E) Divorce, annulment,
dissolution of civil union partnership, or legal separation from the Employee;
F) Loss of eligibility as a
dependent child or domestic partner; or
G) Death of the Employee.
3) A Dependent whose
coverage is voluntarily dropped by an Employee shall not be eligible to elect
continuation coverage.