Federal & State Regulations | Continuation of Benefits Coverage (COBRA) - Illinois

Summary of differences between federal and state regulations

Illinois has three health care continuation laws: the Illinois Continuation Law, the Illinois Spousal Continuation Law, and the Illinois Dependent Child Continuation Law. These laws compare with federal COBRA as follows:

This is a general comparison only.
	COBRA Illinois has enacted provisions in response to the federal American Recovery and Reinvestment Act of 2009 (P.L. 111-5) in regard to COBRA continuation. See HB 2325	Illinois Continuation 215 ILCS 5/267e	Illinois Spousal Continuation 215 ILCS 5/367.2	Dependent Continuation Effective July 1, 2004 215 ILCS 5/367.2-5
Applicability	Applies to employer groups with 20 or more employees.	Applies to employer groups of any size. Applies to insurance companies and HMOs.	Applies to employer groups of any size. Applies to insurance companies. Effective Jan 1, 2004 -- applies to HMOs.	Applies to employer groups of any size. Applies to insurance companies and HMOs.
Who Is Eligible	Employees and/or covered dependents.	Employees and covered dependents.	Divorced or widowed spouses (any age) and covered dependent children. Spouses (age 55 or older) of retired employees, and covered dependents.	Covered dependent children of deceased employee, who are not otherwise covered under the Spousal Continuation Law. Covered dependent children who attain the limiting age under the insurance policy or HMO certificate.
Coverage Requirements	Must be covered by the group plan on the day prior to the qualifying event.	Employees must be covered for 3 continuous months before qualifying event.	Spouse and dependents must be covered on the day prior to the qualifying event.	Dependent child must be covered on the day prior to the qualifying event.
Qualifying Events	Must be offered to employee & covered dependents upon: · Termination of employment; · Employee's retirement; · Reduction in employee's hours. · Must be offered to spouse, former spouse & covered dependents upon: · Employee's eligibility for Medicare; · Divorce or legal separation from employee; · Death of employee; · Loss of dependent child status under plan.	Must be offered upon termination of employment or membership unless termination is due to theft or commission of work-related felony. Must be offered to an employee whose insurance is terminated due to a reduction in hours worked. (Effective January 1, 2004)	Must be offered to divorced spouse or widowed spouse and dependent children upon divorce from or death of employee. Must be offered to spouse (age 55 or older) and dependent children of retiree upon employee's retirement.	Must be offered to dependent child after death of insured if coverage is not available under the Spousal Continuation Law. Must be offered to dependent child upon attainment of limiting age under the insurance policy or HMO certificate.
Benefits	Coverage must be the same as under the group plan.	Coverage must be the same as under the group plan but need not include extra benefits such as dental, vision or prescription drugs.	Coverage must be the same as under the group plan.	Coverage must be the same as under the group plan.
Length of Continuation Coverage	Loss of employment or reduced hours -- for employee & covered dependents, maximum of 18 months. May be extended to 29 months if disabled. Divorce or legal separation from employee, death of employee or employee entitled to Medicare -- maximum of 36 months for spouse, former spouse and dependent children. Loss of dependent child status-maximum of 36 months.	Coverage is provided for a maximum of 9 months.	Spouse under age 55 -- Divorced or widowed spouse (not spouse of retiree) and dependent children --Coverage is provided for maximum of 2 years. Spouse age 55 or older -- Divorced or widowed spouse or spouse of retiree and dependent children -- coverage is provided until spouse is eligible for Medicare.	Coverage is provided for a maximum of 2 years.
Premiums	Premium may not exceed 102% of group rate. Plan may charge 150% after 18 months if the 11-month extension for disability is granted.	Premiums may not exceed the group rate.	Spouse under age 55 -- Divorced or widowed spouse premium may not exceed the group rate. Spouse age 55 or older -- Divorced or widowed spouse or spouse of retiree, administration fee may be added to group rate after first two years of coverage.	Premiums shall not exceed: · the amount that would be charged to an employee if the dependent child was an employee PLUS · the amount the employer would contribute toward the premium if the dependent child were an employee.

Beyond this, federal COBRA applies. Illinois has provisions reflecting the requirements of the American Recovery and Reinvestment Act of 2009, regarding employee subsidy for coverage.

State

Contact

Department of Financial and Professional Regulation, Department of Insurance

Regulations

Illinois Compiled Statutes, 215 ILCS 5/367, 215 ILCS 5/367e, 215 ILCS 5/367-2 (scroll down the page)

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

26 CFR 54.4980B-1 et seq.

['Employee Benefits']

['Consolidated Omnibus Reconciliation Act (COBRA)']

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Continuation of Benefits Coverage (COBRA) - Illinois

Summary of differences between federal and state regulations

State

Federal