215 ILCS 5/367.2
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979.2)Sec. 367.2.     Spousal continuation privilege; group contracts.A.  No policy of group accident or health insurance, nor any  certificate thereunder shall be delivered or issued for delivery in this  State after December 1, 1985, unless the policy provides for a continuation  of the existing insurance benefits for an employee's spouse and dependent  children who are insured under the provisions of that group policy or  certificate thereunder, notwithstanding that the marriage is dissolved by  judgment or terminated by the death of the employee or, after the  effective date of this amendatory Act of the 93rd General Assembly, notwithstanding the  retirement of the employee provided that  the employee's  spouse is at  least 55 years of age, in each case without any other eligibility  requirements.  The provisions of this amendatory Act of the 93rd General  Assembly apply to every  group policy of accident or health insurance and every certificate issued  thereunder delivered or issued for delivery after the effective date of  this amendatory Act of the 93rd General Assembly.B. Within 30 days of the entry of judgment or the death or  retirement of the employee, the spouse of an employee insured under  the policy who seeks a continuation of coverage thereunder shall give the  employer or the insurer written notice of the dissolution of the  marriage  or the death or retirement of the employee.  The employer, within 15  days of receipt of the notice  shall give written notice  of the dissolution of the employee's marriage or the death or retirement of  the employee and that former spouse's or retired employee's spouse's  residence  to the insurance  company issuing the policy.The employer shall immediately send a copy of the notice to the former  spouse of the employee or the spouse of the retired employee at the retired  employee's spouse's residence or at the former spouse's residence.  For  purposes of this Act, the term "former spouse" includes "widow" or "widower".C. Within 30 days after the date of receipt of a notice from the  employer, retired employee's spouse or former spouse or of the initiation  of a new group policy, the insurance company, by certified mail, return  receipt requested, shall notify the retired employee's spouse or former  spouse at his or her residence that the policy may be continued for that  retired employee's spouse or former spouse and covered dependents, and the  notice shall include:(i) a form for election to continue the insurance     coverage;(ii) the amount of periodic premiums to be charged     for continuation coverage and the method and place of payment; and(iii) instructions for returning the election form     within 30 days after the date it is received from the insurance company.Failure of the retired employee's spouse or former spouse to exercise the  election to continue insurance coverage by notifying the insurance company  in writing within such 30  day period  shall terminate the continuation of benefits and the right to continuation.If the insurance company fails to notify the retired employee's spouse  or former spouse as provided for in subsection C hereof, all premiums shall  be waived from the date the notice was required until notice is sent, and  the benefits shall continue under the terms and provisions of the policy,  from the date the notice was required until the notice is sent,  notwithstanding any other provision hereof, except where the benefits in  existence at the time the company's notice was to be sent pursuant to  subsection C are terminated as to all employees.D. With respect to a former spouse who has not attained the age of 55  at the time continuation coverage begins, the monthly premium  for  continuation shall be computed as follows:(i) an amount, if any, that would be charged an     employee if the former spouse were a current employee of the employer, plus;(ii) an amount, if any, that the employer would     contribute toward the premium if the former spouse were a current employee.Failure to pay the initial monthly premium within 30 days after the date of  receipt of notice required in subsection C of this Section terminates  the continuation benefits and the right to continuation benefits.The continuation coverage for former  spouses who have not attained the  age of 55 at the time coverage begins shall terminate upon the  earliest to happen of the following:(i) The failure to pay premiums when due, including     any grace period allowed by the policy; or(ii) When coverage would terminate under the terms of     the existing policy if the employee and former spouse were still married to each other; however, the existing coverage shall not be modified or terminated during the first 120 consecutive days subsequent to the employee spouse's death or to the entry of the judgment dissolving the marriage existing between the employee and the former spouse unless the master policy in existence at the time is modified or terminated as to all employees; or(iii) the date on which the former spouse first     becomes, after the date of election, an insured employee under any other group health plan; or(iv) the date on which the former spouse remarries; or(v) the expiration of 2 years from the date     continuation coverage began.Upon the termination of continuation coverage, the former  spouse shall be  entitled to convert the coverage to an individual policy.The continuation rights granted to former spouses who have not attained age  55  shall also  include eligible dependents insured prior to the dissolution of marriage or the  death of the  employee.E. With respect to a retired employee's spouse or former spouse who  has attained the age of 55 at the time continuation coverage begins, the  monthly premium for the continuation shall be computed as follows:(i) an amount, if any, that would be charged an     employee if the retired employee's spouse or former spouse were a current employee of the employer, plus;(ii) an amount, if any, that the employer would     contribute toward the premium if the retired employee's spouse or former spouse were a current employee.Beginning 2 years after coverage begins under this paragraph, the  monthly premium shall be computed as follows:(i) an amount, if any, that would be charged an     employee if the retired employee's spouse or former spouse were a current employee of the employer, plus;(ii) an amount, if any, that the employer would     contribute toward the premium if the retired employee's spouse or former spouse were a current employee.(iii) an additional amount, not to exceed 20% of (i)     and (ii) above, for costs of administration.Failure to pay the initial monthly premium within 30 days after the date  of receipt of the notice required in subsection C of this Section  terminates the continuation benefits and the right to continuation benefits.The continuation coverage for retired employees'  spouses and former spouses  who have attained the age of 55 at the time coverage begins shall  terminate upon the earliest to happen of the following:(i) The failure to pay premiums when due, including     any grace period allowed by the policy; or(ii) When coverage would terminate, except due to the     retirement of an employee, under the terms of the existing policy if the employee and former spouse were still married to each other; however, the existing coverage shall not be modified or terminated during the first 120 consecutive days subsequent to the employee spouse's death or retirement to the entry of the judgment dissolving the marriage existing between the employee and the former spouse unless the master policy in existence at the time is modified or terminated as to all employees; or(iii) the date on which the retired employee's spouse     or former spouse first becomes, after the date of election, an insured employee under any other group health plan; or(iv) the date on which the former spouse remarries; or(v) the date that person reaches the qualifying age     or otherwise establishes eligibility under the Medicare Program pursuant to Title XVIII of the federal Social Security Act.Upon the termination of continuation coverage, the former  spouse shall be  entitled to convert the coverage to an individual policy.The continuation rights granted to former spouses who have attained age 55  shall also  include eligible dependents insured prior to the dissolution of marriage, the  death of the  employee, or the retirement of the employee.F. The renewal, amendment, or extension of any group policy affected by  this Section shall be deemed to be delivery or issuance for delivery of a  new policy or contract of insurance in this State.G. If (i) the policy is canceled, and (ii) another  insurance company  contracts to provide group health and accident insurance to the employer,  and (iii) continuation coverage is in effect for the retired employee's  spouse or former spouse at the time of cancellation and (iv) the employee  is or would have been included under the new group policy, then the new  insurer must also offer continuation coverage to the retired employee's  spouse and to an employee's former spouse under the same terms and  conditions as contained in this Section.H. This Section shall not limit the right of the retired employee's spouse  or any former spouse to exercise  the privilege to convert to an individual policy as contained in this Code.I. No person who obtains coverage under this Section shall be required  to pay a rate greater than that applicable to any employee or member  covered under that group except as provided in clause (iii) of the  second paragraph of subsection E.    (Source: P.A. 93-477, eff. 1-1-04.)