State RegulationsIL specificDifficulty 2/5
An employer decides to terminate its group health insurance policy, and employees worry they will be left with no coverage options. Under Illinois law, which authority governs the discontinuance of group health coverage and the replacement or conversion obligations that follow?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Illinois addresses the end of group health coverage through 215 ILCS 5/367i, the group discontinuance and replacement provision, and through 50 Ill. Adm. Code 2013, the state's group conversion and replacement rules. Together they ensure that when an employer terminates group coverage, certificate holders have defined pathways such as conversion rather than being left with nothing. The Illinois Department of Insurance enforces these requirements on health insurers.
Why the other options are wrong
- A) The Limited Health Service Organization Act at 215 ILCS 130 governs limited health service organizations, not the discontinuance and conversion duties that follow a group policy termination.
- C) The HMO Act at 215 ILCS 125 regulates health maintenance organizations; it does not supersede or supply the group conversion and replacement rules for ordinary group health policies.
- D) 215 ILCS 5/500-135 is the producer licensing fee schedule and has no role in funding or governing conversion rights after a group discontinuance.
Memory hook
367i ends it, Reg. 2013 converts it: when group coverage dies, Illinois rules the aftermath.