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Illinois Adds Additional Compliance Responsibilities to Employers with Illinois Employees

On August 27, 2021, Illinois passed the Consumer Coverage Disclosure Act (Act), which requires a new disclosure to be provided to Illinois-based employees. The Act requires that any employer that provides group health insurance to Illinois-based employees provide a written list of covered benefits to the employees.

The written list of covered benefits must be provided in a format that easily compares the group health plan’s covered benefits with the essential health insurance benefits required of individual health insurance coverage that the State of Illinois regulates. Illinois-based employees must be provided with this list when hired and at least annually thereafter. Employees can also request a copy at any time.

Employers can comply with the Act by providing the required information by email or providing the information on a website that the employee can regularly access. The Act also instructs the Illinois Department of Insurance to provide information that outlines the essential health insurance coverage regulated by the State of Illinois. Employers can use this information to inform eligible employees of the benefits included or not included in their group health coverage.

OneDigital contacted the Illinois Department of Insurance (IDOI) and was told, “The Department is aware of the newly signed bill and the responsibility to prepare the applicable list of essential health benefits (EHBs) to be disclosed to employee groups by their employer. The Department intends to publish this list of EHBs on our IDOI website in the near future.” However, because the Act took effect immediately, affected employers should now start discussions with their carriers to develop a compliance plan.

One place to start could be the the State of Illinois’ website, which contains a list of essential health benefits for which its Marketplace plans must provide coverage. In addition to the standard ACA essential benefits, Illinois also considers the following to be an essential benefit:

  • Alternative therapies for chronic pain
  • Short-term prescriptions for chronic pain
  • Removal of barriers to medication-assisted treatment for opioid use disorders
  • Telepsychiatry

The Act also requires employers to preserve records that the information was provided for one year. Upon request from the Illinois Department of Labor, employers must show that each eligible employee received the required information. Employers have 30 days to come into compliance before a penalty will be applied. If there is a failure to comply, the penalties are as follows:

Type of Offense

Less than 4 employees in Illinois

4 or more employees in Illinois

First offense Up to $500 Up to $1,000
Second offense Up to $1,000 Up to $3,000
Every subsequent offense Up to $3,000 Up to $5,000

Note: Violations are per employer, not per employee. If an employer had 7 employees and each failed to receive a disclosure, the first offense would be up to $1,000.

For additional guidance on how to navigate these changes in your workplace, contact your local OneDigital business strategist.

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