Consumer Health Insurance

Continuation of Employer-Based Health Insurance


State and federal laws give certain employees, spouses and dependent children the right to continue employer-based health insurance at group rates if they lose their insurance because of specific “qualifying events.” The type of policy, your employer, and qualifying event will determine who is qualified for continuing coverage and for how long.

If you lost your job-based health insurance, you may qualify for a Special Enrollment Period (SEP) through the ACA Health Insurance Marketplace.

You may also qualify for Medicaid or other health insurance programs.



Health Insurance Options Outside of Open Enrollment

Due to the COVID-19 crisis, some people no longer have health insurance coverage. Please see the information below to explore other options:


If you lost your job-based health insurance, you may qualify for a Special Enrollment Period (SEP)

PDF English | Chinese | Polish | Spanish | Tagalog


ACA Marketplace, Medicaid and other health insurance programs

PDF English | Chinese | Polish | Spanish | Tagalog


Health insurance contact information (websites/phone numbers)

PDF English | Chinese | Polish | Spanish | Tagalog


Uninsured Ombudsman Program

    PDF Ombudsman Fact Sheet — provides assistance and education to Illinois consumers who do not have health insurance, are about to lose health insurance or who cannot afford to purchase health insurance


COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) is a federal law, enforced by the U.S. Department of Labor, Employee Benefits Security Administration, which provides continuation of group health coverage that otherwise might be terminated. The law contains provisions giving certain former employees, retirees, spouses and dependent children the right to temporary continuation of health coverage at group rates.
If you need further information about COBRA, HIPAA, or ERISA, visit: dol.gov/agencies/ebsa

Speak to a Live Benefits Advisor or call toll free 1-866-444-3272.


In 2015, Public Act 99-0480 (The Heroin Crisis Act) created a Working Group to discuss issues related to the treatment and coverage of substance abuse disorders and mental illness. Partnering with the Department of Human Services (DHS), the Department of Healthcare and Family Services (HFS), and the Department of Public Health (DPH), the Illinois Department of Insurance (DOI) hosts the Working Group.

In accordance with the Illinois Open Meetings Act, MHSUD Meeting notices, agendas, approved minutes, and annual reports are posted here on our website.

Health Policy Rate Filing Report

In order to better serve the residents of Illinois, the Department of Insurance has implemented a Health Premium Rate Review program. This Program is designed to evaluate premium rate increases proposed by health care plans marketing in Illinois, protect consumers from unreasonable rate increases and educate consumers on the medical and administrative costs driving such increases. The Program covers individual and group major medical policies, hospital/surgical medical expense policies, and student/blanket policies; including any conversion coverage offered through these products.

Consistent with these goals, the Department is making premium rate increase information available to Illinois consumers and policymakers. We are also accepting questions, concerns and comments related to rate filings found on this page. When submitting your comments, please identify both the company and the policy number. The Department cannot respond to submitted comments but will respond to questions consistent with our Comment Policy PDF.

2018 Analysis of Illinois Exchange Plans

Explanations of terms used in the charts PDF.

Individual & Group Health Premium Rate Filings Since 2010

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2011
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2012
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2013
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2014
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2015
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2016
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2017
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Number of Rate Filings 61 145 139 115 149 145 128 113

HealthCare.gov website - Proposed Rate Increases of 10% or more

Starting September 1, 2011, health insurance companies must inform the public when they want to increase health insurance rates for individual or small group policies by an average of 10% or more. Companies requesting such increases must file them with the federal government in addition to filing them with the Department of Insurance.

These filings must include rating documentation called “Justification”. Justification is a federally-developed form that will enable consumers to see a summary of certain factors underlying a proposed rate increase and an explanation, provided by the insurance company, for the proposed increase.

Through the following links, the Department of Insurance is providing you with a link to access this consumer-friendly summary and disclosure form – HealthCare.gov

Premium Rate Review

In order to better serve the residents of Illinois, the Department of Insurance (DOI) has implemented a Health Premium Rate Review program. This Program is designed to access premium rate filings that health care plans marketing in Illinois are required to send to DOI for review, protect consumers from unreasonable rate increases and educate consumers on the medical and administrative costs driving such increases.

Illinois Rate Review Information

Rate Review Webinars/Presentations

Current Premium Rate Filings in Illinois

Federal Regulations and Guidance

Federal Rate Review Reports

Rate Review Grants and Reports

 

Applications

 

Reports

Medical Loss Ratios

The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA), released on November 22, 2010 works in conjunction with the Premium Rate Review Program to increase the value that consumers receive for their health care premium dollars.

Medical Loss Ratio (MLR) refers to the portion of insurance premiums an insurer spends on health care and expenses to improve health care quality. The Affordable Care Act requires that a minimum of 80% (in the small group market) and 85% (in the large group market) of each premium dollar is spent on health care services and health care quality improvement and not on company overhead and administrative costs. The MLR regulations are codified as 45 CFR Part 158.

Insurers failing to meet the applicable MLR standard must pay rebates to consumers beginning in August 2012.

 

Illinois Guidance:

 

Federal Regulations, Guidance and Reports:

 

NAIC Guidance: