IL H.B. 5258
On July 19, 2024, Illinois approved H.B. 5258, which requires coverage for dependent parents when the plan provides dependent coverage.
The requirements herein apply to fully insured and self-funded non-ERISA nonfederal governmental group health benefit plans (Counties, Municipalities, and Public Schools) sponsored by an Illinois employer, that are amended, delivered, issued or renewed on or after January 1, 2026.
Requirements
A group health benefit plan that provides dependent coverage must make dependent coverage available to the parent or stepparent of a covered person if the parent or stepparent meets the definition of a qualifying relative under 26 U.S.C. 152(d)*.
This requirement does not apply to:
• Specialized health care service plans
• Medicare supplement insurance
• Hospital-only policies
• Accident-only policies
• Specified disease insurance policies that reimburse for hospital, medical, or surgical expenses
The requirements herein apply to fully insured and self-funded non-ERISA nonfederal governmental group health benefit plans (Counties, Municipalities, and Public Schools) sponsored by an Illinois employer, that are amended, delivered, issued or renewed on or after January 1, 2026.
Requirements
A group health benefit plan that provides dependent coverage must make dependent coverage available to the parent or stepparent of a covered person if the parent or stepparent meets the definition of a qualifying relative under 26 U.S.C. 152(d)*.
This requirement does not apply to:
• Specialized health care service plans
• Medicare supplement insurance
• Hospital-only policies
• Accident-only policies
• Specified disease insurance policies that reimburse for hospital, medical, or surgical expenses
*Per 26 USCS § 152 (d):
Qualifying relative. For purposes of this section—
(1) In general. The term “qualifying relative” means, with respect to any taxpayer for any taxable year,
an individual—
(A) who bears a relationship to the taxpayer described in paragraph (2),
(B) whose gross income for the calendar year in which such taxable year begins is less than the exemption amount (as defined in section 151(d) [26 USCS § 151(d)]),
(C) with respect to whom the taxpayer provides over one-half of the individual’s support for the calendar year in which such taxable year begins, and
(D) who is not a qualifying child of such taxpayer or of any other taxpayer for any taxable year beginning in the calendar year in which such taxable year begins.
Qualifying relative. For purposes of this section—
(1) In general. The term “qualifying relative” means, with respect to any taxpayer for any taxable year,
an individual—
(A) who bears a relationship to the taxpayer described in paragraph (2),
(B) whose gross income for the calendar year in which such taxable year begins is less than the exemption amount (as defined in section 151(d) [26 USCS § 151(d)]),
(C) with respect to whom the taxpayer provides over one-half of the individual’s support for the calendar year in which such taxable year begins, and
(D) who is not a qualifying child of such taxpayer or of any other taxpayer for any taxable year beginning in the calendar year in which such taxable year begins.