# 89 Ill. Adm. Code 686.235: Section 686.235 Enhanced Rate for Health Insurance Costs

> Illinois · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_235

## Section

- **Citation:** 89 Ill. Adm. Code 686.235
- **Heading:** Section 686.235 Enhanced Rate for Health Insurance Costs
- **Jurisdiction:** Illinois
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Illinois Administrative Code / Title 89 SOCIAL SERVICES / CHAPTER IV: DEPARTMENT OF HUMAN SERVICES / Part 686 PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT / Section 686.235 Enhanced Rate for Health Insurance Costs

## Text

Section 686.235  Enhanced Rate for Health Insurance Costs
An enhanced rate shall be paid to Homemaker Service
Providers that offer health insurance coverage as a benefit to their Homemaker
employees who provide services to customers under HSP.
a)         For
purposes of this Section, "health insurance" means a Type 1 plan or a
Type 2 plan as described in subsections (a)(1) and (2).
1)         Type 1 Plan
A Type 1 plan must comply with, be
comparable to, or exceed required mandated benefits, coverages, and co-payment
levels for individuals and group insurance policies and individual and group
contracts for health maintenance organizations under the Illinois Insurance
Code [215 ILCS 5], the Health Maintenance Organization Act [215 ILCS 125], and 50
Ill. Adm. Code 2001.
2)         Type 2 Plan
A Type 2 plan is employer-paid
health insurance as part of collective bargaining with unionized Homemaker
employees through a Taft-Hartley Multi-employer Health and Welfare Plan.  The
Labor Management Relations Act of 1947 (29 USC 141 et seq.) describes the
requirements and coverage at 29 USC 186(c)(5).
b)         Initial Application
1)         An
interested Homemaker Service Provider must submit an initial application at
least 120 days prior to the end of each State fiscal year.  The application may
be obtained from and must be submitted to the Home Services Liaison for Health
Insurance, Department of Human Services, 100 South Grand Avenue East, P.O. Box
19429, Springfield, Illinois 62794-9429.
2)       Homemaker
Service Providers that are found by HSP to have deficiencies may not apply for
the enhanced rate until deficiencies are corrected to the satisfaction of HSP.
c)         Eligibility
Eligibility
requirements include:
1)         Verification
of a current rate agreement as a Homemaker Service Provider under the HSP
Avenue East, P.O. Box
19429, Springfield, Illinois 62794-9429.
2)       Homemaker
Service Providers that are found by HSP to have deficiencies may not apply for
the enhanced rate until deficiencies are corrected to the satisfaction of HSP.
c)         Eligibility
Eligibility
requirements include:
1)         Verification
of a current rate agreement as a Homemaker Service Provider under the HSP.
2)         A
copy of a health insurance plan or a certification of insurance and the
effective date of that document, to establish that:
A)        the
Homemaker Service Provider provides health insurance at its own expense for its
Homemaker employees, which may include coverage for those employees'
dependents; or
B)        the
Homemaker Service Provider will provide for health insurance as part of
collective bargaining with unionized Homemaker employees, which may include
coverage for those employees' dependents through a Taft-Hartley Multi-employer
Health and Welfare Plan.
3)         Specification
of the total number of employees and the total number of Homemaker employees,
together with a certification from a responsible party for the Homemaker
Service Provider to the effect that:
A)        under a
Type 1 health insurance plan:
i)          health
insurance coverage is offered to all Homemaker employees who have worked at
least an average of 20 hours per week for three consecutive months under HSP;
and
ii)         at
least one quarter of the total number of Homemaker employees accept the offer
of health insurance.
B)        under a
Type 2 health insurance plan:
i)          health
insurance coverage is offered to all of the Homemaker employees subject to the
collective bargaining agreement who have worked at least an average of 20 hours
per week for three consecutive months under HSP; and
ii)         at
least one quarter of the total number of Homemaker employees, or any higher
percentage required under federal law, accept the offer of health insurance
health
insurance coverage is offered to all of the Homemaker employees subject to the
collective bargaining agreement who have worked at least an average of 20 hours
per week for three consecutive months under HSP; and
ii)         at
least one quarter of the total number of Homemaker employees, or any higher
percentage required under federal law, accept the offer of health insurance.
4)         Submission
of any other relevant information requested by HSP for administrative or audit
purposes.
d)         Notification
It is the responsibility of a
Homemaker Service Provider to notify HSP within 7 days of any change in its
eligibility status, including, but not limited to, cancellation or termination
of the health insurance plan or purchase of a new plan.  A Homemaker Service
Provider is only required to monitor participation by Homemaker employees in
order to submit the initial application, the Annual Insurance Review required
by subsection (e), and required financial reporting.
e)         Annual Insurance Review
1)         Once
a Homemaker Service Provider is determined eligible by HSP and is paid an
enhanced rate for health insurance costs, the Homemaker Service Provider must
thereafter substantiate its continued eligibility under subsection (c) by
submitting appropriate supporting documentation at the same time as its annual
financial report under Section 686.250.
2)         As
part of the Annual Insurance Review, an independent certified public accounting
firm for the Homemaker Service Provider must verify the actual, documented
expense for health insurance provided for the period listed as part of the
required financial reporting under Section 686.250
iate supporting documentation at the same time as its annual
financial report under Section 686.250.
2)         As
part of the Annual Insurance Review, an independent certified public accounting
firm for the Homemaker Service Provider must verify the actual, documented
expense for health insurance provided for the period listed as part of the
required financial reporting under Section 686.250.
3)         HSP
reserves the right to require a Homemaker Service Provider to engage an
independent certified public accounting firm, approved by HSP, to verify the
information and data submitted by the Homemaker Service Provider if HSP is in
possession of evidence to suggest the information and data submitted is
inaccurate, incomplete or fraudulent.  This audit will be performed at the
Homemaker Service Provider's expense.
4)         HSP
shall notify a Homemaker Service Provider in the event of a determination
during the Annual Insurance Review that:
A)        the
Homemaker Service Provider is no longer eligible for continued payment of the
enhanced rate for health insurance costs;
B)        the
total revenue from the enhanced rate for health insurance costs exceeds the
actual, documented expenses for health insurance costs for the reporting
period;
C)        there
was an error in eligibility of a Homemaker Service Provider for the prior
reporting period;
D)        there
was an error in the amount of revenue from the enhanced rate for health
insurance costs; or
E)        there
was an error in the amount of the health insurance costs.
5)         A
Homemaker Service Provider may appeal an adverse eligibility decision regarding
continued payment of the enhanced rate for health insurance costs or a
repayment decision in accordance with Section 686.230.  HSP will continue to
pay the enhanced rate for health insurance costs until the appeal is resolved
or
E)        there
was an error in the amount of the health insurance costs.
5)         A
Homemaker Service Provider may appeal an adverse eligibility decision regarding
continued payment of the enhanced rate for health insurance costs or a
repayment decision in accordance with Section 686.230.  HSP will continue to
pay the enhanced rate for health insurance costs until the appeal is resolved.
6)         Supporting
documentation may be subject to release under the Freedom of Information Act [5
ILCS 140] unless an exemption applies for confidentiality, privacy, or other
proprietary business purpose and is marked accordingly on the face of any
submission.

## Nearby sections

- [89 Ill. Adm. Code 686.200 Section 686.200  Homemaker Service Provider Requirements](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_200.md)
- [89 Ill. Adm. Code 686.210 Section 686.210  Services That Must Be Provided by Homemaker Service Providers](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_210.md)
- [89 Ill. Adm. Code 686.230 Section 686.230  Appeal Rights of Homemaker Service Providers](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_230.md)
- [89 Ill. Adm. Code 686.235 Section 686.235  Enhanced Rate for Health Insurance Costs](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_235.md)
- [89 Ill. Adm. Code 686.250 Section 686.250  Financial Reporting of Homemaker Service Providers](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_250.md)
- [89 Ill. Adm. Code 686.260 Section 686.260  Unallowable Expenses for Homemaker Service Providers](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_260.md)
- [89 Ill. Adm. Code 686.270 Section 686.270  Minimum Homemaker Costs for Homemaker Service Providers](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_270.md)
- [89 Ill. Adm. Code 686.280 Section 686.280  Cost Categories for Homemaker Services](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_280.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P686_S686_235. Check the current official text before relying on it. Not legal advice.