103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5493 Introduced , by Rep. Thaddeus Jones SYNOPSIS AS INTRODUCED: See Index Amends the Illinois Insurance Code. Provides that certain coverage requirements apply to an individual policy of accident and health insurance (currently, a policy of accident and health insurance). Provides that an individual or group policy of accident and health insurance or a managed care plan must not require authorization or referral by the plan, issuer, or any person, including a primary care provider, for any covered individual who seeks coverage for certain obstetrical or gynecological care. Provides that if a policy, contract, or certificate requires or allows a covered individual to designate a primary care provider and provides coverage for any obstetrical or gynecological care, the insurer shall provide the notice required under specified federal regulations in all circumstances required under those regulations. Makes changes in provisions concerning post-parturition care. Changes the language required in the disclosure of a limited benefit. Increases the fee for filing a plan of division of a domestic stock company and for filing an insurance business transfer plan. Makes changes in provisions concerning fraud reporting; coverage for epinephrine injectors; blanket accident and health insurance; authorization of policies, agreements, or arrangements with incentives or limits on reimbursement; and refunds and penalties. Repeals a provision concerning the application of certain provisions. Amends the Network Adequacy and Transparency Act. Changes references from "woman's principal health care provider" to "obstetrical and gynecological health care professional". Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, and the Illinois Public Aid Code to make conforming changes. Amends the Health Maintenance Organization Act. Makes changes to the required disclosures. Provides that health maintenance organizations are subject to certain coverage requirements for pharmacy testing, screening, vaccinations, and treatment; for proton beam therapy; for children with neuromuscular, neurological, or cognitive impairment; and for no-cost mental health prevention and wellness visits. Effective immediately, except that certain provisions are effective January 1, 2025. LRB103 39189 RPS 69335 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5493 Introduced , by Rep. Thaddeus Jones SYNOPSIS AS INTRODUCED: See Index See Index Amends the Illinois Insurance Code. Provides that certain coverage requirements apply to an individual policy of accident and health insurance (currently, a policy of accident and health insurance). Provides that an individual or group policy of accident and health insurance or a managed care plan must not require authorization or referral by the plan, issuer, or any person, including a primary care provider, for any covered individual who seeks coverage for certain obstetrical or gynecological care. Provides that if a policy, contract, or certificate requires or allows a covered individual to designate a primary care provider and provides coverage for any obstetrical or gynecological care, the insurer shall provide the notice required under specified federal regulations in all circumstances required under those regulations. Makes changes in provisions concerning post-parturition care. Changes the language required in the disclosure of a limited benefit. Increases the fee for filing a plan of division of a domestic stock company and for filing an insurance business transfer plan. Makes changes in provisions concerning fraud reporting; coverage for epinephrine injectors; blanket accident and health insurance; authorization of policies, agreements, or arrangements with incentives or limits on reimbursement; and refunds and penalties. Repeals a provision concerning the application of certain provisions. Amends the Network Adequacy and Transparency Act. Changes references from "woman's principal health care provider" to "obstetrical and gynecological health care professional". Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, and the Illinois Public Aid Code to make conforming changes. Amends the Health Maintenance Organization Act. Makes changes to the required disclosures. Provides that health maintenance organizations are subject to certain coverage requirements for pharmacy testing, screening, vaccinations, and treatment; for proton beam therapy; for children with neuromuscular, neurological, or cognitive impairment; and for no-cost mental health prevention and wellness visits. Effective immediately, except that certain provisions are effective January 1, 2025. LRB103 39189 RPS 69335 b LRB103 39189 RPS 69335 b A BILL FOR
103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5493 Introduced , by Rep. Thaddeus Jones SYNOPSIS AS INTRODUCED:
See Index See Index
See Index
Amends the Illinois Insurance Code. Provides that certain coverage requirements apply to an individual policy of accident and health insurance (currently, a policy of accident and health insurance). Provides that an individual or group policy of accident and health insurance or a managed care plan must not require authorization or referral by the plan, issuer, or any person, including a primary care provider, for any covered individual who seeks coverage for certain obstetrical or gynecological care. Provides that if a policy, contract, or certificate requires or allows a covered individual to designate a primary care provider and provides coverage for any obstetrical or gynecological care, the insurer shall provide the notice required under specified federal regulations in all circumstances required under those regulations. Makes changes in provisions concerning post-parturition care. Changes the language required in the disclosure of a limited benefit. Increases the fee for filing a plan of division of a domestic stock company and for filing an insurance business transfer plan. Makes changes in provisions concerning fraud reporting; coverage for epinephrine injectors; blanket accident and health insurance; authorization of policies, agreements, or arrangements with incentives or limits on reimbursement; and refunds and penalties. Repeals a provision concerning the application of certain provisions. Amends the Network Adequacy and Transparency Act. Changes references from "woman's principal health care provider" to "obstetrical and gynecological health care professional". Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, and the Illinois Public Aid Code to make conforming changes. Amends the Health Maintenance Organization Act. Makes changes to the required disclosures. Provides that health maintenance organizations are subject to certain coverage requirements for pharmacy testing, screening, vaccinations, and treatment; for proton beam therapy; for children with neuromuscular, neurological, or cognitive impairment; and for no-cost mental health prevention and wellness visits. Effective immediately, except that certain provisions are effective January 1, 2025.
LRB103 39189 RPS 69335 b LRB103 39189 RPS 69335 b
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A BILL FOR
HB5493LRB103 39189 RPS 69335 b HB5493 LRB103 39189 RPS 69335 b
HB5493 LRB103 39189 RPS 69335 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The State Employees Group Insurance Act of 1971
5 is amended by changing Section 6.7 as follows:
6 (5 ILCS 375/6.7)
7 Sec. 6.7. Access to obstetrical and gynecological care
8 Woman's health care provider. The program of health benefits
9 is subject to the provisions of Section 356r of the Illinois
10 Insurance Code.
11 (Source: P.A. 89-514, eff. 7-17-96; 90-14, eff. 7-1-97.)
12 Section 10. The Counties Code is amended by changing
13 Section 5-1069.5 as follows:
14 (55 ILCS 5/5-1069.5)
15 Sec. 5-1069.5. Access to obstetrical and gynecological
16 care Woman's health care provider. All counties, including
17 home rule counties, are subject to the provisions of Section
18 356r of the Illinois Insurance Code. The requirement under
19 this Section that health care benefits provided by counties
20 comply with Section 356r of the Illinois Insurance Code is an
21 exclusive power and function of the State and is a denial and
103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5493 Introduced , by Rep. Thaddeus Jones SYNOPSIS AS INTRODUCED:
See Index See Index
See Index
Amends the Illinois Insurance Code. Provides that certain coverage requirements apply to an individual policy of accident and health insurance (currently, a policy of accident and health insurance). Provides that an individual or group policy of accident and health insurance or a managed care plan must not require authorization or referral by the plan, issuer, or any person, including a primary care provider, for any covered individual who seeks coverage for certain obstetrical or gynecological care. Provides that if a policy, contract, or certificate requires or allows a covered individual to designate a primary care provider and provides coverage for any obstetrical or gynecological care, the insurer shall provide the notice required under specified federal regulations in all circumstances required under those regulations. Makes changes in provisions concerning post-parturition care. Changes the language required in the disclosure of a limited benefit. Increases the fee for filing a plan of division of a domestic stock company and for filing an insurance business transfer plan. Makes changes in provisions concerning fraud reporting; coverage for epinephrine injectors; blanket accident and health insurance; authorization of policies, agreements, or arrangements with incentives or limits on reimbursement; and refunds and penalties. Repeals a provision concerning the application of certain provisions. Amends the Network Adequacy and Transparency Act. Changes references from "woman's principal health care provider" to "obstetrical and gynecological health care professional". Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, and the Illinois Public Aid Code to make conforming changes. Amends the Health Maintenance Organization Act. Makes changes to the required disclosures. Provides that health maintenance organizations are subject to certain coverage requirements for pharmacy testing, screening, vaccinations, and treatment; for proton beam therapy; for children with neuromuscular, neurological, or cognitive impairment; and for no-cost mental health prevention and wellness visits. Effective immediately, except that certain provisions are effective January 1, 2025.
LRB103 39189 RPS 69335 b LRB103 39189 RPS 69335 b
LRB103 39189 RPS 69335 b
A BILL FOR
See Index
LRB103 39189 RPS 69335 b
HB5493 LRB103 39189 RPS 69335 b
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1 limitation of home rule county powers under Article VII,
2 Section 6, subsection (h) of the Illinois Constitution.
3 (Source: P.A. 89-514, eff. 7-17-96; 90-14, eff. 7-1-97.)
4 Section 15. The Illinois Municipal Code is amended by
5 changing Section 10-4-2.5 as follows:
6 (65 ILCS 5/10-4-2.5)
7 Sec. 10-4-2.5. Access to obstetrical and gynecological
8 care Woman's health care provider. The corporate authorities
9 of all municipalities are subject to the provisions of Section
10 356r of the Illinois Insurance Code. The requirement under
11 this Section that health care benefits provided by
12 municipalities comply with Section 356r of the Illinois
13 Insurance Code is an exclusive power and function of the State
14 and is a denial and limitation of home rule municipality
15 powers under Article VII, Section 6, subsection (h) of the
16 Illinois Constitution.
17 (Source: P.A. 89-514, eff. 7-17-96; 90-14, eff. 7-1-97.)
18 Section 20. The School Code is amended by changing Section
19 10-22.3d as follows:
20 (105 ILCS 5/10-22.3d)
21 Sec. 10-22.3d. Access to obstetrical and gynecological
22 care Woman's health care provider. Insurance protection and
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1 benefits for employees are subject to the provisions of
2 Section 356r of the Illinois Insurance Code.
3 (Source: P.A. 89-514, eff. 7-17-96; 90-14, eff. 7-1-97.)
4 Section 25. The Illinois Insurance Code is amended by
5 changing Sections 4, 155.23, 352, 352b, 356a, 356b, 356d,
6 356e, 356f, 356K, 356L, 356r, 356s, 356z.3, 356z.33, 367a,
7 370e, 370i, 408, 412, and 531.03 as follows:
8 (215 ILCS 5/4) (from Ch. 73, par. 616)
9 Sec. 4. Classes of insurance. Insurance and insurance
10 business shall be classified as follows:
11 Class 1. Life, Accident and Health.
12 (a) Life. Insurance on the lives of persons and every
13 insurance appertaining thereto or connected therewith and
14 granting, purchasing or disposing of annuities. Policies of
15 life or endowment insurance or annuity contracts or contracts
16 supplemental thereto which contain provisions for additional
17 benefits in case of death by accidental means and provisions
18 operating to safeguard such policies or contracts against
19 lapse, to give a special surrender value, or special benefit,
20 or an annuity, in the event, that the insured or annuitant
21 shall become a person with a total and permanent disability as
22 defined by the policy or contract, or which contain benefits
23 providing acceleration of life or endowment or annuity
24 benefits in advance of the time they would otherwise be
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1 payable, as an indemnity for long term care which is certified
2 or ordered by a physician, including but not limited to,
3 professional nursing care, medical care expenses, custodial
4 nursing care, non-nursing custodial care provided in a nursing
5 home or at a residence of the insured, or which contain
6 benefits providing acceleration of life or endowment or
7 annuity benefits in advance of the time they would otherwise
8 be payable, at any time during the insured's lifetime, as an
9 indemnity for a terminal illness shall be deemed to be
10 policies of life or endowment insurance or annuity contracts
11 within the intent of this clause.
12 Also to be deemed as policies of life or endowment
13 insurance or annuity contracts within the intent of this
14 clause shall be those policies or riders that provide for the
15 payment of up to 75% of the face amount of benefits in advance
16 of the time they would otherwise be payable upon a diagnosis by
17 a physician licensed to practice medicine in all of its
18 branches that the insured has incurred a covered condition
19 listed in the policy or rider.
20 "Covered condition", as used in this clause, means: heart
21 attack, stroke, coronary artery surgery, life-threatening life
22 threatening cancer, renal failure, Alzheimer's disease,
23 paraplegia, major organ transplantation, total and permanent
24 disability, and any other medical condition that the
25 Department may approve for any particular filing.
26 The Director may issue rules that specify prohibited
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1 policy provisions, not otherwise specifically prohibited by
2 law, which in the opinion of the Director are unjust, unfair,
3 or unfairly discriminatory to the policyholder, any person
4 insured under the policy, or beneficiary.
5 (b) Accident and health. Insurance against bodily injury,
6 disablement or death by accident and against disablement
7 resulting from sickness or old age and every insurance
8 appertaining thereto, including stop-loss insurance. In this
9 clause, "stop-loss Stop-loss insurance" means is insurance
10 against the risk of economic loss issued to or for the benefit
11 of a single employer self-funded employee disability benefit
12 plan or an employee welfare benefit plan as described in 29
13 U.S.C. 1001 100 et seq., where (i) the policy is issued to and
14 insures an employer, trustee, or other sponsor of the plan, or
15 the plan itself, but not employees, members, or participants;
16 and (ii) payments by the insurer are made to the employer,
17 trustee, or other sponsors of the plan, or the plan itself, but
18 not to the employees, members, participants, or health care
19 providers. The insurance laws of this State, including this
20 Code, do not apply to arrangements between a religious
21 organization and the organization's members or participants
22 when the arrangement and organization meet all of the
23 following criteria:
24 (i) the organization is described in Section 501(c)(3)
25 of the Internal Revenue Code and is exempt from taxation
26 under Section 501(a) of the Internal Revenue Code;
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1 (ii) members of the organization share a common set of
2 ethical or religious beliefs and share medical expenses
3 among members in accordance with those beliefs and without
4 regard to the state in which a member resides or is
5 employed;
6 (iii) no funds that have been given for the purpose of
7 the sharing of medical expenses among members described in
8 paragraph (ii) of this subsection (b) are held by the
9 organization in an off-shore trust or bank account;
10 (iv) the organization provides at least monthly to all
11 of its members a written statement listing the dollar
12 amount of qualified medical expenses that members have
13 submitted for sharing, as well as the amount of expenses
14 actually shared among the members;
15 (v) members of the organization retain membership even
16 after they develop a medical condition;
17 (vi) the organization or a predecessor organization
18 has been in existence at all times since December 31,
19 1999, and medical expenses of its members have been shared
20 continuously and without interruption since at least
21 December 31, 1999;
22 (vii) the organization conducts an annual audit that
23 is performed by an independent certified public accounting
24 firm in accordance with generally accepted accounting
25 principles and is made available to the public upon
26 request;
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1 (viii) the organization includes the following
2 statement, in writing, on or accompanying all applications
3 and guideline materials:
4 "Notice: The organization facilitating the sharing of
5 medical expenses is not an insurance company, and
6 neither its guidelines nor plan of operation
7 constitute or create an insurance policy. Any
8 assistance you receive with your medical bills will be
9 totally voluntary. As such, participation in the
10 organization or a subscription to any of its documents
11 should never be considered to be insurance. Whether or
12 not you receive any payments for medical expenses and
13 whether or not this organization continues to operate,
14 you are always personally responsible for the payment
15 of your own medical bills.";
16 (ix) any membership card or similar document issued by
17 the organization and any written communication sent by the
18 organization to a hospital, physician, or other health
19 care provider shall include a statement that the
20 organization does not issue health insurance and that the
21 member or participant is personally liable for payment of
22 his or her medical bills;
23 (x) the organization provides to a participant, within
24 30 days after the participant joins, a complete set of its
25 rules for the sharing of medical expenses, appeals of
26 decisions made by the organization, and the filing of
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1 complaints;
2 (xi) the organization does not offer any other
3 services that are regulated under any provision of the
4 Illinois Insurance Code or other insurance laws of this
5 State; and
6 (xii) the organization does not amass funds as
7 reserves intended for payment of medical services, rather
8 the organization facilitates the payments provided for in
9 this subsection (b) through payments made directly from
10 one participant to another.
11 (c) Legal Expense Insurance. Insurance which involves the
12 assumption of a contractual obligation to reimburse the
13 beneficiary against or pay on behalf of the beneficiary, all
14 or a portion of his fees, costs, or expenses related to or
15 arising out of services performed by or under the supervision
16 of an attorney licensed to practice in the jurisdiction
17 wherein the services are performed, regardless of whether the
18 payment is made by the beneficiaries individually or by a
19 third person for them, but does not include the provision of or
20 reimbursement for legal services incidental to other insurance
21 coverages. The insurance laws of this State, including this
22 Act do not apply to:
23 (i) retainer contracts made by attorneys at law with
24 individual clients with fees based on estimates of the
25 nature and amount of services to be provided to the
26 specific client, and similar contracts made with a group
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1 of clients involved in the same or closely related legal
2 matters;
3 (ii) plans owned or operated by attorneys who are the
4 providers of legal services to the plan;
5 (iii) plans providing legal service benefits to groups
6 where such plans are owned or operated by authority of a
7 state, county, local or other bar association;
8 (iv) any lawyer referral service authorized or
9 operated by a state, county, local or other bar
10 association;
11 (v) the furnishing of legal assistance by labor unions
12 and other employee organizations to their members in
13 matters relating to employment or occupation;
14 (vi) the furnishing of legal assistance to members or
15 dependents, by churches, consumer organizations,
16 cooperatives, educational institutions, credit unions, or
17 organizations of employees, where such organizations
18 contract directly with lawyers or law firms for the
19 provision of legal services, and the administration and
20 marketing of such legal services is wholly conducted by
21 the organization or its subsidiary;
22 (vii) legal services provided by an employee welfare
23 benefit plan defined by the Employee Retirement Income
24 Security Act of 1974;
25 (viii) any collectively bargained plan for legal
26 services between a labor union and an employer negotiated
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1 pursuant to Section 302 of the Labor Management Relations
2 Act as now or hereafter amended, under which plan legal
3 services will be provided for employees of the employer
4 whether or not payments for such services are funded to or
5 through an insurance company.
6 Class 2. Casualty, Fidelity and Surety.
7 (a) Accident and health. Insurance against bodily injury,
8 disablement or death by accident and against disablement
9 resulting from sickness or old age and every insurance
10 appertaining thereto, including stop-loss insurance. In this
11 clause, "stop-loss Stop-loss insurance" has meaning given to
12 that term in clause (b) of Class 1 is insurance against the
13 risk of economic loss issued to a single employer self-funded
14 employee disability benefit plan or an employee welfare
15 benefit plan as described in 29 U.S.C. 1001 et seq.
16 (b) Vehicle. Insurance against any loss or liability
17 resulting from or incident to the ownership, maintenance or
18 use of any vehicle (motor or otherwise), draft animal or
19 aircraft. Any policy insuring against any loss or liability on
20 account of the bodily injury or death of any person may contain
21 a provision for payment of disability benefits to injured
22 persons and death benefits to dependents, beneficiaries or
23 personal representatives of persons who are killed, including
24 the named insured, irrespective of legal liability of the
25 insured, if the injury or death for which benefits are
26 provided is caused by accident and sustained while in or upon
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1 or while entering into or alighting from or through being
2 struck by a vehicle (motor or otherwise), draft animal or
3 aircraft, and such provision shall not be deemed to be
4 accident insurance.
5 (c) Liability. Insurance against the liability of the
6 insured for the death, injury or disability of an employee or
7 other person, and insurance against the liability of the
8 insured for damage to or destruction of another person's
9 property.
10 (d) Workers' compensation. Insurance of the obligations
11 accepted by or imposed upon employers under laws for workers'
12 compensation.
13 (e) Burglary and forgery. Insurance against loss or damage
14 by burglary, theft, larceny, robbery, forgery, fraud or
15 otherwise; including all householders' personal property
16 floater risks.
17 (f) Glass. Insurance against loss or damage to glass
18 including lettering, ornamentation and fittings from any
19 cause.
20 (g) Fidelity and surety. Become surety or guarantor for
21 any person, copartnership or corporation in any position or
22 place of trust or as custodian of money or property, public or
23 private; or, becoming a surety or guarantor for the
24 performance of any person, copartnership or corporation of any
25 lawful obligation, undertaking, agreement or contract of any
26 kind, except contracts or policies of insurance; and
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1 underwriting blanket bonds. Such obligations shall be known
2 and treated as suretyship obligations and such business shall
3 be known as surety business.
4 (h) Miscellaneous. Insurance against loss or damage to
5 property and any liability of the insured caused by accidents
6 to boilers, pipes, pressure containers, machinery and
7 apparatus of any kind and any apparatus connected thereto, or
8 used for creating, transmitting or applying power, light,
9 heat, steam or refrigeration, making inspection of and issuing
10 certificates of inspection upon elevators, boilers, machinery
11 and apparatus of any kind and all mechanical apparatus and
12 appliances appertaining thereto; insurance against loss or
13 damage by water entering through leaks or openings in
14 buildings, or from the breakage or leakage of a sprinkler,
15 pumps, water pipes, plumbing and all tanks, apparatus,
16 conduits and containers designed to bring water into buildings
17 or for its storage or utilization therein, or caused by the
18 falling of a tank, tank platform or supports, or against loss
19 or damage from any cause (other than causes specifically
20 enumerated under Class 3 of this Section) to such sprinkler,
21 pumps, water pipes, plumbing, tanks, apparatus, conduits or
22 containers; insurance against loss or damage which may result
23 from the failure of debtors to pay their obligations to the
24 insured; and insurance of the payment of money for personal
25 services under contracts of hiring.
26 (i) Other casualty risks. Insurance against any other
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1 casualty risk not otherwise specified under Classes 1 or 3,
2 which may lawfully be the subject of insurance and may
3 properly be classified under Class 2.
4 (j) Contingent losses. Contingent, consequential and
5 indirect coverages wherein the proximate cause of the loss is
6 attributable to any one of the causes enumerated under Class
7 2. Such coverages shall, for the purpose of classification, be
8 included in the specific grouping of the kinds of insurance
9 wherein such cause is specified.
10 (k) Livestock and domestic animals. Insurance against
11 mortality, accident and health of livestock and domestic
12 animals.
13 (l) Legal expense insurance. Insurance against risk
14 resulting from the cost of legal services as defined under
15 Class 1(c).
16 Class 3. Fire and Marine, etc.
17 (a) Fire. Insurance against loss or damage by fire, smoke
18 and smudge, lightning or other electrical disturbances.
19 (b) Elements. Insurance against loss or damage by
20 earthquake, windstorms, cyclone, tornado, tempests, hail,
21 frost, snow, ice, sleet, flood, rain, drought or other weather
22 or climatic conditions including excess or deficiency of
23 moisture, rising of the waters of the ocean or its
24 tributaries.
25 (c) War, riot and explosion. Insurance against loss or
26 damage by bombardment, invasion, insurrection, riot, strikes,
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1 civil war or commotion, military or usurped power, or
2 explosion (other than explosion of steam boilers and the
3 breaking of fly wheels on premises owned, controlled, managed,
4 or maintained by the insured).
5 (d) Marine and transportation. Insurance against loss or
6 damage to vessels, craft, aircraft, vehicles of every kind,
7 (excluding vehicles operating under their own power or while
8 in storage not incidental to transportation) as well as all
9 goods, freights, cargoes, merchandise, effects, disbursements,
10 profits, moneys, bullion, precious stones, securities, choses
11 in action, evidences of debt, valuable papers, bottomry and
12 respondentia interests and all other kinds of property and
13 interests therein, in respect to, appertaining to or in
14 connection with any or all risks or perils of navigation,
15 transit, or transportation, including war risks, on or under
16 any seas or other waters, on land or in the air, or while being
17 assembled, packed, crated, baled, compressed or similarly
18 prepared for shipment or while awaiting the same or during any
19 delays, storage, transshipment, or reshipment incident
20 thereto, including marine builder's risks and all personal
21 property floater risks; and for loss or damage to persons or
22 property in connection with or appertaining to marine, inland
23 marine, transit or transportation insurance, including
24 liability for loss of or damage to either arising out of or in
25 connection with the construction, repair, operation,
26 maintenance, or use of the subject matter of such insurance,
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1 (but not including life insurance or surety bonds); but,
2 except as herein specified, shall not mean insurances against
3 loss by reason of bodily injury to the person; and insurance
4 against loss or damage to precious stones, jewels, jewelry,
5 gold, silver and other precious metals whether used in
6 business or trade or otherwise and whether the same be in
7 course of transportation or otherwise, which shall include
8 jewelers' block insurance; and insurance against loss or
9 damage to bridges, tunnels and other instrumentalities of
10 transportation and communication (excluding buildings, their
11 furniture and furnishings, fixed contents and supplies held in
12 storage) unless fire, tornado, sprinkler leakage, hail,
13 explosion, earthquake, riot and civil commotion are the only
14 hazards to be covered; and to piers, wharves, docks and slips,
15 excluding the risks of fire, tornado, sprinkler leakage, hail,
16 explosion, earthquake, riot and civil commotion; and to other
17 aids to navigation and transportation, including dry docks and
18 marine railways, against all risk.
19 (e) Vehicle. Insurance against loss or liability resulting
20 from or incident to the ownership, maintenance or use of any
21 vehicle (motor or otherwise), draft animal or aircraft,
22 excluding the liability of the insured for the death, injury
23 or disability of another person.
24 (f) Property damage, sprinkler leakage and crop. Insurance
25 against the liability of the insured for loss or damage to
26 another person's property or property interests from any cause
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1 enumerated in this class; insurance against loss or damage by
2 water entering through leaks or openings in buildings, or from
3 the breakage or leakage of a sprinkler, pumps, water pipes,
4 plumbing and all tanks, apparatus, conduits and containers
5 designed to bring water into buildings or for its storage or
6 utilization therein, or caused by the falling of a tank, tank
7 platform or supports or against loss or damage from any cause
8 to such sprinklers, pumps, water pipes, plumbing, tanks,
9 apparatus, conduits or containers; insurance against loss or
10 damage from insects, diseases or other causes to trees, crops
11 or other products of the soil.
12 (g) Other fire and marine risks. Insurance against any
13 other property risk not otherwise specified under Classes 1 or
14 2, which may lawfully be the subject of insurance and may
15 properly be classified under Class 3.
16 (h) Contingent losses. Contingent, consequential and
17 indirect coverages wherein the proximate cause of the loss is
18 attributable to any of the causes enumerated under Class 3.
19 Such coverages shall, for the purpose of classification, be
20 included in the specific grouping of the kinds of insurance
21 wherein such cause is specified.
22 (i) Legal expense insurance. Insurance against risk
23 resulting from the cost of legal services as defined under
24 Class 1(c).
25 (Source: P.A. 101-81, eff. 7-12-19.)
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1 (215 ILCS 5/155.23) (from Ch. 73, par. 767.23)
2 Sec. 155.23. Fraud reporting.
3 (1) Upon written request of the The Director, an
4 insurer is authorized to promulgate reasonable rules
5 requiring insurers, as defined in Section 155.24, or agent
6 authorized by an insurer to act on the insurer's behalf
7 shall release to the Department doing business in the
8 State of Illinois to report factual information in their
9 possession that is pertinent to suspected fraudulent
10 insurance claims, fraudulent insurance applications, or
11 premium fraud, after he has made a determination that the
12 information is necessary to detect fraud or arson. Claim
13 information may include:
14 (a) Dates and description of accident or loss.
15 (b) Any insurance policy relevant to the accident or
16 loss.
17 (c) Name of the insurance company claims adjustor and
18 claims adjustor supervisor processing or reviewing any
19 claim or claims made under any insurance policy relevant
20 to the accident or loss.
21 (d) Name of claimant's or insured's attorney.
22 (e) Name of claimant's or insured's physician, or any
23 person rendering or purporting to render medical
24 treatment.
25 (f) Description of alleged injuries, damage or loss.
26 (g) History of previous claims made by the claimant or
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1 insured.
2 (h) Places of medical treatment.
3 (i) Policy premium payment record.
4 (j) Material relating to the investigation of the
5 accident or loss, including statements of any person,
6 proof of loss, and any other relevant evidence.
7 (k) any facts evidencing fraud or arson.
8 The Director shall establish reporting requirements for
9 application and premium fraud information reporting by rule.
10 (2) The Director of Insurance may designate one or more
11 data processing organizations or governmental agencies to
12 assist him in gathering such information and making
13 compilations thereof, and may by rule establish the form and
14 procedure for gathering and compiling such information. The
15 rules may name any organization or agency designated by the
16 Director to provide this service, and may in such case provide
17 for a fee to be paid by the reporting insurers directly to the
18 designated organization or agency to cover any of the costs
19 associated with providing this service. After determination by
20 the Director of substantial evidence of false or fraudulent
21 claims, fraudulent applications, or premium fraud, the
22 information shall be forwarded by the Director or the
23 Director's designee to the proper law enforcement agency or
24 prosecutor. Insurers shall have access to, and may use, the
25 information compiled under the provisions of this Section.
26 Insurers shall release information to, and shall cooperate
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1 with, any law enforcement agency requesting such information.
2 In the absence of malice, no insurer, or person who
3 furnishes information on its behalf, is liable for damages in
4 a civil action or subject to criminal prosecution for any oral
5 or written statement made or any other action taken that is
6 necessary to supply information required pursuant to this
7 Section.
8 (Source: P.A. 92-233, eff. 1-1-02.)
9 (215 ILCS 5/352) (from Ch. 73, par. 964)
10 Sec. 352. Scope of Article.
11 (a) Except as provided in subsections (b), (c), (d), and
12 (e), and (g), this Article shall apply to all companies
13 transacting in this State the kinds of business enumerated in
14 clause (b) of Class 1 and clause (a) of Class 2 of Section 4
15 and to all policies, contracts, and certificates of insurance
16 issued in connection therewith. Nothing in this Article shall
17 apply to, or in any way affect policies or contracts described
18 in clause (a) of Class 1 of Section 4; however, this Article
19 shall apply to policies and contracts which contain benefits
20 providing reimbursement for the expenses of long term health
21 care which are certified or ordered by a physician including
22 but not limited to professional nursing care, custodial
23 nursing care, and non-nursing custodial care provided in a
24 nursing home or at a residence of the insured.
25 (b) (Blank).
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1 (c) A policy issued and delivered in this State that
2 provides coverage under that policy for certificate holders
3 who are neither residents of nor employed in this State does
4 not need to provide to those nonresident certificate holders
5 who are not employed in this State the coverages or services
6 mandated by this Article.
7 (d) Stop-loss insurance, as defined in clause (b) of Class
8 1 or clause (a) of Class 2 of Section 4, is exempt from all
9 Sections of this Article, except this Section and Sections
10 353a, 354, 357.30, and 370. For purposes of this exemption,
11 stop-loss insurance is further defined as follows:
12 (1) The policy must be issued to and insure an
13 employer, trustee, or other sponsor of the plan, or the
14 plan itself, but not employees, members, or participants.
15 (2) Payments by the insurer must be made to the
16 employer, trustee, or other sponsors of the plan, or the
17 plan itself, but not to the employees, members,
18 participants, or health care providers.
19 (e) A policy issued or delivered in this State to the
20 Department of Healthcare and Family Services (formerly
21 Illinois Department of Public Aid) and providing coverage,
22 under clause (b) of Class 1 or clause (a) of Class 2 as
23 described in Section 4, to persons who are enrolled under
24 Article V of the Illinois Public Aid Code or under the
25 Children's Health Insurance Program Act is exempt from all
26 restrictions, limitations, standards, rules, or regulations
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1 respecting benefits imposed by or under authority of this
2 Code, except those specified by subsection (1) of Section 143,
3 Section 370c, and Section 370c.1. Nothing in this subsection,
4 however, affects the total medical services available to
5 persons eligible for medical assistance under the Illinois
6 Public Aid Code.
7 (f) An in-office membership care agreement provided under
8 the In-Office Membership Care Act is not insurance for the
9 purposes of this Code.
10 (g) The provisions of Sections 356a through 359a, both
11 inclusive, shall not apply to or affect:
12 (1) any policy or contract of reinsurance; or
13 (2) life insurance, endowment or annuity contracts, or
14 contracts supplemental thereto, that contain only such
15 provisions relating to accident and sickness insurance
16 that (A) provide additional benefits in case of death or
17 dismemberment or loss of sight by accident, or (B) operate
18 to safeguard such contracts against lapse, or to give a
19 special surrender value or special benefit or an annuity
20 if the insured or annuitant becomes a person with a total
21 and permanent disability, as defined by the contract or
22 supplemental contract.
23 (Source: P.A. 101-190, eff. 8-2-19.)
24 (215 ILCS 5/352b)
25 Sec. 352b. Excepted benefits exempted Policy of individual
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1 or group accident and health insurance.
2 (a) Unless specified otherwise and when used in context of
3 accident and health insurance policy benefits, coverage,
4 terms, or conditions required to be provided under this
5 Article, references to any "policy of individual or group
6 accident and health insurance", or both, as used in this
7 Article, do does not include any coverage or policy that
8 provides an excepted benefit, as that term is defined in
9 Section 2791(c) of the federal Public Health Service Act (42
10 U.S.C. 300gg-91). Nothing in this subsection amendatory Act of
11 the 101st General Assembly applies to a policy of liability,
12 workers' compensation, automobile medical payment, or limited
13 scope dental or vision benefits insurance issued under this
14 Code. Nothing in this subsection shall be construed to subject
15 excepted benefits outside the scope of Section 352 to any
16 requirements of this Article.
17 (b) Unless specified otherwise for a type of excepted
18 benefit, nothing in this Article shall require a policy of
19 excepted benefits to provide benefits, coverage, terms, or
20 conditions in such a manner as to disqualify it from being
21 classified under federal law as the type of excepted benefit
22 for which its policy forms are filed under Sections 143 and 355
23 of this Code.
24 (Source: P.A. 101-456, eff. 8-23-19.)
25 (215 ILCS 5/356a) (from Ch. 73, par. 968a)
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1 Sec. 356a. Form of policy.
2 (1) No individual policy of accident and health insurance
3 shall be delivered or issued for delivery to any person in this
4 State state unless:
5 (a) the entire money and other considerations therefor
6 are expressed therein; and
7 (b) the time at which the insurance takes effect and
8 terminates is expressed therein; and
9 (c) it purports to insure only one person, except that
10 a policy may insure, originally or by subsequent
11 amendment, upon the application of an adult member of a
12 family who shall be deemed the policyholder, any 2 two or
13 more eligible members of that family, including husband,
14 wife, dependent children or any children under a specified
15 age which shall not exceed 19 years and any other person
16 dependent upon the policyholder; and
17 (d) the style, arrangement and over-all appearance of
18 the policy give no undue prominence to any portion of the
19 text, and unless every printed portion of the text of the
20 policy and of any endorsements or attached papers is
21 plainly printed in light-faced type of a style in general
22 use, the size of which shall be uniform and not less than
23 ten-point with a lower-case unspaced alphabet length not
24 less than one hundred and twenty-point (the "text" shall
25 include all printed matter except the name and address of
26 the insurer, name or title of the policy, the brief
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1 description if any, and captions and subcaptions); and
2 (e) the exceptions and reductions of indemnity are set
3 forth in the policy and, except those which are set forth
4 in Sections 357.1 through 357.30 of this act, are printed,
5 at the insurer's option, either included with the benefit
6 provision to which they apply, or under an appropriate
7 caption such as "EXCEPTIONS", or "EXCEPTIONS AND
8 REDUCTIONS", provided that if an exception or reduction
9 specifically applies only to a particular benefit of the
10 policy, a statement of such exception or reduction shall
11 be included with the benefit provision to which it
12 applies; and
13 (f) each such form, including riders and endorsements,
14 shall be identified by a form number in the lower
15 left-hand corner of the first page thereof; and
16 (g) it contains no provision purporting to make any
17 portion of the charter, rules, constitution, or by-laws of
18 the insurer a part of the policy unless such portion is set
19 forth in full in the policy, except in the case of the
20 incorporation of, or reference to, a statement of rates or
21 classification of risks, or short-rate table filed with
22 the Director.
23 (2) If any policy is issued by an insurer domiciled in this
24 state for delivery to a person residing in another state, and
25 if the official having responsibility for the administration
26 of the insurance laws of such other state shall have advised
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1 the Director that any such policy is not subject to approval or
2 disapproval by such official, the Director may by ruling
3 require that such policy meet the standards set forth in
4 subsection (1) of this section and in Sections 357.1 through
5 357.30.
6 (Source: P.A. 76-860.)
7 (215 ILCS 5/356b) (from Ch. 73, par. 968b)
8 Sec. 356b. (a) This Section applies to the hospital and
9 medical expense provisions of an individual accident or health
10 insurance policy.
11 (b) If a policy provides that coverage of a dependent
12 person terminates upon attainment of the limiting age for
13 dependent persons specified in the policy, the attainment of
14 such limiting age does not operate to terminate the hospital
15 and medical coverage of a person who, because of a disabling
16 condition that occurred before attainment of the limiting age,
17 is incapable of self-sustaining employment and is dependent on
18 his or her parents or other care providers for lifetime care
19 and supervision.
20 (c) For purposes of subsection (b), "dependent on other
21 care providers" is defined as requiring a Community Integrated
22 Living Arrangement, group home, supervised apartment, or other
23 residential services licensed or certified by the Department
24 of Human Services (as successor to the Department of Mental
25 Health and Developmental Disabilities), the Department of
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1 Public Health, or the Department of Healthcare and Family
2 Services (formerly Department of Public Aid).
3 (d) The insurer may inquire of the policyholder 2 months
4 prior to attainment by a dependent of the limiting age set
5 forth in the policy, or at any reasonable time thereafter,
6 whether such dependent is in fact a person who has a disability
7 and is dependent and, in the absence of proof submitted within
8 60 days of such inquiry that such dependent is a person who has
9 a disability and is dependent may terminate coverage of such
10 person at or after attainment of the limiting age. In the
11 absence of such inquiry, coverage of any person who has a
12 disability and is dependent shall continue through the term of
13 such policy or any extension or renewal thereof.
14 (e) This amendatory Act of 1969 is applicable to policies
15 issued or renewed more than 60 days after the effective date of
16 this amendatory Act of 1969.
17 (Source: P.A. 99-143, eff. 7-27-15.)
18 (215 ILCS 5/356d) (from Ch. 73, par. 968d)
19 Sec. 356d. Conversion privileges for insured former
20 spouses. (1) No individual policy of accident and health
21 insurance providing coverage of hospital and/or medical
22 expense on either an expense incurred basis or other than an
23 expense incurred basis, which in addition to covering the
24 insured also provides coverage to the spouse of the insured
25 shall contain a provision for termination of coverage for a
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1 spouse covered under the policy solely as a result of a break
2 in the marital relationship except by reason of an entry of a
3 valid judgment of dissolution of marriage between the parties.
4 (2) Every policy which contains a provision for
5 termination of coverage of the spouse upon dissolution of
6 marriage shall contain a provision to the effect that upon the
7 entry of a valid judgment of dissolution of marriage between
8 the insured parties the spouse whose marriage was dissolved
9 shall be entitled to have issued to him or her, without
10 evidence of insurability, upon application made to the company
11 within 60 days following the entry of such judgment, and upon
12 the payment of the appropriate premium, an individual policy
13 of accident and health insurance. Such policy shall provide
14 the coverage then being issued by the insurer which is most
15 nearly similar to, but not greater than, such terminated
16 coverages. Any and all probationary and/or waiting periods set
17 forth in such policy shall be considered as being met to the
18 extent coverage was in force under the prior policy.
19 (3) The requirements of this Section shall apply to all
20 policies delivered or issued for delivery on or after the 60th
21 day following the effective date of this Section.
22 (Source: P.A. 84-545.)
23 (215 ILCS 5/356e) (from Ch. 73, par. 968e)
24 Sec. 356e. Victims of certain offenses.
25 (1) No individual policy of accident and health insurance,
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1 which provides benefits for hospital or medical expenses based
2 upon the actual expenses incurred, delivered or issued for
3 delivery to any person in this State shall contain any
4 specific exception to coverage which would preclude the
5 payment under that policy of actual expenses incurred in the
6 examination and testing of a victim of an offense defined in
7 Sections 11-1.20 through 11-1.60 or 12-13 through 12-16 of the
8 Criminal Code of 1961 or the Criminal Code of 2012, or an
9 attempt to commit such offense to establish that sexual
10 contact did occur or did not occur, and to establish the
11 presence or absence of sexually transmitted disease or
12 infection, and examination and treatment of injuries and
13 trauma sustained by a victim of such offense arising out of the
14 offense. Every policy of accident and health insurance which
15 specifically provides benefits for routine physical
16 examinations shall provide full coverage for expenses incurred
17 in the examination and testing of a victim of an offense
18 defined in Sections 11-1.20 through 11-1.60 or 12-13 through
19 12-16 of the Criminal Code of 1961 or the Criminal Code of
20 2012, or an attempt to commit such offense as set forth in this
21 Section. This Section shall not apply to a policy which covers
22 hospital and medical expenses for specified illnesses or
23 injuries only.
24 (2) For purposes of enabling the recovery of State funds,
25 any insurance carrier subject to this Section shall upon
26 reasonable demand by the Department of Public Health disclose
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1 the names and identities of its insureds entitled to benefits
2 under this provision to the Department of Public Health
3 whenever the Department of Public Health has determined that
4 it has paid, or is about to pay, hospital or medical expenses
5 for which an insurance carrier is liable under this Section.
6 All information received by the Department of Public Health
7 under this provision shall be held on a confidential basis and
8 shall not be subject to subpoena and shall not be made public
9 by the Department of Public Health or used for any purpose
10 other than that authorized by this Section.
11 (3) Whenever the Department of Public Health finds that it
12 has paid all or part of any hospital or medical expenses which
13 an insurance carrier is obligated to pay under this Section,
14 the Department of Public Health shall be entitled to receive
15 reimbursement for its payments from such insurance carrier
16 provided that the Department of Public Health has notified the
17 insurance carrier of its claims before the carrier has paid
18 such benefits to its insureds or in behalf of its insureds.
19 (Source: P.A. 96-1551, eff. 7-1-11; 97-1150, eff. 1-25-13.)
20 (215 ILCS 5/356f) (from Ch. 73, par. 968f)
21 Sec. 356f. No individual policy of accident or health
22 insurance or any renewal thereof shall be denied or cancelled
23 by the insurer, nor shall any such policy contain any
24 exception or exclusion of benefits, solely because the mother
25 of the insured has taken diethylstilbestrol, commonly referred
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1 to as DES.
2 (Source: P.A. 81-656.)
3 (215 ILCS 5/356K) (from Ch. 73, par. 968K)
4 Sec. 356K. Coverage for Organ Transplantation Procedures.
5 No accident and health insurer providing individual accident
6 and health insurance coverage under this Act for hospital or
7 medical expenses shall deny reimbursement for an otherwise
8 covered expense incurred for any organ transplantation
9 procedure solely on the basis that such procedure is deemed
10 experimental or investigational unless supported by the
11 determination of the Office of Health Care Technology
12 Assessment within the Agency for Health Care Policy and
13 Research within the federal Department of Health and Human
14 Services that such procedure is either experimental or
15 investigational or that there is insufficient data or
16 experience to determine whether an organ transplantation
17 procedure is clinically acceptable. If an accident and health
18 insurer has made written request, or had one made on its behalf
19 by a national organization, for determination by the Office of
20 Health Care Technology Assessment within the Agency for Health
21 Care Policy and Research within the federal Department of
22 Health and Human Services as to whether a specific organ
23 transplantation procedure is clinically acceptable and said
24 organization fails to respond to such a request within a
25 period of 90 days, the failure to act may be deemed a
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1 determination that the procedure is deemed to be experimental
2 or investigational.
3 (Source: P.A. 87-218.)
4 (215 ILCS 5/356L) (from Ch. 73, par. 968L)
5 Sec. 356L. No individual policy of accident or health
6 insurance shall include any provision which shall have the
7 effect of denying coverage to or on behalf of an insured under
8 such policy on the basis of a failure by the insured to file a
9 notice of claim within the time period required by the policy,
10 provided such failure is caused solely by the physical
11 inability or mental incapacity of the insured to file such
12 notice of claim because of a period of emergency
13 hospitalization.
14 (Source: P.A. 86-784.)
15 (215 ILCS 5/356r)
16 Sec. 356r. Access to obstetrical and gynecological care
17 Woman's principal health care provider.
18 (a) An individual or group policy of accident and health
19 insurance or a managed care plan amended, delivered, issued,
20 or renewed in this State must not require authorization or
21 referral by the plan, issuer, or any person, including a
22 primary care provider, for any covered individual who seeks
23 coverage for obstetrical or gynecological care provided by any
24 licensed or certified participating health care professional
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1 who specializes in obstetrics or gynecology. after November
2 14, 1996 that requires an insured or enrollee to designate an
3 individual to coordinate care or to control access to health
4 care services shall also permit a female insured or enrollee
5 to designate a participating woman's principal health care
6 provider, and the insurer or managed care plan shall provide
7 the following written notice to all female insureds or
8 enrollees no later than 120 days after the effective date of
9 this amendatory Act of 1998; to all new enrollees at the time
10 of enrollment; and thereafter to all existing enrollees at
11 least annually, as a part of a regular publication or
12 informational mailing:
13 "NOTICE TO ALL FEMALE PLAN MEMBERS:
14 YOUR RIGHT TO SELECT A WOMAN'S PRINCIPAL
15 HEALTH CARE PROVIDER.
16 Illinois law allows you to select "a woman's principal
17 health care provider" in addition to your selection of a
18 primary care physician. A woman's principal health care
19 provider is a physician licensed to practice medicine in
20 all its branches specializing in obstetrics or gynecology
21 or specializing in family practice. A woman's principal
22 health care provider may be seen for care without
23 referrals from your primary care physician. If you have
24 not already selected a woman's principal health care
25 provider, you may do so now or at any other time. You are
26 not required to have or to select a woman's principal
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1 health care provider.
2 Your woman's principal health care provider must be a
3 part of your plan. You may get the list of participating
4 obstetricians, gynecologists, and family practice
5 specialists from your employer's employee benefits
6 coordinator, or for your own copy of the current list, you
7 may call [insert plan's toll free number]. The list will
8 be sent to you within 10 days after your call. To designate
9 a woman's principal health care provider from the list,
10 call [insert plan's toll free number] and tell our staff
11 the name of the physician you have selected.".
12 If the insurer or managed care plan exercises the option set
13 forth in subsection (a-5), the notice shall also state:
14 "Your plan requires that your primary care physician
15 and your woman's principal health care provider have a
16 referral arrangement with one another. If the woman's
17 principal health care provider that you select does not
18 have a referral arrangement with your primary care
19 physician, you will have to select a new primary care
20 physician who has a referral arrangement with your woman's
21 principal health care provider or you may select a woman's
22 principal health care provider who has a referral
23 arrangement with your primary care physician. The list of
24 woman's principal health care providers will also have the
25 names of the primary care physicians and their referral
26 arrangements.".
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1 No later than 120 days after the effective date of this
2 amendatory Act of 1998, the insurer or managed care plan shall
3 provide each employer who has a policy of insurance or a
4 managed care plan with the insurer or managed care plan with a
5 list of physicians licensed to practice medicine in all its
6 branches specializing in obstetrics or gynecology or
7 specializing in family practice who have contracted with the
8 plan. At the time of enrollment and thereafter within 10 days
9 after a request by an insured or enrollee, the insurer or
10 managed care plan also shall provide this list directly to the
11 insured or enrollee. The list shall include each physician's
12 address, telephone number, and specialty. No insurer or plan
13 formal or informal policy may restrict a female insured's or
14 enrollee's right to designate a woman's principal health care
15 provider, except as set forth in subsection (a-5). If the
16 female enrollee is an enrollee of a managed care plan under
17 contract with the Department of Healthcare and Family
18 Services, the physician chosen by the enrollee as her woman's
19 principal health care provider must be a Medicaid-enrolled
20 provider. This requirement does not require a female insured
21 or enrollee to make a selection of a woman's principal health
22 care provider. The female insured or enrollee may designate a
23 physician licensed to practice medicine in all its branches
24 specializing in family practice as her woman's principal
25 health care provider.
26 (a-5) If a policy, contract, or certificate requires or
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1 allows a covered individual to designate a primary care
2 provider and provides coverage for any obstetrical or
3 gynecological care, the insurer shall provide the notice
4 required under 45 CFR 147.138(a)(4) and 149.310(a)(4) in all
5 circumstances required under that provision. The insured or
6 enrollee may be required by the insurer or managed care plan to
7 select a woman's principal health care provider who has a
8 referral arrangement with the insured's or enrollee's
9 individual who coordinates care or controls access to health
10 care services if such referral arrangement exists or to select
11 a new individual to coordinate care or to control access to
12 health care services who has a referral arrangement with the
13 woman's principal health care provider chosen by the insured
14 or enrollee, if such referral arrangement exists. If an
15 insurer or a managed care plan requires an insured or enrollee
16 to select a new physician under this subsection (a-5), the
17 insurer or managed care plan must provide the insured or
18 enrollee with both options to select a new physician provided
19 in this subsection (a-5).
20 Notwithstanding a plan's restrictions of the frequency or
21 timing of making designations of primary care providers, a
22 female enrollee or insured who is subject to the selection
23 requirements of this subsection, may, at any time, effect a
24 change in primary care physicians in order to make a selection
25 of a woman's principal health care provider.
26 (a-6) The requirements of this Section shall be construed
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1 in a manner consistent with the requirements for access to and
2 notice of obstetrical and gynecological care in 45 CFR 147.138
3 and 45 CFR 149.310. If an insurer or managed care plan
4 exercises the option in subsection (a-5), the list to be
5 provided under subsection (a) shall identify the referral
6 arrangements that exist between the individual who coordinates
7 care or controls access to health care services and the
8 woman's principal health care provider in order to assist the
9 female insured or enrollee to make a selection within the
10 insurer's or managed care plan's requirement.
11 (b) Nothing in this Section prevents a health insurance
12 issuer from requiring a participating obstetrical or
13 gynecological health care professional to agree, with respect
14 to individuals covered under a policy of accident and health
15 insurance, to otherwise adhere to the health insurance
16 issuer's policies and procedures, including procedures
17 regarding referrals and obtaining prior authorization and
18 providing services pursuant to a treatment plan, if any,
19 approved by the issuer. If a female insured or enrollee has
20 designated a woman's principal health care provider, then the
21 insured or enrollee must be given direct access to the woman's
22 principal health care provider for services covered by the
23 policy or plan without the need for a referral or prior
24 approval. Nothing shall prohibit the insurer or managed care
25 plan from requiring prior authorization or approval from
26 either a primary care provider or the woman's principal health
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1 care provider for referrals for additional care or services.
2 (c) (Blank). For the purposes of this Section the
3 following terms are defined:
4 (1) "Woman's principal health care provider" means a
5 physician licensed to practice medicine in all of its
6 branches specializing in obstetrics or gynecology or
7 specializing in family practice.
8 (2) "Managed care entity" means any entity including a
9 licensed insurance company, hospital or medical service
10 plan, health maintenance organization, limited health
11 service organization, preferred provider organization,
12 third party administrator, an employer or employee
13 organization, or any person or entity that establishes,
14 operates, or maintains a network of participating
15 providers.
16 (3) "Managed care plan" means a plan operated by a
17 managed care entity that provides for the financing of
18 health care services to persons enrolled in the plan
19 through:
20 (A) organizational arrangements for ongoing
21 quality assurance, utilization review programs, or
22 dispute resolution; or
23 (B) financial incentives for persons enrolled in
24 the plan to use the participating providers and
25 procedures covered by the plan.
26 (4) "Participating provider" means a physician who has
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1 contracted with an insurer or managed care plan to provide
2 services to insureds or enrollees as defined by the
3 contract.
4 (d) Nothing in this Section shall be construed to preclude
5 a health insurance issuer from requiring that a participating
6 obstetrical or gynecological health care professional notify
7 the covered individual's primary care physician or the issuer
8 of treatment decisions or update centralized medical records.
9 The original provisions of this Section became law on July 17,
10 1996 and took effect November 14, 1996, which is 120 days after
11 becoming law.
12 (Source: P.A. 95-331, eff. 8-21-07.)
13 (215 ILCS 5/356s)
14 Sec. 356s. Post-parturition care. An individual or group
15 policy of accident and health insurance that provides
16 maternity coverage and is amended, delivered, issued, or
17 renewed after the effective date of this amendatory Act of
18 1996 shall provide coverage for the following:
19 (1) a minimum of 48 hours of inpatient care following
20 a vaginal delivery for the mother and the newborn, except
21 as otherwise provided in this Section; or
22 (2) a minimum of 96 hours of inpatient care following
23 a delivery by caesarian section for the mother and
24 newborn, except as otherwise provided in this Section.
25 Coverage may be limited to a A shorter length of hospital
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1 inpatient care stay for services related to maternity and
2 newborn care may be provided if the attending physician
3 licensed to practice medicine in all of its branches
4 determines, in accordance with the protocols and guidelines
5 developed by the American College of Obstetricians and
6 Gynecologists or the American Academy of Pediatrics, that the
7 mother and the newborn meet the appropriate guidelines for
8 that length of stay based upon evaluation of the mother and
9 newborn and the coverage and availability of a post-discharge
10 physician office visit or in-home nurse visit to verify the
11 condition of the infant in the first 48 hours after discharge.
12 (Source: P.A. 89-513, eff. 9-15-96; 90-14, eff. 7-1-97.)
13 (215 ILCS 5/356z.3)
14 Sec. 356z.3. Disclosure of limited benefit. An insurer
15 that issues, delivers, amends, or renews an individual or
16 group policy of accident and health insurance in this State
17 after the effective date of this amendatory Act of the 92nd
18 General Assembly and arranges, contracts with, or administers
19 contracts with a provider whereby beneficiaries are provided
20 an incentive to use the services of such provider must include
21 the following disclosure on its contracts and evidences of
22 coverage: "WARNING, LIMITED BENEFITS WILL BE PAID WHEN
23 NON-PARTICIPATING PROVIDERS ARE USED. YOU CAN EXPECT TO PAY
24 MORE THAN THE COST-SHARING AMOUNT DEFINED IN THE POLICY IN
25 NON-EMERGENCY SITUATIONS. Except in limited situations
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1 governed by the federal No Surprises Act or Section 356z.3a of
2 the Illinois Insurance Code (215 ILCS 5/356z.3a),
3 non-participating providers furnishing non-emergency services
4 may bill members for any amount up to the billed charge after
5 the plan has paid its portion of the bill. If you elect to use
6 a non-participating provider, plan benefit payments will be
7 determined according to your policy's fee schedule, usual and
8 customary charge (which is determined by comparing charges for
9 similar services adjusted to the geographical area where the
10 services are performed), or other method as defined by the
11 policy. Participating providers have agreed to ONLY bill
12 members the cost-sharing amounts. You should be aware that
13 when you elect to utilize the services of a non-participating
14 provider for a covered service in non-emergency situations,
15 benefit payments to such non-participating provider are not
16 based upon the amount billed. The basis of your benefit
17 payment will be determined according to your policy's fee
18 schedule, usual and customary charge (which is determined by
19 comparing charges for similar services adjusted to the
20 geographical area where the services are performed), or other
21 method as defined by the policy. YOU CAN EXPECT TO PAY MORE
22 THAN THE COINSURANCE AMOUNT DEFINED IN THE POLICY AFTER THE
23 PLAN HAS PAID ITS REQUIRED PORTION. Non-participating
24 providers may bill members for any amount up to the billed
25 charge after the plan has paid its portion of the bill, except
26 as provided in Section 356z.3a of the Illinois Insurance Code
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1 for covered services received at a participating health care
2 facility from a nonparticipating provider that are: (a)
3 ancillary services, (b) items or services furnished as a
4 result of unforeseen, urgent medical needs that arise at the
5 time the item or service is furnished, or (c) items or services
6 received when the facility or the non-participating provider
7 fails to satisfy the notice and consent criteria specified
8 under Section 356z.3a. Participating providers have agreed to
9 accept discounted payments for services with no additional
10 billing to the member other than co-insurance and deductible
11 amounts. You may obtain further information about the
12 participating status of professional providers and information
13 on out-of-pocket expenses by calling the toll-free toll free
14 telephone number on your identification card.".
15 (Source: P.A. 102-901, eff. 1-1-23.)
16 (215 ILCS 5/356z.33)
17 (Text of Section before amendment by P.A. 103-454)
18 Sec. 356z.33. Coverage for epinephrine injectors. A group
19 or individual policy of accident and health insurance or a
20 managed care plan that is amended, delivered, issued, or
21 renewed on or after January 1, 2020 (the effective date of
22 Public Act 101-281) shall provide coverage for medically
23 necessary epinephrine injectors for persons 18 years of age or
24 under. As used in this Section, "epinephrine injector" has the
25 meaning given to that term in Section 5 of the Epinephrine
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1 Injector Act.
2 (Source: P.A. 101-281, eff. 1-1-20; 102-558, eff. 8-20-21.)
3 (Text of Section after amendment by P.A. 103-454)
4 Sec. 356z.33. Coverage for epinephrine injectors.
5 (a) A group or individual policy of accident and health
6 insurance or a managed care plan that is amended, delivered,
7 issued, or renewed on or after January 1, 2020 (the effective
8 date of Public Act 101-281) shall provide coverage for
9 medically necessary epinephrine injectors for persons 18 years
10 of age or under. As used in this Section, "epinephrine
11 injector" has the meaning given to that term in Section 5 of
12 the Epinephrine Injector Act.
13 (b) An insurer that provides coverage for medically
14 necessary epinephrine injectors shall limit the total amount
15 that an insured is required to pay for a twin-pack of medically
16 necessary epinephrine injectors at an amount not to exceed
17 $60, regardless of the type of epinephrine injector; except
18 that this provision does not apply to the extent such coverage
19 would disqualify a high-deductible health plan from
20 eligibility for a health savings account pursuant to Section
21 223 of the Internal Revenue Code (26 U.S.C. 223).
22 (c) Nothing in this Section prevents an insurer from
23 reducing an insured's cost sharing by an amount greater than
24 the amount specified in subsection (b).
25 (d) The Department may adopt rules as necessary to
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1 implement and administer this Section.
2 (Source: P.A. 102-558, eff. 8-20-21; 103-454, eff. 1-1-25.)
3 (215 ILCS 5/367a) (from Ch. 73, par. 979a)
4 Sec. 367a. Blanket accident and health insurance.
5 (1) Blanket accident and health insurance is that form of
6 accident and health insurance covering special groups of
7 persons as enumerated in one of the following paragraphs (a)
8 to (g), inclusive:
9 (a) Under a policy or contract issued to any carrier
10 for hire, which shall be deemed the policyholder, covering
11 a group defined as all persons who may become passengers
12 on such carrier.
13 (b) Under a policy or contract issued to an employer,
14 who shall be deemed the policyholder, covering all
15 employees or any group of employees defined by reference
16 to exceptional hazards incident to such employment.
17 (c) Under a policy or contract issued to a college,
18 school, or other institution of learning or to the head or
19 principal thereof, who or which shall be deemed the
20 policyholder, covering students or teachers. However,
21 student health insurance coverage, as defined in 45 CFR
22 147.145, shall remain subject to the standards and
23 requirements for individual health insurance coverage
24 except where inconsistent with that regulation. Student
25 health insurance coverage shall not be subject to the
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1 Short-Term, Limited-Duration Health Insurance Coverage
2 Act. An insurer providing student health insurance
3 coverage or a policy or contract covering students for
4 limited-scope dental or vision under 45 CFR 148.220 shall
5 require an individual application or enrollment form and
6 shall furnish each insured individual a certificate, which
7 shall have been approved by the Director under Section
8 355.
9 (d) Under a policy or contract issued in the name of
10 any volunteer fire department, first aid, or other such
11 volunteer group, which shall be deemed the policyholder,
12 covering all of the members of such department or group.
13 (e) Under a policy or contract issued to a creditor,
14 who shall be deemed the policyholder, to insure debtors of
15 the creditors; Provided, however, that in the case of a
16 loan which is subject to the Small Loans Act, no insurance
17 premium or other cost shall be directly or indirectly
18 charged or assessed against, or collected or received from
19 the borrower.
20 (f) Under a policy or contract issued to a sports team
21 or to a camp, which team or camp sponsor shall be deemed
22 the policyholder, covering members or campers.
23 (g) Under a policy or contract issued to any other
24 substantially similar group which, in the discretion of
25 the Director, may be subject to the issuance of a blanket
26 accident and health policy or contract.
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1 (2) Any insurance company authorized to write accident and
2 health insurance in this state shall have the power to issue
3 blanket accident and health insurance. No such blanket policy
4 may be issued or delivered in this State unless a copy of the
5 form thereof shall have been filed in accordance with Section
6 355, and it contains in substance such of those provisions
7 contained in Sections 357.1 through 357.30 as may be
8 applicable to blanket accident and health insurance and the
9 following provisions:
10 (a) A provision that the policy and the application
11 shall constitute the entire contract between the parties,
12 and that all statements made by the policyholder shall, in
13 absence of fraud, be deemed representations and not
14 warranties, and that no such statements shall be used in
15 defense to a claim under the policy, unless it is
16 contained in a written application.
17 (b) A provision that to the group or class thereof
18 originally insured shall be added from time to time all
19 new persons or individuals eligible for coverage.
20 (3) An individual application shall not be required from a
21 person covered under a blanket accident or health policy or
22 contract, nor shall it be necessary for the insurer to furnish
23 each person a certificate.
24 (3.5) Subsection (3) does not apply to major medical
25 insurance, or to any excepted benefits or short-term,
26 limited-duration health insurance coverage for which an
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1 insured individual pays premiums or contributions. In those
2 cases, the insurer shall require an individual application or
3 enrollment form and shall furnish each insured individual a
4 certificate, which shall have been approved by the Director
5 under Section 355 of this Code.
6 (4) All benefits under any blanket accident and health
7 policy shall be payable to the person insured, or to his
8 designated beneficiary or beneficiaries, or to his or her
9 estate, except that if the person insured be a minor or person
10 under legal disability, such benefits may be made payable to
11 his or her parent, guardian, or other person actually
12 supporting him or her. Provided further, however, that the
13 policy may provide that all or any portion of any indemnities
14 provided by any such policy on account of hospital, nursing,
15 medical or surgical services may, at the insurer's option, be
16 paid directly to the hospital or person rendering such
17 services; but the policy may not require that the service be
18 rendered by a particular hospital or person. Payment so made
19 shall discharge the insurer's obligation with respect to the
20 amount of insurance so paid.
21 (5) Nothing contained in this section shall be deemed to
22 affect the legal liability of policyholders for the death of
23 or injury to, any such member of such group.
24 (Source: P.A. 83-1362.)
25 (215 ILCS 5/370e) (from Ch. 73, par. 982e)
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1 Sec. 370e. Companies which issue group accident and health
2 policies or blanket accident and health plans to employer
3 groups in this State shall provide the employer with notice of
4 termination of a group or blanket accident and health plan
5 because of the employer's failure to pay the premium when due.
6 The insurance company shall file send a copy of such notice
7 with to the Department in an electronic format either through
8 the System for Electronic Rate and Form Filing (SERFF) or as
9 otherwise prescribed by the Director.
10 (Source: P.A. 83-1006.)
11 (215 ILCS 5/370i) (from Ch. 73, par. 982i)
12 Sec. 370i. Policies, agreements or arrangements with
13 incentives or limits on reimbursement authorized.
14 (a) Policies, agreements or arrangements issued under this
15 Article may not contain terms or conditions that would operate
16 unreasonably to restrict the access and availability of health
17 care services for the insured.
18 (b) An insurer or administrator may:
19 (1) enter into agreements with certain providers of
20 its choice relating to health care services which may be
21 rendered to insureds or beneficiaries of the insurer or
22 administrator, including agreements relating to the
23 amounts to be charged the insureds or beneficiaries for
24 services rendered;
25 (2) issue or administer programs, policies or
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1 subscriber contracts in this State that include incentives
2 for the insured or beneficiary to utilize the services of
3 a provider which has entered into an agreement with the
4 insurer or administrator pursuant to paragraph (1) above.
5 (c) (Blank). After the effective date of this amendatory
6 Act of the 92nd General Assembly, any insurer that arranges,
7 contracts with, or administers contracts with a provider
8 whereby beneficiaries are provided an incentive to use the
9 services of such provider must include the following
10 disclosure on its contracts and evidences of coverage:
11 "WARNING, LIMITED BENEFITS WILL BE PAID WHEN NON-PARTICIPATING
12 PROVIDERS ARE USED. You should be aware that when you elect to
13 utilize the services of a non-participating provider for a
14 covered service in non-emergency situations, benefit payments
15 to such non-participating provider are not based upon the
16 amount billed. The basis of your benefit payment will be
17 determined according to your policy's fee schedule, usual and
18 customary charge (which is determined by comparing charges for
19 similar services adjusted to the geographical area where the
20 services are performed), or other method as defined by the
21 policy. YOU CAN EXPECT TO PAY MORE THAN THE COINSURANCE AMOUNT
22 DEFINED IN THE POLICY AFTER THE PLAN HAS PAID ITS REQUIRED
23 PORTION. Non-participating providers may bill members for any
24 amount up to the billed charge after the plan has paid its
25 portion of the bill. Participating providers have agreed to
26 accept discounted payments for services with no additional
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1 billing to the member other than co-insurance and deductible
2 amounts. You may obtain further information about the
3 participating status of professional providers and information
4 on out-of-pocket expenses by calling the toll free telephone
5 number on your identification card.".
6 (Source: P.A. 92-579, eff. 1-1-03.)
7 (215 ILCS 5/408) (from Ch. 73, par. 1020)
8 (Text of Section before amendment by P.A. 103-75)
9 Sec. 408. Fees and charges.
10 (1) The Director shall charge, collect and give proper
11 acquittances for the payment of the following fees and
12 charges:
13 (a) For filing all documents submitted for the
14 incorporation or organization or certification of a
15 domestic company, except for a fraternal benefit society,
16 $2,000.
17 (b) For filing all documents submitted for the
18 incorporation or organization of a fraternal benefit
19 society, $500.
20 (c) For filing amendments to articles of incorporation
21 and amendments to declaration of organization, except for
22 a fraternal benefit society, a mutual benefit association,
23 a burial society or a farm mutual, $200.
24 (d) For filing amendments to articles of incorporation
25 of a fraternal benefit society, a mutual benefit
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1 association or a burial society, $100.
2 (e) For filing amendments to articles of incorporation
3 of a farm mutual, $50.
4 (f) For filing bylaws or amendments thereto, $50.
5 (g) For filing agreement of merger or consolidation:
6 (i) for a domestic company, except for a fraternal
7 benefit society, a mutual benefit association, a
8 burial society, or a farm mutual, $2,000.
9 (ii) for a foreign or alien company, except for a
10 fraternal benefit society, $600.
11 (iii) for a fraternal benefit society, a mutual
12 benefit association, a burial society, or a farm
13 mutual, $200.
14 (h) For filing agreements of reinsurance by a domestic
15 company, $200.
16 (i) For filing all documents submitted by a foreign or
17 alien company to be admitted to transact business or
18 accredited as a reinsurer in this State, except for a
19 fraternal benefit society, $5,000.
20 (j) For filing all documents submitted by a foreign or
21 alien fraternal benefit society to be admitted to transact
22 business in this State, $500.
23 (k) For filing declaration of withdrawal of a foreign
24 or alien company, $50.
25 (l) For filing annual statement by a domestic company,
26 except a fraternal benefit society, a mutual benefit
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1 association, a burial society, or a farm mutual, $200.
2 (m) For filing annual statement by a domestic
3 fraternal benefit society, $100.
4 (n) For filing annual statement by a farm mutual, a
5 mutual benefit association, or a burial society, $50.
6 (o) For issuing a certificate of authority or renewal
7 thereof except to a foreign fraternal benefit society,
8 $400.
9 (p) For issuing a certificate of authority or renewal
10 thereof to a foreign fraternal benefit society, $200.
11 (q) For issuing an amended certificate of authority,
12 $50.
13 (r) For each certified copy of certificate of
14 authority, $20.
15 (s) For each certificate of deposit, or valuation, or
16 compliance or surety certificate, $20.
17 (t) For copies of papers or records per page, $1.
18 (u) For each certification to copies of papers or
19 records, $10.
20 (v) For multiple copies of documents or certificates
21 listed in subparagraphs (r), (s), and (u) of paragraph (1)
22 of this Section, $10 for the first copy of a certificate of
23 any type and $5 for each additional copy of the same
24 certificate requested at the same time, unless, pursuant
25 to paragraph (2) of this Section, the Director finds these
26 additional fees excessive.
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1 (w) For issuing a permit to sell shares or increase
2 paid-up capital:
3 (i) in connection with a public stock offering,
4 $300;
5 (ii) in any other case, $100.
6 (x) For issuing any other certificate required or
7 permissible under the law, $50.
8 (y) For filing a plan of exchange of the stock of a
9 domestic stock insurance company, a plan of
10 demutualization of a domestic mutual company, or a plan of
11 reorganization under Article XII, $2,000.
12 (z) For filing a statement of acquisition of a
13 domestic company as defined in Section 131.4 of this Code,
14 $2,000.
15 (aa) For filing an agreement to purchase the business
16 of an organization authorized under the Dental Service
17 Plan Act or the Voluntary Health Services Plans Act or of a
18 health maintenance organization or a limited health
19 service organization, $2,000.
20 (bb) For filing a statement of acquisition of a
21 foreign or alien insurance company as defined in Section
22 131.12a of this Code, $1,000.
23 (cc) For filing a registration statement as required
24 in Sections 131.13 and 131.14, the notification as
25 required by Sections 131.16, 131.20a, or 141.4, or an
26 agreement or transaction required by Sections 124.2(2),
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1 141, 141a, or 141.1, $200.
2 (dd) For filing an application for licensing of:
3 (i) a religious or charitable risk pooling trust
4 or a workers' compensation pool, $1,000;
5 (ii) a workers' compensation service company,
6 $500;
7 (iii) a self-insured automobile fleet, $200; or
8 (iv) a renewal of or amendment of any license
9 issued pursuant to (i), (ii), or (iii) above, $100.
10 (ee) For filing articles of incorporation for a
11 syndicate to engage in the business of insurance through
12 the Illinois Insurance Exchange, $2,000.
13 (ff) For filing amended articles of incorporation for
14 a syndicate engaged in the business of insurance through
15 the Illinois Insurance Exchange, $100.
16 (gg) For filing articles of incorporation for a
17 limited syndicate to join with other subscribers or
18 limited syndicates to do business through the Illinois
19 Insurance Exchange, $1,000.
20 (hh) For filing amended articles of incorporation for
21 a limited syndicate to do business through the Illinois
22 Insurance Exchange, $100.
23 (ii) For a permit to solicit subscriptions to a
24 syndicate or limited syndicate, $100.
25 (jj) For the filing of each form as required in
26 Section 143 of this Code, $50 per form. Informational and
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1 advertising filings shall be $25 per filing. The fee for
2 advisory and rating organizations shall be $200 per form.
3 (i) For the purposes of the form filing fee,
4 filings made on insert page basis will be considered
5 one form at the time of its original submission.
6 Changes made to a form subsequent to its approval
7 shall be considered a new filing.
8 (ii) Only one fee shall be charged for a form,
9 regardless of the number of other forms or policies
10 with which it will be used.
11 (iii) Fees charged for a policy filed as it will be
12 issued regardless of the number of forms comprising
13 that policy shall not exceed $1,500. For advisory or
14 rating organizations, fees charged for a policy filed
15 as it will be issued regardless of the number of forms
16 comprising that policy shall not exceed $2,500.
17 (iv) The Director may by rule exempt forms from
18 such fees.
19 (kk) For filing an application for licensing of a
20 reinsurance intermediary, $500.
21 (ll) For filing an application for renewal of a
22 license of a reinsurance intermediary, $200.
23 (mm) For filing a plan of division of a domestic stock
24 company under Article IIB, $100,000 $10,000.
25 (nn) For filing all documents submitted by a foreign
26 or alien company to be a certified reinsurer in this
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1 State, except for a fraternal benefit society, $1,000.
2 (oo) For filing a renewal by a foreign or alien
3 company to be a certified reinsurer in this State, except
4 for a fraternal benefit society, $400.
5 (pp) For filing all documents submitted by a reinsurer
6 domiciled in a reciprocal jurisdiction, $1,000.
7 (qq) For filing a renewal by a reinsurer domiciled in
8 a reciprocal jurisdiction, $400.
9 (rr) For registering a captive management company or
10 renewal thereof, $50.
11 (2) When printed copies or numerous copies of the same
12 paper or records are furnished or certified, the Director may
13 reduce such fees for copies if he finds them excessive. He may,
14 when he considers it in the public interest, furnish without
15 charge to state insurance departments and persons other than
16 companies, copies or certified copies of reports of
17 examinations and of other papers and records.
18 (3) The expenses incurred in any performance examination
19 authorized by law shall be paid by the company or person being
20 examined. The charge shall be reasonably related to the cost
21 of the examination including but not limited to compensation
22 of examiners, electronic data processing costs, supervision
23 and preparation of an examination report and lodging and
24 travel expenses. All lodging and travel expenses shall be in
25 accord with the applicable travel regulations as published by
26 the Department of Central Management Services and approved by
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1 the Governor's Travel Control Board, except that out-of-state
2 lodging and travel expenses related to examinations authorized
3 under Section 132 shall be in accordance with travel rates
4 prescribed under paragraph 301-7.2 of the Federal Travel
5 Regulations, 41 CFR C.F.R. 301-7.2, for reimbursement of
6 subsistence expenses incurred during official travel. All
7 lodging and travel expenses may be reimbursed directly upon
8 authorization of the Director. With the exception of the
9 direct reimbursements authorized by the Director, all
10 performance examination charges collected by the Department
11 shall be paid to the Insurance Producer Administration Fund,
12 however, the electronic data processing costs incurred by the
13 Department in the performance of any examination shall be
14 billed directly to the company being examined for payment to
15 the Technology Management Revolving Fund.
16 (4) At the time of any service of process on the Director
17 as attorney for such service, the Director shall charge and
18 collect the sum of $40, which may be recovered as taxable costs
19 by the party to the suit or action causing such service to be
20 made if he prevails in such suit or action.
21 (5) (a) The costs incurred by the Department of Insurance
22 in conducting any hearing authorized by law shall be assessed
23 against the parties to the hearing in such proportion as the
24 Director of Insurance may determine upon consideration of all
25 relevant circumstances including: (1) the nature of the
26 hearing; (2) whether the hearing was instigated by, or for the
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1 benefit of a particular party or parties; (3) whether there is
2 a successful party on the merits of the proceeding; and (4) the
3 relative levels of participation by the parties.
4 (b) For purposes of this subsection (5) costs incurred
5 shall mean the hearing officer fees, court reporter fees, and
6 travel expenses of Department of Insurance officers and
7 employees; provided however, that costs incurred shall not
8 include hearing officer fees or court reporter fees unless the
9 Department has retained the services of independent
10 contractors or outside experts to perform such functions.
11 (c) The Director shall make the assessment of costs
12 incurred as part of the final order or decision arising out of
13 the proceeding; provided, however, that such order or decision
14 shall include findings and conclusions in support of the
15 assessment of costs. This subsection (5) shall not be
16 construed as permitting the payment of travel expenses unless
17 calculated in accordance with the applicable travel
18 regulations of the Department of Central Management Services,
19 as approved by the Governor's Travel Control Board. The
20 Director as part of such order or decision shall require all
21 assessments for hearing officer fees and court reporter fees,
22 if any, to be paid directly to the hearing officer or court
23 reporter by the party(s) assessed for such costs. The
24 assessments for travel expenses of Department officers and
25 employees shall be reimbursable to the Director of Insurance
26 for deposit to the fund out of which those expenses had been
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1 paid.
2 (d) The provisions of this subsection (5) shall apply in
3 the case of any hearing conducted by the Director of Insurance
4 not otherwise specifically provided for by law.
5 (6) The Director shall charge and collect an annual
6 financial regulation fee from every domestic company for
7 examination and analysis of its financial condition and to
8 fund the internal costs and expenses of the Interstate
9 Insurance Receivership Commission as may be allocated to the
10 State of Illinois and companies doing an insurance business in
11 this State pursuant to Article X of the Interstate Insurance
12 Receivership Compact. The fee shall be the greater fixed
13 amount based upon the combination of nationwide direct premium
14 income and nationwide reinsurance assumed premium income or
15 upon admitted assets calculated under this subsection as
16 follows:
17 (a) Combination of nationwide direct premium income
18 and nationwide reinsurance assumed premium.
19 (i) $150, if the premium is less than $500,000 and
20 there is no reinsurance assumed premium;
21 (ii) $750, if the premium is $500,000 or more, but
22 less than $5,000,000 and there is no reinsurance
23 assumed premium; or if the premium is less than
24 $5,000,000 and the reinsurance assumed premium is less
25 than $10,000,000;
26 (iii) $3,750, if the premium is less than
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1 $5,000,000 and the reinsurance assumed premium is
2 $10,000,000 or more;
3 (iv) $7,500, if the premium is $5,000,000 or more,
4 but less than $10,000,000;
5 (v) $18,000, if the premium is $10,000,000 or
6 more, but less than $25,000,000;
7 (vi) $22,500, if the premium is $25,000,000 or
8 more, but less than $50,000,000;
9 (vii) $30,000, if the premium is $50,000,000 or
10 more, but less than $100,000,000;
11 (viii) $37,500, if the premium is $100,000,000 or
12 more.
13 (b) Admitted assets.
14 (i) $150, if admitted assets are less than
15 $1,000,000;
16 (ii) $750, if admitted assets are $1,000,000 or
17 more, but less than $5,000,000;
18 (iii) $3,750, if admitted assets are $5,000,000 or
19 more, but less than $25,000,000;
20 (iv) $7,500, if admitted assets are $25,000,000 or
21 more, but less than $50,000,000;
22 (v) $18,000, if admitted assets are $50,000,000 or
23 more, but less than $100,000,000;
24 (vi) $22,500, if admitted assets are $100,000,000
25 or more, but less than $500,000,000;
26 (vii) $30,000, if admitted assets are $500,000,000
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1 or more, but less than $1,000,000,000;
2 (viii) $37,500, if admitted assets are
3 $1,000,000,000 or more.
4 (c) The sum of financial regulation fees charged to
5 the domestic companies of the same affiliated group shall
6 not exceed $250,000 in the aggregate in any single year
7 and shall be billed by the Director to the member company
8 designated by the group.
9 (7) The Director shall charge and collect an annual
10 financial regulation fee from every foreign or alien company,
11 except fraternal benefit societies, for the examination and
12 analysis of its financial condition and to fund the internal
13 costs and expenses of the Interstate Insurance Receivership
14 Commission as may be allocated to the State of Illinois and
15 companies doing an insurance business in this State pursuant
16 to Article X of the Interstate Insurance Receivership Compact.
17 The fee shall be a fixed amount based upon Illinois direct
18 premium income and nationwide reinsurance assumed premium
19 income in accordance with the following schedule:
20 (a) $150, if the premium is less than $500,000 and
21 there is no reinsurance assumed premium;
22 (b) $750, if the premium is $500,000 or more, but less
23 than $5,000,000 and there is no reinsurance assumed
24 premium; or if the premium is less than $5,000,000 and the
25 reinsurance assumed premium is less than $10,000,000;
26 (c) $3,750, if the premium is less than $5,000,000 and
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1 the reinsurance assumed premium is $10,000,000 or more;
2 (d) $7,500, if the premium is $5,000,000 or more, but
3 less than $10,000,000;
4 (e) $18,000, if the premium is $10,000,000 or more,
5 but less than $25,000,000;
6 (f) $22,500, if the premium is $25,000,000 or more,
7 but less than $50,000,000;
8 (g) $30,000, if the premium is $50,000,000 or more,
9 but less than $100,000,000;
10 (h) $37,500, if the premium is $100,000,000 or more.
11 The sum of financial regulation fees under this subsection
12 (7) charged to the foreign or alien companies within the same
13 affiliated group shall not exceed $250,000 in the aggregate in
14 any single year and shall be billed by the Director to the
15 member company designated by the group.
16 (8) Beginning January 1, 1992, the financial regulation
17 fees imposed under subsections (6) and (7) of this Section
18 shall be paid by each company or domestic affiliated group
19 annually. After January 1, 1994, the fee shall be billed by
20 Department invoice based upon the company's premium income or
21 admitted assets as shown in its annual statement for the
22 preceding calendar year. The invoice is due upon receipt and
23 must be paid no later than June 30 of each calendar year. All
24 financial regulation fees collected by the Department shall be
25 paid to the Insurance Financial Regulation Fund. The
26 Department may not collect financial examiner per diem charges
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1 from companies subject to subsections (6) and (7) of this
2 Section undergoing financial examination after June 30, 1992.
3 (9) In addition to the financial regulation fee required
4 by this Section, a company undergoing any financial
5 examination authorized by law shall pay the following costs
6 and expenses incurred by the Department: electronic data
7 processing costs, the expenses authorized under Section 131.21
8 and subsection (d) of Section 132.4 of this Code, and lodging
9 and travel expenses.
10 Electronic data processing costs incurred by the
11 Department in the performance of any examination shall be
12 billed directly to the company undergoing examination for
13 payment to the Technology Management Revolving Fund. Except
14 for direct reimbursements authorized by the Director or direct
15 payments made under Section 131.21 or subsection (d) of
16 Section 132.4 of this Code, all financial regulation fees and
17 all financial examination charges collected by the Department
18 shall be paid to the Insurance Financial Regulation Fund.
19 All lodging and travel expenses shall be in accordance
20 with applicable travel regulations published by the Department
21 of Central Management Services and approved by the Governor's
22 Travel Control Board, except that out-of-state lodging and
23 travel expenses related to examinations authorized under
24 Sections 132.1 through 132.7 shall be in accordance with
25 travel rates prescribed under paragraph 301-7.2 of the Federal
26 Travel Regulations, 41 CFR C.F.R. 301-7.2, for reimbursement
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1 of subsistence expenses incurred during official travel. All
2 lodging and travel expenses may be reimbursed directly upon
3 the authorization of the Director.
4 In the case of an organization or person not subject to the
5 financial regulation fee, the expenses incurred in any
6 financial examination authorized by law shall be paid by the
7 organization or person being examined. The charge shall be
8 reasonably related to the cost of the examination including,
9 but not limited to, compensation of examiners and other costs
10 described in this subsection.
11 (10) Any company, person, or entity failing to make any
12 payment of $150 or more as required under this Section shall be
13 subject to the penalty and interest provisions provided for in
14 subsections (4) and (7) of Section 412.
15 (11) Unless otherwise specified, all of the fees collected
16 under this Section shall be paid into the Insurance Financial
17 Regulation Fund.
18 (12) For purposes of this Section:
19 (a) "Domestic company" means a company as defined in
20 Section 2 of this Code which is incorporated or organized
21 under the laws of this State, and in addition includes a
22 not-for-profit corporation authorized under the Dental
23 Service Plan Act or the Voluntary Health Services Plans
24 Act, a health maintenance organization, and a limited
25 health service organization.
26 (b) "Foreign company" means a company as defined in
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1 Section 2 of this Code which is incorporated or organized
2 under the laws of any state of the United States other than
3 this State and in addition includes a health maintenance
4 organization and a limited health service organization
5 which is incorporated or organized under the laws of any
6 state of the United States other than this State.
7 (c) "Alien company" means a company as defined in
8 Section 2 of this Code which is incorporated or organized
9 under the laws of any country other than the United
10 States.
11 (d) "Fraternal benefit society" means a corporation,
12 society, order, lodge or voluntary association as defined
13 in Section 282.1 of this Code.
14 (e) "Mutual benefit association" means a company,
15 association or corporation authorized by the Director to
16 do business in this State under the provisions of Article
17 XVIII of this Code.
18 (f) "Burial society" means a person, firm,
19 corporation, society or association of individuals
20 authorized by the Director to do business in this State
21 under the provisions of Article XIX of this Code.
22 (g) "Farm mutual" means a district, county and
23 township mutual insurance company authorized by the
24 Director to do business in this State under the provisions
25 of the Farm Mutual Insurance Company Act of 1986.
26 (Source: P.A. 102-775, eff. 5-13-22.)
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1 (Text of Section after amendment by P.A. 103-75)
2 Sec. 408. Fees and charges.
3 (1) The Director shall charge, collect and give proper
4 acquittances for the payment of the following fees and
5 charges:
6 (a) For filing all documents submitted for the
7 incorporation or organization or certification of a
8 domestic company, except for a fraternal benefit society,
9 $2,000.
10 (b) For filing all documents submitted for the
11 incorporation or organization of a fraternal benefit
12 society, $500.
13 (c) For filing amendments to articles of incorporation
14 and amendments to declaration of organization, except for
15 a fraternal benefit society, a mutual benefit association,
16 a burial society or a farm mutual, $200.
17 (d) For filing amendments to articles of incorporation
18 of a fraternal benefit society, a mutual benefit
19 association or a burial society, $100.
20 (e) For filing amendments to articles of incorporation
21 of a farm mutual, $50.
22 (f) For filing bylaws or amendments thereto, $50.
23 (g) For filing agreement of merger or consolidation:
24 (i) for a domestic company, except for a fraternal
25 benefit society, a mutual benefit association, a
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1 burial society, or a farm mutual, $2,000.
2 (ii) for a foreign or alien company, except for a
3 fraternal benefit society, $600.
4 (iii) for a fraternal benefit society, a mutual
5 benefit association, a burial society, or a farm
6 mutual, $200.
7 (h) For filing agreements of reinsurance by a domestic
8 company, $200.
9 (i) For filing all documents submitted by a foreign or
10 alien company to be admitted to transact business or
11 accredited as a reinsurer in this State, except for a
12 fraternal benefit society, $5,000.
13 (j) For filing all documents submitted by a foreign or
14 alien fraternal benefit society to be admitted to transact
15 business in this State, $500.
16 (k) For filing declaration of withdrawal of a foreign
17 or alien company, $50.
18 (l) For filing annual statement by a domestic company,
19 except a fraternal benefit society, a mutual benefit
20 association, a burial society, or a farm mutual, $200.
21 (m) For filing annual statement by a domestic
22 fraternal benefit society, $100.
23 (n) For filing annual statement by a farm mutual, a
24 mutual benefit association, or a burial society, $50.
25 (o) For issuing a certificate of authority or renewal
26 thereof except to a foreign fraternal benefit society,
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1 $400.
2 (p) For issuing a certificate of authority or renewal
3 thereof to a foreign fraternal benefit society, $200.
4 (q) For issuing an amended certificate of authority,
5 $50.
6 (r) For each certified copy of certificate of
7 authority, $20.
8 (s) For each certificate of deposit, or valuation, or
9 compliance or surety certificate, $20.
10 (t) For copies of papers or records per page, $1.
11 (u) For each certification to copies of papers or
12 records, $10.
13 (v) For multiple copies of documents or certificates
14 listed in subparagraphs (r), (s), and (u) of paragraph (1)
15 of this Section, $10 for the first copy of a certificate of
16 any type and $5 for each additional copy of the same
17 certificate requested at the same time, unless, pursuant
18 to paragraph (2) of this Section, the Director finds these
19 additional fees excessive.
20 (w) For issuing a permit to sell shares or increase
21 paid-up capital:
22 (i) in connection with a public stock offering,
23 $300;
24 (ii) in any other case, $100.
25 (x) For issuing any other certificate required or
26 permissible under the law, $50.
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1 (y) For filing a plan of exchange of the stock of a
2 domestic stock insurance company, a plan of
3 demutualization of a domestic mutual company, or a plan of
4 reorganization under Article XII, $2,000.
5 (z) For filing a statement of acquisition of a
6 domestic company as defined in Section 131.4 of this Code,
7 $2,000.
8 (aa) For filing an agreement to purchase the business
9 of an organization authorized under the Dental Service
10 Plan Act or the Voluntary Health Services Plans Act or of a
11 health maintenance organization or a limited health
12 service organization, $2,000.
13 (bb) For filing a statement of acquisition of a
14 foreign or alien insurance company as defined in Section
15 131.12a of this Code, $1,000.
16 (cc) For filing a registration statement as required
17 in Sections 131.13 and 131.14, the notification as
18 required by Sections 131.16, 131.20a, or 141.4, or an
19 agreement or transaction required by Sections 124.2(2),
20 141, 141a, or 141.1, $200.
21 (dd) For filing an application for licensing of:
22 (i) a religious or charitable risk pooling trust
23 or a workers' compensation pool, $1,000;
24 (ii) a workers' compensation service company,
25 $500;
26 (iii) a self-insured automobile fleet, $200; or
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1 (iv) a renewal of or amendment of any license
2 issued pursuant to (i), (ii), or (iii) above, $100.
3 (ee) For filing articles of incorporation for a
4 syndicate to engage in the business of insurance through
5 the Illinois Insurance Exchange, $2,000.
6 (ff) For filing amended articles of incorporation for
7 a syndicate engaged in the business of insurance through
8 the Illinois Insurance Exchange, $100.
9 (gg) For filing articles of incorporation for a
10 limited syndicate to join with other subscribers or
11 limited syndicates to do business through the Illinois
12 Insurance Exchange, $1,000.
13 (hh) For filing amended articles of incorporation for
14 a limited syndicate to do business through the Illinois
15 Insurance Exchange, $100.
16 (ii) For a permit to solicit subscriptions to a
17 syndicate or limited syndicate, $100.
18 (jj) For the filing of each form as required in
19 Section 143 of this Code, $50 per form. Informational and
20 advertising filings shall be $25 per filing. The fee for
21 advisory and rating organizations shall be $200 per form.
22 (i) For the purposes of the form filing fee,
23 filings made on insert page basis will be considered
24 one form at the time of its original submission.
25 Changes made to a form subsequent to its approval
26 shall be considered a new filing.
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1 (ii) Only one fee shall be charged for a form,
2 regardless of the number of other forms or policies
3 with which it will be used.
4 (iii) Fees charged for a policy filed as it will be
5 issued regardless of the number of forms comprising
6 that policy shall not exceed $1,500. For advisory or
7 rating organizations, fees charged for a policy filed
8 as it will be issued regardless of the number of forms
9 comprising that policy shall not exceed $2,500.
10 (iv) The Director may by rule exempt forms from
11 such fees.
12 (kk) For filing an application for licensing of a
13 reinsurance intermediary, $500.
14 (ll) For filing an application for renewal of a
15 license of a reinsurance intermediary, $200.
16 (mm) For filing a plan of division of a domestic stock
17 company under Article IIB, $100,000 $10,000.
18 (nn) For filing all documents submitted by a foreign
19 or alien company to be a certified reinsurer in this
20 State, except for a fraternal benefit society, $1,000.
21 (oo) For filing a renewal by a foreign or alien
22 company to be a certified reinsurer in this State, except
23 for a fraternal benefit society, $400.
24 (pp) For filing all documents submitted by a reinsurer
25 domiciled in a reciprocal jurisdiction, $1,000.
26 (qq) For filing a renewal by a reinsurer domiciled in
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1 a reciprocal jurisdiction, $400.
2 (rr) For registering a captive management company or
3 renewal thereof, $50.
4 (ss) For filing an insurance business transfer plan
5 under Article XLVII, $100,000 $25,000.
6 (2) When printed copies or numerous copies of the same
7 paper or records are furnished or certified, the Director may
8 reduce such fees for copies if he finds them excessive. He may,
9 when he considers it in the public interest, furnish without
10 charge to state insurance departments and persons other than
11 companies, copies or certified copies of reports of
12 examinations and of other papers and records.
13 (3) The expenses incurred in any performance examination
14 authorized by law shall be paid by the company or person being
15 examined. The charge shall be reasonably related to the cost
16 of the examination including but not limited to compensation
17 of examiners, electronic data processing costs, supervision
18 and preparation of an examination report and lodging and
19 travel expenses. All lodging and travel expenses shall be in
20 accord with the applicable travel regulations as published by
21 the Department of Central Management Services and approved by
22 the Governor's Travel Control Board, except that out-of-state
23 lodging and travel expenses related to examinations authorized
24 under Section 132 shall be in accordance with travel rates
25 prescribed under paragraph 301-7.2 of the Federal Travel
26 Regulations, 41 CFR C.F.R. 301-7.2, for reimbursement of
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1 subsistence expenses incurred during official travel. All
2 lodging and travel expenses may be reimbursed directly upon
3 authorization of the Director. With the exception of the
4 direct reimbursements authorized by the Director, all
5 performance examination charges collected by the Department
6 shall be paid to the Insurance Producer Administration Fund,
7 however, the electronic data processing costs incurred by the
8 Department in the performance of any examination shall be
9 billed directly to the company being examined for payment to
10 the Technology Management Revolving Fund.
11 (4) At the time of any service of process on the Director
12 as attorney for such service, the Director shall charge and
13 collect the sum of $40, which may be recovered as taxable costs
14 by the party to the suit or action causing such service to be
15 made if he prevails in such suit or action.
16 (5) (a) The costs incurred by the Department of Insurance
17 in conducting any hearing authorized by law shall be assessed
18 against the parties to the hearing in such proportion as the
19 Director of Insurance may determine upon consideration of all
20 relevant circumstances including: (1) the nature of the
21 hearing; (2) whether the hearing was instigated by, or for the
22 benefit of a particular party or parties; (3) whether there is
23 a successful party on the merits of the proceeding; and (4) the
24 relative levels of participation by the parties.
25 (b) For purposes of this subsection (5) costs incurred
26 shall mean the hearing officer fees, court reporter fees, and
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1 travel expenses of Department of Insurance officers and
2 employees; provided however, that costs incurred shall not
3 include hearing officer fees or court reporter fees unless the
4 Department has retained the services of independent
5 contractors or outside experts to perform such functions.
6 (c) The Director shall make the assessment of costs
7 incurred as part of the final order or decision arising out of
8 the proceeding; provided, however, that such order or decision
9 shall include findings and conclusions in support of the
10 assessment of costs. This subsection (5) shall not be
11 construed as permitting the payment of travel expenses unless
12 calculated in accordance with the applicable travel
13 regulations of the Department of Central Management Services,
14 as approved by the Governor's Travel Control Board. The
15 Director as part of such order or decision shall require all
16 assessments for hearing officer fees and court reporter fees,
17 if any, to be paid directly to the hearing officer or court
18 reporter by the party(s) assessed for such costs. The
19 assessments for travel expenses of Department officers and
20 employees shall be reimbursable to the Director of Insurance
21 for deposit to the fund out of which those expenses had been
22 paid.
23 (d) The provisions of this subsection (5) shall apply in
24 the case of any hearing conducted by the Director of Insurance
25 not otherwise specifically provided for by law.
26 (6) The Director shall charge and collect an annual
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1 financial regulation fee from every domestic company for
2 examination and analysis of its financial condition and to
3 fund the internal costs and expenses of the Interstate
4 Insurance Receivership Commission as may be allocated to the
5 State of Illinois and companies doing an insurance business in
6 this State pursuant to Article X of the Interstate Insurance
7 Receivership Compact. The fee shall be the greater fixed
8 amount based upon the combination of nationwide direct premium
9 income and nationwide reinsurance assumed premium income or
10 upon admitted assets calculated under this subsection as
11 follows:
12 (a) Combination of nationwide direct premium income
13 and nationwide reinsurance assumed premium.
14 (i) $150, if the premium is less than $500,000 and
15 there is no reinsurance assumed premium;
16 (ii) $750, if the premium is $500,000 or more, but
17 less than $5,000,000 and there is no reinsurance
18 assumed premium; or if the premium is less than
19 $5,000,000 and the reinsurance assumed premium is less
20 than $10,000,000;
21 (iii) $3,750, if the premium is less than
22 $5,000,000 and the reinsurance assumed premium is
23 $10,000,000 or more;
24 (iv) $7,500, if the premium is $5,000,000 or more,
25 but less than $10,000,000;
26 (v) $18,000, if the premium is $10,000,000 or
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1 more, but less than $25,000,000;
2 (vi) $22,500, if the premium is $25,000,000 or
3 more, but less than $50,000,000;
4 (vii) $30,000, if the premium is $50,000,000 or
5 more, but less than $100,000,000;
6 (viii) $37,500, if the premium is $100,000,000 or
7 more.
8 (b) Admitted assets.
9 (i) $150, if admitted assets are less than
10 $1,000,000;
11 (ii) $750, if admitted assets are $1,000,000 or
12 more, but less than $5,000,000;
13 (iii) $3,750, if admitted assets are $5,000,000 or
14 more, but less than $25,000,000;
15 (iv) $7,500, if admitted assets are $25,000,000 or
16 more, but less than $50,000,000;
17 (v) $18,000, if admitted assets are $50,000,000 or
18 more, but less than $100,000,000;
19 (vi) $22,500, if admitted assets are $100,000,000
20 or more, but less than $500,000,000;
21 (vii) $30,000, if admitted assets are $500,000,000
22 or more, but less than $1,000,000,000;
23 (viii) $37,500, if admitted assets are
24 $1,000,000,000 or more.
25 (c) The sum of financial regulation fees charged to
26 the domestic companies of the same affiliated group shall
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1 not exceed $250,000 in the aggregate in any single year
2 and shall be billed by the Director to the member company
3 designated by the group.
4 (7) The Director shall charge and collect an annual
5 financial regulation fee from every foreign or alien company,
6 except fraternal benefit societies, for the examination and
7 analysis of its financial condition and to fund the internal
8 costs and expenses of the Interstate Insurance Receivership
9 Commission as may be allocated to the State of Illinois and
10 companies doing an insurance business in this State pursuant
11 to Article X of the Interstate Insurance Receivership Compact.
12 The fee shall be a fixed amount based upon Illinois direct
13 premium income and nationwide reinsurance assumed premium
14 income in accordance with the following schedule:
15 (a) $150, if the premium is less than $500,000 and
16 there is no reinsurance assumed premium;
17 (b) $750, if the premium is $500,000 or more, but less
18 than $5,000,000 and there is no reinsurance assumed
19 premium; or if the premium is less than $5,000,000 and the
20 reinsurance assumed premium is less than $10,000,000;
21 (c) $3,750, if the premium is less than $5,000,000 and
22 the reinsurance assumed premium is $10,000,000 or more;
23 (d) $7,500, if the premium is $5,000,000 or more, but
24 less than $10,000,000;
25 (e) $18,000, if the premium is $10,000,000 or more,
26 but less than $25,000,000;
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1 (f) $22,500, if the premium is $25,000,000 or more,
2 but less than $50,000,000;
3 (g) $30,000, if the premium is $50,000,000 or more,
4 but less than $100,000,000;
5 (h) $37,500, if the premium is $100,000,000 or more.
6 The sum of financial regulation fees under this subsection
7 (7) charged to the foreign or alien companies within the same
8 affiliated group shall not exceed $250,000 in the aggregate in
9 any single year and shall be billed by the Director to the
10 member company designated by the group.
11 (8) Beginning January 1, 1992, the financial regulation
12 fees imposed under subsections (6) and (7) of this Section
13 shall be paid by each company or domestic affiliated group
14 annually. After January 1, 1994, the fee shall be billed by
15 Department invoice based upon the company's premium income or
16 admitted assets as shown in its annual statement for the
17 preceding calendar year. The invoice is due upon receipt and
18 must be paid no later than June 30 of each calendar year. All
19 financial regulation fees collected by the Department shall be
20 paid to the Insurance Financial Regulation Fund. The
21 Department may not collect financial examiner per diem charges
22 from companies subject to subsections (6) and (7) of this
23 Section undergoing financial examination after June 30, 1992.
24 (9) In addition to the financial regulation fee required
25 by this Section, a company undergoing any financial
26 examination authorized by law shall pay the following costs
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1 and expenses incurred by the Department: electronic data
2 processing costs, the expenses authorized under Section 131.21
3 and subsection (d) of Section 132.4 of this Code, and lodging
4 and travel expenses.
5 Electronic data processing costs incurred by the
6 Department in the performance of any examination shall be
7 billed directly to the company undergoing examination for
8 payment to the Technology Management Revolving Fund. Except
9 for direct reimbursements authorized by the Director or direct
10 payments made under Section 131.21 or subsection (d) of
11 Section 132.4 of this Code, all financial regulation fees and
12 all financial examination charges collected by the Department
13 shall be paid to the Insurance Financial Regulation Fund.
14 All lodging and travel expenses shall be in accordance
15 with applicable travel regulations published by the Department
16 of Central Management Services and approved by the Governor's
17 Travel Control Board, except that out-of-state lodging and
18 travel expenses related to examinations authorized under
19 Sections 132.1 through 132.7 shall be in accordance with
20 travel rates prescribed under paragraph 301-7.2 of the Federal
21 Travel Regulations, 41 CFR C.F.R. 301-7.2, for reimbursement
22 of subsistence expenses incurred during official travel. All
23 lodging and travel expenses may be reimbursed directly upon
24 the authorization of the Director.
25 In the case of an organization or person not subject to the
26 financial regulation fee, the expenses incurred in any
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1 financial examination authorized by law shall be paid by the
2 organization or person being examined. The charge shall be
3 reasonably related to the cost of the examination including,
4 but not limited to, compensation of examiners and other costs
5 described in this subsection.
6 (10) Any company, person, or entity failing to make any
7 payment of $150 or more as required under this Section shall be
8 subject to the penalty and interest provisions provided for in
9 subsections (4) and (7) of Section 412.
10 (11) Unless otherwise specified, all of the fees collected
11 under this Section shall be paid into the Insurance Financial
12 Regulation Fund.
13 (12) For purposes of this Section:
14 (a) "Domestic company" means a company as defined in
15 Section 2 of this Code which is incorporated or organized
16 under the laws of this State, and in addition includes a
17 not-for-profit corporation authorized under the Dental
18 Service Plan Act or the Voluntary Health Services Plans
19 Act, a health maintenance organization, and a limited
20 health service organization.
21 (b) "Foreign company" means a company as defined in
22 Section 2 of this Code which is incorporated or organized
23 under the laws of any state of the United States other than
24 this State and in addition includes a health maintenance
25 organization and a limited health service organization
26 which is incorporated or organized under the laws of any
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1 state of the United States other than this State.
2 (c) "Alien company" means a company as defined in
3 Section 2 of this Code which is incorporated or organized
4 under the laws of any country other than the United
5 States.
6 (d) "Fraternal benefit society" means a corporation,
7 society, order, lodge or voluntary association as defined
8 in Section 282.1 of this Code.
9 (e) "Mutual benefit association" means a company,
10 association or corporation authorized by the Director to
11 do business in this State under the provisions of Article
12 XVIII of this Code.
13 (f) "Burial society" means a person, firm,
14 corporation, society or association of individuals
15 authorized by the Director to do business in this State
16 under the provisions of Article XIX of this Code.
17 (g) "Farm mutual" means a district, county and
18 township mutual insurance company authorized by the
19 Director to do business in this State under the provisions
20 of the Farm Mutual Insurance Company Act of 1986.
21 (Source: P.A. 102-775, eff. 5-13-22; 103-75, eff. 1-1-25.)
22 (215 ILCS 5/412) (from Ch. 73, par. 1024)
23 Sec. 412. Refunds; penalties; collection.
24 (1)(a) Whenever it appears to the satisfaction of the
25 Director that because of some mistake of fact, error in
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1 calculation, or erroneous interpretation of a statute of this
2 or any other state, any authorized company, surplus line
3 producer, or industrial insured has paid to him, pursuant to
4 any provision of law, taxes, fees, or other charges in excess
5 of the amount legally chargeable against it, during the 6-year
6 6 year period immediately preceding the discovery of such
7 overpayment, he shall have power to refund to such company,
8 surplus line producer, or industrial insured the amount of the
9 excess or excesses by applying the amount or amounts thereof
10 toward the payment of taxes, fees, or other charges already
11 due, or which may thereafter become due from that company
12 until such excess or excesses have been fully refunded, or
13 upon a written request from the authorized company, surplus
14 line producer, or industrial insured, the Director shall
15 provide a cash refund within 120 days after receipt of the
16 written request if all necessary information has been filed
17 with the Department in order for it to perform an audit of the
18 tax report for the transaction or period or annual return for
19 the year in which the overpayment occurred or within 120 days
20 after the date the Department receives all the necessary
21 information to perform such audit. The Director shall not
22 provide a cash refund if there are insufficient funds in the
23 Insurance Premium Tax Refund Fund to provide a cash refund, if
24 the amount of the overpayment is less than $100, or if the
25 amount of the overpayment can be fully offset against the
26 taxpayer's estimated liability for the year following the year
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1 of the cash refund request. Any cash refund shall be paid from
2 the Insurance Premium Tax Refund Fund, a special fund hereby
3 created in the State treasury.
4 (b) As determined by the Director pursuant to paragraph
5 (a) of this subsection, the Department shall deposit an amount
6 of cash refunds approved by the Director for payment as a
7 result of overpayment of tax liability collected under
8 Sections 121-2.08, 409, 444, 444.1, and 445 of this Code into
9 the Insurance Premium Tax Refund Fund.
10 (c) Beginning July 1, 1999, moneys in the Insurance
11 Premium Tax Refund Fund shall be expended exclusively for the
12 purpose of paying cash refunds resulting from overpayment of
13 tax liability under Sections 121-2.08, 409, 444, 444.1, and
14 445 of this Code as determined by the Director pursuant to
15 subsection 1(a) of this Section. Cash refunds made in
16 accordance with this Section may be made from the Insurance
17 Premium Tax Refund Fund only to the extent that amounts have
18 been deposited and retained in the Insurance Premium Tax
19 Refund Fund.
20 (d) This Section shall constitute an irrevocable and
21 continuing appropriation from the Insurance Premium Tax Refund
22 Fund for the purpose of paying cash refunds pursuant to the
23 provisions of this Section.
24 (2)(a) When any insurance company fails to file any tax
25 return required under Sections 408.1, 409, 444, and 444.1 of
26 this Code or Section 12 of the Fire Investigation Act on the
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1 date prescribed, including any extensions, there shall be
2 added as a penalty $400 or 10% of the amount of such tax,
3 whichever is greater, for each month or part of a month of
4 failure to file, the entire penalty not to exceed $2,000 or 50%
5 of the tax due, whichever is greater. In this paragraph, "tax
6 due" means the full amount due for that year under Section
7 408.1, 409, 444, or 444.1 of this Code or Section 12 of the
8 Fire Investigation Act.
9 (b) When any industrial insured or surplus line producer
10 fails to file any tax return or report required under Sections
11 121-2.08 and 445 of this Code or Section 12 of the Fire
12 Investigation Act on the date prescribed, including any
13 extensions, there shall be added:
14 (i) as a late fee, if the return or report is received
15 at least one day but not more than 15 days after the
16 prescribed due date, $50 or 5% of the tax due, whichever is
17 greater, the entire fee not to exceed $1,000;
18 (ii) as a late fee, if the return or report is received
19 at least 16 days but not more than 30 days after the
20 prescribed due date, $100 or 5% of the tax due, whichever
21 is greater, the entire fee not to exceed $2,000; or
22 (iii) as a penalty, if the return or report is
23 received more than 30 days after the prescribed due date,
24 $100 or 5% of the tax due, whichever is greater, for each
25 month or part of a month of failure to file, the entire
26 penalty not to exceed $500 or 30% of the tax due, whichever
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1 is greater.
2 In this paragraph, "tax due" means the full amount due for
3 that year under Section 121-2.08 or 445 of this Code or Section
4 12 of the Fire Investigation Act. A tax return or report shall
5 be deemed received as of the date mailed as evidenced by a
6 postmark, proof of mailing on a
recognized United States
7 Postal Service form or a form acceptable to the United States
8 Postal Service or other commercial mail delivery service, or
9 other evidence acceptable to the Director.
10 (3)(a) When any insurance company fails to pay the full
11 amount due under the provisions of this Section, Sections
12 408.1, 409, 444, or 444.1 of this Code, or Section 12 of the
13 Fire Investigation Act, there shall be added to the amount due
14 as a penalty an amount equal to 10% of the deficiency.
15 (a-5) When any industrial insured or surplus line producer
16 fails to pay the full amount due under the provisions of this
17 Section, Sections 121-2.08 or 445 of this Code, or Section 12
18 of the Fire Investigation Act on the date prescribed, there
19 shall be added:
20 (i) as a late fee, if the payment is received at least
21 one day but not more than 7 days after the prescribed due
22 date, 10% of the tax due, the entire fee not to exceed
23 $1,000;
24 (ii) as a late fee, if the payment is received at least
25 8 days but not more than 14 days after the prescribed due
26 date, 10% of the tax due, the entire fee not to exceed
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1 $1,500;
2 (iii) as a late fee, if the payment is received at
3 least 15 days but not more than 21 days after the
4 prescribed due date, 10% of the tax due, the entire fee not
5 to exceed $2,000; or
6 (iv) as a penalty, if the return or report is received
7 more than 21 days after the prescribed due date, 10% of the
8 tax due.
9 In this paragraph, "tax due" means the full amount due for
10 that year under this Section, Section 121-2.08 or 445 of this
11 Code, or Section 12 of the Fire Investigation Act. A tax
12 payment shall be deemed received as of the date mailed as
13 evidenced by a postmark, proof of mailing on a recognized
14 United States Postal Service form or a form acceptable to the
15 United States Postal Service or other commercial mail delivery
16 service, or other evidence acceptable to the Director.
17 (b) If such failure to pay is determined by the Director to
18 be willful wilful, after a hearing under Sections 402 and 403,
19 there shall be added to the tax as a penalty an amount equal to
20 the greater of 50% of the deficiency or 10% of the amount due
21 and unpaid for each month or part of a month that the
22 deficiency remains unpaid commencing with the date that the
23 amount becomes due. Such amount shall be in lieu of any
24 determined under paragraph (a) or (a-5).
25 (4) Any insurance company, industrial insured, or surplus
26 line producer that fails to pay the full amount due under this
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1 Section or Sections 121-2.08, 408.1, 409, 444, 444.1, or 445
2 of this Code, or Section 12 of the Fire Investigation Act is
3 liable, in addition to the tax and any late fees and penalties,
4 for interest on such deficiency at the rate of 12% per annum,
5 or at such higher adjusted rates as are or may be established
6 under subsection (b) of Section 6621 of the Internal Revenue
7 Code, from the date that payment of any such tax was due,
8 determined without regard to any extensions, to the date of
9 payment of such amount.
10 (5) The Director, through the Attorney General, may
11 institute an action in the name of the People of the State of
12 Illinois, in any court of competent jurisdiction, for the
13 recovery of the amount of such taxes, fees, and penalties due,
14 and prosecute the same to final judgment, and take such steps
15 as are necessary to collect the same.
16 (6) In the event that the certificate of authority of a
17 foreign or alien company is revoked for any cause or the
18 company withdraws from this State prior to the renewal date of
19 the certificate of authority as provided in Section 114, the
20 company may recover the amount of any such tax paid in advance.
21 Except as provided in this subsection, no revocation or
22 withdrawal excuses payment of or constitutes grounds for the
23 recovery of any taxes or penalties imposed by this Code.
24 (7) When an insurance company or domestic affiliated group
25 fails to pay the full amount of any fee of $200 or more due
26 under Section 408 of this Code, there shall be added to the
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1 amount due as a penalty the greater of $100 or an amount equal
2 to 10% of the deficiency for each month or part of a month that
3 the deficiency remains unpaid.
4 (8) The Department shall have a lien for the taxes, fees,
5 charges, fines, penalties, interest, other charges, or any
6 portion thereof, imposed or assessed pursuant to this Code,
7 upon all the real and personal property of any company or
8 person to whom the assessment or final order has been issued or
9 whenever a tax return is filed without payment of the tax or
10 penalty shown therein to be due, including all such property
11 of the company or person acquired after receipt of the
12 assessment, issuance of the order, or filing of the return.
13 The company or person is liable for the filing fee incurred by
14 the Department for filing the lien and the filing fee incurred
15 by the Department to file the release of that lien. The filing
16 fees shall be paid to the Department in addition to payment of
17 the tax, fee, charge, fine, penalty, interest, other charges,
18 or any portion thereof, included in the amount of the lien.
19 However, where the lien arises because of the issuance of a
20 final order of the Director or tax assessment by the
21 Department, the lien shall not attach and the notice referred
22 to in this Section shall not be filed until all administrative
23 proceedings or proceedings in court for review of the final
24 order or assessment have terminated or the time for the taking
25 thereof has expired without such proceedings being instituted.
26 Upon the granting of Department review after a lien has
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1 attached, the lien shall remain in full force except to the
2 extent to which the final assessment may be reduced by a
3 revised final assessment following the rehearing or review.
4 The lien created by the issuance of a final assessment shall
5 terminate, unless a notice of lien is filed, within 3 years
6 after the date all proceedings in court for the review of the
7 final assessment have terminated or the time for the taking
8 thereof has expired without such proceedings being instituted,
9 or (in the case of a revised final assessment issued pursuant
10 to a rehearing or review by the Department) within 3 years
11 after the date all proceedings in court for the review of such
12 revised final assessment have terminated or the time for the
13 taking thereof has expired without such proceedings being
14 instituted. Where the lien results from the filing of a tax
15 return without payment of the tax or penalty shown therein to
16 be due, the lien shall terminate, unless a notice of lien is
17 filed, within 3 years after the date when the return is filed
18 with the Department.
19 The time limitation period on the Department's right to
20 file a notice of lien shall not run during any period of time
21 in which the order of any court has the effect of enjoining or
22 restraining the Department from filing such notice of lien. If
23 the Department finds that a company or person is about to
24 depart from the State, to conceal himself or his property, or
25 to do any other act tending to prejudice or to render wholly or
26 partly ineffectual proceedings to collect the amount due and
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1 owing to the Department unless such proceedings are brought
2 without delay, or if the Department finds that the collection
3 of the amount due from any company or person will be
4 jeopardized by delay, the Department shall give the company or
5 person notice of such findings and shall make demand for
6 immediate return and payment of the amount, whereupon the
7 amount shall become immediately due and payable. If the
8 company or person, within 5 days after the notice (or within
9 such extension of time as the Department may grant), does not
10 comply with the notice or show to the Department that the
11 findings in the notice are erroneous, the Department may file
12 a notice of jeopardy assessment lien in the office of the
13 recorder of the county in which any property of the company or
14 person may be located and shall notify the company or person of
15 the filing. The jeopardy assessment lien shall have the same
16 scope and effect as the statutory lien provided for in this
17 Section. If the company or person believes that the company or
18 person does not owe some or all of the tax for which the
19 jeopardy assessment lien against the company or person has
20 been filed, or that no jeopardy to the revenue in fact exists,
21 the company or person may protest within 20 days after being
22 notified by the Department of the filing of the jeopardy
23 assessment lien and request a hearing, whereupon the
24 Department shall hold a hearing in conformity with the
25 provisions of this Code and, pursuant thereto, shall notify
26 the company or person of its findings as to whether or not the
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1 jeopardy assessment lien will be released. If not, and if the
2 company or person is aggrieved by this decision, the company
3 or person may file an action for judicial review of the final
4 determination of the Department in accordance with the
5 Administrative Review Law. If, pursuant to such hearing (or
6 after an independent determination of the facts by the
7 Department without a hearing), the Department determines that
8 some or all of the amount due covered by the jeopardy
9 assessment lien is not owed by the company or person, or that
10 no jeopardy to the revenue exists, or if on judicial review the
11 final judgment of the court is that the company or person does
12 not owe some or all of the amount due covered by the jeopardy
13 assessment lien against them, or that no jeopardy to the
14 revenue exists, the Department shall release its jeopardy
15 assessment lien to the extent of such finding of nonliability
16 for the amount, or to the extent of such finding of no jeopardy
17 to the revenue. The Department shall also release its jeopardy
18 assessment lien against the company or person whenever the
19 amount due and owing covered by the lien, plus any interest
20 which may be due, are paid and the company or person has paid
21 the Department in cash or by guaranteed remittance an amount
22 representing the filing fee for the lien and the filing fee for
23 the release of that lien. The Department shall file that
24 release of lien with the recorder of the county where that lien
25 was filed.
26 Nothing in this Section shall be construed to give the
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1 Department a preference over the rights of any bona fide
2 purchaser, holder of a security interest, mechanics
3 lienholder, mortgagee, or judgment lien creditor arising prior
4 to the filing of a regular notice of lien or a notice of
5 jeopardy assessment lien in the office of the recorder in the
6 county in which the property subject to the lien is located.
7 For purposes of this Section, "bona fide" shall not include
8 any mortgage of real or personal property or any other credit
9 transaction that results in the mortgagee or the holder of the
10 security acting as trustee for unsecured creditors of the
11 company or person mentioned in the notice of lien who executed
12 such chattel or real property mortgage or the document
13 evidencing such credit transaction. The lien shall be inferior
14 to the lien of general taxes, special assessments, and special
15 taxes levied by any political subdivision of this State. In
16 case title to land to be affected by the notice of lien or
17 notice of jeopardy assessment lien is registered under the
18 provisions of the Registered Titles (Torrens) Act, such notice
19 shall be filed in the office of the Registrar of Titles of the
20 county within which the property subject to the lien is
21 situated and shall be entered upon the register of titles as a
22 memorial or charge upon each folium of the register of titles
23 affected by such notice, and the Department shall not have a
24 preference over the rights of any bona fide purchaser,
25 mortgagee, judgment creditor, or other lienholder arising
26 prior to the registration of such notice. The regular lien or
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1 jeopardy assessment lien shall not be effective against any
2 purchaser with respect to any item in a retailer's stock in
3 trade purchased from the retailer in the usual course of the
4 retailer's business.
5 (Source: P.A. 102-775, eff. 5-13-22; 103-426, eff. 8-4-23.)
6 (215 ILCS 5/531.03) (from Ch. 73, par. 1065.80-3)
7 Sec. 531.03. Coverage and limitations.
8 (1) This Article shall provide coverage for the policies
9 and contracts specified in subsection (2) of this Section:
10 (a) to persons who, regardless of where they reside
11 (except for non-resident certificate holders under group
12 policies or contracts), are the beneficiaries, assignees
13 or payees, including health care providers rendering
14 services covered under a health insurance policy or
15 certificate, of the persons covered under paragraph (b) of
16 this subsection, and
17 (b) to persons who are owners of or certificate
18 holders or enrollees under the policies or contracts
19 (other than unallocated annuity contracts and structured
20 settlement annuities) and in each case who:
21 (i) are residents; or
22 (ii) are not residents, but only under all of the
23 following conditions:
24 (A) the member insurer that issued the
25 policies or contracts is domiciled in this State;
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1 (B) the states in which the persons reside
2 have associations similar to the Association
3 created by this Article;
4 (C) the persons are not eligible for coverage
5 by an association in any other state due to the
6 fact that the insurer or health maintenance
7 organization was not licensed in that state at the
8 time specified in that state's guaranty
9 association law.
10 (c) For unallocated annuity contracts specified in
11 subsection (2), paragraphs (a) and (b) of this subsection
12 (1) shall not apply and this Article shall (except as
13 provided in paragraphs (e) and (f) of this subsection)
14 provide coverage to:
15 (i) persons who are the owners of the unallocated
16 annuity contracts if the contracts are issued to or in
17 connection with a specific benefit plan whose plan
18 sponsor has its principal place of business in this
19 State; and
20 (ii) persons who are owners of unallocated annuity
21 contracts issued to or in connection with government
22 lotteries if the owners are residents.
23 (d) For structured settlement annuities specified in
24 subsection (2), paragraphs (a) and (b) of this subsection
25 (1) shall not apply and this Article shall (except as
26 provided in paragraphs (e) and (f) of this subsection)
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1 provide coverage to a person who is a payee under a
2 structured settlement annuity (or beneficiary of a payee
3 if the payee is deceased), if the payee:
4 (i) is a resident, regardless of where the
5 contract owner resides; or
6 (ii) is not a resident, but only under both of the
7 following conditions:
8 (A) with regard to residency:
9 (I) the contract owner of the structured
10 settlement annuity is a resident; or
11 (II) the contract owner of the structured
12 settlement annuity is not a resident but the
13 insurer that issued the structured settlement
14 annuity is domiciled in this State and the
15 state in which the contract owner resides has
16 an association similar to the Association
17 created by this Article; and
18 (B) neither the payee or beneficiary nor the
19 contract owner is eligible for coverage by the
20 association of the state in which the payee or
21 contract owner resides.
22 (e) This Article shall not provide coverage to:
23 (i) a person who is a payee or beneficiary of a
24 contract owner resident of this State if the payee or
25 beneficiary is afforded any coverage by the
26 association of another state; or
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1 (ii) a person covered under paragraph (c) of this
2 subsection (1), if any coverage is provided by the
3 association of another state to that person.
4 (f) This Article is intended to provide coverage to a
5 person who is a resident of this State and, in special
6 circumstances, to a nonresident. In order to avoid
7 duplicate coverage, if a person who would otherwise
8 receive coverage under this Article is provided coverage
9 under the laws of any other state, then the person shall
10 not be provided coverage under this Article. In
11 determining the application of the provisions of this
12 paragraph in situations where a person could be covered by
13 the association of more than one state, whether as an
14 owner, payee, enrollee, beneficiary, or assignee, this
15 Article shall be construed in conjunction with other state
16 laws to result in coverage by only one association.
17 (2)(a) This Article shall provide coverage to the persons
18 specified in subsection (1) of this Section for policies or
19 contracts of direct, (i) nongroup life insurance, health
20 insurance (that, for the purposes of this Article, includes
21 health maintenance organization subscriber contracts and
22 certificates), annuities and supplemental contracts to any of
23 these, (ii) for certificates under direct group policies or
24 contracts, (iii) for unallocated annuity contracts and (iv)
25 for contracts to furnish health care services and subscription
26 certificates for medical or health care services issued by
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1 persons licensed to transact insurance business in this State
2 under this Code. Annuity contracts and certificates under
3 group annuity contracts include but are not limited to
4 guaranteed investment contracts, deposit administration
5 contracts, unallocated funding agreements, allocated funding
6 agreements, structured settlement agreements, lottery
7 contracts and any immediate or deferred annuity contracts.
8 (b) Except as otherwise provided in paragraph (c) of this
9 subsection, this Article shall not provide coverage for:
10 (i) that portion of a policy or contract not
11 guaranteed by the member insurer, or under which the risk
12 is borne by the policy or contract owner;
13 (ii) any such policy or contract or part thereof
14 assumed by the impaired or insolvent insurer under a
15 contract of reinsurance, other than reinsurance for which
16 assumption certificates have been issued;
17 (iii) any portion of a policy or contract to the
18 extent that the rate of interest on which it is based or
19 the interest rate, crediting rate, or similar factor is
20 determined by use of an index or other external reference
21 stated in the policy or contract employed in calculating
22 returns or changes in value:
23 (A) averaged over the period of 4 years prior to
24 the date on which the member insurer becomes an
25 impaired or insolvent insurer under this Article,
26 whichever is earlier, exceeds the rate of interest
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1 determined by subtracting 2 percentage points from
2 Moody's Corporate Bond Yield Average averaged for that
3 same 4-year period or for such lesser period if the
4 policy or contract was issued less than 4 years before
5 the member insurer becomes an impaired or insolvent
6 insurer under this Article, whichever is earlier; and
7 (B) on and after the date on which the member
8 insurer becomes an impaired or insolvent insurer under
9 this Article, whichever is earlier, exceeds the rate
10 of interest determined by subtracting 3 percentage
11 points from Moody's Corporate Bond Yield Average as
12 most recently available;
13 (iv) any unallocated annuity contract issued to or in
14 connection with a benefit plan protected under the federal
15 Pension Benefit Guaranty Corporation, regardless of
16 whether the federal Pension Benefit Guaranty Corporation
17 has yet become liable to make any payments with respect to
18 the benefit plan;
19 (v) any portion of any unallocated annuity contract
20 which is not issued to or in connection with a specific
21 employee, union or association of natural persons benefit
22 plan or a government lottery;
23 (vi) an obligation that does not arise under the
24 express written terms of the policy or contract issued by
25 the member insurer to the enrollee, certificate holder,
26 contract owner, or policy owner, including without
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1 limitation:
2 (A) a claim based on marketing materials;
3 (B) a claim based on side letters, riders, or
4 other documents that were issued by the member insurer
5 without meeting applicable policy or contract form
6 filing or approval requirements;
7 (C) a misrepresentation of or regarding policy or
8 contract benefits;
9 (D) an extra-contractual claim; or
10 (E) a claim for penalties or consequential or
11 incidental damages;
12 (vii) any stop-loss insurance, as defined in clause
13 (b) of Class 1 or clause (a) of Class 2 of Section 4, and
14 further defined in subsection (d) of Section 352;
15 (viii) any policy or contract providing any hospital,
16 medical, prescription drug, or other health care benefits
17 pursuant to Part C or Part D of Subchapter XVIII, Chapter 7
18 of Title 42 of the United States Code (commonly known as
19 Medicare Part C & D), Subchapter XIX, Chapter 7 of Title 42
20 of the United States Code (commonly known as Medicaid), or
21 any regulations issued pursuant thereto;
22 (ix) any portion of a policy or contract to the extent
23 that the assessments required by Section 531.09 of this
24 Code with respect to the policy or contract are preempted
25 or otherwise not permitted by federal or State law;
26 (x) any portion of a policy or contract issued to a
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1 plan or program of an employer, association, or other
2 person to provide life, health, or annuity benefits to its
3 employees, members, or others to the extent that the plan
4 or program is self-funded or uninsured, including, but not
5 limited to, benefits payable by an employer, association,
6 or other person under:
7 (A) a multiple employer welfare arrangement as
8 defined in 29 U.S.C. Section 1002;
9 (B) a minimum premium group insurance plan;
10 (C) a stop-loss group insurance plan; or
11 (D) an administrative services only contract;
12 (xi) any portion of a policy or contract to the extent
13 that it provides for:
14 (A) dividends or experience rating credits;
15 (B) voting rights; or
16 (C) payment of any fees or allowances to any
17 person, including the policy or contract owner, in
18 connection with the service to or administration of
19 the policy or contract;
20 (xii) any policy or contract issued in this State by a
21 member insurer at a time when it was not licensed or did
22 not have a certificate of authority to issue the policy or
23 contract in this State;
24 (xiii) any contractual agreement that establishes the
25 member insurer's obligations to provide a book value
26 accounting guaranty for defined contribution benefit plan
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1 participants by reference to a portfolio of assets that is
2 owned by the benefit plan or its trustee, which in each
3 case is not an affiliate of the member insurer;
4 (xiv) any portion of a policy or contract to the
5 extent that it provides for interest or other changes in
6 value to be determined by the use of an index or other
7 external reference stated in the policy or contract, but
8 which have not been credited to the policy or contract, or
9 as to which the policy or contract owner's rights are
10 subject to forfeiture, as of the date the member insurer
11 becomes an impaired or insolvent insurer under this Code,
12 whichever is earlier. If a policy's or contract's interest
13 or changes in value are credited less frequently than
14 annually, then for purposes of determining the values that
15 have been credited and are not subject to forfeiture under
16 this Section, the interest or change in value determined
17 by using the procedures defined in the policy or contract
18 will be credited as if the contractual date of crediting
19 interest or changing values was the date of impairment or
20 insolvency, whichever is earlier, and will not be subject
21 to forfeiture; or
22 (xv) that portion or part of a variable life insurance
23 or variable annuity contract not guaranteed by a member
24 insurer.
25 (c) The exclusion from coverage referenced in subdivision
26 (iii) of paragraph (b) of this subsection shall not apply to
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1 any portion of a policy or contract, including a rider, that
2 provides long-term care or other health insurance benefits.
3 (3) The benefits for which the Association may become
4 liable shall in no event exceed the lesser of:
5 (a) the contractual obligations for which the member
6 insurer is liable or would have been liable if it were not
7 an impaired or insolvent insurer, or
8 (b)(i) with respect to any one life, regardless of the
9 number of policies or contracts:
10 (A) $300,000 in life insurance death benefits, but
11 not more than $100,000 in net cash surrender and net
12 cash withdrawal values for life insurance;
13 (B) for health insurance benefits:
14 (I) $100,000 for coverages not defined as
15 disability income insurance or health benefit
16 plans or long-term care insurance, including any
17 net cash surrender and net cash withdrawal values;
18 (II) $300,000 for disability income insurance
19 and $300,000 for long-term care insurance; and
20 (III) $500,000 for health benefit plans;
21 (C) $250,000 in the present value of annuity
22 benefits, including net cash surrender and net cash
23 withdrawal values;
24 (ii) with respect to each individual participating in
25 a governmental retirement benefit plan established under
26 Section 401, 403(b), or 457 of the U.S. Internal Revenue
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1 Code covered by an unallocated annuity contract or the
2 beneficiaries of each such individual if deceased, in the
3 aggregate, $250,000 in present value annuity benefits,
4 including net cash surrender and net cash withdrawal
5 values;
6 (iii) with respect to each payee of a structured
7 settlement annuity or beneficiary or beneficiaries of the
8 payee if deceased, $250,000 in present value annuity
9 benefits, in the aggregate, including net cash surrender
10 and net cash withdrawal values, if any; or
11 (iv) with respect to either (1) one contract owner
12 provided coverage under subparagraph (ii) of paragraph (c)
13 of subsection (1) of this Section or (2) one plan sponsor
14 whose plans own directly or in trust one or more
15 unallocated annuity contracts not included in subparagraph
16 (ii) of paragraph (b) of this subsection, $5,000,000 in
17 benefits, irrespective of the number of contracts with
18 respect to the contract owner or plan sponsor. However, in
19 the case where one or more unallocated annuity contracts
20 are covered contracts under this Article and are owned by
21 a trust or other entity for the benefit of 2 or more plan
22 sponsors, coverage shall be afforded by the Association if
23 the largest interest in the trust or entity owning the
24 contract or contracts is held by a plan sponsor whose
25 principal place of business is in this State. In no event
26 shall the Association be obligated to cover more than
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1 $5,000,000 in benefits with respect to all these
2 unallocated contracts.
3 In no event shall the Association be obligated to cover
4 more than (1) an aggregate of $300,000 in benefits with
5 respect to any one life under subparagraphs (i), (ii), and
6 (iii) of this paragraph (b) except with respect to benefits
7 for health benefit plans under item (B) of subparagraph (i) of
8 this paragraph (b), in which case the aggregate liability of
9 the Association shall not exceed $500,000 with respect to any
10 one individual or (2) with respect to one owner of multiple
11 nongroup policies of life insurance, whether the policy or
12 contract owner is an individual, firm, corporation, or other
13 person and whether the persons insured are officers, managers,
14 employees, or other persons, $5,000,000 in benefits,
15 regardless of the number of policies and contracts held by the
16 owner.
17 The limitations set forth in this subsection are
18 limitations on the benefits for which the Association is
19 obligated before taking into account either its subrogation
20 and assignment rights or the extent to which those benefits
21 could be provided out of the assets of the impaired or
22 insolvent insurer attributable to covered policies. The costs
23 of the Association's obligations under this Article may be met
24 by the use of assets attributable to covered policies or
25 reimbursed to the Association pursuant to its subrogation and
26 assignment rights.
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1 For purposes of this Article, benefits provided by a
2 long-term care rider to a life insurance policy or annuity
3 contract shall be considered the same type of benefits as the
4 base life insurance policy or annuity contract to which it
5 relates.
6 (4) In performing its obligations to provide coverage
7 under Section 531.08 of this Code, the Association shall not
8 be required to guarantee, assume, reinsure, reissue, or
9 perform or cause to be guaranteed, assumed, reinsured,
10 reissued, or performed the contractual obligations of the
11 insolvent or impaired insurer under a covered policy or
12 contract that do not materially affect the economic values or
13 economic benefits of the covered policy or contract.
14 (Source: P.A. 100-687, eff. 8-3-18; 100-863, eff. 8-14-18.)
15 (215 ILCS 5/362a rep.)
16 Section 26. The Illinois Insurance Code is amended by
17 repealing Section 362a.
18 Section 30. The Network Adequacy and Transparency Act is
19 amended by changing Sections 5 and 10 as follows:
20 (215 ILCS 124/5)
21 Sec. 5. Definitions. In this Act:
22 "Authorized representative" means a person to whom a
23 beneficiary has given express written consent to represent the
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1 beneficiary; a person authorized by law to provide substituted
2 consent for a beneficiary; or the beneficiary's treating
3 provider only when the beneficiary or his or her family member
4 is unable to provide consent.
5 "Beneficiary" means an individual, an enrollee, an
6 insured, a participant, or any other person entitled to
7 reimbursement for covered expenses of or the discounting of
8 provider fees for health care services under a program in
9 which the beneficiary has an incentive to utilize the services
10 of a provider that has entered into an agreement or
11 arrangement with an insurer.
12 "Department" means the Department of Insurance.
13 "Director" means the Director of Insurance.
14 "Family caregiver" means a relative, partner, friend, or
15 neighbor who has a significant relationship with the patient
16 and administers or assists the patient with activities of
17 daily living, instrumental activities of daily living, or
18 other medical or nursing tasks for the quality and welfare of
19 that patient.
20 "Insurer" means any entity that offers individual or group
21 accident and health insurance, including, but not limited to,
22 health maintenance organizations, preferred provider
23 organizations, exclusive provider organizations, and other
24 plan structures requiring network participation, excluding the
25 medical assistance program under the Illinois Public Aid Code,
26 the State employees group health insurance program, workers
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1 compensation insurance, and pharmacy benefit managers.
2 "Material change" means a significant reduction in the
3 number of providers available in a network plan, including,
4 but not limited to, a reduction of 10% or more in a specific
5 type of providers, the removal of a major health system that
6 causes a network to be significantly different from the
7 network when the beneficiary purchased the network plan, or
8 any change that would cause the network to no longer satisfy
9 the requirements of this Act or the Department's rules for
10 network adequacy and transparency.
11 "Network" means the group or groups of preferred providers
12 providing services to a network plan.
13 "Network plan" means an individual or group policy of
14 accident and health insurance that either requires a covered
15 person to use or creates incentives, including financial
16 incentives, for a covered person to use providers managed,
17 owned, under contract with, or employed by the insurer.
18 "Ongoing course of treatment" means (1) treatment for a
19 life-threatening condition, which is a disease or condition
20 for which likelihood of death is probable unless the course of
21 the disease or condition is interrupted; (2) treatment for a
22 serious acute condition, defined as a disease or condition
23 requiring complex ongoing care that the covered person is
24 currently receiving, such as chemotherapy, radiation therapy,
25 or post-operative visits; (3) a course of treatment for a
26 health condition that a treating provider attests that
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1 discontinuing care by that provider would worsen the condition
2 or interfere with anticipated outcomes; or (4) the third
3 trimester of pregnancy through the post-partum period.
4 "Preferred provider" means any provider who has entered,
5 either directly or indirectly, into an agreement with an
6 employer or risk-bearing entity relating to health care
7 services that may be rendered to beneficiaries under a network
8 plan.
9 "Providers" means physicians licensed to practice medicine
10 in all its branches, other health care professionals,
11 hospitals, or other health care institutions that provide
12 health care services.
13 "Telehealth" has the meaning given to that term in Section
14 356z.22 of the Illinois Insurance Code.
15 "Telemedicine" has the meaning given to that term in
16 Section 49.5 of the Medical Practice Act of 1987.
17 "Tiered network" means a network that identifies and
18 groups some or all types of provider and facilities into
19 specific groups to which different provider reimbursement,
20 covered person cost-sharing or provider access requirements,
21 or any combination thereof, apply for the same services.
22 "Woman's principal health care provider" means a physician
23 licensed to practice medicine in all of its branches
24 specializing in obstetrics, gynecology, or family practice.
25 (Source: P.A. 102-92, eff. 7-9-21; 102-813, eff. 5-13-22.)
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1 (215 ILCS 124/10)
2 Sec. 10. Network adequacy.
3 (a) An insurer providing a network plan shall file a
4 description of all of the following with the Director:
5 (1) The written policies and procedures for adding
6 providers to meet patient needs based on increases in the
7 number of beneficiaries, changes in the
8 patient-to-provider ratio, changes in medical and health
9 care capabilities, and increased demand for services.
10 (2) The written policies and procedures for making
11 referrals within and outside the network.
12 (3) The written policies and procedures on how the
13 network plan will provide 24-hour, 7-day per week access
14 to network-affiliated primary care, emergency services,
15 and obstetrical and gynecological health care
16 professionals women's principal health care providers.
17 An insurer shall not prohibit a preferred provider from
18 discussing any specific or all treatment options with
19 beneficiaries irrespective of the insurer's position on those
20 treatment options or from advocating on behalf of
21 beneficiaries within the utilization review, grievance, or
22 appeals processes established by the insurer in accordance
23 with any rights or remedies available under applicable State
24 or federal law.
25 (b) Insurers must file for review a description of the
26 services to be offered through a network plan. The description
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1 shall include all of the following:
2 (1) A geographic map of the area proposed to be served
3 by the plan by county service area and zip code, including
4 marked locations for preferred providers.
5 (2) As deemed necessary by the Department, the names,
6 addresses, phone numbers, and specialties of the providers
7 who have entered into preferred provider agreements under
8 the network plan.
9 (3) The number of beneficiaries anticipated to be
10 covered by the network plan.
11 (4) An Internet website and toll-free telephone number
12 for beneficiaries and prospective beneficiaries to access
13 current and accurate lists of preferred providers,
14 additional information about the plan, as well as any
15 other information required by Department rule.
16 (5) A description of how health care services to be
17 rendered under the network plan are reasonably accessible
18 and available to beneficiaries. The description shall
19 address all of the following:
20 (A) the type of health care services to be
21 provided by the network plan;
22 (B) the ratio of physicians and other providers to
23 beneficiaries, by specialty and including primary care
24 physicians and facility-based physicians when
25 applicable under the contract, necessary to meet the
26 health care needs and service demands of the currently
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1 enrolled population;
2 (C) the travel and distance standards for plan
3 beneficiaries in county service areas; and
4 (D) a description of how the use of telemedicine,
5 telehealth, or mobile care services may be used to
6 partially meet the network adequacy standards, if
7 applicable.
8 (6) A provision ensuring that whenever a beneficiary
9 has made a good faith effort, as evidenced by accessing
10 the provider directory, calling the network plan, and
11 calling the provider, to utilize preferred providers for a
12 covered service and it is determined the insurer does not
13 have the appropriate preferred providers due to
14 insufficient number, type, unreasonable travel distance or
15 delay, or preferred providers refusing to provide a
16 covered service because it is contrary to the conscience
17 of the preferred providers, as protected by the Health
18 Care Right of Conscience Act, the insurer shall ensure,
19 directly or indirectly, by terms contained in the payer
20 contract, that the beneficiary will be provided the
21 covered service at no greater cost to the beneficiary than
22 if the service had been provided by a preferred provider.
23 This paragraph (6) does not apply to: (A) a beneficiary
24 who willfully chooses to access a non-preferred provider
25 for health care services available through the panel of
26 preferred providers, or (B) a beneficiary enrolled in a
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1 health maintenance organization. In these circumstances,
2 the contractual requirements for non-preferred provider
3 reimbursements shall apply unless Section 356z.3a of the
4 Illinois Insurance Code requires otherwise. In no event
5 shall a beneficiary who receives care at a participating
6 health care facility be required to search for
7 participating providers under the circumstances described
8 in subsection (b) or (b-5) of Section 356z.3a of the
9 Illinois Insurance Code except under the circumstances
10 described in paragraph (2) of subsection (b-5).
11 (7) A provision that the beneficiary shall receive
12 emergency care coverage such that payment for this
13 coverage is not dependent upon whether the emergency
14 services are performed by a preferred or non-preferred
15 provider and the coverage shall be at the same benefit
16 level as if the service or treatment had been rendered by a
17 preferred provider. For purposes of this paragraph (7),
18 "the same benefit level" means that the beneficiary is
19 provided the covered service at no greater cost to the
20 beneficiary than if the service had been provided by a
21 preferred provider. This provision shall be consistent
22 with Section 356z.3a of the Illinois Insurance Code.
23 (8) A limitation that, if the plan provides that the
24 beneficiary will incur a penalty for failing to
25 pre-certify inpatient hospital treatment, the penalty may
26 not exceed $1,000 per occurrence in addition to the plan
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1 cost-sharing cost sharing provisions.
2 (c) The network plan shall demonstrate to the Director a
3 minimum ratio of providers to plan beneficiaries as required
4 by the Department.
5 (1) The ratio of physicians or other providers to plan
6 beneficiaries shall be established annually by the
7 Department in consultation with the Department of Public
8 Health based upon the guidance from the federal Centers
9 for Medicare and Medicaid Services. The Department shall
10 not establish ratios for vision or dental providers who
11 provide services under dental-specific or vision-specific
12 benefits. The Department shall consider establishing
13 ratios for the following physicians or other providers:
14 (A) Primary Care;
15 (B) Pediatrics;
16 (C) Cardiology;
17 (D) Gastroenterology;
18 (E) General Surgery;
19 (F) Neurology;
20 (G) OB/GYN;
21 (H) Oncology/Radiation;
22 (I) Ophthalmology;
23 (J) Urology;
24 (K) Behavioral Health;
25 (L) Allergy/Immunology;
26 (M) Chiropractic;
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1 (N) Dermatology;
2 (O) Endocrinology;
3 (P) Ears, Nose, and Throat (ENT)/Otolaryngology;
4 (Q) Infectious Disease;
5 (R) Nephrology;
6 (S) Neurosurgery;
7 (T) Orthopedic Surgery;
8 (U) Physiatry/Rehabilitative;
9 (V) Plastic Surgery;
10 (W) Pulmonary;
11 (X) Rheumatology;
12 (Y) Anesthesiology;
13 (Z) Pain Medicine;
14 (AA) Pediatric Specialty Services;
15 (BB) Outpatient Dialysis; and
16 (CC) HIV.
17 (2) The Director shall establish a process for the
18 review of the adequacy of these standards, along with an
19 assessment of additional specialties to be included in the
20 list under this subsection (c).
21 (d) The network plan shall demonstrate to the Director
22 maximum travel and distance standards for plan beneficiaries,
23 which shall be established annually by the Department in
24 consultation with the Department of Public Health based upon
25 the guidance from the federal Centers for Medicare and
26 Medicaid Services. These standards shall consist of the
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1 maximum minutes or miles to be traveled by a plan beneficiary
2 for each county type, such as large counties, metro counties,
3 or rural counties as defined by Department rule.
4 The maximum travel time and distance standards must
5 include standards for each physician and other provider
6 category listed for which ratios have been established.
7 The Director shall establish a process for the review of
8 the adequacy of these standards along with an assessment of
9 additional specialties to be included in the list under this
10 subsection (d).
11 (d-5)(1) Every insurer shall ensure that beneficiaries
12 have timely and proximate access to treatment for mental,
13 emotional, nervous, or substance use disorders or conditions
14 in accordance with the provisions of paragraph (4) of
15 subsection (a) of Section 370c of the Illinois Insurance Code.
16 Insurers shall use a comparable process, strategy, evidentiary
17 standard, and other factors in the development and application
18 of the network adequacy standards for timely and proximate
19 access to treatment for mental, emotional, nervous, or
20 substance use disorders or conditions and those for the access
21 to treatment for medical and surgical conditions. As such, the
22 network adequacy standards for timely and proximate access
23 shall equally be applied to treatment facilities and providers
24 for mental, emotional, nervous, or substance use disorders or
25 conditions and specialists providing medical or surgical
26 benefits pursuant to the parity requirements of Section 370c.1
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1 of the Illinois Insurance Code and the federal Paul Wellstone
2 and Pete Domenici Mental Health Parity and Addiction Equity
3 Act of 2008. Notwithstanding the foregoing, the network
4 adequacy standards for timely and proximate access to
5 treatment for mental, emotional, nervous, or substance use
6 disorders or conditions shall, at a minimum, satisfy the
7 following requirements:
8 (A) For beneficiaries residing in the metropolitan
9 counties of Cook, DuPage, Kane, Lake, McHenry, and Will,
10 network adequacy standards for timely and proximate access
11 to treatment for mental, emotional, nervous, or substance
12 use disorders or conditions means a beneficiary shall not
13 have to travel longer than 30 minutes or 30 miles from the
14 beneficiary's residence to receive outpatient treatment
15 for mental, emotional, nervous, or substance use disorders
16 or conditions. Beneficiaries shall not be required to wait
17 longer than 10 business days between requesting an initial
18 appointment and being seen by the facility or provider of
19 mental, emotional, nervous, or substance use disorders or
20 conditions for outpatient treatment or to wait longer than
21 20 business days between requesting a repeat or follow-up
22 appointment and being seen by the facility or provider of
23 mental, emotional, nervous, or substance use disorders or
24 conditions for outpatient treatment; however, subject to
25 the protections of paragraph (3) of this subsection, a
26 network plan shall not be held responsible if the
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1 beneficiary or provider voluntarily chooses to schedule an
2 appointment outside of these required time frames.
3 (B) For beneficiaries residing in Illinois counties
4 other than those counties listed in subparagraph (A) of
5 this paragraph, network adequacy standards for timely and
6 proximate access to treatment for mental, emotional,
7 nervous, or substance use disorders or conditions means a
8 beneficiary shall not have to travel longer than 60
9 minutes or 60 miles from the beneficiary's residence to
10 receive outpatient treatment for mental, emotional,
11 nervous, or substance use disorders or conditions.
12 Beneficiaries shall not be required to wait longer than 10
13 business days between requesting an initial appointment
14 and being seen by the facility or provider of mental,
15 emotional, nervous, or substance use disorders or
16 conditions for outpatient treatment or to wait longer than
17 20 business days between requesting a repeat or follow-up
18 appointment and being seen by the facility or provider of
19 mental, emotional, nervous, or substance use disorders or
20 conditions for outpatient treatment; however, subject to
21 the protections of paragraph (3) of this subsection, a
22 network plan shall not be held responsible if the
23 beneficiary or provider voluntarily chooses to schedule an
24 appointment outside of these required time frames.
25 (2) For beneficiaries residing in all Illinois counties,
26 network adequacy standards for timely and proximate access to
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1 treatment for mental, emotional, nervous, or substance use
2 disorders or conditions means a beneficiary shall not have to
3 travel longer than 60 minutes or 60 miles from the
4 beneficiary's residence to receive inpatient or residential
5 treatment for mental, emotional, nervous, or substance use
6 disorders or conditions.
7 (3) If there is no in-network facility or provider
8 available for a beneficiary to receive timely and proximate
9 access to treatment for mental, emotional, nervous, or
10 substance use disorders or conditions in accordance with the
11 network adequacy standards outlined in this subsection, the
12 insurer shall provide necessary exceptions to its network to
13 ensure admission and treatment with a provider or at a
14 treatment facility in accordance with the network adequacy
15 standards in this subsection.
16 (e) Except for network plans solely offered as a group
17 health plan, these ratio and time and distance standards apply
18 to the lowest cost-sharing tier of any tiered network.
19 (f) The network plan may consider use of other health care
20 service delivery options, such as telemedicine or telehealth,
21 mobile clinics, and centers of excellence, or other ways of
22 delivering care to partially meet the requirements set under
23 this Section.
24 (g) Except for the requirements set forth in subsection
25 (d-5), insurers who are not able to comply with the provider
26 ratios and time and distance standards established by the
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1 Department may request an exception to these requirements from
2 the Department. The Department may grant an exception in the
3 following circumstances:
4 (1) if no providers or facilities meet the specific
5 time and distance standard in a specific service area and
6 the insurer (i) discloses information on the distance and
7 travel time points that beneficiaries would have to travel
8 beyond the required criterion to reach the next closest
9 contracted provider outside of the service area and (ii)
10 provides contact information, including names, addresses,
11 and phone numbers for the next closest contracted provider
12 or facility;
13 (2) if patterns of care in the service area do not
14 support the need for the requested number of provider or
15 facility type and the insurer provides data on local
16 patterns of care, such as claims data, referral patterns,
17 or local provider interviews, indicating where the
18 beneficiaries currently seek this type of care or where
19 the physicians currently refer beneficiaries, or both; or
20 (3) other circumstances deemed appropriate by the
21 Department consistent with the requirements of this Act.
22 (h) Insurers are required to report to the Director any
23 material change to an approved network plan within 15 days
24 after the change occurs and any change that would result in
25 failure to meet the requirements of this Act. Upon notice from
26 the insurer, the Director shall reevaluate the network plan's
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1 compliance with the network adequacy and transparency
2 standards of this Act.
3 (Source: P.A. 102-144, eff. 1-1-22; 102-901, eff. 7-1-22;
4 102-1117, eff. 1-13-23.)
5 Section 35. The Health Maintenance Organization Act is
6 amended by changing Sections 4.5-1, 5-3, and 5-3.1 as follows:
7 (215 ILCS 125/4.5-1)
8 Sec. 4.5-1. Point-of-service health service contracts.
9 (a) A health maintenance organization that offers a
10 point-of-service contract:
11 (1) must include as in-plan covered services all
12 services required by law to be provided by a health
13 maintenance organization;
14 (2) must provide incentives, which shall include
15 financial incentives, for enrollees to use in-plan covered
16 services;
17 (3) may not offer services out-of-plan without
18 providing those services on an in-plan basis;
19 (4) may include annual out-of-pocket limits and
20 lifetime maximum benefits allowances for out-of-plan
21 services that are separate from any limits or allowances
22 applied to in-plan services;
23 (5) may not consider emergency services, authorized
24 referral services, or non-routine services obtained out of
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1 the service area to be point-of-service services;
2 (6) may treat as out-of-plan services those services
3 that an enrollee obtains from a participating provider,
4 but for which the proper authorization was not given by
5 the health maintenance organization; and
6 (7) after January 1, 2003 (the effective date of
7 Public Act 92-579), must include the following disclosure
8 on its point-of-service contracts and evidences of
9 coverage: "WARNING, LIMITED BENEFITS WILL BE PAID WHEN
10 NON-PARTICIPATING PROVIDERS ARE USED. YOU CAN EXPECT TO
11 PAY MORE THAN THE COST-SHARING AMOUNT DEFINED IN THE
12 POLICY IN NON-EMERGENCY SITUATIONS. Except in limited
13 situations governed by the federal No Surprises Act or
14 Section 356z.3a of the Illinois Insurance Code (215 ILCS
15 5/356z.3a), non-participating providers furnishing
16 non-emergency services may bill members for any amount up
17 to the billed charge after the plan has paid its portion of
18 the bill. If you elect to use a non-participating
19 provider, plan benefit payments will be determined
20 according to your policy's fee schedule, usual and
21 customary charge (which is determined by comparing charges
22 for similar services adjusted to the geographical area
23 where the services are performed), or other method as
24 defined by the policy. Participating providers have agreed
25 to ONLY bill members the cost-sharing amounts. You should
26 be aware that when you elect to utilize the services of a
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1 non-participating provider for a covered service in
2 non-emergency situations, benefit payments to such
3 non-participating provider are not based upon the amount
4 billed. The basis of your benefit payment will be
5 determined according to your policy's fee schedule, usual
6 and customary charge (which is determined by comparing
7 charges for similar services adjusted to the geographical
8 area where the services are performed), or other method as
9 defined by the policy. YOU CAN EXPECT TO PAY MORE THAN THE
10 COINSURANCE AMOUNT DEFINED IN THE POLICY AFTER THE PLAN
11 HAS PAID ITS REQUIRED PORTION. Non-participating providers
12 may bill members for any amount up to the billed charge
13 after the plan has paid its portion of the bill, except as
14 provided in Section 356z.3a of the Illinois Insurance Code
15 for covered services received at a participating health
16 care facility from a non-participating provider that are:
17 (a) ancillary services, (b) items or services furnished as
18 a result of unforeseen, urgent medical needs that arise at
19 the time the item or service is furnished, or (c) items or
20 services received when the facility or the
21 non-participating provider fails to satisfy the notice and
22 consent criteria specified under Section 356z.3a.
23 Participating providers have agreed to accept discounted
24 payments for services with no additional billing to the
25 member other than co-insurance and deductible amounts. You
26 may obtain further information about the participating
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1 status of professional providers and information on
2 out-of-pocket expenses by calling the toll-free toll free
3 telephone number on your identification card.".
4 (b) A health maintenance organization offering a
5 point-of-service contract is subject to all of the following
6 limitations:
7 (1) The health maintenance organization may not expend
8 in any calendar quarter more than 20% of its total
9 expenditures for all its members for out-of-plan covered
10 services.
11 (2) If the amount specified in item (1) of this
12 subsection is exceeded by 2% in a quarter, the health
13 maintenance organization must effect compliance with item
14 (1) of this subsection by the end of the following
15 quarter.
16 (3) If compliance with the amount specified in item
17 (1) of this subsection is not demonstrated in the health
18 maintenance organization's next quarterly report, the
19 health maintenance organization may not offer the
20 point-of-service contract to new groups or include the
21 point-of-service option in the renewal of an existing
22 group until compliance with the amount specified in item
23 (1) of this subsection is demonstrated or until otherwise
24 allowed by the Director.
25 (4) A health maintenance organization failing, without
26 just cause, to comply with the provisions of this
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1 subsection shall be required, after notice and hearing, to
2 pay a penalty of $250 for each day out of compliance, to be
3 recovered by the Director. Any penalty recovered shall be
4 paid into the General Revenue Fund. The Director may
5 reduce the penalty if the health maintenance organization
6 demonstrates to the Director that the imposition of the
7 penalty would constitute a financial hardship to the
8 health maintenance organization.
9 (c) A health maintenance organization that offers a
10 point-of-service product must do all of the following:
11 (1) File a quarterly financial statement detailing
12 compliance with the requirements of subsection (b).
13 (2) Track out-of-plan, point-of-service utilization
14 separately from in-plan or non-point-of-service,
15 out-of-plan emergency care, referral care, and urgent care
16 out of the service area utilization.
17 (3) Record out-of-plan utilization in a manner that
18 will permit such utilization and cost reporting as the
19 Director may, by rule, require.
20 (4) Demonstrate to the Director's satisfaction that
21 the health maintenance organization has the fiscal,
22 administrative, and marketing capacity to control its
23 point-of-service enrollment, utilization, and costs so as
24 not to jeopardize the financial security of the health
25 maintenance organization.
26 (5) Maintain, in addition to any other deposit
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1 required under this Act, the deposit required by Section
2 2-6.
3 (6) Maintain cash and cash equivalents of sufficient
4 amount to fully liquidate 10 days' average claim payments,
5 subject to review by the Director.
6 (7) Maintain and file with the Director, reinsurance
7 coverage protecting against catastrophic losses on
8 out-of-network point-of-service services. Deductibles may
9 not exceed $100,000 per covered life per year, and the
10 portion of risk retained by the health maintenance
11 organization once deductibles have been satisfied may not
12 exceed 20%. Reinsurance must be placed with licensed
13 authorized reinsurers qualified to do business in this
14 State.
15 (d) A health maintenance organization may not issue a
16 point-of-service contract until it has filed and had approved
17 by the Director a plan to comply with the provisions of this
18 Section. The compliance plan must, at a minimum, include
19 provisions demonstrating that the health maintenance
20 organization will do all of the following:
21 (1) Design the benefit levels and conditions of
22 coverage for in-plan covered services and out-of-plan
23 covered services as required by this Article.
24 (2) Provide or arrange for the provision of adequate
25 systems to:
26 (A) process and pay claims for all out-of-plan
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1 covered services;
2 (B) meet the requirements for point-of-service
3 contracts set forth in this Section and any additional
4 requirements that may be set forth by the Director;
5 and
6 (C) generate accurate data and financial and
7 regulatory reports on a timely basis so that the
8 Department of Insurance can evaluate the health
9 maintenance organization's experience with the
10 point-of-service contract and monitor compliance with
11 point-of-service contract provisions.
12 (3) Comply with the requirements of subsections (b)
13 and (c).
14 (Source: P.A. 102-901, eff. 1-1-23; 103-154, eff. 6-30-23.)
15 (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
16 Sec. 5-3. Insurance Code provisions.
17 (a) Health Maintenance Organizations shall be subject to
18 the provisions of Sections 133, 134, 136, 137, 139, 140,
19 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
20 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 155.49,
21 355.2, 355.3, 355b, 355c, 356f, 356g.5-1, 356m, 356q, 356v,
22 356w, 356x, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
23 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
24 356z.15, 356z.17, 356z.18, 356z.19, 356z.20, 356z.21, 356z.22,
25 356z.23, 356z.24, 356z.25, 356z.26, 356z.28, 356z.29, 356z.30,
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1 356z.30a, 356z.31, 356z.32, 356z.33, 356z.34, 356z.35,
2 356z.36, 356z.37, 356z.38, 356z.39, 356z.40, 356z.41, 356z.44,
3 356z.45, 356z.46, 356z.47, 356z.48, 356z.49, 356z.50, 356z.51,
4 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.58, 356z.59,
5 356z.60, 356z.61, 356z.62, 356z.63, 356z.64, 356z.65, 356z.66,
6 356z.67, 356z.68, 356z.69, 356z.70, 364, 364.01, 364.3, 367.2,
7 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1,
8 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and
9 444.1, paragraph (c) of subsection (2) of Section 367, and
10 Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV,
11 XXVI, and XXXIIB of the Illinois Insurance Code.
12 (b) For purposes of the Illinois Insurance Code, except
13 for Sections 444 and 444.1 and Articles XIII and XIII 1/2,
14 Health Maintenance Organizations in the following categories
15 are deemed to be "domestic companies":
16 (1) a corporation authorized under the Dental Service
17 Plan Act or the Voluntary Health Services Plans Act;
18 (2) a corporation organized under the laws of this
19 State; or
20 (3) a corporation organized under the laws of another
21 state, 30% or more of the enrollees of which are residents
22 of this State, except a corporation subject to
23 substantially the same requirements in its state of
24 organization as is a "domestic company" under Article VIII
25 1/2 of the Illinois Insurance Code.
26 (c) In considering the merger, consolidation, or other
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1 acquisition of control of a Health Maintenance Organization
2 pursuant to Article VIII 1/2 of the Illinois Insurance Code,
3 (1) the Director shall give primary consideration to
4 the continuation of benefits to enrollees and the
5 financial conditions of the acquired Health Maintenance
6 Organization after the merger, consolidation, or other
7 acquisition of control takes effect;
8 (2)(i) the criteria specified in subsection (1)(b) of
9 Section 131.8 of the Illinois Insurance Code shall not
10 apply and (ii) the Director, in making his determination
11 with respect to the merger, consolidation, or other
12 acquisition of control, need not take into account the
13 effect on competition of the merger, consolidation, or
14 other acquisition of control;
15 (3) the Director shall have the power to require the
16 following information:
17 (A) certification by an independent actuary of the
18 adequacy of the reserves of the Health Maintenance
19 Organization sought to be acquired;
20 (B) pro forma financial statements reflecting the
21 combined balance sheets of the acquiring company and
22 the Health Maintenance Organization sought to be
23 acquired as of the end of the preceding year and as of
24 a date 90 days prior to the acquisition, as well as pro
25 forma financial statements reflecting projected
26 combined operation for a period of 2 years;
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1 (C) a pro forma business plan detailing an
2 acquiring party's plans with respect to the operation
3 of the Health Maintenance Organization sought to be
4 acquired for a period of not less than 3 years; and
5 (D) such other information as the Director shall
6 require.
7 (d) The provisions of Article VIII 1/2 of the Illinois
8 Insurance Code and this Section 5-3 shall apply to the sale by
9 any health maintenance organization of greater than 10% of its
10 enrollee population (including, without limitation, the health
11 maintenance organization's right, title, and interest in and
12 to its health care certificates).
13 (e) In considering any management contract or service
14 agreement subject to Section 141.1 of the Illinois Insurance
15 Code, the Director (i) shall, in addition to the criteria
16 specified in Section 141.2 of the Illinois Insurance Code,
17 take into account the effect of the management contract or
18 service agreement on the continuation of benefits to enrollees
19 and the financial condition of the health maintenance
20 organization to be managed or serviced, and (ii) need not take
21 into account the effect of the management contract or service
22 agreement on competition.
23 (f) Except for small employer groups as defined in the
24 Small Employer Rating, Renewability and Portability Health
25 Insurance Act and except for medicare supplement policies as
26 defined in Section 363 of the Illinois Insurance Code, a
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1 Health Maintenance Organization may by contract agree with a
2 group or other enrollment unit to effect refunds or charge
3 additional premiums under the following terms and conditions:
4 (i) the amount of, and other terms and conditions with
5 respect to, the refund or additional premium are set forth
6 in the group or enrollment unit contract agreed in advance
7 of the period for which a refund is to be paid or
8 additional premium is to be charged (which period shall
9 not be less than one year); and
10 (ii) the amount of the refund or additional premium
11 shall not exceed 20% of the Health Maintenance
12 Organization's profitable or unprofitable experience with
13 respect to the group or other enrollment unit for the
14 period (and, for purposes of a refund or additional
15 premium, the profitable or unprofitable experience shall
16 be calculated taking into account a pro rata share of the
17 Health Maintenance Organization's administrative and
18 marketing expenses, but shall not include any refund to be
19 made or additional premium to be paid pursuant to this
20 subsection (f)). The Health Maintenance Organization and
21 the group or enrollment unit may agree that the profitable
22 or unprofitable experience may be calculated taking into
23 account the refund period and the immediately preceding 2
24 plan years.
25 The Health Maintenance Organization shall include a
26 statement in the evidence of coverage issued to each enrollee
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1 describing the possibility of a refund or additional premium,
2 and upon request of any group or enrollment unit, provide to
3 the group or enrollment unit a description of the method used
4 to calculate (1) the Health Maintenance Organization's
5 profitable experience with respect to the group or enrollment
6 unit and the resulting refund to the group or enrollment unit
7 or (2) the Health Maintenance Organization's unprofitable
8 experience with respect to the group or enrollment unit and
9 the resulting additional premium to be paid by the group or
10 enrollment unit.
11 In no event shall the Illinois Health Maintenance
12 Organization Guaranty Association be liable to pay any
13 contractual obligation of an insolvent organization to pay any
14 refund authorized under this Section.
15 (g) Rulemaking authority to implement Public Act 95-1045,
16 if any, is conditioned on the rules being adopted in
17 accordance with all provisions of the Illinois Administrative
18 Procedure Act and all rules and procedures of the Joint
19 Committee on Administrative Rules; any purported rule not so
20 adopted, for whatever reason, is unauthorized.
21 (Source: P.A. 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
22 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
23 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
24 eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
25 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
26 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
HB5493 - 130 - LRB103 39189 RPS 69335 b
HB5493- 131 -LRB103 39189 RPS 69335 b HB5493 - 131 - LRB103 39189 RPS 69335 b
HB5493 - 131 - LRB103 39189 RPS 69335 b
1 eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24;
2 103-91, eff. 1-1-24; 103-123, eff. 1-1-24; 103-154, eff.
3 6-30-23; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
4 eff. 1-1-24; 103-551, eff. 8-11-23; revised 8-29-23.)
5 (215 ILCS 125/5-3.1)
6 Sec. 5-3.1. Access to obstetrical and gynecological care
7 Woman's health care provider. Health maintenance organizations
8 are subject to the provisions of Section 356r of the Illinois
9 Insurance Code.
10 (Source: P.A. 89-514, eff. 7-17-96.)
11 Section 40. The Limited Health Service Organization Act is
12 amended by changing Section 4002.1 as follows:
13 (215 ILCS 130/4002.1)
14 Sec. 4002.1. Access to obstetrical and gynecological care
15 Woman's health care provider. Limited health service
16 organizations are subject to the provisions of Section 356r of
17 the Illinois Insurance Code.
18 (Source: P.A. 89-514, eff. 7-17-96.)
19 Section 45. The Illinois Public Aid Code is amended by
20 changing Section 5-16.9 as follows:
21 (305 ILCS 5/5-16.9)
HB5493 - 131 - LRB103 39189 RPS 69335 b
HB5493- 132 -LRB103 39189 RPS 69335 b HB5493 - 132 - LRB103 39189 RPS 69335 b
HB5493 - 132 - LRB103 39189 RPS 69335 b
1 Sec. 5-16.9. Access to obstetrical and gynecological care
2 Woman's health care provider. The medical assistance program
3 is subject to the provisions of Section 356r of the Illinois
4 Insurance Code. The Illinois Department shall adopt rules to
5 implement the requirements of Section 356r of the Illinois
6 Insurance Code in the medical assistance program including
7 managed care components.
8 On and after July 1, 2012, the Department shall reduce any
9 rate of reimbursement for services or other payments or alter
10 any methodologies authorized by this Code to reduce any rate
11 of reimbursement for services or other payments in accordance
12 with Section 5-5e.
13 (Source: P.A. 97-689, eff. 6-14-12.)
14 Section 95. No acceleration or delay. Where this Act makes
15 changes in a statute that is represented in this Act by text
16 that is not yet or no longer in effect (for example, a Section
17 represented by multiple versions), the use of that text does
18 not accelerate or delay the taking effect of (i) the changes
19 made by this Act or (ii) provisions derived from any other
20 Public Act.
21 Section 99. Effective date. This Act takes effect upon
22 becoming law, except that the changes to Sections 356r, 356s,
23 356z.3, and 367a of the Illinois Insurance Code and Section
24 4.5-1 of the Health Maintenance Organization Act take effect
25 January 1, 2025.
HB5493- 133 -LRB103 39189 RPS 69335 b 1 INDEX 2 Statutes amended in order of appearance 3 5 ILCS 375/6.74 55 ILCS 5/5-1069.55 65 ILCS 5/10-4-2.56 105 ILCS 5/10-22.3d7 215 ILCS 5/4from Ch. 73, par. 6168 215 ILCS 5/155.23from Ch. 73, par. 767.239 215 ILCS 5/352from Ch. 73, par. 96410 215 ILCS 5/352b11 215 ILCS 5/356afrom Ch. 73, par. 968a12 215 ILCS 5/356bfrom Ch. 73, par. 968b13 215 ILCS 5/356dfrom Ch. 73, par. 968d14 215 ILCS 5/356efrom Ch. 73, par. 968e15 215 ILCS 5/356ffrom Ch. 73, par. 968f16 215 ILCS 5/356Kfrom Ch. 73, par. 968K17 215 ILCS 5/356Lfrom Ch. 73, par. 968L18 215 ILCS 5/356r19 215 ILCS 5/356s20 215 ILCS 5/356z.321 215 ILCS 5/356z.3322 215 ILCS 5/367afrom Ch. 73, par. 979a23 215 ILCS 5/370efrom Ch. 73, par. 982e24 215 ILCS 5/370ifrom Ch. 73, par. 982i25 215 ILCS 5/408from Ch. 73, par. 1020 HB5493- 134 -LRB103 39189 RPS 69335 b HB5493- 133 -LRB103 39189 RPS 69335 b HB5493 - 133 - LRB103 39189 RPS 69335 b 1 INDEX 2 Statutes amended in order of appearance 3 5 ILCS 375/6.7 4 55 ILCS 5/5-1069.5 5 65 ILCS 5/10-4-2.5 6 105 ILCS 5/10-22.3d 7 215 ILCS 5/4 from Ch. 73, par. 616 8 215 ILCS 5/155.23 from Ch. 73, par. 767.23 9 215 ILCS 5/352 from Ch. 73, par. 964 10 215 ILCS 5/352b 11 215 ILCS 5/356a from Ch. 73, par. 968a 12 215 ILCS 5/356b from Ch. 73, par. 968b 13 215 ILCS 5/356d from Ch. 73, par. 968d 14 215 ILCS 5/356e from Ch. 73, par. 968e 15 215 ILCS 5/356f from Ch. 73, par. 968f 16 215 ILCS 5/356K from Ch. 73, par. 968K 17 215 ILCS 5/356L from Ch. 73, par. 968L 18 215 ILCS 5/356r 19 215 ILCS 5/356s 20 215 ILCS 5/356z.3 21 215 ILCS 5/356z.33 22 215 ILCS 5/367a from Ch. 73, par. 979a 23 215 ILCS 5/370e from Ch. 73, par. 982e 24 215 ILCS 5/370i from Ch. 73, par. 982i 25 215 ILCS 5/408 from Ch. 73, par. 1020 HB5493- 134 -LRB103 39189 RPS 69335 b HB5493 - 134 - LRB103 39189 RPS 69335 b
HB5493- 133 -LRB103 39189 RPS 69335 b HB5493 - 133 - LRB103 39189 RPS 69335 b
HB5493 - 133 - LRB103 39189 RPS 69335 b
1 INDEX
2 Statutes amended in order of appearance
3 5 ILCS 375/6.7
4 55 ILCS 5/5-1069.5
5 65 ILCS 5/10-4-2.5
6 105 ILCS 5/10-22.3d
7 215 ILCS 5/4 from Ch. 73, par. 616
8 215 ILCS 5/155.23 from Ch. 73, par. 767.23
9 215 ILCS 5/352 from Ch. 73, par. 964
10 215 ILCS 5/352b
11 215 ILCS 5/356a from Ch. 73, par. 968a
12 215 ILCS 5/356b from Ch. 73, par. 968b
13 215 ILCS 5/356d from Ch. 73, par. 968d
14 215 ILCS 5/356e from Ch. 73, par. 968e
15 215 ILCS 5/356f from Ch. 73, par. 968f
16 215 ILCS 5/356K from Ch. 73, par. 968K
17 215 ILCS 5/356L from Ch. 73, par. 968L
18 215 ILCS 5/356r
19 215 ILCS 5/356s
20 215 ILCS 5/356z.3
21 215 ILCS 5/356z.33
22 215 ILCS 5/367a from Ch. 73, par. 979a
23 215 ILCS 5/370e from Ch. 73, par. 982e
24 215 ILCS 5/370i from Ch. 73, par. 982i
25 215 ILCS 5/408 from Ch. 73, par. 1020
HB5493- 134 -LRB103 39189 RPS 69335 b HB5493 - 134 - LRB103 39189 RPS 69335 b
HB5493 - 134 - LRB103 39189 RPS 69335 b
HB5493 - 132 - LRB103 39189 RPS 69335 b
HB5493- 133 -LRB103 39189 RPS 69335 b HB5493 - 133 - LRB103 39189 RPS 69335 b
HB5493 - 133 - LRB103 39189 RPS 69335 b
1 INDEX
2 Statutes amended in order of appearance
3 5 ILCS 375/6.7
4 55 ILCS 5/5-1069.5
5 65 ILCS 5/10-4-2.5
6 105 ILCS 5/10-22.3d
7 215 ILCS 5/4 from Ch. 73, par. 616
8 215 ILCS 5/155.23 from Ch. 73, par. 767.23
9 215 ILCS 5/352 from Ch. 73, par. 964
10 215 ILCS 5/352b
11 215 ILCS 5/356a from Ch. 73, par. 968a
12 215 ILCS 5/356b from Ch. 73, par. 968b
13 215 ILCS 5/356d from Ch. 73, par. 968d
14 215 ILCS 5/356e from Ch. 73, par. 968e
15 215 ILCS 5/356f from Ch. 73, par. 968f
16 215 ILCS 5/356K from Ch. 73, par. 968K
17 215 ILCS 5/356L from Ch. 73, par. 968L
18 215 ILCS 5/356r
19 215 ILCS 5/356s
20 215 ILCS 5/356z.3
21 215 ILCS 5/356z.33
22 215 ILCS 5/367a from Ch. 73, par. 979a
23 215 ILCS 5/370e from Ch. 73, par. 982e
24 215 ILCS 5/370i from Ch. 73, par. 982i
25 215 ILCS 5/408 from Ch. 73, par. 1020
HB5493 - 133 - LRB103 39189 RPS 69335 b
HB5493- 134 -LRB103 39189 RPS 69335 b HB5493 - 134 - LRB103 39189 RPS 69335 b
HB5493 - 134 - LRB103 39189 RPS 69335 b
HB5493 - 134 - LRB103 39189 RPS 69335 b