Public Act 098-0226
 
HB1552 EnrolledLRB098 02751 RPM 39104 b

    AN ACT concerning insurance.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Insurance Code is amended by
changing Sections 143, 356z.12, and 1202 as follows:
 
    (215 ILCS 5/143)  (from Ch. 73, par. 755)
    Sec. 143. Policy forms.
    (1) Life, accident and health. No company transacting the
kind or kinds of business enumerated in Classes 1 (a), 1 (b)
and 2 (a) of Section 4 shall issue or deliver in this State a
policy or certificate of insurance or evidence of coverage,
attach an endorsement or rider thereto, incorporate by
reference bylaws or other matter therein or use an application
blank in this State until the form and content of such policy,
certificate, evidence of coverage, endorsement, rider, bylaw
or other matter incorporated by reference or application blank
has been filed electronically with the Director, either through
the System for Electronic Rate and Form Filing (SERFF) or as
otherwise prescribed by the Director, and approved by the
Director. The Department shall mail a quarterly invoice to the
company for the appropriate filing fees required under Section
408. Any such endorsement or rider that unilaterally reduces
benefits and is to be attached to a policy subsequent to the
date the policy is issued must be filed with, reviewed, and
formally approved by the Director prior to the date it is
attached to a policy issued or delivered in this State. It
shall be the duty of the Director to withhold approval of any
such policy, certificate, endorsement, rider, bylaw or other
matter incorporated by reference or application blank filed
with him if it contains provisions which encourage
misrepresentation or are unjust, unfair, inequitable,
ambiguous, misleading, inconsistent, deceptive, contrary to
law or to the public policy of this State, or contains
exceptions and conditions that unreasonably or deceptively
affect the risk purported to be assumed in the general coverage
of the policy. In all cases the Director shall approve or
disapprove any such form within 60 days after submission unless
the Director extends by not more than an additional 30 days the
period within which he shall approve or disapprove any such
form by giving written notice to the insurer of such extension
before expiration of the initial 60 days period. The Director
shall withdraw his approval of a policy, certificate, evidence
of coverage, endorsement, rider, bylaw, or other matter
incorporated by reference or application blank if he
subsequently determines that such policy, certificate,
evidence of coverage, endorsement, rider, bylaw, other matter,
or application blank is misrepresentative, unjust, unfair,
inequitable, ambiguous, misleading, inconsistent, deceptive,
contrary to law or public policy of this State, or contains
exceptions or conditions which unreasonably or deceptively
affect the risk purported to be assumed in the general coverage
of the policy or evidence of coverage.
    If a previously approved policy, certificate, evidence of
coverage, endorsement, rider, bylaw or other matter
incorporated by reference or application blank is withdrawn for
use, the Director shall serve upon the company an order of
withdrawal of use, either personally or by mail, and if by
mail, such service shall be completed if such notice be
deposited in the post office, postage prepaid, addressed to the
company's last known address specified in the records of the
Department of Insurance. The order of withdrawal of use shall
take effect 30 days from the date of mailing but shall be
stayed if within the 30-day period a written request for
hearing is filed with the Director. Such hearing shall be held
at such time and place as designated in the order given by the
Director. The hearing may be held either in the City of
Springfield, the City of Chicago or in the county where the
principal business address of the company is located. The
action of the Director in disapproving or withdrawing such form
shall be subject to judicial review under the Administrative
Review Law.
    This subsection shall not apply to riders or endorsements
issued or made at the request of the individual policyholder
relating to the manner of distribution of benefits or to the
reservation of rights and benefits under his life insurance
policy.
    (2) Casualty, fire, and marine. The Director shall require
the filing of all policy forms issued or delivered by any
company transacting the kind or kinds of business enumerated in
Classes 2 (except Class 2 (a)) and 3 of Section 4 in an
electronic format either through the System for Electronic Rate
and Form Filing (SERFF) or as otherwise prescribed and approved
by the Director. In addition, he may require the filing of any
generally used riders, endorsements, certificates, application
blanks, and other matter incorporated by reference in any such
policy or contract of insurance. The Department shall mail a
quarterly invoice to the company for the appropriate filing
fees required under Section 408. Companies that are members of
an organization, bureau, or association may have the same filed
for them by the organization, bureau, or association. If the
Director shall find from an examination of any such policy
form, rider, endorsement, certificate, application blank, or
other matter incorporated by reference in any such policy so
filed that it (i) violates any provision of this Code, (ii)
contains inconsistent, ambiguous, or misleading clauses, or
(iii) contains exceptions and conditions that will
unreasonably or deceptively affect the risks that are purported
to be assumed by the policy, he shall order the company or
companies issuing these forms to discontinue their use. Nothing
in this subsection shall require a company transacting the kind
or kinds of business enumerated in Classes 2 (except Class 2
(a)) and 3 of Section 4 to obtain approval of these forms
before they are issued nor in any way affect the legality of
any policy that has been issued and found to be in conflict
with this subsection, but such policies shall be subject to the
provisions of Section 442.
    (3) This Section shall not apply (i) to surety contracts or
fidelity bonds, (ii) to policies issued to an industrial
insured as defined in Section 121-2.08 except for workers'
compensation policies, nor (iii) to riders or endorsements
prepared to meet special, unusual, peculiar, or extraordinary
conditions applying to an individual risk.
(Source: P.A. 97-486, eff. 1-1-12.)
 
    (215 ILCS 5/356z.12)
    Sec. 356z.12. Dependent coverage.
    (a) A group or individual policy of accident and health
insurance or managed care plan that provides coverage for
dependents and that is amended, delivered, issued, or renewed
after the effective date of this amendatory Act of the 95th
General Assembly shall not terminate coverage or deny the
election of coverage for an unmarried dependent by reason of
the dependent's age before the dependent's 26th birthday.
    (b) A policy or plan subject to this Section shall, upon
amendment, delivery, issuance, or renewal, establish an
initial enrollment period of not less than 90 days during which
an insured may make a written election for coverage of an
unmarried person as a dependent under this Section. After the
initial enrollment period, enrollment by a dependent pursuant
to this Section shall be consistent with the enrollment terms
of the plan or policy.
    (c) A policy or plan subject to this Section shall allow
for dependent coverage during the annual open enrollment date
or the annual renewal date if the dependent, as of the date on
which the insured elects dependent coverage under this
subsection, has:
        (1) a period of continuous creditable coverage of 90
    days or more; and
        (2) not been without creditable coverage for more than
    63 days.
An insured may elect coverage for a dependent who does not meet
the continuous creditable coverage requirements of this
subsection (c) and that dependent shall not be denied coverage
due to age.
    For purposes of this subsection (c), "creditable coverage"
shall have the meaning provided under subsection (C)(1) of
Section 20 of the Illinois Health Insurance Portability and
Accountability Act.
    (d) Military personnel. A group or individual policy of
accident and health insurance or managed care plan that
provides coverage for dependents and that is amended,
delivered, issued, or renewed after the effective date of this
amendatory Act of the 95th General Assembly shall not terminate
coverage or deny the election of coverage for an unmarried
dependent by reason of the dependent's age before the
dependent's 30th birthday if the dependent (i) is an Illinois
resident, (ii) served as a member of the active or reserve
components of any of the branches of the Armed Forces of the
United States, and (iii) has received a release or discharge
other than a dishonorable discharge. To be eligible for
coverage under this subsection (d), the eligible dependent
shall submit to the insurer a form approved by the Illinois
Department of Veterans' Affairs stating the date on which the
dependent was released from service.
    (e) Calculation of the cost of coverage provided to an
unmarried dependent under this Section shall be identical.
    (f) Nothing in this Section shall prohibit an employer from
requiring an employee to pay all or part of the cost of
coverage provided under this Section.
    (g) No exclusions or limitations may be applied to coverage
elected pursuant to this Section that do not apply to all
dependents covered under the policy.
    (h) A policy or plan subject to this Section shall not
condition eligibility for dependent coverage provided pursuant
to this Section on enrollment in any educational institution.
    (i) Notice regarding coverage for a dependent as provided
pursuant to this Section shall be provided to an insured by the
insurer:
        (1) upon application or enrollment;
        (2) in the certificate of coverage or equivalent
    document prepared for an insured and delivered on or about
    the date on which the coverage commences; and
        (3) (blank) in a notice delivered to an insured on a
    semi-annual basis.
(Source: P.A. 95-958, eff. 6-1-09.)
 
    (215 ILCS 5/1202)  (from Ch. 73, par. 1065.902)
    Sec. 1202. Duties. The Director shall:
    (a) determine the relationship of insurance premiums and
related income as compared to insurance costs and expenses and
provide such information to the General Assembly and the
general public;
    (b) study the insurance system in the State of Illinois,
and recommend to the General Assembly what it deems to be the
most appropriate and comprehensive cost containment system for
the State;
    (c) respond to the requests by agencies of government and
the General Assembly for special studies and analysis of data
collected pursuant to this Article. Such reports shall be made
available in a form prescribed by the Director. The Director
may also determine a fee to be charged to the requesting agency
to cover the direct and indirect costs for producing such a
report, and shall permit affected insurers the right to review
the accuracy of the report before it is released. The fees
shall be deposited into the Statistical Services Revolving Fund
and credited to the account of the Department of Insurance;
    (d) make an interim report to the General Assembly no later
than August 15, 1987, and a annual report to the General
Assembly no later than July 1 April 15 every year thereafter
which shall include the Director's findings and
recommendations regarding its duties as provided under
subsections (a), (b), and (c) of this Section.
(Source: P.A. 91-357, eff. 7-29-99.)