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93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004 HB5929
Introduced 2/6/2004, by Frank J. Mautino SYNOPSIS AS INTRODUCED: |
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215 ILCS 5/531.02 |
from Ch. 73, par. 1065.80-2 |
215 ILCS 5/531.02a new |
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215 ILCS 5/531.03 |
from Ch. 73, par. 1065.80-3 |
215 ILCS 5/531.04 |
from Ch. 73, par. 1065.80-4 |
215 ILCS 5/531.05 |
from Ch. 73, par. 1065.80-5 |
215 ILCS 5/531.06 |
from Ch. 73, par. 1065.80-6 |
215 ILCS 5/531.07 |
from Ch. 73, par. 1065.80-7 |
215 ILCS 5/531.08 |
from Ch. 73, par. 1065.80-8 |
215 ILCS 5/531.09 |
from Ch. 73, par. 1065.80-9 |
215 ILCS 5/531.10 |
from Ch. 73, par. 1065.80-10 |
215 ILCS 5/531.11 |
from Ch. 73, par. 1065.80-11 |
215 ILCS 5/531.12 |
from Ch. 73, par. 1065.80-12 |
215 ILCS 5/531.14 |
from Ch. 73, par. 1065.80-14 |
215 ILCS 5/531.15 |
from Ch. 73, par. 1065.80-15 |
215 ILCS 5/531.17 |
from Ch. 73, par. 1065.80-17 |
215 ILCS 5/531.19 |
from Ch. 73, par. 1065.80-19 |
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Amends the Life and Health Insurance Guaranty Association Article of the
Illinois Insurance Code. Prohibits health care providers from seeking payment
from insureds until a final determination of the Association's liability has
been made. Excludes from coverage certain variable rate instruments. Excludes
from coverage certain self-funded employer and employee benefit plans. Removes
authority of the Association to loan money to an impaired insurer. Sets forth
conditions under which coverage is provided to residents and nonresidents.
Makes changes with respect to the manner assessments are made upon insurers.
Limits the liability of the Association and the Director of Insurance with
respect to the operation of the Association. Effective January 1, 2005.
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| FISCAL NOTE ACT MAY APPLY | |
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A BILL FOR
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HB5929 |
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LRB093 18698 SAS 44426 b |
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| AN ACT concerning insurance.
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| Be it enacted by the People of the State of Illinois, |
3 |
| represented in the General Assembly:
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4 |
| Section 5. The Illinois Insurance Code is amended by | 5 |
| changing Sections
531.02, 531.03,
531.04, 531.05,
531.06, | 6 |
| 531.07, 531.08,
531.09, 531.10,
531.11, 531.12,
531.14, | 7 |
| 531.15,
531.17, and 531.19, and adding Section 531.02a as | 8 |
| follows:
| 9 |
| (215 ILCS 5/531.02) (from Ch. 73, par. 1065.80-2)
| 10 |
| Sec. 531.02. Purpose. The purpose of this Article is to | 11 |
| protect,
subject to certain limitations, the persons specified | 12 |
| in paragraph (1) of
Section 531.03 against failure
in the | 13 |
| performance of contractual obligations, under life and
or
| 14 |
| health
insurance policies, and annuity contracts and health or | 15 |
| medical care
service
contracts specified in paragraph (2) of | 16 |
| Section 531.03, due to the
impairment or insolvency of the
| 17 |
| insurer issuing such policies or contracts. To provide this | 18 |
| protection,
(1) an association of insurers is created to enable | 19 |
| the guaranty of payment
of benefits and of continuation of | 20 |
| coverages as limited by this Article ,
(2) members of the | 21 |
| Association
are subject to assessment to provide funds to carry | 22 |
| out the purpose of this
Article, and (3) the Association is | 23 |
| authorized to assist the Director, in
the prescribed manner, in | 24 |
| the detection and prevention of insurer impairments
or | 25 |
| insolvencies.
| 26 |
| (Source: P.A. 86-753.)
| 27 |
| (215 ILCS 5/531.02a new)
| 28 |
| Sec. 531.02a. Restrictions on recoveries by health care | 29 |
| providers. In the
event of the insolvency of a member insurer, | 30 |
| no provider of health
care
services
shall seek to recover any | 31 |
| amount from any insured until a final determination
has been |
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HB5929 |
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LRB093 18698 SAS 44426 b |
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| 1 |
| made
as to the Association's liability for such services | 2 |
| (including the resolution
of any dispute or
litigation | 3 |
| resulting therefrom).
| 4 |
| In the event that a provider seeks to recover any such | 5 |
| amount before a final
determination of the Association's | 6 |
| liability (or the resolution of any dispute
or litigation
| 7 |
| resulting therefrom) has been made, the provider shall be | 8 |
| liable for all
reasonable costs and
attorney fees incurred by | 9 |
| the Director and the Association in enforcing this
provision or | 10 |
| any court orders related thereto.
| 11 |
| (215 ILCS 5/531.03) (from Ch. 73, par. 1065.80-3)
| 12 |
| Sec. 531.03. Coverage and limitations.
| 13 |
| (1) This Article shall provide
coverage for the policies | 14 |
| and contracts specified in paragraph (2) of this
Section:
| 15 |
| (a) to persons who, regardless of where they reside | 16 |
| (except for
non-resident certificate holders under group | 17 |
| policies or contracts), are the
beneficiaries, assignees | 18 |
| or payees of the persons covered under subparagraph
(1)(b), | 19 |
| and
| 20 |
| (b) to persons who are owners of or certificate holders | 21 |
| under such
policies or contracts (other than unallocated | 22 |
| annuity contracts and
structured settlement annuities) and | 23 |
| in each case
; or, in the case of
unallocated annuity | 24 |
| contracts, to
the persons who are the contract holders, and
| 25 |
| who :
| 26 |
| (i) are residents of this State , or
| 27 |
| (ii) are not residents, but only under all of the | 28 |
| following conditions:
| 29 |
| (A) the insurer
insurers
that
which issued | 30 |
| such
policies or contracts
is
are domiciled
in this | 31 |
| State;
| 32 |
| (B) the states in which such persons reside | 33 |
| have associations
similar to the association | 34 |
| created by this Article
such insurers never held
a | 35 |
| license or certificate of authority in
the states |
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HB5929 |
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LRB093 18698 SAS 44426 b |
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| in which such persons reside ; and
| 2 |
| (C) the persons are not eligible for coverage | 3 |
| by an association in
any other state due to the | 4 |
| fact that the insurer was not licensed in the state
| 5 |
| at the time specified in the state's guaranty | 6 |
| association law.
such states
have associations | 7 |
| similar to the association created
by this Act; and
| 8 |
| (D) such persons are not eligible for coverage | 9 |
| by such
associations.
| 10 |
| (c) For unallocated annuity contracts specified in | 11 |
| paragraph (2) of this
Section,
subparagraphs (a) and (b) of | 12 |
| this paragraph shall not apply, and this Article
shall | 13 |
| (except as
provided in subparagraphs (e) and (f) of this | 14 |
| paragraph) 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 is 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 |
| paragraph (2) of this
Section,
subparagraphs (a) and (b) of | 25 |
| this paragraph shall not apply, and this Article
shall | 26 |
| (except as
provided in subparagraphs (e) and (f) of this | 27 |
| paragraph) provide coverage to a
person who is a
payee | 28 |
| under a structured settlement annuity (or beneficiary of a | 29 |
| payee if the
payee is
deceased), if the payee:
| 30 |
| (i) is a resident, regardless of where the contract | 31 |
| owner resides; or
| 32 |
| (ii) is not a resident, but only under both of the | 33 |
| following conditions:
| 34 |
| (A)(1) the contract owner of the structured | 35 |
| settlement annuity
is a resident, or
| 36 |
| (II) the contract owner of the structured |
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HB5929 |
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LRB093 18698 SAS 44426 b |
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| settlement annuity
is not a resident, but
| 2 |
| the insurer that issued the structured | 3 |
| settlement
annuity is domiciled in this State; and
| 4 |
| the state in which the contract owner resides | 5 |
| has an
association similar to the association | 6 |
| created by this
Article; and
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| (B) neither the payee (or beneficiary) nor the | 8 |
| contract owner is
eligible for coverage by the | 9 |
| association of the state in which the
payee or | 10 |
| contract owner resides.
| 11 |
| (e) This Article shall not provide coverage for:
| 12 |
| (i) a person who is a payee (or beneficiary) of a | 13 |
| contract owner
resident
of this State,
if the payee (or | 14 |
| beneficiary) is afforded any coverage by the | 15 |
| association of
another
state, or
| 16 |
| (ii) a person covered under subparagraph (c) of | 17 |
| this paragraph, if any
coverage is
provided by the | 18 |
| association of another state to or through the trustee | 19 |
| who is
the
contract owner.
| 20 |
| (f) This Article is intended to provide coverage to a | 21 |
| person who is a
resident
of this
State and, in special | 22 |
| circumstances, to a nonresident. In order to avoid
| 23 |
| duplicate coverage, if a
person who would otherwise receive | 24 |
| coverage under this Article is provided
coverage under the
| 25 |
| laws of any other state, the person shall not be provided | 26 |
| coverage under this
Article. In
determining the | 27 |
| application of the provisions of this paragraph in | 28 |
| situations
where a person
could be covered by the | 29 |
| association of more than one state, whether as an
owner, | 30 |
| payee,
beneficiary, or assignee, this Article shall be | 31 |
| construed in conjunction with
other state laws to
result in | 32 |
| coverage by only one association.
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| (2)(a) Except as otherwise provided, this Article shall | 34 |
| provide coverage
to the persons
specified in paragraph (l) of | 35 |
| this Section for direct, (i)
individual or other nongroup life, | 36 |
| health, and annuity and
supplemental policies, or contracts, |
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LRB093 18698 SAS 44426 b |
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| and supplemental contracts to any of
these,
(ii) for
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| certificates under direct group policies or contracts, (iii)
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| and for
unallocated
annuity contracts , in each case issued by | 4 |
| member insurers. "Annuity
contracts" and "certificates under | 5 |
| group annuity contracts" shall have the
meaning set forth in | 6 |
| subdivision (2) of Section 531.05
and (iv) for
contracts to | 7 |
| furnish
health care services and subscription certificates for | 8 |
| medical or health
care services issued by persons licensed to | 9 |
| transact insurance business
in this State under the Illinois | 10 |
| Insurance Code.
Annuity contracts and certificates under group | 11 |
| annuity contracts include
but are not limited to guaranteed | 12 |
| investment contracts, deposit
administration contracts, | 13 |
| unallocated funding agreements, allocated funding
agreements, | 14 |
| structured settlement agreements, lottery contracts
and any | 15 |
| immediate or deferred annuity contracts .
| 16 |
| (b) This Article shall not provide coverage for:
| 17 |
| (i) any
that portion or provision
part of such policies | 18 |
| or
contracts not guaranteed by the insurer, or under which | 19 |
| the
risk is borne by the policy or contract owner
| 20 |
| policyholder ; provided
however, that nothing in this
| 21 |
| subparagraph (2)(b) (i) shall make this Article | 22 |
| inapplicable
to assessment life and
accident and health | 23 |
| insurance policies or contracts; or
| 24 |
| (ii) any such policy or contract or part thereof | 25 |
| assumed by the impaired
or insolvent insurer under a | 26 |
| contract of reinsurance, unless
other than
reinsurance
for | 27 |
| which assumption certificates have been issued pursuant to | 28 |
| the
reinsurance policy or contract by the impaired or | 29 |
| insolvent insurer ; or
| 30 |
| (iii) any interest rate, crediting rate, or similar | 31 |
| factor employed in
calculating returns or changes in value | 32 |
| (whether or not determined by use of an
index or other
| 33 |
| external reference stated in the policy or contract), and | 34 |
| any portion of a
policy or contract to the extent that it | 35 |
| is based on such a rate or factor,
that
any portion of a | 36 |
| policy or contract to the extent such portion
represents an |
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HB5929 |
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LRB093 18698 SAS 44426 b |
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| accrued value that the rate of interest on which it is | 2 |
| accrued
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| (A) averaged over the period of 4
four years prior | 4 |
| to the date
on which
the Association becomes obligated | 5 |
| with respect to such policy or contract,
exceeds a rate | 6 |
| of interest determined by subtracting 2
two percentage
| 7 |
| points
from Moody's Corporate Bond Yield Average | 8 |
| averaged for that same 4
four
year
period or for such | 9 |
| lesser period if the policy or contract was issued less
| 10 |
| than 4
four years before the Association became | 11 |
| obligated; and
| 12 |
| (B) on and after the date on which the Association | 13 |
| becomes obligated
with respect to such policy or | 14 |
| contract, exceeds the rate of interest
determined by | 15 |
| subtracting 3
three percentage points from Moody's
| 16 |
| Corporate
Bond Yield Average on a month-to-month basis
| 17 |
| as most recently
available ; or
| 18 |
| (iv) any provision or portion of a policy or contract | 19 |
| issued to a plan
or program
of an employer, association, or | 20 |
| other person to provide life, health, or
annuity benefits | 21 |
| to
its employees, members, or others, to the extent that | 22 |
| the plan or program is
self-funded
or uninsured, including | 23 |
| but not limited to benefits payable by an employer,
| 24 |
| association,
or other person under:
| 25 |
| (A) a multiple-employer welfare arrangement as | 26 |
| defined in 29 U.S.C.
1144;
| 27 |
| (B) a minimum premium group insurance plan;
| 28 |
| (C) a stop-loss group insurance plan and any | 29 |
| stop-loss insurance, as
defined in clause (b) of Class | 30 |
| 1 or clause (a) of Class 2 of Section 4, and
further
| 31 |
| defined in subsection (d) of Section 352;
| 32 |
| (D) an administrative services only contract; or
| 33 |
| (E) a cost-plus contract; or
| 34 |
| (v) any provision or portion of a policy or contract to | 35 |
| the extent that it
provides:
| 36 |
| (A) dividends or experience rating credits which, |
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HB5929 |
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LRB093 18698 SAS 44426 b |
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| in each case, were not
paid or credited as of the date | 2 |
| of impairment or insolvency, whichever is
earlier;
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| (B) voting rights;
| 4 |
| (C) obligations to report to the policy owner or | 5 |
| contract owner more
frequently than annually;
| 6 |
| (D) payment of any fees or allowances to any | 7 |
| person, including the
policy
or contract owner, in | 8 |
| connection with the service to or administration of the
| 9 |
| policy
or contract; or
| 10 |
| (E) other nonmonetary obligations; or
| 11 |
| (vi)
(iv) any unallocated annuity contract issued to or | 12 |
| in
connection with a
an employee
benefit plan
the | 13 |
| beneficiaries of which are protected by
protected under the | 14 |
| federal
Pension Benefit Guaranty Corporation law, | 15 |
| regardless of whether the federal
Pension Benefit Guaranty | 16 |
| Corporation has yet become liable to make any payments
with | 17 |
| respect to the benefit plan ; or
| 18 |
| (vii)
(v) any portion of any unallocated annuity | 19 |
| contract which
is not issued
to or in connection with a | 20 |
| specific employee, union or association of
natural persons | 21 |
| benefit plan or a government lottery; or
| 22 |
| (viii)
(vi)
any policy or contract or portion thereof | 23 |
| issued
by any burial society organized under Article XIX of | 24 |
| this Code
Act ,
any
fraternal benefit society organized | 25 |
| under Article XVII of this Code
Act , any
mutual benefit | 26 |
| association organized under Article XVIII of this
Code
Act , | 27 |
| and any foreign fraternal benefit society licensed under
| 28 |
| Article
VI of this Code
Act ; or
| 29 |
| (ix)
(vii)
any policy or contract or portion thereof | 30 |
| issued
by any health maintenance organization established
| 31 |
| pursuant to the Health
Maintenance Organization Act
| 32 |
| including any health maintenance organization business of | 33 |
| a member insurer; or
| 34 |
| (x)
(viii)
any policy or contract or portion thereof | 35 |
| issued
by any health services plan corporation established | 36 |
| pursuant to the
Voluntary Health Services Plans Act;
or
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LRB093 18698 SAS 44426 b |
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| (ix) (blank); or
| 2 |
| (xi)
(x)
any policy or contract or portion thereof | 3 |
| issued by
any dental service plan corporation established
| 4 |
| pursuant to the Dental
Service Plan Act; or
| 5 |
| (xi) any stop-loss insurance, as defined in clause (b) | 6 |
| of Class 1 or
clause (a) of Class 2 of Section 4, and | 7 |
| further defined in subsection (d) of
Section 352; or
| 8 |
| (xii) any
that portion or part of a variable life | 9 |
| insurance or
variable
annuity
policy or contract not | 10 |
| guaranteed by an insurer ; or .
| 11 |
| (xiii) any policy or contract or portion thereof to the | 12 |
| extent that
assessments with
respect to such policy or | 13 |
| contract or portion thereof are prohibited or
preempted by
| 14 |
| federal or state law; or
| 15 |
| (xiv) any obligation that does not arise under the | 16 |
| express written terms
of
the
policy or contract issued by | 17 |
| the insurer to the contract owner or policy owner,
| 18 |
| including
without limitation:
| 19 |
| (A) claims based on marketing materials;
| 20 |
| (B) claims based on side letters, riders, or other | 21 |
| documents that were
issued
by
the insurer without | 22 |
| meeting applicable policy or contract form filing or
| 23 |
| approval requirements;
| 24 |
| (C) misrepresentations of or regarding policy or | 25 |
| contract benefits;
| 26 |
| (D) extra-contractual claims;
| 27 |
| (E) a claim for penalties or consequential or | 28 |
| incidental damages; or
| 29 |
| (xv) any contractual agreement that establishes the | 30 |
| member insurer's
obligations to
provide a book value | 31 |
| accounting guaranty for defined contribution benefit plan
| 32 |
| participants by
reference to a portfolio of assets that is | 33 |
| owned by the benefit plan or its
trustee, which in each
| 34 |
| case is not an affiliate of the member insurer; or
| 35 |
| (xvi) any portion of a policy or contract that, on the | 36 |
| date the
Association
becomes
obligated, exceeds in value |
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LRB093 18698 SAS 44426 b |
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| the maximum benefit levels specified in paragraph
(3)(b) of | 2 |
| this
Section; or
| 3 |
| (xvii) any portion of a policy or contract to the | 4 |
| extent it provides for
interest or other
changes in value | 5 |
| to be determined by the use of an index or other external
| 6 |
| reference stated in
the policy or contract, but which have | 7 |
| not been credited to the policy or
contract, or as to
which | 8 |
| the policy or contract owner's rights are subject to | 9 |
| forfeiture, as of
the date the member
insurer becomes an | 10 |
| impaired or insolvent insurer under this Article, | 11 |
| whichever
is earlier. If a
policy's or contract's interest | 12 |
| or changes in value are credited less
frequently than | 13 |
| annually,
then for purposes of determining the values that | 14 |
| have been credited and are not
subject to
forfeiture under | 15 |
| this subdivision 531.03(2)(b)(xvii), the interest or | 16 |
| change in
value determined by
using the procedures defined | 17 |
| in the policy or contract shall be credited as if
the | 18 |
| contractual date
of crediting interest or changing values | 19 |
| was the date of impairment or
insolvency, whichever is
| 20 |
| earlier, and shall not be subject to forfeiture; or
| 21 |
| (xviii) a policy or contract issued in this State by a | 22 |
| member insurer
at a
time when it
was not licensed or did | 23 |
| not have a certificate of authority to issue the policy
or | 24 |
| contract in this
State.
| 25 |
| (3) The benefits that
for which the Association may become
| 26 |
| obligated to cover
liable shall in
no event exceed the lesser | 27 |
| of:
| 28 |
| (a) the contractual obligations for which the insurer | 29 |
| is liable or would
have been liable if it were not an | 30 |
| impaired or insolvent insurer, or
| 31 |
| (b)(i) with respect to any one life, regardless of the | 32 |
| number of policies
or
contracts:
| 33 |
| (A) $300,000 in life insurance death benefits, but | 34 |
| not more than
$100,000 in net cash surrender and net | 35 |
| cash withdrawal values for life
insurance;
| 36 |
| (B) $300,000 in health insurance benefits, |
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LRB093 18698 SAS 44426 b |
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| including any net cash
surrender and net cash | 2 |
| withdrawal values;
| 3 |
| (C) $100,000 in the present value of annuity | 4 |
| benefits, including net
cash surrender and net cash | 5 |
| withdrawal values;
| 6 |
| (ii) with respect to each individual participating in a | 7 |
| governmental
retirement benefit plan established under | 8 |
| Section 401, 403(b) or 457 of the
United States
U.S.
| 9 |
| Internal Revenue Code covered by an unallocated annuity | 10 |
| contract or the
beneficiaries of each such individual if | 11 |
| deceased, in the aggregate,
$100,000 in present value | 12 |
| annuity benefits, including net cash surrender
and net cash | 13 |
| withdrawal values; provided, however, that in no event | 14 |
| shall
the Association be liable to expend more than | 15 |
| $300,000 in the aggregate
with respect to any one | 16 |
| individual under subparagraph (1) and this
subparagraph;
| 17 |
| (iii) with respect to each payee of a structured | 18 |
| settlement annuity
contract
(or
the beneficiary or | 19 |
| beneficiaries of the payee if deceased), $100,000 in the
| 20 |
| present value
of annuity benefits, in the aggregate | 21 |
| including net cash surrender and net cash
withdrawal | 22 |
| values;
| 23 |
| (iv) provided, however, that in no event shall the | 24 |
| Association be liable
to expend more than $300,000 in the | 25 |
| aggregate with respect any one life under
subparagraphs | 26 |
| (3)(b)(i), (ii), and (iii);
| 27 |
| (v) with respect to one owner of multiple non-group | 28 |
| policies or
contracts of
life
insurance, whether the policy | 29 |
| owner is an individual, firm, corporation, or
other person,
| 30 |
| and whether the persons insured are officers, managers, | 31 |
| employees, or other
persons,
$5,000,000 in benefits, | 32 |
| regardless of the number of policies and contracts held
by | 33 |
| the
owner;
| 34 |
| (vi)
(iii) with respect to either (i) one contract | 35 |
| owner
provided coverage
under subparagraph (1)(c)(ii) of | 36 |
| this Section; or (ii)
any one plan
sponsor whose plans own |
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LRB093 18698 SAS 44426 b |
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| directly or in trust one or more
contract holder
covered by | 2 |
| any
unallocated
annuity contracts
contract not included in | 3 |
| subparagraph (3)(b)(ii) of
this Section
above , $5,000,000
| 4 |
| in benefits, irrespective of the number of such contracts | 5 |
| held by that contract
owner or plan sponsor;
holder .
| 6 |
| provided, however, that in the case where one or more
| 7 |
| unallocated
annuity contracts not included in subparagraph | 8 |
| (3)(b)(ii) of this Section are
covered
contracts under this | 9 |
| Article and are owned by a trust or other entity for the
| 10 |
| benefit of
2 or more plan sponsors, coverage shall be | 11 |
| afforded by the Association if the
largest
interest in the | 12 |
| trust or entity owning the contract or contracts is held by | 13 |
| a
plan sponsor
whose principal place of business is in this | 14 |
| State and in no event shall the
Association
be obligated to | 15 |
| cover more than $5,000,000 in benefits with respect to all
| 16 |
| these
unallocated contracts; and provided further that | 17 |
| where one or more unallocated
annuity
contracts not | 18 |
| included in subparagraph (3)(b)(ii) of this Section are | 19 |
| owned by
a benefit
plan, or the trustee of a benefit plan, | 20 |
| with fewer than 50 participants, the
Association
shall not | 21 |
| be liable for an amount that in the aggregate is greater | 22 |
| than
$100,000 times
the number of individuals who are | 23 |
| participants in the benefit plan;
| 24 |
| (vii) The limitations set forth in this paragraph (3) | 25 |
| are limitations on
the
coverage for which the Association | 26 |
| is obligated before taking into account
either its
| 27 |
| subrogation and assignment rights or the extent to which | 28 |
| such coverage could be
provided out of the assets of the | 29 |
| impaired or insolvent insurer attributable to
covered
| 30 |
| policies or contracts. The costs of the Association's | 31 |
| obligations under this
Article may be
met by the use of | 32 |
| assets attributable to covered policies or contracts or
| 33 |
| reimbursed to
the Association pursuant to its subrogation | 34 |
| and assignment rights.
| 35 |
| (4) In performing its obligations to provide coverage under | 36 |
| Section 531.08
of
this
Article, the Association shall not be |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| required to guarantee, assume, reinsure,
or perform, or
cause | 2 |
| to be guaranteed, assumed, reinsured, or performed, the | 3 |
| contractual
obligations of the
insolvent or impaired insurer | 4 |
| under a covered policy or contract that do not
materially | 5 |
| affect
the economic values or economic benefits of the covered | 6 |
| policy or contract.
| 7 |
| (Source: P.A. 90-177, eff. 7-23-97; 91-357, eff. 7-29-99.)
| 8 |
| (215 ILCS 5/531.04) (from Ch. 73, par. 1065.80-4)
| 9 |
| Sec. 531.04. Construction. ) This Article is to be liberally
| 10 |
| construed to
effect the purpose established under Section | 11 |
| 531.02 which constitutes an
aid and guide to
interpretation .
| 12 |
| (Source: P.A. 81-899.)
| 13 |
| (215 ILCS 5/531.05) (from Ch. 73, par. 1065.80-5)
| 14 |
| Sec. 531.05. Definitions. As used in this Act:
| 15 |
| (1) "Account" means either of the 2
3 accounts created | 16 |
| under Section
531.06.
| 17 |
| (2) "Annuity contracts" and "certificates under group | 18 |
| annuity contracts"
include but
are not limited to guaranteed | 19 |
| investment contracts, deposit administration
contracts,
| 20 |
| unallocated funding agreements, allocated funding agreements, | 21 |
| structured
settlement
annuities, annuities issued to or in | 22 |
| connection with government lotteries, and
any immediate
or | 23 |
| deferred annuity contracts.
| 24 |
| (3)
(2) "Association" means the Illinois Life and Health | 25 |
| Insurance
Guaranty Association created under Section 531.06.
| 26 |
| (3) "Director" means the Director of Insurance of this | 27 |
| State.
| 28 |
| (4) "Authorized assessment" or the term "authorized" when | 29 |
| used in the
context of
assessments means a resolution by the | 30 |
| board of directors has been passed
whereby an
assessment may be | 31 |
| called immediately or in the future from member insurers for
a | 32 |
| specified
amount. An assessment is authorized when the | 33 |
| resolution is passed or, where the
terms of the
resolution | 34 |
| specify an effective date, on such effective date.
|
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| (5) "Benefit plan" means a plan for the provision of | 2 |
| pension, severance,
health, or
other benefits sponsored by one | 3 |
| or more specific employers, unions, or
associations of natural
| 4 |
| persons.
| 5 |
| (6) "Board" or "board of directors" means the board of | 6 |
| directors of the
Association.
| 7 |
| (7) "Called assessment" or the term "called" when used in | 8 |
| the context of
assessments
means that a notice has been issued | 9 |
| by the Association to member insurers
requiring that all
or | 10 |
| part of an authorized assessment be paid at such time and | 11 |
| subject to such
conditions as are
set forth within the notice. | 12 |
| An authorized assessment becomes a called
assessment when
| 13 |
| notice is mailed by the Association to member insurers.
| 14 |
| (8) "Certificates under group annuity contracts" is | 15 |
| defined in paragraph (2)
of this Section.
| 16 |
| (9)
(4) "Contractual obligation" means any obligation | 17 |
| under a
policy or
contract or certificate under a group policy | 18 |
| or contract, or portion
thereof for which coverage is provided | 19 |
| under Section 531.03.
| 20 |
| (10)
(5) "Covered person" means any person who is entitled | 21 |
| to the
protection of the Association as described in Section | 22 |
| 531.02.
| 23 |
| (11)
(6) "Covered policy" means any policy or contract or | 24 |
| portion
of a policy or contract for which coverage is provided
| 25 |
| within the scope
of this Article under Section 531.03.
| 26 |
| (12) "Director" means the Director of Insurance of this | 27 |
| State.
| 28 |
| (13) "Extra-contractual claim" includes, for example, | 29 |
| claims relating to bad
faith in the payment or adjudication of | 30 |
| claims, claims for punitive or
exemplary damages or attorney's | 31 |
| fees and costs, and claims for breaches of
statutory or | 32 |
| fiduciary duty.
| 33 |
| (14)
(7) "Impaired insurer" means a member insurer | 34 |
| determined
deemed by the Director
in a written notice to the | 35 |
| Association after the effective date of this
Article to be | 36 |
| potentially unable to
fulfill its contractual obligations and |
|
|
|
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LRB093 18698 SAS 44426 b |
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| 1 |
| not an insolvent insurer.
| 2 |
| (15)
(8) "Insolvent insurer" means (a) a member insurer
| 3 |
| that is found to be
either at the time the policy was issued or | 4 |
| when the
insured event
occurred, or any company which has | 5 |
| acquired such direct policy obligations
through purchase, | 6 |
| merger, consolidation, reinsurance or otherwise, whether
or | 7 |
| not such acquiring company held a certificate of authority to | 8 |
| transact
insurance in this State at the time such policy was | 9 |
| issued or when the
insured event occurred; and (b) becomes
| 10 |
| insolvent , and is placed under a
final order of liquidation, | 11 |
| rehabilitation , or conservation by a court of
competent | 12 |
| jurisdiction.
| 13 |
| (16)
(9) "Member insurer" means any person licensed or that
| 14 |
| who holds a
certificate
of authority to transact in this
State | 15 |
| any kind of insurance business to which this Article applies | 16 |
| under
Section 531.03. For purposes of this Article "member | 17 |
| insurer" includes
any person whose certificate of authority may | 18 |
| have been suspended pursuant
to Section 119 , revoked, | 19 |
| voluntarily withdrawn, or not renewed subsequent to
the date on | 20 |
| which a member insurer became an impaired insurer or an | 21 |
| insolvent
insurer, whichever is earlier. "Member insurer" does | 22 |
| not include any of the
following: .
| 23 |
| (a) a mandatory State pooling plan;
| 24 |
| (b) an insurance exchange;
| 25 |
| (c) an organization (other than an insurer authorized | 26 |
| to transact business
in this State) issuing charitable gift | 27 |
| annuities; or
| 28 |
| (d) any entity similar to any of the above.
| 29 |
| (17)
(10) "Moody's Corporate Bond Yield Average" means the | 30 |
| Monthly
Average
Corporates as published by Moody's Investors | 31 |
| Service, Inc., or any successor
thereto.
| 32 |
| (18) "Owner" of a policy or contract and "policy owner" and | 33 |
| "contract
owner"
mean the
person who is identified as the legal | 34 |
| owner under the terms of the policy or
contract or who is
| 35 |
| otherwise vested with legal title to the policy or contract | 36 |
| through a valid
assignment completed
in accordance with the |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| terms of the policy or contract and properly recorded as
the | 2 |
| owner on
the books of the insurer. The terms "owner", "contract | 3 |
| owner", and "policy
owner" do not
include persons with a mere | 4 |
| beneficial interest in a policy or contract.
| 5 |
| (19) "Person" means any individual, corporation, trust, | 6 |
| limited liability
company, partnership, association, | 7 |
| governmental body or entity, or voluntary
organization.
| 8 |
| (20) "Plan sponsor" means:
| 9 |
| (a) the employer in the case of a benefit plan | 10 |
| established or maintained
by a
single employer;
| 11 |
| (b) the employee organization in the case of a benefit | 12 |
| plan established or
maintained by an employee | 13 |
| organization; or
| 14 |
| (c) in a case of a benefit plan established or | 15 |
| maintained by 2 or
more
employers or jointly by one or more | 16 |
| employers and one or more employee
organizations, the | 17 |
| association, committee, joint board of trustees, or other
| 18 |
| similar group of representatives of the parties who | 19 |
| establish or maintain the
benefit plan.
| 20 |
| (21)
(11) "Premiums" means direct gross insurance | 21 |
| premiums ,
or
subscriptions , or
and annuity
considerations (by | 22 |
| whatever name called) received on covered policies or
| 23 |
| contracts, less returned
return premiums ,
and
considerations , | 24 |
| and deposits
thereon and less dividends and
experience credits
| 25 |
| paid or credited to policy or contract owners
policyholders
on | 26 |
| such direct business. "Premiums" do not include premiums and
| 27 |
| considerations on contracts between insurers and reinsurers.
| 28 |
| "Premiums" do not include any amounts or considerations
| 29 |
| received for any
policies or
contracts or for the portions of | 30 |
| any policies or contracts for which
coverage is not provided | 31 |
| under paragraph (2) of Section 531.03 except that
assessable | 32 |
| premium shall not be reduced on account of subparagraph
| 33 |
| (2)(b)(iii) of Section 531.03 relating to interest limitations | 34 |
| and
subparagraph (3)(b) of Section 531.03 relating to | 35 |
| limitations with respect
to any one life, any one individual, | 36 |
| any one participant , and any one
policy or contract owner.
|
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| contractholder;
provided that "Premiums" shall not include :
| 2 |
| (a) any premiums in excess of $5,000,000
five
million | 3 |
| dollars on any unallocated annuity contract not issued | 4 |
| under a
governmental retirement benefit plan (or its | 5 |
| trustee) established under
Sections 401, 403(b) or 457
of | 6 |
| the United States Internal Revenue Code ; or .
| 7 |
| (b) with respect to multiple non-group policies or | 8 |
| contracts of life
insurance
owned by one owner, whether the | 9 |
| policy or contract owner is an individual,
firm,
| 10 |
| corporation, or other person, and whether the persons | 11 |
| insured are officers,
managers,
employees, or other | 12 |
| persons, premiums in excess of $5,000,000 with respect to
| 13 |
| these
policies or contracts, regardless of the number of | 14 |
| policies or contracts held
by the owner.
| 15 |
| (12) "Person" means any individual, corporation, | 16 |
| partnership,
association or voluntary organization.
| 17 |
| (22) "Principal place of business" of a plan sponsor or a | 18 |
| person other
than a
natural
person means the single state in | 19 |
| which the natural persons who establish policy
for the
| 20 |
| direction, control, and coordination of the operations of the | 21 |
| entity as a whole
primarily exercise
that function, determined | 22 |
| by the Association in its reasonable judgment by
considering | 23 |
| the
following factors:
| 24 |
| (a) the state in which the primary executive and | 25 |
| administrative
headquarters
of
the entity are located;
| 26 |
| (b) the state in which the principal office of the | 27 |
| chief executive officer
of
the
entity is located;
| 28 |
| (c) the state in which the board of directors (or | 29 |
| similar governing person
or
persons) of the entity conducts | 30 |
| the majority of its meetings;
| 31 |
| (d) the state in which the executive or management | 32 |
| committee of the board
of
directors (or similar governing | 33 |
| person or persons) of the entity conducts the
majority of
| 34 |
| its meetings;
| 35 |
| (e) the state from which the management of the overall | 36 |
| operations of the
entity
is directed; and
|
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| (f) in the case of a benefit plan sponsored by | 2 |
| affiliated companies
comprising
a
consolidated | 3 |
| corporation, the state in which the holding company or | 4 |
| controlling
affiliate
has its principal place of business | 5 |
| as determined using the above factors.
| 6 |
| However, in the case of a plan sponsor, if more than 50% of | 7 |
| the
participants in the
benefit plan are employed in a single | 8 |
| state, that state shall be deemed to be
the principal place
of | 9 |
| business of the plan sponsor; except that the principal place | 10 |
| of business of
a plan sponsor
of a benefit plan described in | 11 |
| paragraph (20)(c) of this Section shall be
deemed to be the
| 12 |
| principal place of business of the association, committee, | 13 |
| joint board of
trustees, or other
similar group of | 14 |
| representatives of the parties who establish or maintain the
| 15 |
| benefit plan;
provided, however, that in the absence of a | 16 |
| specific or clear designation of
such a principal
place of | 17 |
| business, the principal place of business shall be deemed to be | 18 |
| the
principal place of
business of the employer or employee | 19 |
| organization that has the largest
investment in the
benefit | 20 |
| plan in question.
| 21 |
| (23) "Receivership court" means the court in the insolvent | 22 |
| or impaired
insurer's state
of domicile having jurisdiction | 23 |
| over the conservation, rehabilitation, or
liquidation of the
| 24 |
| insurer.
| 25 |
| (24)
(13) "Resident" means any person
to whom a contractual | 26 |
| obligation
is owed and,
except in the case of a contract owner | 27 |
| of an unallocated annuity contract
issued to a benefit
plan or | 28 |
| trustee of a benefit plan,
who resides in this State
on the | 29 |
| date the
Director determines a member insurer to be an impaired | 30 |
| insurer or a court order
determines a
member insurer to be an | 31 |
| insolvent insurer, whichever occurs first. In the case
of an
| 32 |
| unallocated annuity contract issued to a benefit plan, or the | 33 |
| trustee of a
benefit plan, the
contract owner shall be a | 34 |
| "resident" of the state in which the principal place
of | 35 |
| business of the
plan sponsor was located on such date
at the
| 36 |
| time the insurer is determined to be impaired or insolvent and |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| to whom
contractual obligations are owed .
A person may be a | 2 |
| resident of only one state which, in the case of a
person other | 3 |
| than a natural person, shall be its principal place of | 4 |
| business.
Citizens of the United States that are either (i) | 5 |
| residents of foreign
countries or (ii) residents of
United | 6 |
| States possessions, territories, or protectorates that do not | 7 |
| have an
association similar
to the Association shall be deemed | 8 |
| residents of the state of domicile of the
insurer that issued
| 9 |
| the policies or contracts.
| 10 |
| (25) "State" means a state, the District of Columbia, | 11 |
| Puerto Rico, and a
United States
possession, territory, or | 12 |
| protectorate.
| 13 |
| (26) "Structured settlement annuity contract" means an | 14 |
| annuity contract
purchased in
order to fund periodic payments | 15 |
| for a plaintiff or other claimant in payment
for or with | 16 |
| respect
to personal injury suffered by the plaintiff or other | 17 |
| claimant.
| 18 |
| (27) "Subaccount" means any of the 3 subaccounts of the | 19 |
| life insurance
and
annuity account created under subdivision | 20 |
| (1) of 531.06.
| 21 |
| (28)
(14) "Supplemental contract" means any written
| 22 |
| agreement
entered into for
the
distribution of proceeds under a | 23 |
| life, health, or annuity policy or
contract
proceeds .
| 24 |
| (29)
(15) "Unallocated annuity contract" means any annuity | 25 |
| contract
or group
annuity certificate which is not issued to | 26 |
| and owned by an individual,
except to the extent of any annuity | 27 |
| benefits guaranteed to an individual by
an insurer under such | 28 |
| contract or certificate.
| 29 |
| (Source: P.A. 86-753.)
| 30 |
| (215 ILCS 5/531.06) (from Ch. 73, par. 1065.80-6)
| 31 |
| Sec. 531.06. Creation of the Association. There is created | 32 |
| a
non-profit legal entity to be known as the Illinois Life and | 33 |
| Health
Insurance Guaranty Association. All member insurers are | 34 |
| and must remain
members of the Association as a condition of | 35 |
| their authority to transact
insurance in this State. The |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| Association must perform its functions under
the plan of | 2 |
| operation established and approved under Section 531.10 and | 3 |
| must
exercise its powers through a board of directors | 4 |
| established under
Section 531.07. For purposes of | 5 |
| administration and assessment, the Association
must maintain 2 | 6 |
| accounts:
| 7 |
| (1) The life insurance and annuity account which includes | 8 |
| the following
subaccounts:
| 9 |
| (a) Life insurance account;
| 10 |
| (b) Annuity account
which shall include annuity contracts | 11 |
| owned by a
governmental retirement plan (or its trustee) | 12 |
| established under Section 401,
403(b), or
457 of the United | 13 |
| States Internal Revenue Code, but shall otherwise exclude
| 14 |
| unallocated
annuity contracts ; and
| 15 |
| (c) Unallocated annuity account which shall
exclude | 16 |
| contracts owned by a
governmental retirement benefit plan (or | 17 |
| its trustee) established under Section
401,
403(b), or 457 of | 18 |
| the United States Internal Revenue Code
include contracts | 19 |
| qualified
under Section 403(b) of the United State Internal | 20 |
| Revenue Code .
| 21 |
| (2) The health insurance account.
| 22 |
| The Association shall be supervised by the Director
and is | 23 |
| subject to the applicable provisions of the Illinois Insurance
| 24 |
| Code.
| 25 |
| (Source: P.A. 86-753.)
| 26 |
| (215 ILCS 5/531.07) (from Ch. 73, par. 1065.80-7)
| 27 |
| Sec. 531.07. Board of Directors. ) The board of directors of | 28 |
| the
Association consists of not less than 5 nor more than 9 | 29 |
| members serving
terms as established in the plan of operation. | 30 |
| The members of the board
are to be selected by member insurers | 31 |
| subject to the approval of the
Director. Vacancies on the board | 32 |
| must be filled for the remaining period
of the term in the | 33 |
| manner described in the plan of operation. To select
the | 34 |
| initial board of directors, and initially organize the | 35 |
| Association,
the Director must give notice to all member |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| insurers of the time and
place of the organizational meeting. | 2 |
| In determining voting rights at the
organizational meeting each | 3 |
| member insurer is entitled to one vote in
person or by proxy. | 4 |
| If the board of directors is not selected within
60 days after | 5 |
| notice of the organizational meeting, the Director may
appoint | 6 |
| the initial members.
| 7 |
| In approving selections or in appointing members to the | 8 |
| board, the
Director must consider , whether all member insurers | 9 |
| are
fairly represented.
| 10 |
| Members of the board may be reimbursed from the assets of | 11 |
| the Association
for expenses incurred by them as members of the | 12 |
| board of directors but
members of the board may not otherwise | 13 |
| be compensated by the Association for
their services.
| 14 |
| (Source: P.A. 81-899.)
| 15 |
| (215 ILCS 5/531.08) (from Ch. 73, par. 1065.80-8)
| 16 |
| Sec. 531.08. Powers and duties of the Association. In | 17 |
| addition to
the powers and duties enumerated in other Sections | 18 |
| of this Article:
| 19 |
| (1) If an
a domestic insurer is an impaired insurer, | 20 |
| the Association
may, in its discretion and subject to any | 21 |
| conditions imposed by the Association other than
those | 22 |
| which impair the contractual obligations of the impaired | 23 |
| insurer ,
and approval
approved by the impaired insurer and | 24 |
| the Director:
| 25 |
| (a) Guarantee , assume, or reinsure, or cause to be | 26 |
| guaranteed, assumed , or
reinsured, any or all of the | 27 |
| covered policies of covered persons of the
impaired | 28 |
| insurer;
| 29 |
| (b) Provide such monies, pledges, notes, | 30 |
| guarantees, or other means
as are proper to effectuate | 31 |
| subparagraph
paragraph
(1) (a), and assure payment of | 32 |
| the
contractual obligations of the impaired insurer | 33 |
| pending action under
subparagraph
paragraph
(1) (a) . ;
| 34 |
| ( c) Loan money to the impaired insurer;
| 35 |
| (2) If an
a domestic, foreign, or alien insurer is an |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| insolvent
insurer, the Association
shall, in its | 2 |
| discretion, either
subject to the approval of the Director;
| 3 |
| (a)(i) Guarantee, assume , or reinsure or cause to | 4 |
| be guaranteed,
assumed, or reinsured the covered | 5 |
| policies of covered persons of the
insolvent insurer; | 6 |
| or
| 7 |
| (ii) Otherwise assure
Assure payment of the | 8 |
| contractual obligations of the insolvent
insurer to | 9 |
| covered persons; and
| 10 |
| (iii) Provide such monies, pledges, loans, notes, | 11 |
| guaranties, or other means
as are reasonably necessary | 12 |
| to discharge such duties under subparagraphs (2)(a)(i) | 13 |
| and (2)(a)(ii) ; or
| 14 |
| (b) Provide
with respect to only life and health | 15 |
| insurance policies, provide
benefits and coverages in | 16 |
| accordance with Section 531.08(3).
| 17 |
| (c) Provided however
that this paragraph
| 18 |
| subsection (2) shall not apply when the Director has | 19 |
| determined
that the foreign or alien insurer's
| 20 |
| insurers domiciliary jurisdiction or state of
entry | 21 |
| provides, by statute, protection substantially similar | 22 |
| to that
provided by this Article for residents of this | 23 |
| State and such protection
will be provided in a timely | 24 |
| manner.
| 25 |
| (3) When proceeding under subparagraph (2)(b) of this | 26 |
| Section the
Association shall, with respect to only life | 27 |
| and health insurance policies and annuity contracts :
| 28 |
| (a) assure payment of benefits for premiums | 29 |
| identical to the premiums
and benefits (except for | 30 |
| terms of conversion and renewability) that would
have | 31 |
| been payable under the policies or contracts of the | 32 |
| insolvent insurer, for claims
incurred:
| 33 |
| (i) with respect to group policies and | 34 |
| contracts , not later than the earlier of the
next | 35 |
| renewal date under such policies or contracts or 60
| 36 |
| sixty days, but in no
event less than 30
thirty
|
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| days, after the date on which the Association
| 2 |
| becomes obligated with respect to such policies | 3 |
| and contracts ;
| 4 |
| (ii) with respect to individual and other
| 5 |
| non-group policies and contracts , not later than | 6 |
| the earlier of
the next renewal date (if any) under | 7 |
| such policies or contracts or one year, but in no
| 8 |
| event less than 30
thirty days, from the date on | 9 |
| which the Association becomes
obligated with | 10 |
| respect to such policies or contracts ;
| 11 |
| (b) make diligent efforts to provide all known | 12 |
| policy and contract owners 30
insureds or group
| 13 |
| policyholders with respect to group policies thirty
| 14 |
| days notice of the
termination (pursuant to | 15 |
| subparagraph (3)(a)) of the benefits provided; and
| 16 |
| (c) with respect to individual and other non-group | 17 |
| life and health policies and annuity contracts covered | 18 |
| by the Association , make available to each known
| 19 |
| insured, or owner if other than the insured or | 20 |
| annuitant , and with respect to an
individual formerly | 21 |
| insured or formerly an annuitant under a group policy | 22 |
| on contract who is not eligible for
replacement group | 23 |
| coverage, make available substitute coverage on an
| 24 |
| individual basis in accordance with the provisions of | 25 |
| subparagraph (3)(d) of
this Section, if the insureds or | 26 |
| annuitants had a right under law or the terminated
| 27 |
| policy or annuity contract to convert coverage to | 28 |
| individual coverage or to continue a
an individual
| 29 |
| non-group policy or annuity contract in force until a | 30 |
| specified age or for a specified time,
during which the | 31 |
| insurer has no right unilaterally to make changes in | 32 |
| any
provision of the policy or annuity contract or had | 33 |
| a right only to make changes in premium by
class.
| 34 |
| (d)(i) In providing the substitute coverage | 35 |
| required under subparagraph
(3)(c) of this Section, | 36 |
| the Association may offer either to reissue the
|
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| terminated coverage or to issue an alternative policy | 2 |
| or contract .
| 3 |
| (ii) Alternative or reissued policies or contracts
| 4 |
| shall be offered without requiring
evidence of | 5 |
| insurability, and shall not provide for any waiting | 6 |
| period or
exclusion that would not have applied under | 7 |
| the terminated policy or contract .
| 8 |
| (iii) The Association may cause
reinsure any | 9 |
| alternative or reissued policy or contract to be | 10 |
| assumed or reinsured .
| 11 |
| (e)(i) Alternative policies or contracts adopted | 12 |
| by the Association shall be subject
to the approval of | 13 |
| either (A) the Director or (B) the domiciliary | 14 |
| commissioner and the receivership court . The | 15 |
| Association may adopt alternative
policies or | 16 |
| contracts of various types for future issuance
| 17 |
| insurance without regard to any
particular impairment | 18 |
| or insolvency.
| 19 |
| (ii) Alternative policies or contracts shall | 20 |
| contain at least the minimum statutory
provisions | 21 |
| required in this State and provide benefits that shall | 22 |
| not be
unreasonable in relation to the premium charged. | 23 |
| The
Association shall set the premium in accordance | 24 |
| with a table of rates which
it shall adopt. The premium | 25 |
| shall reflect the amount of insurance to be
provided | 26 |
| and the age and class of risk of each insured, but | 27 |
| shall not
reflect any changes in the health of the | 28 |
| insured after the original policy
was last | 29 |
| underwritten.
| 30 |
| (iii) Any alternative policy or contract issued by | 31 |
| the Association shall provide
coverage of a type | 32 |
| similar to that of the policy or contract issued by the | 33 |
| impaired or
insolvent insurer, as determined by the | 34 |
| Association.
| 35 |
| (f) If the Association elects to reissue | 36 |
| terminated coverage at a
premium rate different from |
|
|
|
HB5929 |
- 24 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| that charged under the terminated policy or contract , | 2 |
| the
premium shall be set by the Association in | 3 |
| accordance with the amount of
insurance provided and | 4 |
| the age and class of risk, subject to approval of
| 5 |
| either (A) the Director or (B) by the domiciliary | 6 |
| commissioner and the receivership court
by a court of | 7 |
| competent jurisdiction .
| 8 |
| (g) The Association's obligations with respect to | 9 |
| coverage under any
policy or contract of the impaired | 10 |
| or insolvent insurer or under any reissued or
| 11 |
| alternative policy or contract shall cease on the date | 12 |
| such coverage or policy or contract is
replaced by | 13 |
| another similar policy or contract by the policy owner
| 14 |
| policyholder , the insured, or the
Association.
| 15 |
| (4) When proceeding under subparagraph (2)(b) of this | 16 |
| Section with
respect to any policy or contract carrying | 17 |
| guaranteed minimum interest
rates, the Association shall | 18 |
| assure the payment or crediting of a rate of
interest | 19 |
| consistent with subparagraph (2)(b)(iii) (B) of Section | 20 |
| 531.03.
| 21 |
| (5) Nonpayment of premiums 31
thirty-one days after the | 22 |
| date required under
the terms of any guaranteed, assumed, | 23 |
| alternative or reissued policy or
contract or substitute | 24 |
| coverage shall terminate the Association's
obligations | 25 |
| under such policy or contract or coverage under this | 26 |
| Article
Act with respect to
such policy or contract or | 27 |
| coverage, except with respect to any claims incurred or any
| 28 |
| net cash surrender value which may be due in accordance | 29 |
| with the provisions of
this Article
Act .
| 30 |
| (6) Premiums due for coverage after entry of an order | 31 |
| of liquidation of
an insolvent insurer shall belong to and | 32 |
| be payable at the direction of the
Association,
and the | 33 |
| Association shall be liable for unearned premiums due to | 34 |
| policy or
contract owners arising after the entry of such | 35 |
| order.
| 36 |
| (7) The protection provided by this Article shall not |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| apply when any
guaranty protection is provided to residents | 2 |
| of this State by the laws of the
domicilary state or | 3 |
| jurisdiction of the impaired or insolvent insurer other
| 4 |
| than this State. | 5 |
| (8)
(7) (a) In carrying out its duties under paragraph
| 6 |
| subsection (2) of this Section ,
the Association may
| 7 |
| permanent policy liens, or contract liens, may be imposed | 8 |
| in connection
with any guarantee, assumption or | 9 |
| reinsurance agreement, if the court :
| 10 |
| (a)
(i)
subject to approval by the receivership | 11 |
| court or a court
of competent jurisdiction is this | 12 |
| State, impose permanent policy or contract
liens in | 13 |
| connection with a guarantee, assumption, or | 14 |
| reinsurance agreement, if
the Association
finds
Finds
| 15 |
| that the amounts which can be assessed under this | 16 |
| Article
Act are
less than the amounts needed to assure | 17 |
| full and prompt performance of
the insolvent insurer's | 18 |
| contractual obligations, or that the economic or
| 19 |
| financial conditions as they affect member insurers | 20 |
| are sufficiently
adverse to render the imposition of | 21 |
| policy or contract liens, to be in
the public interest; | 22 |
| and
| 23 |
| (b) subject to
approval by the receivership court | 24 |
| or a court of competent jurisdiction in this
State,
| 25 |
| impose temporary moratoriums or liens on payments of | 26 |
| cash values and policy
loans, or
any other right to | 27 |
| withdraw funds held in conjunction with policies or
| 28 |
| contracts, in
addition to any contractual provisions | 29 |
| for deferral of cash or policy or
contract loan
value. | 30 |
| In addition, in the event of a temporary moratorium or | 31 |
| moratorium charge
imposed by the receivership court or | 32 |
| a court of competent jurisdiction in this
State on
| 33 |
| payment of cash values or policy or contract loans, or | 34 |
| on any other right to
withdraw
funds held in | 35 |
| conjunction with policies or contracts, out of the | 36 |
| assets of the
impaired or
insolvent insurer, the |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| Association may defer the payment of cash values, | 2 |
| policy
or
contract loans, or other rights by the | 3 |
| Association for the period of the
moratorium or
| 4 |
| moratorium charge imposed by the receivership court or | 5 |
| a court of competent
jurisdiction in this State, except | 6 |
| for claims covered by the Association to be
paid in
| 7 |
| accordance with a hardship procedure (i) established | 8 |
| by the liquidator or
rehabilitator
and approved by the | 9 |
| receivership court or (ii) approved by a court of | 10 |
| competent
jurisdiction in this State.
| 11 |
| (ii) Approves the specific policy liens or | 12 |
| contract liens to be used.
| 13 |
| (b) Before being obligated under subsection (2) the
| 14 |
| Association may request that there be imposed temporary | 15 |
| moratoriums or
liens on payments of cash values and policy | 16 |
| loans in addition to any
contractual provisions for | 17 |
| deferral of cash or policy loan
values, and such
temporary | 18 |
| moratoriums and liens may be imposed if they are approved | 19 |
| by
the court.
| 20 |
| (9) A deposit in this State, held pursuant to law or | 21 |
| required by the
Director
for the
benefit of creditors, | 22 |
| including policy and contract owners, not turned over to
| 23 |
| the domiciliary
liquidator upon the entry of a final order | 24 |
| of liquidation or order approving a
rehabilitation plan
of | 25 |
| an insurer domiciled in this State or in a reciprocal state | 26 |
| shall be
promptly paid to the
Association. The Association | 27 |
| (i) shall be entitled to retain a portion of any
amount so | 28 |
| paid to it
equal to the percentage determined by dividing | 29 |
| the aggregate amount of policy
and contract
owners' claims | 30 |
| related to that insolvency for which the Association has
| 31 |
| provided statutory
benefits by the aggregate amount of all | 32 |
| policy and contract owners' claims in
this State related
to | 33 |
| that insolvency and (ii) shall remit to the domiciliary | 34 |
| receiver the amount
so paid to the
Association, less the | 35 |
| amount retained pursuant to clause (i). Any amount so
paid | 36 |
| to the
Association and retained by it pursuant to clause |
|
|
|
HB5929 |
- 27 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| (i) shall be treated as a
distribution of estate
assets | 2 |
| pursuant to subsection (2) of Section 205 of this Code or | 3 |
| similar
provision of the
state of domicile of
the impaired | 4 |
| or insolvent insurer. | 5 |
| (10) The Association may fulfill its obligations under | 6 |
| paragraph (2) of this
Section by
providing benefits in | 7 |
| connection with policies or contracts of the insolvent
| 8 |
| insurer whose terms
have been modified pursuant to an order | 9 |
| of the receivership court or a court of
competent
| 10 |
| jurisdiction in this State, provided that the economic | 11 |
| values and economic
benefits of such
modified policies or | 12 |
| contracts, after the Association has acted to fulfill its
| 13 |
| obligations, are not
materially less than the economic | 14 |
| values and economic benefits that covered
persons would
| 15 |
| have received after the Association had acted to fulfill | 16 |
| its obligations if
the terms of such
policies or contracts | 17 |
| had not been modified. In determining what economic
values | 18 |
| and
economic benefits covered persons would have received | 19 |
| after the Association had
acted to
fulfill its obligations | 20 |
| if the terms of the insolvent insurer's policies or
| 21 |
| contracts had not been
modified, the Association shall take | 22 |
| into account (i) the coverage limitations
set forth in
| 23 |
| paragraphs (2) and (3) of Section 531.03, (ii) any | 24 |
| substitute coverage that the
Association
would have | 25 |
| provided pursuant to paragraphs (3) and (22) of this | 26 |
| Section, and
(iii) any
permanent policy or contract liens | 27 |
| and any temporary moratoriums that would
have been
| 28 |
| necessary under paragraph (8) of this Section but for the | 29 |
| modifications in
terms approved by
the court.
| 30 |
| (11)
(8) There shall be no liability on the part of and | 31 |
| no cause of action
shall arise against the Association or | 32 |
| against any transferee from the
Association in connection | 33 |
| with the transfer by reinsurance or otherwise of
all or any | 34 |
| part of an impaired or insolvent insurer's business by | 35 |
| reason of
any action taken or any failure to take any | 36 |
| action by the impaired or
insolvent insurer at any time.
|
|
|
|
HB5929 |
- 28 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| (12)
(9) If the Association fails to act within a | 2 |
| reasonable period of
time with respect to an insolvent | 3 |
| insurer as provided in paragraph
subsection (2) of this | 4 |
| Section with respect to an
insolvent insurer , the
Director | 5 |
| may assume
shall have the powers and duties of the | 6 |
| Association under this
Article
Act with regard to the
such
| 7 |
| insolvent insurer
insurers .
| 8 |
| (13)
(10) The Association or its designated | 9 |
| representatives
may render assistance and advice to the
| 10 |
| Director, upon his or her request, concerning | 11 |
| rehabilitation, payment of
claims, continuations of | 12 |
| coverage, or the performance of other
contractual | 13 |
| obligations of any impaired or insolvent insurer.
| 14 |
| (14) The
Association has standing to appear or | 15 |
| intervene before any court or agency with
jurisdiction
over | 16 |
| an impaired or insolvent insurer concerning which the | 17 |
| Association is or
may become
obligated under this Article, | 18 |
| or with jurisdiction over any person or property
against | 19 |
| whom or
which the Association may have rights through | 20 |
| subrogation or otherwise. Such
standing
extends to all | 21 |
| matters germane to the powers and duties of the Association
| 22 |
| including, but not
limited to, proposals for reinsuring, | 23 |
| modifying, or guaranteeing the policies
or
contracts of the
| 24 |
| impaired or insolvent insurer and the determination of the | 25 |
| policies or
contracts and
contractual obligations.
| 26 |
| (11)
The Association has standing to appear before any | 27 |
| court concerning
all matters germane to the powers and | 28 |
| duties of
the Association, including, but not limited to, | 29 |
| proposals for reinsuring
or guaranteeing the covered | 30 |
| policies of the impaired or insolvent
insurer and the | 31 |
| determination of the covered policies and contractual
| 32 |
| obligations.
| 33 |
| (15)
(12) (a) Any person receiving benefits under this | 34 |
| Article is deemed
to have assigned the rights under , and | 35 |
| any causes of action against any person for losses arising | 36 |
| under, resulting from, or otherwise relating to the covered |
|
|
|
HB5929 |
- 29 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| policy
or contract to the Association
to the extent of the | 2 |
| benefits received because of this Article whether
the | 3 |
| benefits are payments of contractual obligations ,
or
| 4 |
| continuation of
coverage , or provision of substitute | 5 |
| coverages . The Association may require an assignment to it | 6 |
| of such
rights and causes of action by any payee, policy or | 7 |
| contract owner, beneficiary, insured,
certificate holder ,
| 8 |
| or
annuitant as a condition precedent to the receipt of any | 9 |
| rights or
benefits conferred by this Article upon such | 10 |
| person. The Association is
subrogated to these rights | 11 |
| against the assets of any insolvent insurer.
| 12 |
| (b) The subrogation rights of the Association under | 13 |
| this subsection
have the same priority against the assets | 14 |
| of the insolvent insurer as
that possessed by the person | 15 |
| entitled to receive benefits under this
Article. The | 16 |
| Association's
subrogation rights
against the assets of the | 17 |
| insolvent insurer shall not be reduced by any
recoveries | 18 |
| from
persons other than the estate of the insolvent insurer | 19 |
| obtained by the
Association
pursuant to assignment rights | 20 |
| provided under this subsection, except that the
| 21 |
| Association's subrogation rights against the assets of the | 22 |
| insolvent insurer
with respect
to a covered policy or | 23 |
| contract shall be deemed fulfilled where any and all
such
| 24 |
| recoveries from third parties with respect to the covered | 25 |
| policy or contract,
together with
any distributions of | 26 |
| estate assets with respect to the covered policy or
| 27 |
| contract, have
made the Association whole, after | 28 |
| accounting for any and all legal fees and
expenses
| 29 |
| (including interest) incurred by the Association in | 30 |
| achieving such recoveries.
| 31 |
| (c) In addition to the rights set forth in | 32 |
| subparagraphs (15)(a) and (b) of
this
Section, the | 33 |
| Association has all common law rights of subrogation and | 34 |
| any other
equitable or legal remedy that would have been | 35 |
| available to the impaired or
insolvent
insurer or owner, | 36 |
| beneficiary, or payee of a policy or contract with respect |
|
|
|
HB5929 |
- 30 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| to
the policy or
contract (including without limitation, in | 2 |
| the case of a structured settlement
annuity
contract, any | 3 |
| rights of the owner, beneficiary, or payee of the annuity
| 4 |
| contract, to the
extent of benefits received pursuant to | 5 |
| this Article, against a person
originally or by
succession | 6 |
| responsible for the losses arising from the personal injury | 7 |
| relating
to the
annuity contract or payment therefor), | 8 |
| excepting any such person responsible by
reason
of serving | 9 |
| as an assignee in respect of a qualified assignment under | 10 |
| United
States
Internal Revenue Code Section 130.
| 11 |
| (d) If subparagraph (a), (b), or (c) of this paragraph | 12 |
| is invalid or
ineffective with
respect to any person or | 13 |
| claim for any reason, the amount payable by the
Association
| 14 |
| with respect to the related covered obligations shall be | 15 |
| reduced by the amount
realized
by any other person with | 16 |
| respect to the person or claim that is attributable to
the
| 17 |
| policies and contracts (or portion thereof) covered by the | 18 |
| Association.
| 19 |
| (e) If the Association has provided benefits with | 20 |
| respect to a covered
obligation
and a person recovers | 21 |
| amounts as to which the Association has rights as
described | 22 |
| in
subparagraph (a), (b), (c) or (d) of this paragraph, the | 23 |
| person shall pay to
the
Association the portion of the | 24 |
| recovery attributable to the policies and
contracts (or | 25 |
| portion thereof) covered by the Association.
| 26 |
| (16)
(13)
In addition to the rights and powers | 27 |
| elsewhere in this Article,
the
The Association may do any | 28 |
| of the following :
| 29 |
| (a) Enter into such contracts as are necessary or | 30 |
| proper to carry
out the provisions and purposes of this | 31 |
| Article .
;
| 32 |
| (b) Sue or be sued, including taking any legal | 33 |
| actions necessary or
proper for recovery of any unpaid | 34 |
| assessments under Section 531.09 and to settle any | 35 |
| litigation, any threatened or potential litigation, | 36 |
| and any claims or potential claims by or against the |
|
|
|
HB5929 |
- 31 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| Association . The
Association shall not be liable for | 2 |
| punitive or exemplary damages;
| 3 |
| (c) Borrow money to effect the purposes of this | 4 |
| Article. Any notes
or other evidence of indebtedness of | 5 |
| the Association not in default are
legal investments | 6 |
| for domestic insurers and may be carried as admitted
| 7 |
| assets.
| 8 |
| (d) Employ or retain such persons as are necessary | 9 |
| or appropriate to handle the
financial transactions of | 10 |
| the Association, and to perform such other
functions as | 11 |
| become necessary or proper under this Article.
| 12 |
| (e) Negotiate and contract with any liquidator, | 13 |
| rehabilitator,
conservator, or ancillary receiver to | 14 |
| carry out the powers and duties of
the Association.
| 15 |
| (f) Take such legal action as may be necessary or | 16 |
| appropriate to avoid or recover payment of
improper | 17 |
| claims.
| 18 |
| (g) Exercise, for the purposes of this Article and | 19 |
| to the extent
approved by the Director, the powers of a | 20 |
| domestic life or health
insurer, but in no case may the | 21 |
| Association issue insurance policies or
annuity | 22 |
| contracts other than those issued to perform the | 23 |
| contractual
obligations of the impaired or insolvent | 24 |
| insurer.
| 25 |
| (h) Exercise all the rights of the Director under | 26 |
| Section 193(4) of
this Code with respect to covered | 27 |
| policies after the association becomes
obligated by | 28 |
| statute.
| 29 |
| (i) Request information from a person seeking | 30 |
| coverage from the
Association
in
order to aid the | 31 |
| Association in determining its obligations under this | 32 |
| Article
with respect
to the person. The person shall | 33 |
| promptly comply with the request as a
condition
| 34 |
| precedent to the receipt of any right or benefit | 35 |
| conferred by this Article.
| 36 |
| (j) Take other necessary or appropriate action to |
|
|
|
HB5929 |
- 32 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| discharge its duties and
obligations under this | 2 |
| Article or to exercise its powers under this Article.
| 3 |
| (17)(a) At any time within one year after the date on | 4 |
| which the
Association
becomes responsible for the | 5 |
| obligations of a member insurer (the coverage
date), the
| 6 |
| Association may elect to succeed to the rights and | 7 |
| obligations of the member
insurer
that accrue on or after | 8 |
| the coverage date and that relate to policies and
contracts
| 9 |
| covered (in whole or in part) by the Association under any | 10 |
| one or more
indemnity
reinsurance agreements entered into | 11 |
| by the member insurer as a ceding insurer
and
selected by | 12 |
| the Association. However, the Association may not exercise | 13 |
| an
election with
respect to a reinsurance agreement if the | 14 |
| receiver, rehabilitator, or
liquidator
of the
member | 15 |
| insurer has previously and expressly disaffirmed the | 16 |
| reinsurance
agreement.
The election shall be effected by a | 17 |
| notice to the receiver, rehabilitator, or
liquidator and to
| 18 |
| the affected reinsurers. If the Association makes an | 19 |
| election, subparagraphs
(i) through
(iv) of this paragraph | 20 |
| shall apply with respect to the agreements selected by
the
| 21 |
| Association:
| 22 |
| (i) The Association shall be responsible for all | 23 |
| unpaid premiums due under
the
agreements (for periods | 24 |
| both before and after the coverage date) and shall
be | 25 |
| responsible for the performance of all other | 26 |
| obligations to be performed
after the coverage date, in | 27 |
| each case which relate to policies and contracts
| 28 |
| covered (in whole or in part) by the Association. The | 29 |
| Association may
charge policies and contracts covered | 30 |
| in part by the Association, through
reasonable | 31 |
| allocation methods, the costs for reinsurance in | 32 |
| excess of the
obligations of the Association. | 33 |
| (ii) The Association shall be entitled to any | 34 |
| amounts payable by the
reinsurer
under the agreements | 35 |
| with respect to losses or events that occur in periods
| 36 |
| after the coverage date and that relate to policies and |
|
|
|
HB5929 |
- 33 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| contracts covered by
the Association (in whole or in | 2 |
| part), provided that, upon receipt of any
such amounts, | 3 |
| the Association shall be obliged to pay to the | 4 |
| beneficiary
under the policy or contract on account of | 5 |
| which the amounts were paid a
portion of the amount | 6 |
| equal to the excess of:
| 7 |
| (A) the amount received by the Association over
| 8 |
| (B) the benefits paid by the Association on account | 9 |
| of the policy or
contract less the retention of the | 10 |
| impaired or insolvent member
insurer applicable to the | 11 |
| loss or event.
| 12 |
| (iii) Within 30 days following the Association's | 13 |
| election, the
Association
and each indemnity reinsurer | 14 |
| shall calculate the net balance due to or from
the | 15 |
| Association under each reinsurance agreement as of the | 16 |
| date of the
Association's election, giving full credit | 17 |
| to all items paid by either the
member insurer (or its | 18 |
| receiver, rehabilitator, or liquidator) or the | 19 |
| indemnity
reinsurer during the period between the | 20 |
| coverage date and the date of the
Association's | 21 |
| election. Either the Association or indemnity | 22 |
| reinsurer shall
pay the net balance due the other | 23 |
| within 5 days after the completion of
the calculation. | 24 |
| If the receiver, rehabilitator, or liquidator
has | 25 |
| received any amounts due the Association pursuant to | 26 |
| subparagraph
(17)(a)(ii), the receiver, rehabilitator, | 27 |
| or liquidator shall remit the same to
the
Association | 28 |
| as promptly as practicable.
| 29 |
| (iv) If the Association, within 60 days of the | 30 |
| election, pays the
premiums
due for periods both before | 31 |
| and after the coverage date that relate to
policies and | 32 |
| contracts covered by the Association (in whole or in | 33 |
| part), the
reinsurer shall not be entitled to terminate | 34 |
| the reinsurance agreements
insofar as such agreements | 35 |
| relate to policies and contracts covered by the
| 36 |
| Association (in whole or in part) and shall not be |
|
|
|
HB5929 |
- 34 - |
LRB093 18698 SAS 44426 b |
|
| 1 |
| entitled to set off any
unpaid premium due for periods | 2 |
| prior to the coverage date against amounts
due the | 3 |
| Association. | 4 |
| (b) In the event the Association transfers its | 5 |
| obligations to another
insurer,
and
if the Association and | 6 |
| the other insurer agree, the other insurer shall succeed
to | 7 |
| the
rights and obligations of the Association under | 8 |
| subparagraph (17)(a) of this
Section
effective as of the | 9 |
| date agreed upon by the Association and the other insurer
| 10 |
| and
regardless of whether the Association has made the | 11 |
| election referred to
in
subparagraph (17)(a) provided | 12 |
| that:
| 13 |
| (i) the indemnity reinsurance agreements shall | 14 |
| automatically terminate for
new reinsurance unless the | 15 |
| indemnity reinsurer and the other insurer
agree to the | 16 |
| contrary;
| 17 |
| (ii) the obligations described in the proviso to | 18 |
| subparagraph (17)(a)(ii) of
this
Section shall no | 19 |
| longer apply on and after the date the indemnity
| 20 |
| reinsurance agreement is transferred to the third | 21 |
| party insurer; and
| 22 |
| (iii) this subparagraph (17)(b) shall not apply if | 23 |
| the Association has
previously
expressly determined in | 24 |
| writing that it will not exercise the election
referred
| 25 |
| to in subparagraph (17)(a) of this Section. | 26 |
| (c) The provisions of this paragraph (17) shall | 27 |
| supersede the provisions
of
any law of this State or of any | 28 |
| affected reinsurance agreement that provides
for or
| 29 |
| requires any payment of reinsurance proceeds, on account of | 30 |
| losses or events
that occur
in periods after the coverage | 31 |
| date, to the receiver, liquidator, or
rehabilitator of the
| 32 |
| insolvent member insurer. The receiver, rehabilitator, or | 33 |
| liquidator shall
remain entitled
to any amounts payable by | 34 |
| the reinsurer under the reinsurance agreement with
respect
| 35 |
| to losses or events that occur in periods prior to the | 36 |
| coverage date (subject
to applicable
setoff provisions).
|
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| (d) Except as otherwise expressly provided in this | 2 |
| paragraph (17), nothing
herein shall alter or modify the | 3 |
| terms and conditions of the indemnity
reinsurance
| 4 |
| agreements of the insolvent member insurer. Nothing herein | 5 |
| shall abrogate or
limit any
rights of any reinsurer to | 6 |
| claim that it is entitled to rescind a reinsurance
| 7 |
| agreement. | 8 |
| Nothing herein shall give a policy or contract owner or | 9 |
| beneficiary an
independent cause
of action against an | 10 |
| indemnity reinsurer that is not otherwise set forth in the
| 11 |
| indemnity
reinsurance agreement.
| 12 |
| (14) With respect to covered policies for which the | 13 |
| Association becomes
obligated after an entry of an order of | 14 |
| liquidation or rehabilitation,
the Association may
elect | 15 |
| to succeed to the rights of the insolvent insurer arising | 16 |
| after the
date of the order of liquidation or | 17 |
| rehabilitation under any contract
of reinsurance to which
| 18 |
| the insolvent insurer was a party, to the extent that such | 19 |
| contract
provides coverage for losses occurring after the | 20 |
| date of the order of
liquidation or rehabilitation. As a | 21 |
| condition to making this election,
the Association must pay | 22 |
| all unpaid premiums due under the contract for
coverage | 23 |
| relating to periods before and after the date of the order | 24 |
| of
liquidation or rehabilitation.
| 25 |
| (18) The Association may join an organization of one or | 26 |
| more other state
associations
of similar purposes to further | 27 |
| the purposes and administer the powers and
duties of the
| 28 |
| Association.
| 29 |
| (19) The board of directors of the Association shall have | 30 |
| discretion and may
exercise
reasonable business judgment to | 31 |
| determine the means by which the Association is
to provide
the | 32 |
| benefits of this Article in an economical and efficient manner.
| 33 |
| (20) Where the Association has arranged or offered to | 34 |
| provide the benefits
of
this
Article to a covered person under | 35 |
| a plan or arrangement that fulfills the
Association's
| 36 |
| obligations under this Article, the person shall not be |
|
|
|
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LRB093 18698 SAS 44426 b |
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| 1 |
| entitled to benefits
from the Association
in addition to or | 2 |
| other than those provided under the plan or arrangement.
| 3 |
| (21) Venue in a suit against the Association arising under | 4 |
| this Article
shall
be in Cook
County. The Association shall not | 5 |
| be required to give an appeal bond in any
case or
proceeding | 6 |
| that arises from or is based in whole or in part on claims or | 7 |
| other
rights asserted
under this Article.
| 8 |
| (22) In carrying out its duties in connection with | 9 |
| guaranteeing, assuming,
or
reinsuring
policies or contracts | 10 |
| under this Section, the Association may, subject to
approval of | 11 |
| the
Director or the receivership court, issue substitute | 12 |
| coverage for a policy or
contract that
provides an interest | 13 |
| rate, crediting rate, or similar factor determined by use
of an | 14 |
| index or other
external reference stated in the policy or | 15 |
| contract employed in calculating
returns or changes
in value by | 16 |
| issuing an alternative policy or contract in accordance with | 17 |
| the
following
provisions:
| 18 |
| (a) in lieu of the index or other external reference | 19 |
| provided for in the
original
policy or contract, the | 20 |
| alternative policy or contract provides for (i) a fixed
| 21 |
| interest rate, (ii) payment of dividends with minimum | 22 |
| guarantees, or (iii) a
different
method
for
calculating | 23 |
| interest or changes in value;
| 24 |
| (b) there is no requirement for evidence of | 25 |
| insurability, waiting period, or
other
exclusion that | 26 |
| would not have applied under the replaced policy or | 27 |
| contract;
and
| 28 |
| (c) the alternative policy or contract is | 29 |
| substantially similar to the
replaced
policy or contract in | 30 |
| all other material terms.
| 31 |
| (Source: P.A. 93-326, eff. 1-1-04.)
| 32 |
| (215 ILCS 5/531.09) (from Ch. 73, par. 1065.80-9)
| 33 |
| Sec. 531.09. Assessments.
| 34 |
| (1) For the purpose of providing the funds
necessary to | 35 |
| carry out the powers and duties of the Association, the board
|
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| of directors shall assess the member insurers, separately for | 2 |
| each account
and subaccount , at such
times and for such amounts | 3 |
| as the board finds necessary. Assessments shall
be due not less | 4 |
| than 30 days after written notice to the member insurers
and | 5 |
| shall accrue interest from the due date the rate of 10% per
| 6 |
| annum
at such adjusted rate as is
established under Section | 7 |
| 6621 of Chapter 26 of the United States Code and
such interest | 8 |
| shall be compounded daily.
| 9 |
| (2) There shall be 2 classes of assessments, as follows:
| 10 |
| (a) Class A assessments shall be authorized and called
made
| 11 |
| for the
purpose of meeting administrative
costs and other | 12 |
| general expenses and examinations conducted under the
| 13 |
| authority
of the Director under subsection (5) of Section | 14 |
| 531.12 . Class A
assessments may be authorized and called | 15 |
| whether or not related to a particular
impaired or insolvent | 16 |
| insurer.
| 17 |
| (b) Class B assessments shall be authorized and called
made
| 18 |
| to the
extent necessary to carry
out the powers and duties of | 19 |
| the Association under Section 531.08 with regard
to an impaired | 20 |
| or an insolvent domestic insurer or insolvent foreign
or alien
| 21 |
| insurers .
| 22 |
| (3) (a) The amount of any Class A assessment shall be | 23 |
| determined by the
board of directors
Board and may be | 24 |
| authorized and called
made
on a pro-rata or non-pro rata basis. | 25 |
| With respect to any pro rata Class
A assessment, the board may | 26 |
| provide that no member insurer shall be assessed
less than $100 | 27 |
| as its share of such assessment, notwithstanding that such
| 28 |
| assessment is pro rata. The board may provide that any pro rata | 29 |
| assessment
shall be credited against future Class B | 30 |
| assessments. The total of all non-pro
rata
Such assessments | 31 |
| shall be in an amount determined
by the board, but shall
not
| 32 |
| exceed $500
$200
per company in any one calendar year. The | 33 |
| amount of any Class B
assessment shall be allocated for | 34 |
| assessment
purposes among the accounts
and subaccounts | 35 |
| pursuant to an allocation formula which may be based on
the | 36 |
| premiums or reserves of the impaired or insolvent insurer or |
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| any other
standard deemed by the board in its sole discretion | 2 |
| as being fair and
reasonable under the circumstances.
| 3 |
| (b) Class B assessments against member insurers for each | 4 |
| account and
subaccount shall
be in the proportion that the | 5 |
| premiums received on business in this State
by each assessed | 6 |
| member insurer on policies or contracts covered by
each account | 7 |
| or subaccount for the three most recent calendar years
for | 8 |
| which information is available preceding the year in which the | 9 |
| insurer
became impaired or insolvent, as the case may be, bears | 10 |
| to such premiums
received on business in this State for such | 11 |
| calendar years by all assessed
member insurers. To the extent | 12 |
| that any federal or state
law prohibits or preempts the | 13 |
| Association from making assessments on the basis
of any
such | 14 |
| premiums, assessments under this subparagraph shall be made on | 15 |
| the basis
of all
such premiums not subject to any prohibitions | 16 |
| or preemption, and the assessment
method set forth in this | 17 |
| subparagraph shall not be rendered invalid by any such
| 18 |
| prohibitions or preemption.
| 19 |
| (c) Assessments for funds to meet the requirements of the | 20 |
| Association
with respect to an impaired or insolvent insurer | 21 |
| shall not be authorized or
called
made until
the board in its | 22 |
| judgment determines that such authorization or call is
| 23 |
| necessary to implement the purposes of this Article. When in | 24 |
| the judgment
of the board an
assessment will be necessary to | 25 |
| implement the purposes of this Article, the
board may
authorize | 26 |
| a future assessment, to become effective after a member insurer | 27 |
| has
become
an impaired or insolvent insurer, and such | 28 |
| assessment shall not be
invalid because the
member insurer was | 29 |
| not an impaired or insolvent insurer at the time the board
| 30 |
| authorized such future assessment. Classification
of | 31 |
| assessments
under paragraph
subsection (2) of this Section and | 32 |
| computations of
assessments under this paragraph (3)
| 33 |
| subsection
shall be made with a reasonable degree of accuracy, | 34 |
| recognizing that exact
determinations may not always be | 35 |
| possible. The Association shall notify each
member
insurer of | 36 |
| its anticipated pro rata share of an authorized assessment not |
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| yet
called
within 180 days after the assessment is authorized.
| 2 |
| (4) The Association may abate or defer, in whole or in | 3 |
| part, the assessment
of a member insurer if, in the opinion of | 4 |
| the board, payment of the assessment
would endanger the ability | 5 |
| of the member insurer to fulfill its contractual
obligations. | 6 |
| In the event an assessment against a member insurer is abated
| 7 |
| or deferred, in
whole or in part, because of the limitations | 8 |
| set forth in this paragraph (4),
the amount by
which such | 9 |
| assessment is abated or deferred, may be assessed against the | 10 |
| other
member
insurers in a manner consistent with the basis for | 11 |
| assessments set forth in
this Section
531.09. Once the | 12 |
| conditions that caused a deferral have been removed or
| 13 |
| rectified, the
member insurer shall pay all assessments that | 14 |
| were deferred pursuant to a
repayment plan
approved by the | 15 |
| Association
The total of all assessments upon a member
insurer | 16 |
| for the
life and annuity
account and for each subaccount | 17 |
| thereunder may not in any one calendar
year exceed 2% and for | 18 |
| the health account may not in any one calendar
year exceed 2% | 19 |
| of such insurer's
average premiums received in this State on | 20 |
| the policies and contracts
covered by the account or subaccount | 21 |
| during the three calendar years
preceding the year in which the | 22 |
| insurer became an impaired or insolvent
insurer. If a one | 23 |
| percent assessment for any subaccount of the life and
annuity | 24 |
| account in any one year does not provide an amount sufficient | 25 |
| to
carry out the responsibilities of the Association, then | 26 |
| pursuant to
subsection 3(b), the board shall access all | 27 |
| subaccounts of the life and
annuity account for the necessary | 28 |
| additional amount, subject to the maximum
stated in this | 29 |
| subsection .
| 30 |
| (5) (a)(i) Subject to the provisions of paragraph | 31 |
| (5)(a)(ii) of this
Section,
the
total of
all assessments upon a | 32 |
| member insurer for the life and annuity account and for
each
| 33 |
| subaccount thereunder may not in any one calendar year exceed | 34 |
| 2%, and for the
health
account may not in any one calendar year | 35 |
| exceed 2%, of such insurer's average
premiums received in this | 36 |
| State on the policies and contracts covered by the
account or
|
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| subaccount during the 3 calendar years preceding the year in | 2 |
| which the
insurer
became an impaired or insolvent insurer.
| 3 |
| (ii) If 2 or more assessments are authorized in one | 4 |
| calendar year with
respect to insurers that become impaired | 5 |
| insurers or insolvent insurers in
different
calendar years, the | 6 |
| average annual premiums for purposes of the aggregate
| 7 |
| assessment
percentage limitation referenced in subparagraph | 8 |
| (5)(a)(i) of this Section
shall be equal
and limited to the | 9 |
| higher of the 3-year average annual premiums for the
applicable
| 10 |
| subaccount or account as calculated pursuant to this Section.
| 11 |
| In the event an assessment against a member insurer is abated, | 12 |
| or
deferred,
in whole or in part, because of the limitations | 13 |
| set forth in subsection (4) of
this
Section the amount by which | 14 |
| such assessment is abated or deferred, may be
assessed against | 15 |
| the other member insurers in a manner consistent with the
basis | 16 |
| for assessments set forth in this Section.
| 17 |
| (iii) If funds available from assessments, investment | 18 |
| income,
recoveries of
estate assets, or other recoveries are | 19 |
| insufficient to
the maximum assessment,
together with the other | 20 |
| assets of the Association in either account, does
not
provide | 21 |
| in any
one year in either account an amount sufficient to carry | 22 |
| out the
responsibilities
of the Association, the necessary | 23 |
| additional funds may be assessed as soon
thereafter
as | 24 |
| permitted by this Article.
| 25 |
| (iv) If the maximum assessment for any subaccount of the | 26 |
| life and annuity
account in any one year does not provide an | 27 |
| amount sufficient to carry out the
responsibilities of the | 28 |
| Association, then pursuant to subparagraph (3)(b) of
this | 29 |
| Section
531.09, the board shall access all subaccounts of the | 30 |
| life and annuity account
for the
necessary additional amount, | 31 |
| subject to the maximum stated in this paragraph
(5).
| 32 |
| (6) The board may provide in the plan of operation a method | 33 |
| of
allocating
funds among claims, whether relating to one or | 34 |
| more impaired or insolvent
insurers, when the maximum | 35 |
| assessment will be insufficient to cover anticipated
claims.
| 36 |
| (7)
(6) The board may, by an equitable method as |
|
|
|
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LRB093 18698 SAS 44426 b |
|
| 1 |
| established in the
plan of operation, refund to member | 2 |
| insurers, in proportion to the contribution
of each insurer to | 3 |
| that account, the amount by which the assets of the account
| 4 |
| exceed the amount the board finds is necessary to carry out | 5 |
| during the coming
year the obligations of the Association with | 6 |
| regard to that account,
including
assets accruing from | 7 |
| assignment, subrogation, net realized gains , and
income
from | 8 |
| investments. A
reasonable amount may be retained in any account | 9 |
| to provide funds for the
continuing expenses of the Association | 10 |
| and for future claims
losses if
refunds are
impractical .
| 11 |
| (8)
(7)
Unless otherwise determined by the board pursuant | 12 |
| to
subdivision 531.09(3)(c), an assessment is deemed to occur | 13 |
| on the date upon
which
the board
votes such assessment. The | 14 |
| board may defer calling the payment of the
assessment or may | 15 |
| call for payment in one or more installments.
| 16 |
| (9)
(8) It is proper for any member insurer, in determining | 17 |
| its
premium
rates and policyowner dividends as to any kind of | 18 |
| insurance within the scope of
this Article, to consider the | 19 |
| amount reasonably necessary to meet its
assessment
obligations | 20 |
| under this Article.
| 21 |
| (10)
(9) The Association must issue to each insurer paying | 22 |
| an
a
Class B assessment
under this Article , other than a Class | 23 |
| A assessment, a certificate of
contribution,
in a form | 24 |
| acceptable to the
Director, for the amount of the assessment so | 25 |
| paid. All outstanding
certificates
are of equal
dignity and | 26 |
| priority without reference to amounts or dates of issue. A
| 27 |
| certificate
of contribution may be shown by the insurer in its | 28 |
| financial statement as an
asset
in such form and for such | 29 |
| amount, if any, and period of time as the Director
may approve, | 30 |
| provided the insurer shall in any event at its option have
the | 31 |
| right to show a certificate of contribution as an admitted | 32 |
| asset at
percentages of the original face amount for calendar | 33 |
| years as follows:
| 34 |
| 100% for the calendar year after the year of issuance;
| 35 |
| 80% for the second calendar year after the year of | 36 |
| issuance;
|
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| 60% for the third calendar year after the year of issuance;
| 2 |
| 40% for the fourth calendar year after the year of | 3 |
| issuance;
| 4 |
| 20% for the fifth calendar year after the year of issuance.
| 5 |
| (11) The Association may request information from member | 6 |
| insurers in order
to aid in the exercise of its power under | 7 |
| Section 531.09 and member insurers
shall promptly comply with | 8 |
| such a request.
| 9 |
| (Source: P.A. 86-753.)
| 10 |
| (215 ILCS 5/531.10) (from Ch. 73, par. 1065.80-10)
| 11 |
| Sec. 531.10. Plan of Operation. )
| 12 |
| (1) (a) The Association must
submit to the Director a plan | 13 |
| of operation and any amendments thereto necessary
or suitable | 14 |
| to assure the fair, reasonable, and equitable administration of | 15 |
| the
Association. The plan of operation and any amendments | 16 |
| thereto become effective
upon approval in writing by the | 17 |
| Director.
| 18 |
| (b) If the Association fails to submit a suitable plan of | 19 |
| operation
within 180 days following the effective date of this | 20 |
| Article or if at any time
thereafter the Association fails to | 21 |
| submit suitable amendments to the plan, the
Director may, after | 22 |
| notice and hearing, adopt and promulgate such reasonable
rules | 23 |
| as are necessary or advisable to effectuate the provisions of | 24 |
| this
Article.
Such rules are in force until modified by the | 25 |
| Director or superseded by a plan
submitted by the Association | 26 |
| and approved by the Director.
| 27 |
| (2) All member insurers must comply with the plan of | 28 |
| operation.
| 29 |
| (3) The plan of operation must, in addition to requirements | 30 |
| enumerated
elsewhere in this Article:
| 31 |
| (a) Establish procedures for handling the assets of the | 32 |
| Association;
| 33 |
| (b) Establish the amount and method of reimbursing members | 34 |
| of the
board of directors under Section 531.07;
| 35 |
| (c) Establish regular places and times for meetings , |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| including telephone
conference calls, of the board
of | 2 |
| directors;
| 3 |
| (d) Establish procedures for records to be kept of all | 4 |
| financial
transactions of the Association, its agents, and the | 5 |
| board of directors;
| 6 |
| (e) Establish the procedures whereby selections for the | 7 |
| board
of directors will be made and submitted to the Director;
| 8 |
| (f) Establish any additional procedures for assessments | 9 |
| under
Section 531.09; and
| 10 |
| (g) Contain additional provisions necessary or proper for | 11 |
| the execution
of the powers and duties of the Association.
| 12 |
| (4) The plan of operation shall establish a procedure for | 13 |
| protest by
any member insurer of assessments made by the | 14 |
| Association pursuant to
Section 531.09. Such procedures shall | 15 |
| require that:
| 16 |
| (a) Any member insurer that wishes to protest all or any | 17 |
| part of an
assessment for any year shall first pay the full | 18 |
| amount of the assessment
as set forth in the notice provided by | 19 |
| the Association. The payment shall be
available and may be used | 20 |
| to meet Association obligations during the pendency
of the | 21 |
| protest and any subsequent appeal. Such payments
shall be | 22 |
| accompanied by a statement in writing that the payment is made
| 23 |
| under protest, setting forth a brief statement of the ground | 24 |
| for the
protest. The Association shall hold such payments in a | 25 |
| separate interest
bearing account.
| 26 |
| (b) Within 60
30 days following the payment of an | 27 |
| assessment under
protest by any protesting member insurer, the | 28 |
| Association must notify the
member insurer in writing of its | 29 |
| final decision
determination with
respect to the protest
unless | 30 |
| the Association notifies the member that additional time is | 31 |
| required
to resolve the issues raised by the protest.
| 32 |
| (c) Within 30 days after a final
decision has been made, | 33 |
| the Association shall notify the protesting member
insurer in | 34 |
| writing of that final decision.
In the event the Association
| 35 |
| determines that the protesting member
insurer is entitled to a | 36 |
| refund, such refund shall be made within 30
days following the |
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| date upon which the Association makes its determination.
| 2 |
| (d) The final decision of the Association with respect to a | 3 |
| protest may
be
appealed to the Director pursuant to Section | 4 |
| 531.11(3).
| 5 |
| (e) In the alternative to rendering a decision with respect | 6 |
| to any
protest based on a question regarding the assessment | 7 |
| base, the Association
may refer such protests to the Director | 8 |
| for final decision, with or without
a recommendation from the | 9 |
| Association.
| 10 |
| (f) In the event the Association determines, or on appeal | 11 |
| of the
Association's
decision it is determined, that the | 12 |
| protesting member insurer is entitled to a
refund of all
or a | 13 |
| portion of the amount paid under protest, such refund shall be | 14 |
| made to the
protesting member insurer. Interest on any refund | 15 |
| due a protesting member
insurer
shall be paid at the rate | 16 |
| actually earned by the Association.
Interest on
any refund due | 17 |
| a protesting member insurer shall be paid
at the rate actually | 18 |
| earned by the Association on the separate account.
| 19 |
| (5) The plan of operation may provide that any or all | 20 |
| powers and duties
of the Association, except those under | 21 |
| paragraph (c) of subsection (10)
subdivision (16)(c) of Section | 22 |
| 531.08 and Section 531.09 are delegated to a
corporation,
| 23 |
| association or other organization which performs or will | 24 |
| perform functions
similar to those of this Association, or its | 25 |
| equivalent, in 2 or more states.
Such a corporation, | 26 |
| association or organization shall be reimbursed for any
| 27 |
| payments made on behalf of the Association and shall be paid | 28 |
| for its
performance of any function of the Association. A | 29 |
| delegation under this
subsection shall take effect only with | 30 |
| the approval of both the board of
directors and the Director, | 31 |
| and may be made only to a corporation, association
or | 32 |
| organization which extends protection not substantially less | 33 |
| favorable and
effective than that provided by this Article
Act .
| 34 |
| (Source: P.A. 84-1035.)
| 35 |
| (215 ILCS 5/531.11) (from Ch. 73, par. 1065.80-11)
|
|
|
|
HB5929 |
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LRB093 18698 SAS 44426 b |
|
| 1 |
| Sec. 531.11. Duties and powers of the Director. In addition | 2 |
| to
the duties and powers enumerated elsewhere in this Article:
| 3 |
| (1) The Director must:
| 4 |
| (a) Upon request of the board of directors, provide the | 5 |
| Association with
a statement of the premiums in the | 6 |
| appropriate accounts for each
member insurer.
| 7 |
| (b) notify the board of directors of the existence of | 8 |
| an impaired or
insolvent
insurer not later than 3 days | 9 |
| after a determination of impairment or insolvency
is made | 10 |
| or when the Director receives notice of impairment or | 11 |
| insolvency.
| 12 |
| (c) give notice to an impaired insurer as required by | 13 |
| Sections
34 or 60. Notice to the impaired insurer shall | 14 |
| constitute
notice to its shareholders, if any.
| 15 |
| (d) In any liquidation or rehabilitation proceeding | 16 |
| involving
a domestic insurer, be appointed as the | 17 |
| liquidator or rehabilitator. If
a foreign or alien member | 18 |
| insurer is subject to a liquidation proceeding
in its | 19 |
| domiciliary
jurisdiction or state of entry, the Director | 20 |
| shall be appointed conservator.
| 21 |
| (2) The Director may suspend or revoke, after notice and | 22 |
| hearing,
the certificate of authority to transact insurance in | 23 |
| this State of any member
insurer which fails to pay an | 24 |
| assessment when due or fails to comply with the
plan
of | 25 |
| operation. As an alternative the Director may levy a forfeiture | 26 |
| on any
member
insurer which fails to pay an assessment when | 27 |
| due. Such forfeiture may not
exceed
5% of the unpaid assessment | 28 |
| per month, but no forfeiture may be less than
$100 per month.
| 29 |
| (3) Any final decision or action of the board of directors | 30 |
| or the
Association may be
appealed to the Director by any | 31 |
| member insurer or any other person
adversely affected by such | 32 |
| action if such appeal is taken within 30
days of the decision | 33 |
| or action being appealed. Any final action or order
of the | 34 |
| Director
is subject to judicial review in a court of competent | 35 |
| jurisdiction. An
action or order of the Director may be final | 36 |
| and subject to judicial review
even if the aggrieved party |
|
|
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| 1 |
| seeking judicial review has not sought
reconsideration or | 2 |
| rehearing by the Director.
| 3 |
| (4) The liquidator, rehabilitator, or conservator of any | 4 |
| impaired insurer
may notify all interested persons of the | 5 |
| effect of this Article.
| 6 |
| (Source: P.A. 89-97, eff. 7-7-95.)
| 7 |
| (215 ILCS 5/531.12) (from Ch. 73, par. 1065.80-12)
| 8 |
| Sec. 531.12. Prevention of Insolvencies. To aid in the | 9 |
| detection and
prevention of insurer insolvencies or | 10 |
| impairments:
| 11 |
| (1) It shall be the duty of the Director:
| 12 |
| (a) To notify the commissioners of all other states, | 13 |
| territories of the
United States, and the District of Columbia | 14 |
| when he or she takes any of the
following
actions against a | 15 |
| member insurer:
| 16 |
| (i) revocation of license;
| 17 |
| (ii) suspension of license;
| 18 |
| (iii) makes any formal order except for an order issued | 19 |
| pursuant to
Article XII 1/2 of this Code that such company | 20 |
| restrict its premium writing,
obtain additional contributions | 21 |
| to surplus, withdraw from the State,
reinsure all or any part | 22 |
| of its business, or increase capital, surplus or
any other | 23 |
| account for the security of policyholders or creditors.
| 24 |
| Such notice shall be transmitted to all commissioners
| 25 |
| within 30 days following
the action taken or the date on which | 26 |
| the action occurs.
| 27 |
| (b) To report to the board of directors when he or she has | 28 |
| taken any of
the actions
set forth in subparagraph (a) of this | 29 |
| paragraph or has received a report
from any other commissioner | 30 |
| indicating that any such action has been taken
in another | 31 |
| state. Such report to the board of directors shall contain all
| 32 |
| significant details of the action taken or the report received | 33 |
| from another
commissioner.
| 34 |
| (2) The Director may seek the advice and recommendations of | 35 |
| the board
of directors concerning any matter affecting the |
|
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| Director's
his duties
and responsibilities
regarding the | 2 |
| financial condition of member companies and companies seeking
| 3 |
| admission
to transact insurance business in this State.
| 4 |
| (3) The board of directors may, upon majority vote, make | 5 |
| reports and
recommendations
to the Director upon any matter | 6 |
| germane to the liquidation, rehabilitation
or conservation of | 7 |
| any member insurer. Such reports
and recommendations shall not | 8 |
| be considered public documents.
| 9 |
| (4) The board of directors may, upon majority vote, make | 10 |
| recommendations
to the Director for the detection and | 11 |
| prevention of insurer insolvencies.
| 12 |
| (5) The board of directors may
shall , at the conclusion of | 13 |
| any
insurer insolvency
in which the Association was obligated | 14 |
| to pay covered claims prepare a report
to the Director | 15 |
| containing such information as it may have in its possession
| 16 |
| bearing on the history and causes of such insolvency. The board | 17 |
| shall
cooperate
with the boards of directors of guaranty | 18 |
| associations in other states in
preparing a report on the | 19 |
| history and causes for insolvency of a particular
insurer, and | 20 |
| may adopt by reference any report prepared by such other
| 21 |
| associations.
| 22 |
| (Source: P.A. 86-753.)
| 23 |
| (215 ILCS 5/531.14) (from Ch. 73, par. 1065.80-14)
| 24 |
| Sec. 531.14. Miscellaneous Provisions. ) (1) Nothing in | 25 |
| this
Article may be construed to reduce the liability for | 26 |
| unpaid assessments of the
insured
of an impaired or insolvent | 27 |
| insurer operating under a plan with assessment
liability.
| 28 |
| (2) No member insurer may voluntarily withdraw from this | 29 |
| State or
liquidate
its property, business, and affairs, and no | 30 |
| such voluntary withdrawal or
voluntary liquidation shall be | 31 |
| effective, until such member insurer has paid
all authorized | 32 |
| assessments, whether called or
uncalled, for which it is liable | 33 |
| under this Article.
| 34 |
| (3)
(2) Records must be kept of all meetings of the board | 35 |
| of
directors
negotiations and meetings in which
the Association |
|
|
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| or its representatives are involved to discuss the activities
| 2 |
| of the
Association in carrying out its powers and duties under | 3 |
| Section 531.08.
The records of the Association with
respect to | 4 |
| an impaired or insolvent insurer may be made public only (a) | 5 |
| upon
the order of the
Director or a court of competent | 6 |
| jurisdiction or upon a determination by the
board, and (b)
| 7 |
| during the pendency
Records of such
negotiations or meetings | 8 |
| may be made public only upon the termination of a
liquidation, | 9 |
| rehabilitation, or conservation proceeding involving the | 10 |
| impaired
or insolvent insurer, upon a showing of compelling | 11 |
| circumstances
the
termination of the impairment or insolvency
| 12 |
| of the insurer, or upon the order
of a court of competent | 13 |
| jurisdiction . Nothing in this paragraph (3)
(2) limits the
duty | 14 |
| of the Association to render a report of its activities under | 15 |
| Section
531.15.
| 16 |
| (4)
(3) For the purpose of carrying out its obligations | 17 |
| under this
Article,
the Association is deemed to be a creditor | 18 |
| of the impaired or insolvent
insurer to the extent of assets | 19 |
| attributable to covered policies reduced by any
amounts to | 20 |
| which the Association is entitled as subrogee (under paragraph
| 21 |
| (15)
(8)
of Section 531.08). All assets of the impaired or | 22 |
| insolvent insurer
attributable to covered policies must be used | 23 |
| to continue all covered policies
and pay all contractual | 24 |
| obligations of the impaired insurer as required by this
| 25 |
| Article. "Assets attributable to covered policies", as used in | 26 |
| this paragraph
(4)
(3) , is that proportion of the
assets which | 27 |
| the reserves that should have been established
for such | 28 |
| policies bear to the reserves
reserve that should have been
| 29 |
| established for all policies of
insurance written by the | 30 |
| impaired or insolvent insurer.
| 31 |
| (5) As a creditor of the impaired or insolvent insurer as | 32 |
| established in
paragraph (4) of this Section 531.14 and | 33 |
| paragraph (15) of Section 531.08 and
consistent with paragraph | 34 |
| (2) of Section 205 of the Code and similar provisions
under the | 35 |
| laws of other states, the Association and other similar | 36 |
| associations
shall be entitled to receive disbursements of |
|
|
|
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| assets out of the marshaled
assets from time to time as the | 2 |
| assets become available. If the liquidator
has not, within 120 | 3 |
| days of a final determination of insolvency of an insurer
by | 4 |
| the receivership court, made an application to the court for | 5 |
| the approval of
a proposal to disburse assets out of marshaled | 6 |
| assets to guaranty associations
having obligations because of | 7 |
| the insolvency, then the Association shall be
entitled to make | 8 |
| application to the receivership court for approval of its own
| 9 |
| proposal to disburse these assets.
| 10 |
| (6)
(4) (a) Prior to the termination of any liquidation,
| 11 |
| rehabilitation,
or conservation proceeding, the court may take | 12 |
| into consideration the
contributions
of the respective | 13 |
| parties, including the Association, the shareholders and
the | 14 |
| policy and contract owners
policyowners of the impaired or
| 15 |
| insolvent insurer, and any other party with
a bona fide | 16 |
| interest,
in making an equitable distribution of the ownership | 17 |
| rights of such impaired
or insolvent
insurer. In such a | 18 |
| determination, consideration must be given to the welfare
of | 19 |
| the
policy owners and contract owners
policyholders of the | 20 |
| continuing or
successor insurer.
| 21 |
| (b) No distribution to stockholders, if any, of an impaired | 22 |
| or insolvent
insurer
may be made until and unless the total
| 23 |
| amount of valid claims of the Association for funds expended in | 24 |
| carrying
out its powers and duties under Section 531.08, with | 25 |
| respect to such insurer
have been fully recovered by the | 26 |
| Association.
| 27 |
| (7)
(5) (a) If an order for liquidation or rehabilitation | 28 |
| of
an insurer
domiciled in this State has been entered, the | 29 |
| receiver appointed under such
order has a right to recover on | 30 |
| behalf of the insurer, from any affiliate that
controlled it, | 31 |
| the amount of distributions, other than stock dividends paid by
| 32 |
| the insurer on its capital stock, made at any time during the 5 | 33 |
| years preceding
the petition for liquidation or rehabilitation | 34 |
| subject to the limitations of
subparagraphs
paragraphs (b) to | 35 |
| (d) of this paragraph (7) .
| 36 |
| (b) No such dividend is recoverable if the insurer shows |
|
|
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| 1 |
| that when
paid the distribution was lawful and reasonable, and | 2 |
| that the insurer did not
know and could not reasonably have | 3 |
| known that the distribution might adversely
affect
the ability | 4 |
| of the insurer to fulfill its contractual obligations.
| 5 |
| (c) Any person who was
as an affiliate that controlled the | 6 |
| insurer
at
the time the distributions were paid is liable up to | 7 |
| the amount of
distributions
the person
he received. Any person | 8 |
| who was an affiliate that
controlled the insurer at
the
time | 9 |
| the distributions were declared, is liable up to the amount of
| 10 |
| distributions
the person
he would have received if they had | 11 |
| been paid immediately.
If 2 or more persons are
liable with | 12 |
| respect to the same distributions, they are jointly and | 13 |
| severally
liable.
| 14 |
| (d) The maximum amount recoverable under this paragraph (7)
| 15 |
| subsection
(5) of this Section is
the amount needed in excess | 16 |
| of all other available assets of the insolvent
insurer
to pay | 17 |
| the contractual obligations of the insolvent insurer.
| 18 |
| (e) If any person liable under subparagraph
paragraph (c) | 19 |
| of
this paragraph (7)
subsection (5) of this
Section is | 20 |
| insolvent, all its
affiliates that controlled it at the time | 21 |
| the dividend was paid are jointly and
severally liable for any | 22 |
| resulting deficiency in the amount recovered from
the insolvent | 23 |
| affiliate.
| 24 |
| (Source: P.A. 81-899.)
| 25 |
| (215 ILCS 5/531.15) (from Ch. 73, par. 1065.80-15)
| 26 |
| Sec. 531.15. Examination of the Association . Annual | 27 |
| Report. The
Association shall be subject to examination and | 28 |
| regulation by the Director.
The board of directors must submit | 29 |
| to the Director, not later than the
first day of the fifth | 30 |
| month following the end of the Association's fiscal
year, a | 31 |
| financial report for such fiscal year in a
form acceptable to | 32 |
| the Director and a report of its
activities during such fiscal | 33 |
| year. Upon the request of a member insurer,
the Association | 34 |
| shall provide the member with a copy of the report.
| 35 |
| (Source: P.A. 86-753.)
|
|
|
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| 1 |
| (215 ILCS 5/531.17) (from Ch. 73, par. 1065.80-17)
| 2 |
| Sec. 531.17. Immunity. ) There is no liability on the part | 3 |
| of and
no cause of action of any nature may arise against any | 4 |
| member insurer or its
agents
or employees, the Association or | 5 |
| its agents or employees, members of the board
of
directors or | 6 |
| their representatives or alternate representatives , or the
| 7 |
| Director or the Director's
his representatives , for any | 8 |
| decision
or
action taken or omission made by them
in the | 9 |
| performance of their powers and duties under this Article. | 10 |
| Without
limitation, the Association shall be immune from any | 11 |
| claim that any
omission
by the Association or any action of the | 12 |
| Association, taken separately or in
concert with the
Director | 13 |
| in any of his or her capacities, has caused loss or any other | 14 |
| injury
to any impaired
insurer or any insolvent insurer. | 15 |
| Immunity shall extend to the Association's
participation in
any | 16 |
| organization of one or more other state associations of similar | 17 |
| purposes
and to any such
organization and its agents or | 18 |
| employees.
| 19 |
| (Source: P.A. 81-899.)
| 20 |
| (215 ILCS 5/531.19) (from Ch. 73, par. 1065.80-19)
| 21 |
| Sec. 531.19. Prohibited advertisement of action of the | 22 |
| Insurance
Guaranty
Association in sale of insurance.
| 23 |
| (a) No person, including an insurer,
agent
or affiliate of | 24 |
| an insurer shall make, publish, disseminate, circulate,
or | 25 |
| place before the public, or cause directly or indirectly, to be | 26 |
| made,
published, disseminated, circulated or placed before the | 27 |
| public, in any
newspaper, magazine or other publication, or in | 28 |
| the form of a notice, circular,
pamphlet, letter or poster, or | 29 |
| over any radio station or television station,
or in any other | 30 |
| way, any advertisement, announcement or statement, written or
| 31 |
| oral, which
uses the existence of the Insurance Guaranty
| 32 |
| Association of this State
for
the purpose of sales, | 33 |
| solicitation or inducement to purchase any form of
insurance | 34 |
| covered by this Article; provided, however, that this Section
|
|
|
|
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| 1 |
| shall not apply to the Illinois Life and Health Guaranty
| 2 |
| Association or
any other entity which does not sell or solicit | 3 |
| insurance.
| 4 |
| (b) Within 180 days of August 16,
1993, the Association | 5 |
| shall prepare a summary document describing the general
| 6 |
| purposes and current limitations of this Article and complying | 7 |
| with subsection
(c). This document shall be submitted to the | 8 |
| Director for approval. Sixty
days after receiving approval, no | 9 |
| insurer may deliver a policy or contract
described in | 10 |
| subparagraph (2) (a) of paragraph (2) of Section 531.03 and
not
| 11 |
| excluded under subparagraph (2) (b) of that Section to a policy | 12 |
| or
contract owner
holder unless the document is delivered to | 13 |
| the policy or
contract
owner
holder prior to or at the time of | 14 |
| delivery of the policy or
contract. The document should also be | 15 |
| available upon request
by
a policy or contract owner
| 16 |
| policyholder . The distribution, delivery,
or contents or | 17 |
| interpretation of
this document shall not mean that either the | 18 |
| policy or the contract or the
holder thereof would be covered | 19 |
| in the event of the impairment or insolvency of
a member | 20 |
| insurer. The description document shall be revised by the | 21 |
| Association
as amendments to this Article may require. Failure | 22 |
| to receive this document
does not give the policy or
| 23 |
| policyholder, contract owner
holder , certificate holder, or | 24 |
| insured
any greater rights than those stated in this Article.
| 25 |
| (c) The document prepared under subsection (b) shall | 26 |
| contain a clear and
conspicuous disclaimer on its face. The | 27 |
| Director shall promulgate a rule
establishing the form and | 28 |
| content of the disclaimer. The disclaimer shall:
| 29 |
| (1) State the name and address of the Illinois Life and | 30 |
| Health
Insurance Guaranty
Association and of the | 31 |
| Department.
| 32 |
| (2) Prominently warn the policy or contract owner
| 33 |
| holder that the
Illinois Life and
Health Insurance Guaranty | 34 |
| Association may not cover the policy or contract
or, if | 35 |
| coverage
is available, it will be subject to substantial | 36 |
| limitations and exclusions and
conditioned on continued |
|
|
|
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| 1 |
| residence in the State.
| 2 |
| (3) State that the insurer and its agents are | 3 |
| prohibited by law from using
the existence of the Illinois
| 4 |
| Life and Health Insurance Guaranty
Association for the
| 5 |
| purpose of sales, solicitation, or inducement to purchase | 6 |
| any form of
insurance.
| 7 |
| (4) Emphasize that the policy or contract owner
holder
| 8 |
| should not
rely on
coverage under the Illinois Life and | 9 |
| Health Insurance Guaranty Association
Law when
selecting | 10 |
| an insurer.
| 11 |
| (5) Set forth the name, address, and a toll-free | 12 |
| telephone number of the
insurer
along with a statement that | 13 |
| the policy or contract owner should direct
inquiries or
| 14 |
| comments to the insurer at such address or telephone | 15 |
| number.
| 16 |
| (6)
(5) Provide other information as directed by the | 17 |
| Director.
| 18 |
| (d) (Blank).
| 19 |
| (Source: P.A. 88-364; 88-627, eff. 9-9-94; 89-97, eff. 7-7-95.)
|
|
20 |
| Section 99. Effective date. This Act takes effect on |
21 |
| January 1, 2005.
|