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Sen. William R. Haine
Filed: 5/5/2011
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1 | | AMENDMENT TO HOUSE BILL 1870
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2 | | AMENDMENT NO. ______. Amend House Bill 1870 by replacing |
3 | | everything after the enacting clause with the following:
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4 | | "Section 5. The Illinois Insurance Code is amended by |
5 | | changing Sections 245.21, 531.03, 531.05, 531.07, 531.08, |
6 | | 531.09, and 531.14 as follows:
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7 | | (215 ILCS 5/245.21) (from Ch. 73, par. 857.21)
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8 | | Sec. 245.21.
Establishment of separate accounts by |
9 | | domestic companies
organized to do a life, annuity, or accident |
10 | | and health insurance business. A
domestic company, including |
11 | | for the purposes of this
Article all domestic fraternal benefit
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12 | | societies, may, for authorized
classes of insurance, establish |
13 | | one or more
separate accounts, and may allocate thereto amounts |
14 | | (including without
limitation proceeds applied under optional |
15 | | modes of settlement or under
dividend options) to provide for |
16 | | life, annuity, or accident and health
insurance (and benefits
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1 | | incidental thereto), payable in fixed or variable amounts or |
2 | | both, subject
to the following:
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3 | | (1) The income, gains and losses, realized or unrealized, |
4 | | from
assets allocated to a separate account must be credited to |
5 | | or charged
against the account, without regard to other income, |
6 | | gains or losses of
the company.
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7 | | (2) Except as may be provided with respect to reserves for
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8 | | guaranteed benefits and funds referred to in paragraph (3) of |
9 | | this
Section (i) amounts allocated to any separate account and |
10 | | accumulations
thereon may be invested and reinvested without |
11 | | regard to any requirements
or limitations of Part 2 or Part 3 |
12 | | of Article VIII of this Code and (ii) the
investments in any |
13 | | separate account or accounts may not be taken into
account in |
14 | | applying the investment limitations otherwise applicable to |
15 | | the
investments of the company.
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16 | | (3) Except with the approval of the Director and under the
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17 | | conditions as to investments and other matters as the Director |
18 | | may
prescribe,
that must recognize the guaranteed nature of the |
19 | | benefits provided,
reserves for (i) benefits guaranteed as to |
20 | | dollar amount and duration
and (ii) funds guaranteed as to |
21 | | principal amount or stated rate of
interest may not be |
22 | | maintained in a separate account.
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23 | | (4) Unless otherwise approved by the Director, assets |
24 | | allocated to a
separate account must be valued at their market |
25 | | value on the date of
valuation, or if there is no readily |
26 | | available market, then as provided
in the contract or the rules |
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1 | | or other written agreement applicable to
the separate account. |
2 | | Unless otherwise approved by the Director, the
portion, if any, |
3 | | of the assets of the separate account equal to the
company's |
4 | | reserve liability with regard to the guaranteed benefits and
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5 | | funds referred to in paragraph (3) of this Section must be |
6 | | valued in
accordance with the rules otherwise applicable to the |
7 | | company's assets.
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8 | | (5) Amounts allocated to a separate account under this |
9 | | Article are
owned by the company, and the company may not be, |
10 | | nor hold itself out to
be, a trustee with respect to those |
11 | | amounts. The assets of any
separate account equal to the |
12 | | reserves and other contract liabilities
with respect to the |
13 | | account may not be charged with liabilities arising
out of any |
14 | | other business the company may conduct , except with approval of |
15 | | the Director under conditions as to investments and other |
16 | | matters as the Director may prescribe .
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17 | | (6) No sale, exchange or other transfer of assets may be |
18 | | made by a
company between any of its separate accounts or |
19 | | between any other
investment account and one or more of its |
20 | | separate accounts unless, in
case of a transfer into a separate |
21 | | account, the transfer is made solely
to establish the account |
22 | | or to support the operation of the contracts
with respect to |
23 | | the separate account to which the transfer is made, and
unless |
24 | | the transfer, whether into or from a separate account, is made
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25 | | (i) by a transfer of cash, or (ii) by a transfer of securities |
26 | | having a
readily determinable market value, if the transfer of |
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1 | | securities is
approved by the Director. The Director may |
2 | | approve other transfers among
those accounts if, in his or her |
3 | | opinion, the transfers would not be
inequitable.
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4 | | (7) To the extent a company considers it necessary to |
5 | | comply with
any applicable federal or state laws, the company, |
6 | | with respect to any
separate account, including without |
7 | | limitation any separate account
which is a management |
8 | | investment company or a unit investment trust, may
provide for |
9 | | persons having an interest therein appropriate voting and
other |
10 | | rights and special procedures for the conduct of the business |
11 | | of
the account, including without limitation special rights and |
12 | | procedures
relating to investment policy, investment advisory |
13 | | services, selection
of independent public accountants, and the |
14 | | selection of a committee, the
members of which need not be |
15 | | otherwise affiliated with the company, to
manage the business |
16 | | of the account.
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17 | | (Source: P.A. 90-381, eff. 8-14-97; 90-418, eff. 8-15-97;
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18 | | 90-655, eff. 7-30-98.)".
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19 | | (215 ILCS 5/531.03) (from Ch. 73, par. 1065.80-3)
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20 | | Sec. 531.03. Coverage and limitations.
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21 | | (1) This Article shall provide
coverage for the policies |
22 | | and contracts specified in paragraph (2) of this
Section:
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23 | | (a) to persons who, regardless of where they reside |
24 | | (except for
non-resident certificate holders under group |
25 | | policies or contracts), are the
beneficiaries, assignees |
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1 | | or payees of the persons covered under subparagraph
(1)(b), |
2 | | and
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3 | | (b) to persons who are owners of or certificate holders |
4 | | under the policies or contracts (other than unallocated |
5 | | annuity contracts and structured settlement annuities) and |
6 | | in each case who: |
7 | | (i) are residents; or |
8 | | (ii) are not residents, but only under all of the |
9 | | following conditions: |
10 | | (A) the insurer that issued the policies or |
11 | | contracts is domiciled in this State; |
12 | | (B) the states in which the persons reside have |
13 | | associations similar to the Association created by |
14 | | this Article; |
15 | | (C) the persons are not eligible for coverage |
16 | | by an association in any other state due to the |
17 | | fact that the insurer was not licensed in that |
18 | | state at the time specified in that state's |
19 | | guaranty association law. |
20 | | (c) For unallocated annuity contracts specified in |
21 | | subsection (2), paragraphs (a) and (b) of this subsection |
22 | | (1) shall not apply and this Article shall (except as |
23 | | provided in paragraphs (e) and (f) of this subsection) |
24 | | provide coverage to: |
25 | | (i) persons who are the owners of the unallocated |
26 | | annuity contracts if the contracts are issued to or in |
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1 | | connection with a specific benefit plan whose plan |
2 | | sponsor has its principal place of business in this |
3 | | State; and |
4 | | (ii) persons who are owners of unallocated annuity |
5 | | contracts issued to or in connection with government |
6 | | lotteries if the owners are residents. |
7 | | (d) For structured settlement annuities specified in |
8 | | subsection (2), paragraphs (a) and (b) of this subsection |
9 | | (1) shall not apply and this Article shall (except as |
10 | | provided in paragraphs (e) and (f) of this subsection) |
11 | | provide coverage to a person who is a payee under a |
12 | | structured settlement annuity (or beneficiary of a payee if |
13 | | the payee is deceased), if the payee: |
14 | | (i) is a resident, regardless of where the contract |
15 | | owner resides; or |
16 | | (ii) is not a resident, but only under both of the |
17 | | following conditions: |
18 | | (A) with regard to residency: |
19 | | (I) the contract owner of the structured |
20 | | settlement annuity is a resident; or |
21 | | (II) the contract owner of the structured |
22 | | settlement annuity is not a resident but the |
23 | | insurer that issued the structured settlement |
24 | | annuity is domiciled in this State and the |
25 | | state in which the contract owner resides has |
26 | | an association similar to the Association |
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1 | | created by this Article; and |
2 | | (B) neither the payee or beneficiary nor the |
3 | | contract owner is eligible for coverage by the |
4 | | association of the state in which the payee or |
5 | | contract owner resides. |
6 | | (e) This Article shall not provide coverage to: |
7 | | (i) a person who is a payee or beneficiary of a |
8 | | contract owner resident of this State if the payee or |
9 | | beneficiary is afforded any coverage by the |
10 | | association of another state; or |
11 | | (ii) a person covered under paragraph (c) of this |
12 | | subsection (1), if any coverage is provided by the |
13 | | association of another state to that person. |
14 | | (f) This Article is intended to provide coverage to a |
15 | | person who is a resident of this State and, in special |
16 | | circumstances, to a nonresident. In order to avoid |
17 | | duplicate coverage, if a person who would otherwise receive |
18 | | coverage under this Article is provided coverage under the |
19 | | laws of any other state, then the person shall not be |
20 | | provided coverage under this Article. In determining the |
21 | | application of the provisions of this paragraph in |
22 | | situations where a person could be covered by the |
23 | | association of more than one state, whether as an owner, |
24 | | payee, beneficiary, or assignee, this Article shall be |
25 | | construed in conjunction with other state laws to result in |
26 | | coverage by only one association.
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1 | | (2)(a) This Article shall provide coverage to the persons
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2 | | specified in paragraph (l) of this Section for direct, (i)
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3 | | nongroup life, health, annuity and
supplemental policies, or |
4 | | contracts, (ii) for
certificates under direct group policies or |
5 | | contracts, (iii) for unallocated
annuity contracts and (iv) for |
6 | | contracts to furnish
health care services and subscription |
7 | | certificates for medical or health
care services issued by |
8 | | persons licensed to transact insurance business
in this State |
9 | | under the Illinois Insurance Code.
Annuity contracts and |
10 | | certificates under group annuity contracts include
but are not |
11 | | limited to guaranteed investment contracts, deposit
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12 | | administration contracts, unallocated funding agreements, |
13 | | allocated funding
agreements, structured settlement |
14 | | agreements, lottery contracts
and any immediate or deferred |
15 | | annuity contracts.
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16 | | (b) This Article shall not provide coverage for:
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17 | | (i) that portion of a policy or contract not guaranteed |
18 | | by the insurer, or under which the risk is borne by the |
19 | | policy or contract owner;
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20 | | (ii) any such policy or contract or part thereof |
21 | | assumed by the impaired
or insolvent insurer under a |
22 | | contract of reinsurance, other than reinsurance
for which |
23 | | assumption certificates have been issued;
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24 | | (iii) any portion of a policy or contract to the extent |
25 | | that the rate of interest on which it is based or the |
26 | | interest rate, crediting rate, or similar factor is |
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1 | | determined by use of an index or other external reference |
2 | | stated in the policy or contract employed in calculating |
3 | | returns or changes in value:
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4 | | (A) averaged over the period of 4 years prior to |
5 | | the date on which the member insurer becomes an |
6 | | impaired or insolvent insurer under this Article, |
7 | | whichever is earlier, exceeds the rate of interest |
8 | | determined by subtracting 2 percentage points from |
9 | | Moody's Corporate Bond Yield Average averaged for that |
10 | | same 4-year period or for such lesser period if the |
11 | | policy or contract was issued less than 4 years before |
12 | | the member insurer becomes an impaired or insolvent |
13 | | insurer under this Article, whichever is earlier; and
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14 | | (B) on and after the date on which the member |
15 | | insurer becomes an impaired or insolvent insurer under |
16 | | this Article, whichever is earlier, exceeds the rate of |
17 | | interest determined by subtracting 3 percentage points |
18 | | from Moody's Corporate Bond Yield Average as most |
19 | | recently available;
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20 | | (iv) any unallocated annuity contract issued to or in |
21 | | connection with a benefit plan protected under the federal |
22 | | Pension Benefit Guaranty Corporation, regardless of |
23 | | whether the federal Pension Benefit Guaranty Corporation |
24 | | has yet become liable to make any payments with respect to |
25 | | the benefit plan;
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26 | | (v) any portion of any unallocated annuity contract |
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1 | | which is not issued
to or in connection with a specific |
2 | | employee, union or association of
natural persons benefit |
3 | | plan or a government lottery;
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4 | | (vi) an obligation that does not arise under the |
5 | | express written terms of the policy or contract issued by |
6 | | the insurer to the contract owner or policy owner, |
7 | | including without limitation: |
8 | | (A) a claim based on marketing materials; |
9 | | (B) a claim based on side letters, riders, or other |
10 | | documents that were issued by the insurer without |
11 | | meeting applicable policy form filing or approval |
12 | | requirements; |
13 | | (C) a misrepresentation of or regarding policy |
14 | | benefits; |
15 | | (D) an extra-contractual claim; or |
16 | | (E) a claim for penalties or consequential or |
17 | | incidental damages;
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18 | | (vii) any stop-loss insurance, as defined in clause (b) |
19 | | of Class 1 or
clause (a) of Class 2 of Section 4, and |
20 | | further defined in subsection (d) of
Section 352;
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21 | | (viii) any policy or contract providing any hospital, |
22 | | medical, prescription drug, or other health care benefits |
23 | | pursuant to Part C or Part D of Subchapter XVIII, Chapter 7 |
24 | | of Title 42 of the United States Code (commonly known as |
25 | | Medicare Part C & D) or any regulations issued pursuant |
26 | | thereto; |
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1 | | (ix) any portion of a policy or contract to the extent |
2 | | that the assessments required by Section 531.09 of this |
3 | | Code with respect to the policy or contract are preempted |
4 | | or otherwise not permitted by federal or State law; |
5 | | (x) any portion of a policy or contract issued to a |
6 | | plan or program of an employer, association, or other |
7 | | person to provide life, health, or annuity benefits to its |
8 | | employees, members, or others to the extent that the plan |
9 | | or program is self-funded or uninsured, including, but not |
10 | | limited to, benefits payable by an employer, association, |
11 | | or other person under: |
12 | | (A) a multiple employer welfare arrangement as |
13 | | defined in 29 U.S.C. Section 1002 29 U.S.C. Section |
14 | | 1144 ; |
15 | | (B) a minimum premium group insurance plan; |
16 | | (C) a stop-loss group insurance plan; or |
17 | | (D) an administrative services only contract; |
18 | | (xi) any portion of a policy or contract to the extent |
19 | | that it provides for: |
20 | | (A) dividends or experience rating credits; |
21 | | (B) voting rights; or |
22 | | (C) payment of any fees or allowances to any |
23 | | person, including the policy or contract owner, in |
24 | | connection with the service to or administration of the |
25 | | policy or contract; |
26 | | (xii) any policy or contract issued in this State by a |
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1 | | member insurer at a time when it was not licensed or did |
2 | | not have a certificate of authority to issue the policy or |
3 | | contract in this State; |
4 | | (xiii) any contractual agreement that establishes the |
5 | | member insurer's obligations to provide a book value |
6 | | accounting guaranty for defined contribution benefit plan |
7 | | participants by reference to a portfolio of assets that is |
8 | | owned by the benefit plan or its trustee, which in each |
9 | | case is not an affiliate of the member insurer; |
10 | | (xiv) any portion of a policy or contract to the extent |
11 | | that it provides for interest or other changes in value to |
12 | | be determined by the use of an index or other external |
13 | | reference stated in the policy or contract, but which have |
14 | | not been credited to the policy or contract, or as to which |
15 | | the policy or contract owner's rights are subject to |
16 | | forfeiture, as of the date the member insurer becomes an |
17 | | impaired or insolvent insurer under this Code, whichever is |
18 | | earlier. If a policy's or contract's interest or changes in |
19 | | value are credited less frequently than annually, then for |
20 | | purposes of determining the values that have been credited |
21 | | and are not subject to forfeiture under this Section, the |
22 | | interest or change in value determined by using the |
23 | | procedures defined in the policy or contract will be |
24 | | credited as if the contractual date of crediting interest |
25 | | or changing values was the date of impairment or |
26 | | insolvency, whichever is earlier, and will not be subject |
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1 | | to forfeiture; or
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2 | | (xv) that portion or part of a variable life insurance |
3 | | or
variable
annuity
contract not guaranteed by an insurer.
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4 | | (3) The benefits for which the Association may become |
5 | | liable shall in
no event exceed the lesser of:
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6 | | (a) the contractual obligations for which the insurer |
7 | | is liable or would
have been liable if it were not an |
8 | | impaired or insolvent insurer, or
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9 | | (b)(i) with respect to any one life, regardless of the |
10 | | number of policies
or
contracts:
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11 | | (A) $300,000 in life insurance death benefits, but |
12 | | not more than
$100,000 in net cash surrender and net |
13 | | cash withdrawal values for life
insurance;
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14 | | (B) in health insurance benefits: |
15 | | (I) $100,000 for coverages not defined as |
16 | | disability insurance or basic hospital, medical, |
17 | | and surgical insurance or major medical insurance |
18 | | or long-term care insurance, including any net |
19 | | cash surrender and net cash withdrawal values; |
20 | | (II) $300,000 for disability insurance and |
21 | | $300,000 for long-term care insurance as defined |
22 | | in Section 351A-1 of this Code ; and |
23 | | (III) $500,000 for basic hospital medical and |
24 | | surgical insurance or major medical insurance;
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25 | | (C) $250,000 in the present value of annuity |
26 | | benefits, including net cash surrender and net cash |
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1 | | withdrawal values; |
2 | | (ii) with respect to each individual participating in a |
3 | | governmental retirement benefit plan established under |
4 | | Sections 401, 403(b), or 457 of the U.S. Internal Revenue |
5 | | Code covered by an unallocated annuity contract or the |
6 | | beneficiaries of each such individual if deceased, in the |
7 | | aggregate, $250,000 in present value annuity benefits, |
8 | | including net cash surrender and net cash withdrawal |
9 | | values; |
10 | | (iii) with respect to each payee of a structured |
11 | | settlement annuity or beneficiary or beneficiaries of the |
12 | | payee if deceased, $250,000 in present value annuity |
13 | | benefits, in the aggregate, including net cash surrender |
14 | | and net cash withdrawal values, if any; or |
15 | | (iv) with respect to either (1) one contract owner |
16 | | provided coverage under subparagraph (ii) of paragraph (c) |
17 | | of subsection (1) of this Section or (2) one plan sponsor |
18 | | whose plans own directly or in trust one or more |
19 | | unallocated annuity contracts not included in subparagraph |
20 | | (ii) of paragraph (b) of this subsection, $5,000,000 in |
21 | | benefits, irrespective of the number of contracts with |
22 | | respect to the contract owner or plan sponsor. However, in |
23 | | the case where one or more unallocated annuity contracts |
24 | | are covered contracts under this Article and are owned by a |
25 | | trust or other entity for the benefit of 2 or more plan |
26 | | sponsors, coverage shall be afforded by the Association if |
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1 | | the largest interest in the trust or entity owning the |
2 | | contract or contracts is held by a plan sponsor whose |
3 | | principal place of business is in this State. In no event |
4 | | shall the Association be obligated to cover more than |
5 | | $5,000,000 in benefits with respect to all these |
6 | | unallocated contracts. |
7 | | (3.1) Notwithstanding the provisions of subsection (3), in |
8 | | In no event shall the Association be obligated to cover more |
9 | | than (1) an aggregate of $300,000 in benefits with respect to |
10 | | any one life under subparagraphs (i), (ii), and (iii) of this |
11 | | paragraph (b) of subsection (3) except with respect to benefits |
12 | | for basic hospital, medical, and surgical insurance and major |
13 | | medical insurance under item (B) of subparagraph (i) of this |
14 | | paragraph (b) of subsection (3) , in which case the aggregate |
15 | | liability of the Association shall not exceed $500,000 with |
16 | | respect to any one individual or (2) with respect to one owner |
17 | | of multiple nongroup policies of life insurance, whether the |
18 | | policy owner is an individual, firm, corporation, or other |
19 | | person and whether the persons insured are officers, managers, |
20 | | employees, or other persons, $5,000,000 in benefits, |
21 | | regardless of the number of policies and contracts held by the |
22 | | owner. |
23 | | (3.2) The limitations set forth in subsections (3) and |
24 | | (3.1) this subsection are limitations on the benefits for which |
25 | | the Association is obligated before taking into account either |
26 | | its subrogation and assignment rights or the extent to which |
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1 | | those benefits could be provided out of the assets of the |
2 | | impaired or insolvent insurer attributable to covered |
3 | | policies. The costs of the Association's obligations under this |
4 | | Article may be met by the use of assets attributable to covered |
5 | | policies or reimbursed to the Association pursuant to its |
6 | | subrogation and assignment rights.
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7 | | (4) In performing its obligations to provide coverage under |
8 | | Section 531.08 of this Code, the Association shall not be |
9 | | required to guarantee, assume, reinsure, or perform or cause to |
10 | | be guaranteed, assumed, reinsured, or performed the |
11 | | contractual obligations of the insolvent or impaired insurer |
12 | | under a covered policy or contract that do not materially |
13 | | affect the economic values or economic benefits of the covered |
14 | | policy or contract. |
15 | | (Source: P.A. 96-1450, eff. 8-20-10.)
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16 | | (215 ILCS 5/531.05) (from Ch. 73, par. 1065.80-5)
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17 | | Sec. 531.05. Definitions. As used in this Act:
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18 | | "Account" means either of the 2 3 accounts created under |
19 | | Section
531.06.
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20 | | "Association" means the Illinois Life and Health Insurance
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21 | | Guaranty Association created under Section 531.06.
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22 | | "Authorized assessment" or the term "authorized" when used |
23 | | in the context of assessments means a resolution by the Board |
24 | | of Directors has been passed whereby an assessment shall be |
25 | | called immediately or in the future from member insurers for a |
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1 | | specified amount. An assessment is authorized when the |
2 | | resolution is passed. |
3 | | "Benefit plan" means a specific employee, union, or |
4 | | association of natural persons benefit plan. |
5 | | "Called assessment" or the term "called" when used in the |
6 | | context of assessments means that a notice has been issued by |
7 | | the Association to member insurers requiring that an authorized |
8 | | assessment be paid within the time frame set forth within the |
9 | | notice. An authorized assessment becomes a called assessment |
10 | | when notice is mailed by the Association to member insurers. |
11 | | "Director" means the Director of Insurance of this State.
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12 | | "Contractual obligation" means any obligation under a |
13 | | policy or
contract or certificate under a group policy or |
14 | | contract, or portion
thereof for which coverage is provided |
15 | | under Section 531.03.
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16 | | "Covered person" means any person who is entitled to the
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17 | | protection of the Association as described in Section 531.02.
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18 | | "Covered policy" means any policy or contract within the |
19 | | scope
of this Article under Section 531.03.
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20 | | "Extra-contractual claims" shall include , for example, |
21 | | claims relating to bad faith in the payment of claims, punitive |
22 | | or exemplary damages, or attorneys' fees and costs. |
23 | | "Impaired insurer" means (A) a member insurer which, after |
24 | | the effective date of this amendatory Act of the 96th General |
25 | | Assembly, is not an insolvent insurer, and is placed under an |
26 | | order of rehabilitation or conservation by a court of competent |
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1 | | jurisdiction or (B) a member insurer deemed by the Director |
2 | | after the effective date of this amendatory Act of the 96th |
3 | | General Assembly to be potentially unable to fulfill its |
4 | | contractual obligations and not an insolvent insurer.
|
5 | | "Insolvent insurer" means a member insurer that, after the |
6 | | effective date of this amendatory Act of the 96th General |
7 | | Assembly, is placed under a final order of liquidation by a |
8 | | court of competent jurisdiction with a finding of insolvency.
|
9 | | "Member insurer" means an insurer licensed or holding a |
10 | | certificate of authority to transact in this State any kind of |
11 | | insurance for which coverage is provided under Section 531.03 |
12 | | of this Code and includes an insurer whose license or |
13 | | certificate of authority in this State may have been suspended, |
14 | | revoked, not renewed, or voluntarily withdrawn or whose |
15 | | certificate of authority may have been suspended pursuant to |
16 | | Section 119 of this Code, but does not include: |
17 | | (1) a hospital or medical service organization, |
18 | | whether profit or nonprofit; |
19 | | (2) a health maintenance organization; |
20 | | (3) any burial society organized under Article XIX of |
21 | | this Code, any fraternal benefit society organized under |
22 | | Article XVII of this Code, any mutual benefit association |
23 | | organized under Article XVIII of this Code, and any foreign |
24 | | fraternal benefit society licensed under Article VI of this |
25 | | Code or
a fraternal benefit society ; |
26 | | (4) a mandatory State pooling plan; |
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1 | | (5) a mutual assessment company or other person that |
2 | | operates on an assessment basis; |
3 | | (6) an insurance exchange; |
4 | | (7) an organization that is permitted to issue |
5 | | charitable gift annuities pursuant to Section 121-2.10 of |
6 | | this Code; |
7 | | (8) any health services plan corporation established |
8 | | pursuant to the Voluntary Health Services Plans Act; |
9 | | (9) any dental service plan corporation established |
10 | | pursuant to the Dental Service Plan Act; or |
11 | | (10) an entity similar to any of the above.
|
12 | | "Moody's Corporate Bond Yield Average" means the Monthly |
13 | | Average
Corporates as published by Moody's Investors Service, |
14 | | Inc., or any successor
thereto. |
15 | | "Owner" of a policy or contract and "policy owner" and |
16 | | "contract owner" mean the person who is identified as the legal |
17 | | owner under the terms of the policy or contract or who is |
18 | | otherwise vested with legal title to the policy or contract |
19 | | through a valid assignment completed in accordance with the |
20 | | terms of the policy or contract and properly recorded as the |
21 | | owner on the books of the insurer. The terms owner, contract |
22 | | owner, and policy owner do not include persons with a mere |
23 | | beneficial interest in a policy or contract. |
24 | | "Person" means an individual, corporation, limited |
25 | | liability company, partnership, association, governmental body |
26 | | or entity, or voluntary organization. |
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1 | | "Plan sponsor" means: |
2 | | (1) the employer in the case of a benefit plan |
3 | | established or maintained by a single employer; |
4 | | (2) the employee organization in the case of a benefit |
5 | | plan established or maintained by an employee |
6 | | organization; or |
7 | | (3) in a case of a benefit plan established or |
8 | | maintained by 2 or more employers or jointly by one or more |
9 | | employers and one or more employee organizations, the |
10 | | association, committee, joint board of trustees, or other |
11 | | similar group of representatives of the parties who |
12 | | establish or maintain the benefit plan. |
13 | | "Premiums" mean amounts or considerations, by whatever |
14 | | name called, received on covered policies or contracts less |
15 | | returned premiums, considerations, and deposits and less |
16 | | dividends and experience credits. |
17 | | "Premiums" does not include: |
18 | | (A) amounts or considerations received for policies or |
19 | | contracts or for the portions of policies or contracts for |
20 | | which coverage is not provided under Section 531.03 of this |
21 | | Code except that assessable premium shall not be reduced on |
22 | | account of the provisions of subparagraph (iii) of |
23 | | paragraph (b) of subsection (2) (a) of Section 531.03 of |
24 | | this Code relating to interest limitations and the |
25 | | provisions of paragraph (b) of subsection (3) , subsection |
26 | | (3.1), or subsection (3.2) of Section 531.03 relating to |
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1 | | limitations with respect to one individual, one |
2 | | participant, and one contract owner; |
3 | | (B) premiums in excess of $5,000,000 on an unallocated |
4 | | annuity contract not issued under a governmental |
5 | | retirement benefit plan (or its trustee) established under |
6 | | Section 401, 403(b) or 457 of the United States Internal |
7 | | Revenue Code; or |
8 | | (C) with respect to multiple nongroup policies of life |
9 | | insurance owned by one owner, whether the policy owner is |
10 | | an individual, firm, corporation, or other person, and |
11 | | whether the persons insured are officers, managers, |
12 | | employees, or other persons, premiums in excess of |
13 | | $5,000,000 with respect to these policies or contracts, |
14 | | regardless of the number of policies or contracts held by |
15 | | the owner.
|
16 | | "Principal place of business" of a plan sponsor or a person |
17 | | other than a natural person means the single state in which the |
18 | | natural persons who establish policy for the direction, |
19 | | control, and coordination of the operations of the entity as a |
20 | | whole primarily exercise that function, determined by the |
21 | | Association in its reasonable judgment by considering the |
22 | | following factors: |
23 | | (A) the state in which the primary executive and |
24 | | administrative headquarters of the entity is located; |
25 | | (B) the state in which the principal office of the |
26 | | chief executive officer of the entity is located; |
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1 | | (C) the state in which the board of directors (or |
2 | | similar governing person or persons) of the entity conducts |
3 | | the majority of its meetings; |
4 | | (D) the state in which the executive or management |
5 | | committee of the board of directors (or similar governing |
6 | | person or persons) of the entity conducts the majority of |
7 | | its meetings; |
8 | | (E) the state from which the management of the overall |
9 | | operations of the entity is directed; and |
10 | | (F) in the case of a benefit plan sponsored by |
11 | | affiliated companies comprising a consolidated |
12 | | corporation, the state in which the holding company or |
13 | | controlling affiliate has its principal place of business |
14 | | as determined using the above factors. |
15 | | However, in the case of a plan sponsor, if more than 50% of |
16 | | the participants in the benefit plan are employed in a single |
17 | | state, that state shall be deemed to be the principal place of |
18 | | business of the plan sponsor. |
19 | | The principal place of business of a plan sponsor of a |
20 | | benefit plan described in paragraph (3) of the definition of |
21 | | "plan sponsor" this Section shall be deemed to be the principal |
22 | | place of business of the association, committee, joint board of |
23 | | trustees, or other similar group of representatives of the |
24 | | parties who establish or maintain the benefit plan that, in |
25 | | lieu of a specific or clear designation of a principal place of |
26 | | business, shall be deemed to be the principal place of business |
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1 | | of the employer or employee organization that has the largest |
2 | | investment in the benefit plan in question. |
3 | | "Receivership court" means the court in the insolvent or |
4 | | impaired insurer's state having jurisdiction over the |
5 | | conservation, rehabilitation, or liquidation of the insurer. |
6 | | "Resident" means a person to whom a contractual obligation |
7 | | is owed and who resides in this State on the date of entry of a |
8 | | court order that determines a member insurer to be an impaired |
9 | | insurer or a court order that determines a member insurer to be |
10 | | an insolvent insurer. A person may be a resident of only one |
11 | | state, which in the case of a person other than a natural |
12 | | person shall be its principal place of business. Citizens of |
13 | | the United States that are either (i) residents of foreign |
14 | | countries or (ii) residents of United States possessions, |
15 | | territories, or protectorates that do not have an association |
16 | | similar to the Association created by this Article, shall be |
17 | | deemed residents of the state of domicile of the insurer that |
18 | | issued the policies or contracts.
|
19 | | "Structured settlement annuity" means an annuity purchased |
20 | | in order to fund periodic payments for a plaintiff or other |
21 | | claimant in payment for or with respect to personal injury |
22 | | suffered by the plaintiff or other claimant. |
23 | | "State" means a state, the District of Columbia, Puerto |
24 | | Rico, and a United States possession, territory, or |
25 | | protectorate. |
26 | | "Supplemental contract" means a written agreement entered |
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1 | | into for the distribution of proceeds under a life, health, or |
2 | | annuity policy or a life, health, or annuity contract.
|
3 | | "Unallocated annuity contract" means any annuity contract |
4 | | or group
annuity certificate which is not issued to and owned |
5 | | by an individual,
except to the extent of any annuity benefits |
6 | | guaranteed to an individual by
an insurer under such contract |
7 | | or certificate.
|
8 | | (Source: P.A. 96-1450, eff. 8-20-10.)
|
9 | | (215 ILCS 5/531.07) (from Ch. 73, par. 1065.80-7)
|
10 | | Sec. 531.07. Board of Directors. ) The board of directors |
11 | | of the
Association consists of not less than 7 nor more than 11 |
12 | | members serving
terms as established in the plan of operation. |
13 | | The insurer members insurers of the board
are to be selected by |
14 | | member insurers subject to the approval of the
Director. In |
15 | | addition, 2 persons who must be public representatives may be |
16 | | appointed by the Director to the board of directors. A public |
17 | | representative may not be an officer, director, or employee of |
18 | | an insurance company or any person engaged in the business of |
19 | | insurance. Vacancies on the board must be filled for the |
20 | | remaining period
of the term in the manner described in the |
21 | | plan of operation.
|
22 | | In approving selections or in appointing members to the |
23 | | board, the
Director must consider, whether all member insurers |
24 | | are
fairly represented.
|
25 | | Members of the board may be reimbursed from the assets of |
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1 | | the Association
for expenses incurred by them as members of the |
2 | | board of directors but
members of the board may not otherwise |
3 | | be compensated by the Association for
their services.
|
4 | | (Source: P.A. 96-1450, eff. 8-20-10.)
|
5 | | (215 ILCS 5/531.08) (from Ch. 73, par. 1065.80-8)
|
6 | | Sec. 531.08. Powers and duties of the Association. |
7 | | (a) In addition to
the powers and duties enumerated in |
8 | | other Sections of this Article:
|
9 | | (1) If a member insurer is an impaired insurer, then |
10 | | the Association may, in its discretion and subject to any |
11 | | conditions imposed by the Association that do not impair |
12 | | the contractual obligations of the impaired insurer and |
13 | | that are approved by the Director: |
14 | | (a) (A) guarantee, assume, or reinsure or cause to |
15 | | be guaranteed, assumed, or reinsured, any or all of the |
16 | | policies or contracts of the impaired insurer; or |
17 | | (b) (B) provide such money, pledges, loans, notes, |
18 | | guarantees, or other means as are proper to effectuate |
19 | | paragraph (a) (A) and assure payment of the contractual |
20 | | obligations of the impaired insurer pending action |
21 | | under paragraph (a) (A) . |
22 | | (2) If a member insurer is an insolvent insurer, then |
23 | | the Association shall, in its discretion, either: |
24 | | (a) (A) guaranty, assume, or reinsure or cause to |
25 | | be guaranteed, assumed, or reinsured the policies or |
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1 | | contracts of the insolvent insurer or assure payment of |
2 | | the contractual obligations of the insolvent insurer |
3 | | and provide money, pledges, loans, notes, guarantees, |
4 | | or other means reasonably necessary to discharge the |
5 | | Association's duties; or |
6 | | (b) (B) provide benefits and coverages in |
7 | | accordance with the following provisions: |
8 | | (i) with respect to life and health insurance |
9 | | policies and annuities, assure ensure payment of |
10 | | benefits for premiums identical to the premiums |
11 | | and benefits (except for terms of conversion and |
12 | | renewability) that would have been payable under |
13 | | the policies or contracts of the insolvent insurer |
14 | | for claims incurred: |
15 | | (A) (a) with respect to group policies and |
16 | | contracts, not later than the earlier of the |
17 | | next renewal date under those policies or |
18 | | contracts or 45 days, but in no event less than |
19 | | 30 days, after the date on which the |
20 | | Association becomes obligated with respect to |
21 | | the policies and contracts; |
22 | | (B) (b) with respect to nongroup policies, |
23 | | contracts, and annuities not later than the |
24 | | earlier of the next renewal date (if any) under |
25 | | the policies or contracts or one year, but in |
26 | | no event less than 30 days, from the date on |
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1 | | which the Association becomes obligated with |
2 | | respect to the policies or contracts; |
3 | | (ii) make diligent efforts to provide all |
4 | | known insureds or annuitants (for nongroup |
5 | | policies and contracts), or group policy owners |
6 | | with respect to group policies and contracts, 30 |
7 | | days notice of the termination (pursuant to |
8 | | subparagraph (i) of this paragraph (b) (B) ) of the |
9 | | benefits provided; |
10 | | (iii) with respect to nongroup life and health |
11 | | insurance policies and annuities covered by the |
12 | | Association, make available to each known insured |
13 | | or annuitant, or owner if other than the insured or |
14 | | annuitant, and with respect to an individual |
15 | | formerly insured or formerly an annuitant under a |
16 | | group policy who is not eligible for replacement |
17 | | group coverage, make available substitute coverage |
18 | | on an individual basis in accordance with the |
19 | | provisions of paragraph (iv) (3) , if the insureds |
20 | | or annuitants had a right under law or the |
21 | | terminated policy or annuity to convert coverage |
22 | | to individual coverage or to continue an |
23 | | individual policy or annuity in force until a |
24 | | specified age or for a specified time, during which |
25 | | the insurer had no right unilaterally to make |
26 | | changes in any provision of the policy or annuity |
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1 | | or had a right only to make changes in premium by |
2 | | class.
|
3 | |
(iv) (b) In providing the substitute coverage |
4 | | required under subparagraph (iii) , of paragraph |
5 | | (B) of item (2) of subsection (a)
of this Section, |
6 | | the Association may offer either to reissue the
|
7 | | terminated coverage or to issue an alternative |
8 | | policy.
|
9 | |
Alternative or reissued policies shall be |
10 | | offered without requiring
evidence of |
11 | | insurability, and shall not provide for any |
12 | | waiting period or
exclusion that would not have |
13 | | applied under the terminated policy.
|
14 | |
The Association may reinsure any alternative |
15 | | or reissued policy.
|
16 | |
Alternative policies adopted by the |
17 | | Association shall be subject
to the approval of the |
18 | | Director. The Association may adopt alternative
|
19 | | policies of various types for future insurance |
20 | | without regard to any
particular impairment or |
21 | | insolvency.
|
22 | |
(v) Alternative policies shall contain at |
23 | | least the minimum statutory
provisions required in |
24 | | this State and provide benefits that shall not be
|
25 | | unreasonable in relation to the premium charged. |
26 | | The
Association shall set the premium in |
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1 | | accordance with a table of rates which
it shall |
2 | | adopt. The premium shall reflect the amount of |
3 | | insurance to be
provided and the age and class of |
4 | | risk of each insured, but shall not
reflect any |
5 | | changes in the health of the insured after the |
6 | | original policy
was last underwritten.
|
7 | |
Any alternative policy issued by the |
8 | | Association shall provide
coverage of a type |
9 | | similar to that of the policy issued by the |
10 | | impaired or
insolvent insurer, as determined by |
11 | | the Association.
|
12 | |
(vi) (c) If the Association elects to reissue |
13 | | terminated coverage at a
premium rate different |
14 | | from that charged under the terminated policy, the
|
15 | | premium shall be set by the Association in |
16 | | accordance with the amount of
insurance provided |
17 | | and the age and class of risk, subject to approval |
18 | | of
the Director or by a court of competent |
19 | | jurisdiction.
|
20 | |
(vii) (d) The Association's obligations with |
21 | | respect to coverage under any
policy of the |
22 | | impaired or insolvent insurer or under any |
23 | | reissued or
alternative policy shall cease on the |
24 | | date such coverage or policy is
replaced by another |
25 | | similar policy by the policyholder, the insured, |
26 | | or the
Association.
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1 | |
(viii) (e) When proceeding under this Section |
2 | | with
respect to any policy or contract carrying |
3 | | guaranteed minimum interest
rates, the Association |
4 | | shall assure the payment or crediting of a rate of
|
5 | | interest consistent with subparagraph |
6 | | (2)(b)(iii)(B) of Section 531.03.
|
7 | |
(3) (f) Nonpayment of premiums thirty-one days after |
8 | | the date required under
the terms of any guaranteed, |
9 | | assumed, alternative or reissued policy or
contract or |
10 | | substitute coverage shall terminate the Association's
|
11 | | obligations under such policy or coverage under this Act |
12 | | with respect to
such policy or coverage, except with |
13 | | respect to any claims incurred or any
net cash surrender |
14 | | value which may be due in accordance with the provisions of
|
15 | | this Act.
|
16 | |
(4) (g) Premiums due for coverage after entry of an |
17 | | order of liquidation of
an insolvent insurer shall belong |
18 | | to and be payable at the direction of the
Association,
and |
19 | | the Association shall be liable for unearned premiums due |
20 | | to policy or
contract owners arising after the entry of |
21 | | such order.
|
22 | | (5) (h) In carrying out its duties under paragraph (2) |
23 | | of subsection (a) of this Section, the Association may: |
24 | | (a) (1) subject to approval by a court in this |
25 | | State , impose permanent policy or contract liens in |
26 | | connection with a guarantee, assumption, or |
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1 | | reinsurance agreement if the Association finds that |
2 | | the amounts which can be assessed under this Article |
3 | | are less than the amounts needed to assure full and |
4 | | prompt performance of the Association's duties under |
5 | | this Article or that the economic or financial |
6 | | conditions as they affect member insurers are |
7 | | sufficiently adverse to render the imposition of such |
8 | | permanent policy or contract liens to be in the public |
9 | | interest; or |
10 | | (b) (2) subject to approval by a court in this |
11 | | State , impose temporary moratoriums or liens on |
12 | | payments of cash values and policy loans or any other |
13 | | right to withdraw funds held in conjunction with |
14 | | policies or contracts in addition to any contractual |
15 | | provisions for deferral of cash or policy loan value. |
16 | | In addition, in the event of a temporary moratorium or |
17 | | moratorium charge imposed by the receivership court on |
18 | | payment of cash values or policy loans or on any other |
19 | | right to withdraw funds held in conjunction with |
20 | | policies or contracts, out of the assets of the |
21 | | impaired or insolvent insurer, the Association may |
22 | | defer the payment of cash values, policy loans, or |
23 | | other rights by the Association for the period of the |
24 | | moratorium or moratorium charge imposed by the |
25 | | receivership court, except for claims covered by the |
26 | | Association to be paid in accordance with a hardship |
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1 | | procedure established by the liquidator or |
2 | | rehabilitator and approved by the receivership court.
|
3 | | (6) (i) There shall be no liability on the part of and |
4 | | no cause of action
shall arise against the Association or |
5 | | against any transferee from the
Association in connection |
6 | | with the transfer by reinsurance or otherwise of
all or any |
7 | | part of an impaired or insolvent insurer's business by |
8 | | reason of
any action taken or any failure to take any |
9 | | action by the impaired or
insolvent insurer at any time.
|
10 | | (7) (j) If the Association fails to act within a |
11 | | reasonable period of
time as provided in subsection (2) of |
12 | | this Section with respect to an
insolvent insurer, the
|
13 | | Director shall have the powers and duties of the |
14 | | Association under this
Act with regard to such insolvent |
15 | | insurers.
|
16 | | (8) (k) The Association or its designated |
17 | | representatives
may render assistance and advice to the
|
18 | | Director, upon his request, concerning rehabilitation, |
19 | | payment of
claims, continuations of coverage, or the |
20 | | performance of other
contractual obligations of any |
21 | | impaired or insolvent insurer.
|
22 | | (9) (l) The Association shall have standing to appear |
23 | | or intervene before a court or agency in this State with |
24 | | jurisdiction over an impaired or insolvent insurer |
25 | | concerning which the Association is or may become obligated |
26 | | under this Article or with jurisdiction over any person or |
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1 | | property against which the Association may have rights |
2 | | through subrogation or otherwise. Standing shall extend to |
3 | | all matters germane to the powers and duties of the |
4 | | Association, including, but not limited to, proposals for |
5 | | reinsuring, modifying, or guaranteeing the policies or |
6 | | contracts of the impaired or insolvent insurer and the |
7 | | determination of the policies or contracts and contractual |
8 | | obligations. The Association shall also have the right to |
9 | | appear or intervene before a court or agency in another |
10 | | state with jurisdiction over an impaired or insolvent |
11 | | insurer for which the Association is or may become |
12 | | obligated or with jurisdiction over any person or property |
13 | | against whom the Association may have rights through |
14 | | subrogation or otherwise.
|
15 | | (10)(a) (m)(1) A person receiving benefits under this |
16 | | Article shall be deemed to have assigned the rights under |
17 | | and any causes of action against any person for losses |
18 | | arising under, resulting from, or otherwise relating to the |
19 | | covered policy or contract to the Association to the extent |
20 | | of the benefits received because of this Article, whether |
21 | | the benefits are payments of or on account of contractual |
22 | | obligations, continuation of coverage, or provision of |
23 | | substitute or alternative coverages. The Association may |
24 | | require an assignment to it of such rights and cause of |
25 | | action by any payee, policy, or contract owner, |
26 | | beneficiary, insured, or annuitant as a condition |
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1 | | precedent to the receipt of any right or benefits conferred |
2 | | by this Article upon the person.
|
3 | | (b) (2) The subrogation rights of the Association under |
4 | | this subsection
have the same priority against the assets |
5 | | of the impaired or insolvent insurer as
that possessed by |
6 | | the person entitled to receive benefits under this
Article. |
7 | | (c) (3) In addition to paragraphs (a) (1) and (b) (2) , |
8 | | the Association shall have all common law rights of |
9 | | subrogation and any other equitable or legal remedy that |
10 | | would have been available to the impaired or insolvent |
11 | | insurer or owner, beneficiary, or payee of a policy or |
12 | | contract with respect to the policy or contracts, including |
13 | | without limitation, in the case of a structured settlement |
14 | | annuity, any rights of the owner, beneficiary, or payee of |
15 | | the annuity to the extent of benefits received pursuant to |
16 | | this Article, against a person originally or by succession |
17 | | responsible for the losses arising from the personal injury |
18 | | relating to the annuity or payment therefor, excepting any |
19 | | such person responsible solely by reason of serving as an |
20 | | assignee in respect of a qualified assignment under |
21 | | Internal Revenue Code Section 130. |
22 | | (d) (4) If the preceding provisions of this subsection |
23 | | (10) (l) are invalid or ineffective with respect to any |
24 | | person or claim for any reason, then the amount payable by |
25 | | the Association with respect to the related covered |
26 | | obligations shall be reduced by the amount realized by any |
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1 | | other person with respect to the person or claim that is |
2 | | attributable to the policies, or portion thereof, covered |
3 | | by the Association. |
4 | | (e) (5) If the Association has provided benefits with |
5 | | respect to a covered obligation and a person recovers |
6 | | amounts as to which the Association has rights as described |
7 | | in the preceding paragraphs of this subsection (10), then |
8 | | the person shall pay to the Association the portion of the |
9 | | recovery attributable to the policies, or portion thereof, |
10 | | covered by the Association.
|
11 | | (11) (n) The Association may:
|
12 | | (a) (1) Enter into such contracts as are necessary |
13 | | or proper to carry
out the provisions and purposes of |
14 | | this Article . ;
|
15 | | (b) (2) Sue or be sued, including taking any legal |
16 | | actions necessary or
proper for recovery of any unpaid |
17 | | assessments under Section 531.09. The
Association |
18 | | shall not be liable for punitive or exemplary damages . ;
|
19 | | (c) (3) Borrow money to effect the purposes of this |
20 | | Article. Any notes
or other evidence of indebtedness of |
21 | | the Association not in default are
legal investments |
22 | | for domestic insurers and may be carried as admitted
|
23 | | assets.
|
24 | | (d) (4) Employ or retain such persons as are |
25 | | necessary to handle the
financial transactions of the |
26 | | Association, and to perform such other
functions as |
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1 | | become necessary or proper under this Article.
|
2 | | (e) (5) Negotiate and contract with any |
3 | | liquidator, rehabilitator,
conservator, or ancillary |
4 | | receiver to carry out the powers and duties of
the |
5 | | Association.
|
6 | | (f) (6) Take such legal action as may be necessary |
7 | | to avoid payment of
improper claims.
|
8 | | (g) (7) Exercise, for the purposes of this Article |
9 | | and to the extent
approved by the Director, the powers |
10 | | of a domestic life or health
insurer, but in no case |
11 | | may the Association issue insurance policies or
|
12 | | annuity contracts other than those issued to perform |
13 | | the contractual
obligations of the impaired or |
14 | | insolvent insurer.
|
15 | | (h) (8) Exercise all the rights of the Director |
16 | | under Section 193(4) of
this Code with respect to |
17 | | covered policies after the association becomes
|
18 | | obligated by statute.
|
19 | | (i) (9) Request information from a person seeking |
20 | | coverage from the Association in order to aid the |
21 | | Association in determining its obligations under this |
22 | | Article with respect to the person, and the person |
23 | | shall promptly comply with the request. |
24 | | (j) (10) Take other necessary or appropriate |
25 | | action to discharge its duties and obligations under |
26 | | this Article or to exercise its powers under this |
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1 | | Article. |
2 | |
(12) (o) With respect to covered policies for which |
3 | | the Association becomes
obligated after an entry of an |
4 | | order of liquidation or rehabilitation,
the Association |
5 | | may
elect to succeed to the rights of the insolvent insurer |
6 | | arising after the
date of the order of liquidation or |
7 | | rehabilitation under any contract
of reinsurance to which
|
8 | | the insolvent insurer was a party, to the extent that such |
9 | | contract
provides coverage for losses occurring after the |
10 | | date of the order of
liquidation or rehabilitation. As a |
11 | | condition to making this election,
the Association must pay |
12 | | all unpaid premiums due under the contract for
coverage |
13 | | relating to periods before and after the date of the order |
14 | | of
liquidation or rehabilitation.
|
15 | | (13) (p) A deposit in this State, held pursuant to law |
16 | | or required by the Director for the benefit of creditors, |
17 | | including policy owners, not turned over to the domiciliary |
18 | | liquidator upon the entry of a final order of liquidation |
19 | | or order approving a rehabilitation plan of an insurer |
20 | | domiciled in this State or in a reciprocal state, pursuant |
21 | | to Article XIII 1/2 of this Code, shall be promptly paid to |
22 | | the Association. The Association shall be entitled to |
23 | | retain a portion of any amount so paid to it equal to the |
24 | | percentage determined by dividing the aggregate amount of |
25 | | policy owners' claims related to that insolvency for which |
26 | | the Association has provided statutory benefits by the |
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1 | | aggregate amount of all policy owners' claims in this State |
2 | | related to that insolvency and shall remit to the |
3 | | domiciliary receiver the amount so paid to the Association |
4 | | less the amount retained pursuant to this subsection (13) . |
5 | | Any amount so paid to the Association and retained by it |
6 | | shall be treated as a distribution of estate assets |
7 | | pursuant to applicable State receivership law dealing with |
8 | | early access disbursements. |
9 | | (14) (q) The Board of Directors of the Association |
10 | | shall have discretion and may exercise reasonable business |
11 | | judgment to determine the means by which the Association is |
12 | | to provide the benefits of this Article in an economical |
13 | | and efficient manner. |
14 | | (15) (r) Where the Association has arranged or offered |
15 | | to provide the benefits of this Article to a covered person |
16 | | under a plan or arrangement that fulfills the Association's |
17 | | obligations under this Article, the person shall not be |
18 | | entitled to benefits from the Association in addition to or |
19 | | other than those provided under the plan or arrangement. |
20 | | (16) (s) Venue in a suit against the Association |
21 | | arising under the Article shall be in Cook County. The |
22 | | Association shall not be required to give any appeal bond |
23 | | in an appeal that relates to a cause of action arising |
24 | | under this Article. |
25 | | (17) (t) The Association may join an organization of |
26 | | one or more other State associations of similar purposes to |
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1 | | further the purposes and administer the powers and duties |
2 | | of the Association. |
3 | | (18) (u) In carrying out its duties in connection with |
4 | | guaranteeing, assuming, or reinsuring policies or |
5 | | contracts under subsections (1) or (2), the Association |
6 | | may, subject to approval of the receivership court, issue |
7 | | substitute coverage for a policy or contract that provides |
8 | | an interest rate, crediting rate, or similar factor |
9 | | determined by use of an index or other external reference |
10 | | stated in the policy or contract employed in calculating |
11 | | returns or changes in value by issuing an alternative |
12 | | policy or contract in accordance with the following |
13 | | provisions: |
14 | | (a) (1) in lieu of the index or other external |
15 | | reference provided for in the original policy or |
16 | | contract, the alternative policy or contract provides |
17 | | for (i) a fixed interest rate, or (ii) payment of |
18 | | dividends with minimum guarantees, or (iii) a |
19 | | different method for calculating interest or changes |
20 | | in value; |
21 | | (b) (2) there is no requirement for evidence of |
22 | | insurability, waiting period, or other exclusion that |
23 | | would not have applied under the replaced policy or |
24 | | contract; and |
25 | | (c) (3) the alternative policy or contract is |
26 | | substantially similar to the replaced policy or |
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1 | | contract in all other material terms. |
2 | | (Source: P.A. 96-1450, eff. 8-20-10; revised 9-16-10.)
|
3 | | (215 ILCS 5/531.09) (from Ch. 73, par. 1065.80-9)
|
4 | | Sec. 531.09. Assessments. |
5 | | (1) For the purpose of providing the funds
necessary to |
6 | | carry out the powers and duties of the Association, the board
|
7 | | of directors shall assess the member insurers, separately for |
8 | | each account, at such
times and for such amounts as the board |
9 | | finds necessary. Assessments shall
be due not less than 30 days |
10 | | after written notice to the member insurers
and shall accrue |
11 | | interest from the due date at such adjusted rate as is
|
12 | | established under Section 6621 of Chapter 26 of the United |
13 | | States Code and
such interest shall be compounded daily.
|
14 | | (2) There shall be 2 classes of assessments, as follows:
|
15 | | (a) Class A assessments shall be made for the purpose |
16 | | of meeting administrative
costs and other general expenses |
17 | | and examinations conducted under the authority
of the |
18 | | Director under subsection (5) of Section 531.12.
|
19 | | (b) Class B assessments shall be made to the extent |
20 | | necessary to carry
out the powers and duties of the |
21 | | Association under Section 531.08 with regard
to an impaired |
22 | | or insolvent domestic insurer or insolvent foreign or alien |
23 | | insurers.
|
24 | | (3)(a) The amount of any Class A assessment shall be |
25 | | determined at the discretion of the board of directors and such |
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1 | | assessments shall be authorized and called on a non-pro rata |
2 | | basis. The amount of any Class B
assessment shall be allocated |
3 | | for assessment
purposes among the accounts
and subaccounts |
4 | | pursuant to an allocation formula which may be based on
the |
5 | | premiums or reserves of the impaired or insolvent insurer or |
6 | | any other
standard deemed by the board in its sole discretion |
7 | | as being fair and
reasonable under the circumstances.
|
8 | | (b) Class B assessments against member insurers for each |
9 | | account and
subaccount shall
be in the proportion that the |
10 | | premiums received on business in this State
by each assessed |
11 | | member insurer on policies or contracts covered by
each account |
12 | | or subaccount for the three most recent calendar years
for |
13 | | which information is available preceding the year in which the |
14 | | insurer
became impaired or insolvent, as the case may be, bears |
15 | | to such premiums
received on business in this State for such |
16 | | calendar years by all assessed
member insurers.
|
17 | | (c) Assessments for funds to meet the requirements of the |
18 | | Association
with respect to an impaired or insolvent insurer |
19 | | shall not be made until
necessary to implement the purposes of |
20 | | this Article. Classification
of assessments
under subsection |
21 | | (2) and computations of assessments under this subsection
shall |
22 | | be made with a reasonable degree of accuracy, recognizing that |
23 | | exact
determinations may not always be possible.
|
24 | | (4) The Association may abate or defer, in whole or in |
25 | | part, the assessment of a member insurer if, in the opinion of |
26 | | the board, payment of the assessment would endanger the ability |
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1 | | of the member insurer to fulfill its contractual obligations. |
2 | | In the event an assessment against a member insurer is abated |
3 | | or deferred in whole or in part the amount by which the |
4 | | assessment is abated or deferred may be assessed against the |
5 | | other member insurers in a manner consistent with the basis for |
6 | | assessments set forth in this Section. Once the conditions that |
7 | | caused a deferral have been removed or rectified, the member |
8 | | insurer shall pay all assessments that were deferred pursuant |
9 | | to a repayment plan approved by the Association. |
10 | | (5) (a) (i) Subject to the provisions of subparagraph (ii) |
11 | | of this paragraph, the total of all assessments authorized by |
12 | | the Association with respect to a member insurer for each |
13 | | subaccount of the life insurance and annuity account and for |
14 | | the health account shall not in one calendar year exceed 2% of |
15 | | that member insurer's average annual premiums received in this |
16 | | State on the policies and contracts covered by the subaccount |
17 | | or account during the 3 calendar years preceding the year in |
18 | | which the insurer became an impaired or insolvent insurer. |
19 | | (ii) If 2 or more assessments are authorized in one |
20 | | calendar year with respect to insurers that become impaired or |
21 | | insolvent in different calendar years, the average annual |
22 | | premiums for purposes of the aggregate assessment percentage |
23 | | limitation referenced in subparagraph (a) of this paragraph |
24 | | shall be equal and limited to the higher of the 3-year average |
25 | | annual premiums for the applicable subaccount or account as |
26 | | calculated pursuant to this Section. |
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1 | | (iii) If the maximum assessment, together with the other |
2 | | assets of the Association in an account, does not provide in |
3 | | one year in either account an amount sufficient to carry out |
4 | | the responsibilities of the Association, the necessary |
5 | | additional funds shall be assessed as soon thereafter as |
6 | | permitted by this Article. |
7 | | (b) The board may provide in the plan of operation a method |
8 | | of allocating funds among claims, whether relating to one or |
9 | | more impaired or insolvent insurers, when the maximum |
10 | | assessment will be insufficient to cover anticipated claims. |
11 | | (c) If the maximum assessment for a subaccount of the life |
12 | | insurance and annuity account in one year does not provide an |
13 | | amount sufficient to carry out the responsibilities of the |
14 | | Association, then pursuant to paragraph (b) of subsection (3), |
15 | | the board shall assess the other subaccounts of the life and |
16 | | annuity account for the necessary additional amount, subject to |
17 | | the maximum stated in paragraph (a) of this subsection.
|
18 | | (6) The board may, by an equitable method as established in |
19 | | the
plan of operation, refund to member insurers, in proportion |
20 | | to the contribution
of each insurer to that account, the amount |
21 | | by which the assets of the account
exceed the amount the board |
22 | | finds is necessary to carry out during the coming
year the |
23 | | obligations of the Association with regard to that account, |
24 | | including
assets accruing from net realized gains and income |
25 | | from investments. A
reasonable amount may be retained in any |
26 | | account to provide funds for the
continuing expenses of the |
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1 | | Association and for future losses.
|
2 | | (7) An assessment is deemed to occur on the date upon which |
3 | | the board
votes such assessment. The board may defer calling |
4 | | the payment of the
assessment or may call for payment in one or |
5 | | more installments.
|
6 | | (8) It is proper for any member insurer, in determining its |
7 | | premium
rates and policyowner dividends as to any kind of |
8 | | insurance within the scope of
this Article, to consider the |
9 | | amount reasonably necessary to meet its assessment
obligations |
10 | | under this Article.
|
11 | | (9) The Association must issue to each insurer paying a
|
12 | | Class B assessment
under this Article a certificate of |
13 | | contribution,
in a form acceptable to the
Director, for the |
14 | | amount of the assessment so paid. All outstanding certificates
|
15 | | are of equal
dignity and priority without reference to amounts |
16 | | or dates of issue. A certificate
of contribution may be shown |
17 | | by the insurer in its financial statement as an asset
in such |
18 | | form and for such amount, if any, and period of time as the |
19 | | Director
may approve, provided the insurer shall in any event |
20 | | at its option have
the right to show a certificate of |
21 | | contribution as an admitted asset at
percentages of the |
22 | | original face amount for calendar years as follows:
|
23 | | 100% for the calendar year after the year of issuance;
|
24 | | 80% for the second calendar year after the year of |
25 | | issuance;
|
26 | | 60% for the third calendar year after the year of issuance;
|
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1 | | 40% for the fourth calendar year after the year of |
2 | | issuance;
|
3 | | 20% for the fifth calendar year after the year of issuance.
|
4 | | (10) The Association may request information of member |
5 | | insurers in order to aid in the exercise of its power under |
6 | | this Section and member insurers shall promptly comply with a |
7 | | request. |
8 | | (Source: P.A. 95-86, eff. 9-25-07 (changed from 1-1-08 by P.A. |
9 | | 95-632); 96-1450, eff. 8-20-10.)
|
10 | | (215 ILCS 5/531.14) (from Ch. 73, par. 1065.80-14)
|
11 | | Sec. 531.14. Miscellaneous Provisions. |
12 | | (1) Nothing in this
Article may be construed to reduce the |
13 | | liability for unpaid assessments of the insured
of an impaired |
14 | | or insolvent insurer operating under a plan with assessment |
15 | | liability.
|
16 | | (2) Records must be kept of all negotiations and meetings |
17 | | in which
the Association or its representatives are involved to |
18 | | discuss the activities of the
Association in carrying out its |
19 | | powers and duties under Section 531.08. Records of such
|
20 | | negotiations or meetings may be made public only upon the |
21 | | termination of a
liquidation, rehabilitation, or conservation |
22 | | proceeding involving the impaired
or insolvent insurer, upon |
23 | | the termination of the impairment or insolvency
of the insurer, |
24 | | or upon the order
of a court of competent jurisdiction. Nothing |
25 | | in this paragraph (2) limits the
duty of the Association to |
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1 | | render a report of its activities under Section
531.15.
|
2 | | (3) For the purpose of carrying out its obligations under |
3 | | this Article,
the Association is deemed to be a creditor of the |
4 | | impaired or insolvent
insurer to the extent of assets |
5 | | attributable to covered policies reduced by any
amounts to |
6 | | which the Association is entitled as subrogee (under paragraph |
7 | | (8)
of Section 531.08). All assets of the impaired or insolvent |
8 | | insurer
attributable to covered policies must be used to |
9 | | continue all covered policies
and pay all contractual |
10 | | obligations of the impaired insurer as required by this
|
11 | | Article. "Assets attributable to covered policies", as used in |
12 | | this paragraph
(3), is that proportion of the
assets which the |
13 | | reserves that should have been established
for such policies |
14 | | bear to the reserve that should have been
established for all |
15 | | policies of
insurance written by the impaired or insolvent |
16 | | insurer.
|
17 | | (4) (a) Prior to the termination of any liquidation, |
18 | | rehabilitation,
or conservation proceeding, the court may take |
19 | | into consideration the contributions
of the respective |
20 | | parties, including the Association, the shareholders and
|
21 | | policyowners of the impaired or insolvent insurer, and any |
22 | | other party with
a bona fide interest,
in making an equitable |
23 | | distribution of the ownership rights of such impaired
or |
24 | | insolvent
insurer. In such a determination, consideration must |
25 | | be given to the welfare of the
policyholders of the continuing |
26 | | or successor insurer.
|
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1 | | (b) No distribution to stockholders, if any, of an impaired |
2 | | or insolvent insurer
may be made until and unless the total
|
3 | | amount of valid claims of the Association for funds expended , |
4 | | with interest, in carrying
out its powers and duties under |
5 | | Section 531.08, with respect to such insurer
have been fully |
6 | | recovered by the Association.
|
7 | | (5) (a) If an order for liquidation or rehabilitation of
an |
8 | | insurer
domiciled in this State has been entered, the receiver |
9 | | appointed under such
order has a right to recover on behalf of |
10 | | the insurer, from any affiliate that
controlled it, the amount |
11 | | of distributions, other than stock dividends paid by
the |
12 | | insurer on its capital stock, made at any time during the 5 |
13 | | years preceding
the petition for liquidation or rehabilitation |
14 | | subject to the limitations of
paragraphs (b) to (d).
|
15 | | (b) No such dividend is recoverable if the insurer shows |
16 | | that when
paid the distribution was lawful and reasonable, and |
17 | | that the insurer did not
know and could not reasonably have |
18 | | known that the distribution might adversely affect
the ability |
19 | | of the insurer to fulfill its contractual obligations.
|
20 | | (c) Any person who as an affiliate that controlled the |
21 | | insurer at
the time the distributions were paid is liable up to |
22 | | the amount of distributions
he received. Any person who was an |
23 | | affiliate that controlled the insurer at the
time the |
24 | | distributions were declared, is liable up to the amount of |
25 | | distributions
he would have received if they had been paid |
26 | | immediately. If 2 persons are
liable with respect to the same |
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1 | | distributions, they are jointly and severally liable.
|
2 | | (d) The maximum amount recoverable under subsection (5) of |
3 | | this Section is
the amount needed in excess of all other |
4 | | available assets of the insolvent insurer
to pay the |
5 | | contractual obligations of the insolvent insurer.
|
6 | | (e) If any person liable under paragraph (c) of subsection |
7 | | (5) of this
Section is insolvent, all its
affiliates that |
8 | | controlled it at the time the dividend was paid are jointly and
|
9 | | severally liable for any resulting deficiency in the amount |
10 | | recovered from
the insolvent affiliate.
|
11 | | (6) As a creditor of the impaired or insolvent insurer as |
12 | | established in subsection (3) of this Section and consistent |
13 | | with subsection (2) of Section 205 of this Code, the |
14 | | Association and other similar associations shall be entitled to |
15 | | receive a disbursement of assets out of the marshaled assets, |
16 | | from time to time as the assets become available to reimburse |
17 | | it, as a credit against contractual obligations under this |
18 | | Article. If the liquidator has not, within 120 days after a |
19 | | final determination of insolvency of an insurer by the |
20 | | receivership court, made an application to the court for the |
21 | | approval of a proposal to disburse assets out of marshaled |
22 | | assets to guaranty associations having obligations because of |
23 | | the insolvency, then the Association shall be entitled to make |
24 | | application to the receivership court for approval of its own |
25 | | proposal to disburse these assets. |
26 | | (Source: P.A. 96-1450, eff. 8-20-10.)
|
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1 | | Section 10. The Health Maintenance Organization Act is |
2 | | amended by changing Section 6-14 as follows:
|
3 | | (215 ILCS 125/6-14) (from Ch. 111 1/2, par. 1418.14)
|
4 | | Sec. 6-14. Miscellaneous Provisions. (1) Records must be |
5 | | kept of all
negotiations and meetings in which the Association |
6 | | or its representatives
are involved to discuss the activities |
7 | | of the Association in carrying out
its powers and duties under |
8 | | Section 6-8. Records of such
negotiations or meetings may be |
9 | | made public only upon the termination of a
liquidation, |
10 | | rehabilitation, or conservation proceeding involving the |
11 | | impaired
or insolvent organization, upon the termination of the |
12 | | impairment or
insolvency of the organization, or upon the order |
13 | | of a court of competent
jurisdiction. Nothing in this |
14 | | subsection (1) limits the duty of the
Association to submit a |
15 | | report of its activities under Section 6-15.
|
16 | | (2) For the purpose of carrying out its obligations under |
17 | | this Article,
the Association is deemed to be a creditor of the |
18 | | impaired or insolvent
organization to the extent of assets |
19 | | attributable to covered health care plan
certificates reduced |
20 | | by any amounts to which the Association is entitled as
subrogee |
21 | | (under subsection (7) of Section 6-8). All assets of the |
22 | | impaired
or insolvent organization attributable to covered |
23 | | health care plan
certificates must be used to continue all |
24 | | covered health care plan
certificates and pay all contractual |
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1 | | obligations of the impaired
organization as required by this |
2 | | Article. "Assets attributable to covered
health care plan |
3 | | certificates", as used in this subsection (2), is that
|
4 | | proportion of the assets which the reserves that should have |
5 | | been
established for such health care plan certificates bear to |
6 | | the reserve that
should have been established for all health |
7 | | care plan certificates of the
impaired or insolvent |
8 | | organization.
|
9 | | (3) (a) Prior to the termination of any liquidation, |
10 | | rehabilitation,
or conservation proceeding, the court may take |
11 | | into consideration the
contributions of the respective |
12 | | parties, including the Association, the
shareholders of the |
13 | | impaired or insolvent organization, and any other party
with a |
14 | | bona fide interest, in making an equitable distribution of the
|
15 | | ownership rights of such impaired or insolvent organization. In |
16 | | such a
determination, consideration must be given to the |
17 | | welfare of the enrollees
of the continuing or successor |
18 | | organization.
|
19 | | (b) No distribution to stockholders, if any, of an impaired |
20 | | or insolvent
organization may be made until and unless the |
21 | | total
amount of valid claims of the Association for funds |
22 | | expended in carrying
out its powers and duties under Section |
23 | | 6-8, with interest, with respect to such organization
have been |
24 | | fully recovered by the Association.
|
25 | | (4) (a) If an order for liquidation or rehabilitation of an |
26 | | organization
domiciled in this State has been entered, the |
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1 | | receiver appointed under such
order has a right to recover on |
2 | | behalf of the organization, from any
affiliate that controlled |
3 | | it, the amount of distributions, other than stock
dividends |
4 | | paid by the organization on its capital stock, made at any time
|
5 | | during the 5 years preceding the petition for liquidation or |
6 | | rehabilitation
subject to the limitations of paragraphs (b) to |
7 | | (d).
|
8 | | (b) No such distribution is recoverable if the organization |
9 | | shows that when
paid the distribution was lawful and |
10 | | reasonable, and that the organization
did not know and could |
11 | | not reasonably have known that the distribution
might adversely |
12 | | affect the ability of the organization to fulfill its
|
13 | | contractual obligations.
|
14 | | (c) Any person who was an affiliate that controlled the |
15 | | organization at
the time the distributions were paid is liable |
16 | | up to the amount of
distributions he received. Any person who |
17 | | was an affiliate that controlled
the organization at the time |
18 | | the distributions were declared, is liable up
to the amount of |
19 | | distributions he would have received if they had been paid
|
20 | | immediately. If 2 persons are liable with respect to the same
|
21 | | distributions, they are jointly and severally liable.
|
22 | | (d) The maximum amount recoverable under subsection (4) of |
23 | | this Section is
the amount needed in excess of all other |
24 | | available assets of the insolvent
organization to pay the |
25 | | contractual obligations of the insolvent organization.
|
26 | | (e) If any person liable under paragraph (c) of subsection |