Full Text of HB0317 102nd General Assembly
HB0317eng 102ND GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Insurance Code is amended by | 5 | | changing Section 352 as follows:
| 6 | | (215 ILCS 5/352) (from Ch. 73, par. 964)
| 7 | | Sec. 352. Scope of Article.
| 8 | | (a) Except as provided in subsections (b), (c), (d), and | 9 | | (e),
this Article shall
apply to all companies transacting in | 10 | | this State the kinds of business
enumerated in clause (b) of | 11 | | Class 1 and clause (a) of Class 2 of Section 4.
Nothing in this | 12 | | Article shall apply to, or in any way affect policies or
| 13 | | contracts described in clause (a) of Class 1 of Section 4; | 14 | | however, this
Article shall apply to policies and contracts | 15 | | which contain benefits
providing reimbursement for the | 16 | | expenses of long term health care which are
certified or | 17 | | ordered by a physician including but not limited to
| 18 | | professional nursing care, custodial nursing care, and | 19 | | non-nursing
custodial care provided in a nursing home or at a | 20 | | residence of the insured.
| 21 | | (a-5) An air ambulance service or other entity that | 22 | | directly or indirectly, whether through an affiliated entity, | 23 | | agreement with a third-party entity, or otherwise, is engaging |
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| 1 | | in the business of insurance as an insurer if the service or | 2 | | other entity, for the purpose of covering the copayments, | 3 | | deductibles, or cost-sharing amounts of a patient or | 4 | | post-service payments of costs to third parties, solicits air | 5 | | ambulance membership subscriptions, accepts membership | 6 | | applications, or charges membership fees. An air ambulance | 7 | | membership that covers the copayments, deductibles, or other | 8 | | cost-sharing amounts of a patient or provides for post-service | 9 | | payments of costs to third parties shall be considered | 10 | | insurance and an insurance product and may be considered | 11 | | secondary insurance coverage or a supplement to any insurance | 12 | | coverage and shall be regulated accordingly by the Department | 13 | | of Insurance. | 14 | | (b) (Blank).
| 15 | | (c) A policy issued and delivered in this State
that | 16 | | provides coverage under that policy for
certificate holders | 17 | | who are neither residents of nor employed in this State
does | 18 | | not need to provide to those nonresident
certificate holders | 19 | | who are not employed in this State the coverages or
services | 20 | | mandated by this Article.
| 21 | | (d) Stop-loss insurance is exempt from all Sections
of | 22 | | this Article, except this Section and Sections 353a, 354, | 23 | | 357.30, and
370. For purposes of this exemption, stop-loss | 24 | | insurance is further defined as
follows:
| 25 | | (1) The policy must be issued to and insure an | 26 | | employer, trustee, or other
sponsor of the plan, or the |
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| 1 | | plan itself, but not employees, members, or
participants.
| 2 | | (2) Payments by the insurer must be made to the | 3 | | employer, trustee, or
other sponsors of the plan, or the | 4 | | plan itself, but not to the employees,
members, | 5 | | participants, or health care providers.
| 6 | | (e) A policy issued or delivered in this State to the | 7 | | Department of Healthcare and Family Services (formerly
| 8 | | Illinois Department
of Public Aid) and providing coverage, | 9 | | under clause (b) of Class 1 or clause (a)
of Class 2 as | 10 | | described in Section 4, to persons who are enrolled under | 11 | | Article V of the Illinois
Public Aid Code or under the | 12 | | Children's Health Insurance Program Act is
exempt from all | 13 | | restrictions, limitations,
standards, rules, or regulations | 14 | | respecting benefits imposed by or under
authority of this | 15 | | Code, except those specified by subsection (1) of Section
143, | 16 | | Section 370c, and Section 370c.1. Nothing in this subsection, | 17 | | however, affects the total medical services
available to | 18 | | persons eligible for medical assistance under the Illinois | 19 | | Public
Aid Code.
| 20 | | (f) An in-office membership care agreement provided under | 21 | | the In-Office Membership Care Act is not insurance for the | 22 | | purposes of this Code. | 23 | | (Source: P.A. 101-190, eff. 8-2-19.)
| 24 | | Section 99. Effective date. This Act takes effect upon | 25 | | becoming law.
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