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90_HB3015
215 ILCS 5/352 from Ch. 73, par. 964
Amends the Illinois Insurance Code. Makes a technical
change in a Section concerning the scope of the Accident and
Health Insurance Article of the Code.
LRB9010988JSgc
LRB9010988JSgc
1 AN ACT to amend the Illinois Insurance Code by changing
2 Section 352.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Insurance Code is amended by
6 changing Section 352 as follows:
7 (215 ILCS 5/352) (from Ch. 73, par. 964)
8 Sec. 352. Scope of Article.
9 (a) Except as provided in subsections (b), (c), (d), and
10 (e), this Article applies shall apply to all companies
11 transacting in this State the kinds of business enumerated in
12 clause (b) of Class 1 and clause (a) of Class 2 of section 4.
13 Nothing in this Article shall apply to, or in any way affect
14 policies or contracts described in clause (a) of Class 1 of
15 Section 4; however, this Article shall apply to policies and
16 contracts which contain benefits providing reimbursement for
17 the expenses of long term health care which are certified or
18 ordered by a physician including but not limited to
19 professional nursing care, custodial nursing care, and
20 non-nursing custodial care provided in a nursing home or at a
21 residence of the insured.
22 (b) This Article does not apply to policies of accident
23 and health insurance issued in compliance with Article XIXB
24 of this Code.
25 (c) A policy issued and delivered in this State that
26 provides coverage under that policy for certificate holders
27 who are neither residents of nor employed in this State does
28 not need to provide to those nonresident certificate holders
29 who are not employed in this State the coverages or services
30 mandated by this Article.
31 (d) Stop-loss insurance is exempt from all Sections of
-2- LRB9010988JSgc
1 this Article, except this Section and Sections 353a, 354,
2 357.30, and 370. For purposes of this exemption, stop-loss
3 insurance is further defined as follows:
4 (1) The policy must be issued to and insure an
5 employer, trustee, or other sponsor of the plan, or the
6 plan itself, but not employees, members, or participants.
7 (2) Payments by the insurer must be made to the
8 employer, trustee, or other sponsors of the plan, or the
9 plan itself, but not to the employees, members,
10 participants, or health care providers.
11 (e) A policy issued or delivered in this State to the
12 Illinois Department of Public Aid and providing coverage,
13 under clause (b) of Class 1 or clause (a) of Class 2 as
14 described in Section 4, to persons who are enrolled in the
15 integrated health care program established under Section
16 5-16.3 of the Illinois Public Aid Code is exempt from all
17 restrictions, limitations, standards, rules, or regulations
18 respecting benefits imposed by or under authority of this
19 Code, except those specified by subsection (1) of Section
20 143. Nothing in this subsection, however, affects the total
21 medical services available to persons eligible for medical
22 assistance under the Illinois Public Aid Code.
23 (Source: P.A. 87-435; 87-757; 87-938; 87-956; 88-364; 88-554,
24 eff. 7-26-94.)