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Public Act 097-0486 | ||||
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AN ACT concerning insurance.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 3. The Illinois Insurance Code is amended by | ||||
changing Sections 136, 143, and 408 as follows:
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(215 ILCS 5/136) (from Ch. 73, par. 748)
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Sec. 136. Annual statement.
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(1) Every company authorized to do business in this State | ||||
or accredited by
this State shall submit to file with the | ||||
Director by March 1st in each year 2 copies of
its financial | ||||
statement for the year ending December 31st immediately | ||||
preceding in such manner and in such form as
on forms | ||||
prescribed by the Director, which shall conform substantially | ||||
to the
form of statement adopted by the National Association of | ||||
Insurance
Commissioners. Unless the Director provides | ||||
otherwise, the annual statement is
to be prepared in accordance | ||||
with the annual statement instructions and the
Accounting | ||||
Practices and Procedures Manual adopted by the National | ||||
Association
of Insurance Commissioners. The Director shall | ||||
have power to make such
modifications and additions in this | ||||
form as he may deem desirable
or necessary to ascertain the | ||||
condition and affairs of the company. The
Director shall have | ||||
authority to extend the time for filing any statement by
any |
company for reasons which he considers good and sufficient. In | ||
every
statement the admitted assets shall be shown at the | ||
actual values as of the
last day of the preceding year, in | ||
accordance with Section 126.7.
The statement
shall be verified | ||
by oaths of the president and secretary of the company or, in
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their absence, by 2 other principal officers. In addition, any | ||
company may be
required by the Director, when he considers that | ||
action to be necessary and
appropriate for the protection of | ||
policyholders, creditors, shareholders, or
claimants, to file, | ||
within 60 days after mailing to the company a notice that
such | ||
is required, a supplemental summary statement as of the last | ||
day of any
calendar month occurring during the 100 days next | ||
preceding the mailing of such
notice designated by him on forms | ||
prescribed and furnished by the Director. The
Director may | ||
require supplemental summary statements to be certified by an
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independent actuary deemed competent by the Director or by an | ||
independent
certified public accountant.
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(2) The statement of an alien company shall embrace only | ||
its
condition and transactions in the United States and shall | ||
be verified by
the oaths of its resident manager or principal | ||
representative in the
United States, except that in the case of | ||
any life company organized
under the laws of Canada or any | ||
province thereof, the statement may be
verified by the oaths of | ||
any of its principal officers designated for
that purpose by | ||
its board of directors.
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(3) For the information of the public generally the |
Director shall
cause an abstract of the information contained | ||
in the annual statement
to be made available to the public as | ||
soon as practicable after filing
with the Department, by | ||
printing those abstracts in pamphlet tabular form
for free | ||
general distribution by the Department, or by such other
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publication in the city of Springfield or in the city of | ||
Chicago as may
be reasonably necessary more fully to inform the | ||
public of the financial
condition of companies transacting | ||
business in this State.
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(4) Each domestic, foreign, and alien insurer authorized to
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do business in this State or accredited by this State shall | ||
participate
in the National Association of Insurance | ||
Commissioners' Insurance Regulatory
Information System, | ||
including the payment of all fees and charges of the
system. | ||
Each company shall, on or before March 1 of each year, file | ||
with the
National Association of Insurance Commissioners a copy | ||
of its annual financial
statement along with any additional | ||
filings prescribed by the Director for the
preceding year. The | ||
statement filed with the National Association of Insurance
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Commissioners shall be in the same format and scope as that | ||
required by this
Code and shall include a signed jurat page and | ||
actuarial certification. Any
amendments and addendums to the | ||
annual statement shall also be filed with the
National | ||
Association of Insurance Commissioners. Each company shall | ||
also file
with the National Association of Insurance | ||
Commissioners annual and quarterly
financial statement |
information in computer readable format as required by the
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Insurance Regulatory Information System.
Failure of a company | ||
to file financial statement information in computer
readable | ||
format shall subject the company to the provisions of Section | ||
139.
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(5) All financial analysis ratios and examination synopsis | ||
concerning
insurance companies that are submitted to the | ||
Director by the National
Association of Insurance | ||
Commissioners' Insurance Regulatory Information
System are | ||
confidential and may not be disclosed by the Director.
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(6) Every property and casualty insurance company doing | ||
business in this State, unless otherwise exempted by the | ||
Director, shall annually submit the opinion of an appointed | ||
actuary entitled "Statement of Actuarial Opinion". This | ||
opinion shall be filed in accordance with the appropriate | ||
National Association of Insurance Commissioners Property and | ||
Casualty Annual Statement Instructions. | ||
(a) Every property and casualty insurance company | ||
domiciled in this State that is required to submit a | ||
Statement of Actuarial Opinion shall annually submit an | ||
Actuarial Opinion Summary, written by the company's | ||
appointed actuary. This Actuarial Opinion Summary shall be | ||
filed in accordance with the appropriate National | ||
Association of Insurance Commissioners Property and | ||
Casualty Annual Statement Instructions and shall be | ||
considered as a document supporting the Actuarial Opinion |
required in this subsection (6). Each foreign and alien | ||
property and casualty company authorized to do business in | ||
this State shall provide the Actuarial Opinion Summary upon | ||
request. | ||
(b) An Actuarial Report and underlying workpapers as | ||
required by the appropriate National Association of | ||
Insurance Commissioners Property and Casualty Annual | ||
Statement Instructions shall be prepared to support each | ||
Actuarial Opinion. If the insurance company fails to | ||
provide a supporting Actuarial Report or workpapers at the | ||
request of the Director or the Director determines that the | ||
supporting Actuarial Report or workpapers provided by the | ||
insurance company is otherwise unacceptable to the | ||
Director, the Director may engage a qualified actuary at | ||
the expense of the company to review the opinion and the | ||
basis for the opinion and prepare the supporting Actuarial | ||
Report or workpapers. | ||
(c) The appointed actuary shall not be liable for | ||
damages to any person (other than the insurance company and | ||
the Director) for any act, error, omission, decision, or | ||
conduct with respect to the actuary's opinion, except in | ||
cases of fraud or willful misconduct on the part of the | ||
appointed actuary. | ||
(d) The Statement of Actuarial Opinion shall be | ||
provided with the Annual Statement in accordance with the | ||
appropriate National Association of Insurance |
Commissioners Property and Casualty Annual Statement | ||
Instructions and shall be treated as a public document. | ||
Documents, materials, or other information in the | ||
possession or control of the Director that are considered | ||
an Actuarial Report, workpapers, or Actuarial Opinion | ||
Summary provided in support of the opinion, and any other | ||
material provided by the company to the Director in | ||
connection with the Actuarial Report, workpapers or | ||
Actuarial Opinion Summary, must be given confidential | ||
treatment, are not subject to subpoena, and may not be made | ||
public by the Director or any other persons. This paragraph | ||
(d) shall not be construed to limit the Director's | ||
authority to release the documents to the Actuarial Board | ||
for Counseling and Discipline (ABCD), so long as the | ||
material is required for the purpose of professional | ||
disciplinary proceedings and that the ABCD establishes | ||
procedures satisfactory to the Director for preserving the | ||
confidentiality of the documents, nor shall this paragraph | ||
(d) be construed to limit the Director's authority to use | ||
the documents, materials or other information in | ||
furtherance of any regulatory or legal action brought as | ||
part of the Director's official duties. Neither the | ||
Director nor any person who received documents, materials, | ||
or other information while acting under the authority of | ||
the Director shall be permitted or required to testify in | ||
any private civil action concerning any confidential |
documents, materials, or information subject to this | ||
subsection (6). Except where another provision of this Code | ||
expressly prohibits a disclosure of confidential | ||
information to the specific officials or organizations | ||
described in this subsection, the Director may: | ||
(i) share documents, materials, or other | ||
information, including the confidential and privileged | ||
documents, materials or information subject to this | ||
paragraph (d) with the insurance department of any | ||
other state or country or with law enforcement | ||
officials of this or any other state or agency of the | ||
federal government at any time, as long as the agency | ||
or office receiving the document, material, or other | ||
information agrees in writing to hold it confidential | ||
and in a manner consistent with this Code; | ||
(ii) receive documents, materials, or information, | ||
including otherwise confidential and privileged | ||
documents, materials, or information, from the | ||
National Association of Insurance Commissioners and | ||
its affiliates and subsidiaries, and from regulatory | ||
and law enforcement officials of other foreign or | ||
domestic jurisdictions, and shall maintain as | ||
confidential or privileged any document, material, or | ||
information received with notice or the understanding | ||
that it is confidential or privileged under the laws of | ||
the jurisdiction that is the source of the document, |
material, or information; and | ||
(iii) enter into agreements governing sharing and | ||
use of information consistent with paragraph (d). | ||
(e) No waiver of any applicable privilege or claim of | ||
confidentiality in the documents, materials or information | ||
shall occur as a result of disclosure to the Director under | ||
this Section or as a result of sharing as authorized in | ||
subparagraphs (i), (ii), and (iii) of paragraph (d) of | ||
subsection (6) of this Section.
All 2008 Annual Statements, | ||
which are filed in 2009, and all subsequent Annual | ||
Statement filings shall be done in accordance with | ||
subsection (6) of this Section. | ||
(Source: P.A. 96-145, eff. 8-7-09.)
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(215 ILCS 5/143) (from Ch. 73, par. 755)
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Sec. 143. Policy forms.
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(1) Life, accident and health. No company
transacting the | ||
kind or kinds of business enumerated in Classes 1 (a), 1
(b) | ||
and 2 (a) of Section 4 shall issue or deliver in this State a | ||
policy
or certificate of insurance or evidence of coverage, | ||
attach an
endorsement or rider thereto,
incorporate by | ||
reference bylaws or other matter therein or use an
application | ||
blank in this State until the form and content of such
policy, | ||
certificate, evidence of coverage, endorsement, rider, bylaw | ||
or
other matter
incorporated by reference or application blank | ||
has been filed electronically
with the Director, either through |
the System for Electronic Rate and Form Filing (SERFF) or as | ||
otherwise prescribed by the Director, and
approved by the | ||
Director. The Department shall mail a quarterly invoice to the | ||
company for the appropriate filing fees required under Section | ||
408. Any such endorsement or rider
that unilaterally reduces | ||
benefits and is to be attached to a
policy subsequent to the | ||
date the policy is
issued must be filed with, reviewed, and | ||
formally approved by the
Director prior to the date it is | ||
attached to a policy issued or
delivered in this State. It | ||
shall be the duty of the Director to
withhold approval of any | ||
such policy, certificate, endorsement, rider,
bylaw or other | ||
matter incorporated by reference or application blank
filed | ||
with him if it contains provisions which encourage
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misrepresentation or are unjust, unfair, inequitable, | ||
ambiguous,
misleading, inconsistent, deceptive, contrary to | ||
law or to the public
policy of this State, or contains | ||
exceptions and conditions that
unreasonably or deceptively | ||
affect the risk purported to be assumed in
the general coverage | ||
of the policy. In all cases the Director shall
approve or | ||
disapprove any such form within 60 days after submission
unless | ||
the Director extends by not more than an additional 30 days the
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period within which he shall approve or disapprove any such | ||
form by
giving written notice to the insurer of such extension | ||
before expiration
of the initial 60 days period. The Director | ||
shall withdraw his approval
of a policy, certificate, evidence | ||
of coverage, endorsement, rider,
bylaw, or other matter |
incorporated
by reference or application blank if he | ||
subsequently determines that such
policy, certificate, | ||
evidence of coverage, endorsement, rider, bylaw,
other matter, | ||
or application
blank is misrepresentative, unjust, unfair, | ||
inequitable, ambiguous, misleading,
inconsistent, deceptive, | ||
contrary to law or public policy of this State,
or contains | ||
exceptions or conditions which unreasonably or deceptively | ||
affect
the risk purported to be assumed in the general coverage | ||
of the policy or
evidence of coverage.
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If a previously approved policy, certificate, evidence of
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coverage, endorsement, rider, bylaw
or other matter | ||
incorporated by reference or application blank is withdrawn
for | ||
use, the Director shall serve upon the company an order of | ||
withdrawal
of use, either personally or by mail, and if by | ||
mail, such service shall
be completed if such notice be | ||
deposited in the post office, postage prepaid,
addressed to the | ||
company's last known address specified in the records
of the | ||
Department of Insurance. The order of withdrawal of use shall | ||
take
effect 30 days from the date of mailing but shall be | ||
stayed if within the
30-day period a written request for | ||
hearing is filed with the Director.
Such hearing shall be held | ||
at such time and place as designated in the order
given by the | ||
Director. The hearing may be held either in the City of | ||
Springfield,
the City of Chicago or in the county where the | ||
principal business address
of the company is located.
The | ||
action of the Director in
disapproving or withdrawing such form |
shall be subject to judicial review under
the
Administrative | ||
Review Law.
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This subsection shall not apply to riders or endorsements | ||
issued or
made at the request of the individual policyholder | ||
relating to the
manner of distribution of benefits or to the | ||
reservation of rights and
benefits under his life insurance | ||
policy.
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(2) Casualty, fire, and marine. The Director shall require | ||
the
filing of all policy forms issued or delivered by any | ||
company transacting
the kind or
kinds of business enumerated in | ||
Classes 2 (except Class 2 (a)) and 3 of
Section 4 in an | ||
electronic format either through the System for Electronic Rate | ||
and Form Filing (SERFF) or as otherwise prescribed and approved | ||
by the Director . In addition, he may require the filing of any
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generally used riders, endorsements, certificates, application | ||
blanks, and
other matter
incorporated by reference in any such | ||
policy or contract of insurance. The Department shall mail a | ||
quarterly invoice to the company for the appropriate filing | ||
fees required under Section 408.
Companies that are members of | ||
an organization, bureau, or association may
have the same filed | ||
for them by the organization, bureau, or association. If
the | ||
Director shall find from an examination of any such policy | ||
form,
rider, endorsement, certificate, application blank, or | ||
other matter
incorporated by
reference in any such policy so | ||
filed that it (i) violates any provision of
this Code, (ii) | ||
contains inconsistent, ambiguous, or misleading clauses, or
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(iii) contains exceptions and conditions that will | ||
unreasonably or deceptively
affect the risks that are purported | ||
to be assumed by the policy, he
shall order the company or | ||
companies issuing these forms to discontinue
their use. Nothing | ||
in this subsection shall require a company
transacting the kind | ||
or kinds of business enumerated in Classes 2
(except Class 2 | ||
(a)) and 3 of Section 4 to obtain approval of these forms
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before they are issued nor in any way affect the legality of | ||
any
policy that has been issued and found to be in conflict | ||
with this
subsection, but such policies shall be subject to the | ||
provisions of
Section 442.
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(3) This Section shall not apply (i) to surety contracts or | ||
fidelity
bonds, (ii) to policies issued to an industrial | ||
insured as defined in Section
121-2.08 except for workers' | ||
compensation policies, nor (iii) to riders
or
endorsements | ||
prepared to meet special, unusual,
peculiar, or extraordinary | ||
conditions applying to an individual risk.
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(Source: P.A. 93-1083, eff. 2-7-05.)
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(215 ILCS 5/408) (from Ch. 73, par. 1020)
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Sec. 408. Fees and charges.
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(1) The Director shall charge, collect and
give proper | ||
acquittances for the payment of the following fees and charges:
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(a) For filing all documents submitted for the | ||
incorporation or
organization or certification of a | ||
domestic company, except for a fraternal
benefit society, |
$2,000.
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(b) For filing all documents submitted for the | ||
incorporation or
organization of a fraternal benefit | ||
society, $500.
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(c) For filing amendments to articles of incorporation | ||
and amendments to
declaration of organization, except for a | ||
fraternal benefit society, a
mutual benefit association, a | ||
burial society or a farm mutual, $200.
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(d) For filing amendments to articles of incorporation | ||
of a fraternal
benefit society, a mutual benefit | ||
association or a burial society, $100.
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(e) For filing amendments to articles of incorporation | ||
of a farm mutual,
$50.
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(f) For filing bylaws or amendments thereto, $50.
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(g) For filing agreement of merger or consolidation:
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(i) for a domestic company, except
for a fraternal | ||
benefit society, a
mutual benefit association, a | ||
burial society,
or a farm mutual, $2,000.
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(ii) for a foreign or
alien company, except for a | ||
fraternal
benefit society, $600.
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(iii) for a fraternal benefit society,
a mutual | ||
benefit association, a burial society,
or a farm | ||
mutual, $200.
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(h) For filing agreements of reinsurance by a domestic | ||
company, $200.
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(i) For filing all documents submitted by a foreign or |
alien
company to be admitted to transact business or | ||
accredited as a
reinsurer in this State, except for a
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fraternal benefit society, $5,000.
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(j) For filing all documents submitted by a foreign or | ||
alien
fraternal benefit society to be admitted to transact | ||
business
in this State, $500.
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(k) For filing declaration of withdrawal of a foreign | ||
or
alien company, $50.
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(l) For filing annual statement by a domestic company , | ||
except a fraternal benefit
society, a mutual benefit | ||
association, a burial society, or
a farm mutual, $200.
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(m) For filing annual statement by a domestic fraternal | ||
benefit
society, $100.
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(n) For filing annual statement by a farm mutual, a | ||
mutual benefit
association, or a burial society, $50.
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(o) For issuing a certificate of authority or
renewal | ||
thereof except to a foreign fraternal benefit society, $400 | ||
$200 .
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(p) For issuing a certificate of authority or renewal | ||
thereof to a foreign
fraternal benefit society, $200 $100 .
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(q) For issuing an amended certificate of authority, | ||
$50.
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(r) For each certified copy of certificate of | ||
authority, $20.
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(s) For each certificate of deposit, or valuation, or | ||
compliance
or surety certificate, $20.
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(t) For copies of papers or records per page, $1.
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(u) For each certification to copies
of papers or | ||
records, $10.
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(v) For multiple copies of documents or certificates | ||
listed in
subparagraphs (r), (s), and (u) of paragraph (1) | ||
of this Section, $10 for
the first copy of a certificate of | ||
any type and $5 for each additional copy
of the same | ||
certificate requested at the same time, unless, pursuant to
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paragraph (2) of this Section, the Director finds these | ||
additional fees
excessive.
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(w) For issuing a permit to sell shares or increase | ||
paid-up
capital:
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(i) in connection with a public stock offering, | ||
$300;
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(ii) in any other case, $100.
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(x) For issuing any other certificate required or | ||
permissible
under the law, $50.
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(y) For filing a plan of exchange of the stock of a | ||
domestic
stock insurance company, a plan of | ||
demutualization of a domestic
mutual company, or a plan of | ||
reorganization under Article XII, $2,000.
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(z) For filing a statement of acquisition of a
domestic | ||
company as defined in Section 131.4 of this Code, $2,000.
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(aa) For filing an agreement to purchase the business | ||
of an
organization authorized under the Dental Service Plan | ||
Act
or the Voluntary Health Services Plans Act or
of a |
health maintenance
organization or a limited health | ||
service organization, $2,000.
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(bb) For filing a statement of acquisition of a foreign | ||
or alien
insurance company as defined in Section 131.12a of | ||
this Code, $1,000.
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(cc) For filing a registration statement as required in | ||
Sections 131.13
and 131.14, the notification as required by | ||
Sections 131.16,
131.20a, or 141.4, or an
agreement or | ||
transaction required by Sections 124.2(2), 141, 141a, or
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141.1, $200.
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(dd) For filing an application for licensing of:
| ||
(i) a religious or charitable risk pooling trust or | ||
a workers'
compensation pool, $1,000;
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(ii) a workers' compensation service company, | ||
$500;
| ||
(iii) a self-insured automobile fleet, $200; or
| ||
(iv) a renewal of or amendment of any license | ||
issued pursuant to (i),
(ii), or (iii) above, $100.
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(ee) For filing articles of incorporation for a | ||
syndicate to engage in
the business of insurance through | ||
the Illinois Insurance Exchange, $2,000.
| ||
(ff) For filing amended articles of incorporation for a | ||
syndicate engaged
in the business of insurance through the | ||
Illinois Insurance Exchange, $100.
| ||
(gg) For filing articles of incorporation for a limited | ||
syndicate to
join with other subscribers or limited |
syndicates to do business through
the Illinois Insurance | ||
Exchange, $1,000.
| ||
(hh) For filing amended articles of incorporation for a | ||
limited
syndicate to do business through the Illinois | ||
Insurance Exchange, $100.
| ||
(ii) For a permit to solicit subscriptions to a | ||
syndicate
or limited syndicate, $100.
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(jj) For the filing of each form as required in Section | ||
143 of this
Code, $50 per form. The fee for advisory and | ||
rating
organizations shall be $200 per form.
| ||
(i) For the purposes of the form filing fee, | ||
filings made on insert page
basis will be considered | ||
one form at the time of its original submission.
| ||
Changes made to a form subsequent to its approval shall | ||
be considered a
new filing.
| ||
(ii) Only one fee shall be charged for a form, | ||
regardless of the number
of other forms or policies | ||
with which it will be used.
| ||
(iii) (Blank).
| ||
(iv) The Director may by rule exempt forms from | ||
such fees.
| ||
(kk) For filing an application for licensing of a | ||
reinsurance
intermediary, $500.
| ||
(ll) For filing an application for renewal of a license | ||
of a reinsurance
intermediary, $200.
| ||
(2) When printed copies or numerous copies of the same |
paper or records
are furnished or certified, the Director may | ||
reduce such fees for copies
if he finds them excessive. He may, | ||
when he considers it in the public
interest, furnish without | ||
charge to state insurance departments and persons
other than | ||
companies, copies or certified copies of reports of | ||
examinations
and of other papers and records.
| ||
(3) The expenses incurred in any performance
examination | ||
authorized by law shall be paid by the company or person being
| ||
examined. The charge shall be reasonably related to the cost of | ||
the
examination including but not limited to compensation of | ||
examiners,
electronic data processing costs, supervision and | ||
preparation of an
examination report and lodging and travel | ||
expenses.
All lodging and travel expenses shall be in accord
| ||
with the applicable travel regulations as published by the | ||
Department of
Central Management Services and approved by the | ||
Governor's Travel Control
Board, except that out-of-state | ||
lodging and travel expenses related to
examinations authorized | ||
under Section 132 shall be in accordance with
travel rates | ||
prescribed under paragraph 301-7.2 of the Federal Travel
| ||
Regulations, 41 C.F.R. 301-7.2, for reimbursement of | ||
subsistence expenses
incurred during official travel. All | ||
lodging and travel expenses may be reimbursed directly upon | ||
authorization of the
Director. With the exception of the
direct | ||
reimbursements authorized by the
Director, all performance | ||
examination charges collected by the
Department shall be paid
| ||
to the Insurance Producers Administration Fund,
however, the |
electronic data processing costs
incurred by the Department in | ||
the performance of any examination shall be
billed directly to | ||
the company being examined for payment to the
Statistical | ||
Services Revolving Fund.
| ||
(4) At the time of any service of process on the Director
| ||
as attorney for such service, the Director shall charge and | ||
collect the
sum of $20, which may be recovered as taxable costs | ||
by
the party to the suit or action causing such service to be | ||
made if he prevails
in such suit or action.
| ||
(5) (a) The costs incurred by the Department of Insurance
| ||
in conducting any hearing authorized by law shall be assessed | ||
against the
parties to the hearing in such proportion as the | ||
Director of Insurance may
determine upon consideration of all | ||
relevant circumstances including: (1)
the nature of the | ||
hearing; (2) whether the hearing was instigated by, or
for the | ||
benefit of a particular party or parties; (3) whether there is | ||
a
successful party on the merits of the proceeding; and (4) the | ||
relative levels
of participation by the parties.
| ||
(b) For purposes of this subsection (5) costs incurred | ||
shall
mean the hearing officer fees, court reporter fees, and | ||
travel expenses
of Department of Insurance officers and | ||
employees; provided however, that
costs incurred shall not | ||
include hearing officer fees or court reporter
fees unless the | ||
Department has retained the services of independent
| ||
contractors or outside experts to perform such functions.
| ||
(c) The Director shall make the assessment of costs |
incurred as part of
the final order or decision arising out of | ||
the proceeding; provided, however,
that such order or decision | ||
shall include findings and conclusions in support
of the | ||
assessment of costs. This subsection (5) shall not be construed | ||
as
permitting the payment of travel expenses unless calculated | ||
in accordance
with the applicable travel regulations of the | ||
Department
of Central Management Services, as approved by the | ||
Governor's Travel Control
Board. The Director as part of such | ||
order or decision shall require all
assessments for hearing | ||
officer fees and court reporter fees, if any, to
be paid | ||
directly to the hearing officer or court reporter by the | ||
party(s)
assessed for such costs. The assessments for travel | ||
expenses of Department
officers and employees shall be | ||
reimbursable to the
Director of Insurance for
deposit to the | ||
fund out of which those expenses had been paid.
| ||
(d) The provisions of this subsection (5) shall apply in | ||
the case of any
hearing conducted by the Director of Insurance | ||
not otherwise specifically
provided for by law.
| ||
(6) The Director shall charge and collect an annual | ||
financial
regulation fee from every domestic company for | ||
examination and analysis of
its financial condition and to fund | ||
the internal costs and expenses of the
Interstate Insurance | ||
Receivership Commission as may be allocated to the State
of | ||
Illinois and companies doing an insurance business in this | ||
State pursuant to
Article X of the Interstate Insurance | ||
Receivership Compact. The fee shall be
the greater fixed amount |
based upon
the combination of nationwide direct premium income | ||
and
nationwide reinsurance
assumed premium
income or upon | ||
admitted assets calculated under this subsection as follows:
| ||
(a) Combination of nationwide direct premium income | ||
and
nationwide reinsurance assumed premium.
| ||
(i) $150, if the premium is less than $500,000 and | ||
there is
no
reinsurance assumed premium;
| ||
(ii) $750, if the premium is $500,000 or more, but | ||
less
than $5,000,000
and there is no reinsurance | ||
assumed premium; or if the premium is less than
| ||
$5,000,000 and the reinsurance assumed premium is less | ||
than $10,000,000;
| ||
(iii) $3,750, if the premium is less than | ||
$5,000,000 and
the reinsurance
assumed premium is | ||
$10,000,000 or more;
| ||
(iv) $7,500, if the premium is $5,000,000 or more, | ||
but
less than
$10,000,000;
| ||
(v) $18,000, if the premium is $10,000,000 or more, | ||
but
less than $25,000,000;
| ||
(vi) $22,500, if the premium is $25,000,000 or | ||
more, but
less
than $50,000,000;
| ||
(vii) $30,000, if the premium is $50,000,000 or | ||
more,
but less than $100,000,000;
| ||
(viii) $37,500, if the premium is $100,000,000 or | ||
more.
| ||
(b) Admitted assets.
|
(i) $150, if admitted assets are less than | ||
$1,000,000;
| ||
(ii) $750, if admitted assets are $1,000,000 or | ||
more, but
less than
$5,000,000;
| ||
(iii) $3,750, if admitted assets are $5,000,000 or | ||
more,
but less than
$25,000,000;
| ||
(iv) $7,500, if admitted assets are $25,000,000 or | ||
more,
but less than
$50,000,000;
| ||
(v) $18,000, if admitted assets are $50,000,000 or | ||
more,
but less than
$100,000,000;
| ||
(vi) $22,500, if admitted assets are $100,000,000 | ||
or
more, but less
than $500,000,000;
| ||
(vii) $30,000, if admitted assets are $500,000,000 | ||
or
more, but less
than $1,000,000,000;
| ||
(viii) $37,500, if admitted assets are | ||
$1,000,000,000
or more.
| ||
(c) The sum of financial regulation fees charged to the | ||
domestic
companies of the same affiliated group shall not | ||
exceed $250,000
in the aggregate in any single year and | ||
shall be billed by the Director to
the member company | ||
designated by the
group.
| ||
(7) The Director shall charge and collect an annual | ||
financial regulation
fee from every foreign or alien company, | ||
except fraternal benefit
societies, for the
examination and | ||
analysis of its financial condition and to fund the internal
| ||
costs and expenses of the Interstate Insurance Receivership |
Commission as may
be allocated to the State of Illinois and | ||
companies doing an insurance business
in this State pursuant to | ||
Article X of the Interstate Insurance Receivership
Compact.
The | ||
fee shall be a fixed amount based upon Illinois direct premium | ||
income
and nationwide reinsurance assumed premium income in | ||
accordance with the
following schedule:
| ||
(a) $150, if the premium is less than $500,000 and | ||
there is
no
reinsurance assumed premium;
| ||
(b) $750, if the premium is $500,000 or more, but less | ||
than
$5,000,000
and there is no reinsurance assumed | ||
premium;
or if the premium is less than $5,000,000 and the | ||
reinsurance assumed
premium is less than $10,000,000;
| ||
(c) $3,750, if the premium is less than $5,000,000 and | ||
the
reinsurance
assumed premium is $10,000,000 or more;
| ||
(d) $7,500, if the premium is $5,000,000 or more, but | ||
less
than
$10,000,000;
| ||
(e) $18,000, if the premium is $10,000,000 or more, but
| ||
less than
$25,000,000;
| ||
(f) $22,500, if the premium is $25,000,000 or more, but
| ||
less than
$50,000,000;
| ||
(g) $30,000, if the premium is $50,000,000 or more, but
| ||
less than
$100,000,000;
| ||
(h) $37,500, if the premium is $100,000,000 or more.
| ||
The sum of financial regulation fees under this subsection | ||
(7)
charged to the foreign or alien companies within the same | ||
affiliated group
shall not exceed $250,000 in the aggregate in |
any single year
and shall be
billed by the Director to the | ||
member company designated by the group.
| ||
(8) Beginning January 1, 1992, the financial regulation | ||
fees imposed
under subsections (6) and (7)
of this Section | ||
shall be paid by each company or domestic affiliated group
| ||
annually. After January
1, 1994, the fee shall be billed by | ||
Department invoice
based upon the company's
premium income or | ||
admitted assets as shown in its annual statement for the
| ||
preceding calendar year. The invoice is due upon
receipt and | ||
must be paid no later than June 30 of each calendar year. All
| ||
financial
regulation fees collected by the Department shall be | ||
paid to the Insurance
Financial Regulation Fund. The Department | ||
may not collect financial
examiner per diem charges from | ||
companies subject to subsections (6) and (7)
of this Section | ||
undergoing financial examination
after June 30, 1992.
| ||
(9) In addition to the financial regulation fee required by | ||
this
Section, a company undergoing any financial examination | ||
authorized by law
shall pay the following costs and expenses | ||
incurred by the Department:
electronic data processing costs, | ||
the expenses authorized under Section 131.21
and
subsection (d) | ||
of Section 132.4 of this Code, and lodging and travel expenses.
| ||
Electronic data processing costs incurred by the | ||
Department in the
performance of any examination shall be | ||
billed directly to the company
undergoing examination for | ||
payment to the Statistical Services Revolving
Fund. Except for | ||
direct reimbursements authorized by the Director or
direct |
payments made under Section 131.21 or subsection (d) of Section
| ||
132.4 of this Code, all financial regulation fees and all | ||
financial
examination charges collected by the Department | ||
shall be paid to the
Insurance Financial Regulation Fund.
| ||
All lodging and travel expenses shall be in accordance with | ||
applicable
travel regulations published by the Department of | ||
Central Management
Services and approved by the Governor's | ||
Travel Control Board, except that
out-of-state lodging and | ||
travel expenses related to examinations authorized
under | ||
Sections 132.1 through 132.7 shall be in accordance
with travel | ||
rates prescribed
under paragraph 301-7.2 of the Federal Travel | ||
Regulations, 41 C.F.R. 301-7.2,
for reimbursement of | ||
subsistence expenses incurred during official travel.
All | ||
lodging and travel expenses may be
reimbursed directly upon the | ||
authorization of the Director.
| ||
In the case of an organization or person not subject to the | ||
financial
regulation fee, the expenses incurred in any | ||
financial examination authorized
by law shall be paid by the | ||
organization or person being examined. The charge
shall be | ||
reasonably related to the cost of the examination including, | ||
but not
limited to, compensation of examiners and other costs | ||
described in this
subsection.
| ||
(10) Any company, person, or entity failing to make any | ||
payment of $150
or more as required under this Section shall be | ||
subject to the penalty and
interest provisions provided for in | ||
subsections (4) and (7)
of Section 412.
|
(11) Unless otherwise specified, all of the fees collected | ||
under this
Section shall be paid into the Insurance Financial | ||
Regulation Fund.
| ||
(12) For purposes of this Section:
| ||
(a) "Domestic company" means a company as defined in | ||
Section 2 of this
Code which is incorporated or organized | ||
under the laws of this State, and in
addition includes a | ||
not-for-profit corporation authorized under the Dental
| ||
Service Plan Act or the Voluntary Health
Services Plans | ||
Act, a health maintenance organization, and a
limited
| ||
health service organization.
| ||
(b) "Foreign company" means a company as defined in | ||
Section 2 of this
Code which is incorporated or organized | ||
under the laws of any state of the
United States other than | ||
this State and in addition includes a health
maintenance | ||
organization and a limited health service organization | ||
which is
incorporated or organized under the laws
of any | ||
state of the United States other than this State.
| ||
(c) "Alien company" means a company as defined in | ||
Section 2 of this Code
which is incorporated or organized | ||
under the laws of any country other than
the United States.
| ||
(d) "Fraternal benefit society" means a corporation, | ||
society, order,
lodge or voluntary association as defined | ||
in Section 282.1 of this
Code.
| ||
(e) "Mutual benefit association" means a company, | ||
association or
corporation authorized by the Director to do |
business in this State under
the provisions of Article | ||
XVIII of this Code.
| ||
(f) "Burial society" means a person, firm, | ||
corporation, society or
association of individuals | ||
authorized by the Director to do business in
this State | ||
under the provisions of Article XIX of this Code.
| ||
(g) "Farm mutual" means a district, county and township | ||
mutual insurance
company authorized by the Director to do | ||
business in this State under the
provisions of the Farm | ||
Mutual Insurance Company Act of 1986.
| ||
(Source: P.A. 93-32, eff. 7-1-03; 93-1083, eff. 2-7-05.)
| ||
Section 5. The Dental Service Plan Act is amended by | ||
changing Section 25 as follows:
| ||
(215 ILCS 110/25) (from Ch. 32, par. 690.25)
| ||
Sec. 25. Application of Insurance Code provisions. Dental | ||
service
plan corporations and all persons interested therein or | ||
dealing therewith
shall be subject to the provisions of | ||
Articles IIA and XII 1/2
and
Sections 3.1,
133, 136, 139, 140, | ||
143, 143c, 149, 355.2, 367.2, 401, 401.1, 402, 403, 403A, 408,
| ||
408.2, and 412, and subsection (15) of Section 367 of the | ||
Illinois Insurance
Code.
| ||
(Source: P.A. 91-549, eff. 8-14-99.)
| ||
Section 10. The Health Maintenance Organization Act is |
amended by changing Section 5-3 as follows:
| ||
(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
| ||
Sec. 5-3. Insurance Code provisions.
| ||
(a) Health Maintenance Organizations
shall be subject to | ||
the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
| ||
141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 154, | ||
154.5, 154.6,
154.7, 154.8, 155.04, 355.2, 356g.5-1, 356m, | ||
356v, 356w, 356x, 356y,
356z.2, 356z.4, 356z.5, 356z.6, 356z.8, | ||
356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, | ||
356z.17, 356z.18, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, | ||
368c, 368d, 368e, 370c,
401, 401.1, 402, 403, 403A,
408, 408.2, | ||
409, 412, 444,
and
444.1,
paragraph (c) of subsection (2) of | ||
Section 367, and Articles IIA, VIII 1/2,
XII,
XII 1/2, XIII, | ||
XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
| ||
(b) For purposes of the Illinois Insurance Code, except for | ||
Sections 444
and 444.1 and Articles XIII and XIII 1/2, Health | ||
Maintenance Organizations in
the following categories are | ||
deemed to be "domestic companies":
| ||
(1) a corporation authorized under the
Dental Service | ||
Plan Act or the Voluntary Health Services Plans Act;
| ||
(2) a corporation organized under the laws of this | ||
State; or
| ||
(3) a corporation organized under the laws of another | ||
state, 30% or more
of the enrollees of which are residents | ||
of this State, except a
corporation subject to |
substantially the same requirements in its state of
| ||
organization as is a "domestic company" under Article VIII | ||
1/2 of the
Illinois Insurance Code.
| ||
(c) In considering the merger, consolidation, or other | ||
acquisition of
control of a Health Maintenance Organization | ||
pursuant to Article VIII 1/2
of the Illinois Insurance Code,
| ||
(1) the Director shall give primary consideration to | ||
the continuation of
benefits to enrollees and the financial | ||
conditions of the acquired Health
Maintenance Organization | ||
after the merger, consolidation, or other
acquisition of | ||
control takes effect;
| ||
(2)(i) the criteria specified in subsection (1)(b) of | ||
Section 131.8 of
the Illinois Insurance Code shall not | ||
apply and (ii) the Director, in making
his determination | ||
with respect to the merger, consolidation, or other
| ||
acquisition of control, need not take into account the | ||
effect on
competition of the merger, consolidation, or | ||
other acquisition of control;
| ||
(3) the Director shall have the power to require the | ||
following
information:
| ||
(A) certification by an independent actuary of the | ||
adequacy
of the reserves of the Health Maintenance | ||
Organization sought to be acquired;
| ||
(B) pro forma financial statements reflecting the | ||
combined balance
sheets of the acquiring company and | ||
the Health Maintenance Organization sought
to be |
acquired as of the end of the preceding year and as of | ||
a date 90 days
prior to the acquisition, as well as pro | ||
forma financial statements
reflecting projected | ||
combined operation for a period of 2 years;
| ||
(C) a pro forma business plan detailing an | ||
acquiring party's plans with
respect to the operation | ||
of the Health Maintenance Organization sought to
be | ||
acquired for a period of not less than 3 years; and
| ||
(D) such other information as the Director shall | ||
require.
| ||
(d) The provisions of Article VIII 1/2 of the Illinois | ||
Insurance Code
and this Section 5-3 shall apply to the sale by | ||
any health maintenance
organization of greater than 10% of its
| ||
enrollee population (including without limitation the health | ||
maintenance
organization's right, title, and interest in and to | ||
its health care
certificates).
| ||
(e) In considering any management contract or service | ||
agreement subject
to Section 141.1 of the Illinois Insurance | ||
Code, the Director (i) shall, in
addition to the criteria | ||
specified in Section 141.2 of the Illinois
Insurance Code, take | ||
into account the effect of the management contract or
service | ||
agreement on the continuation of benefits to enrollees and the
| ||
financial condition of the health maintenance organization to | ||
be managed or
serviced, and (ii) need not take into account the | ||
effect of the management
contract or service agreement on | ||
competition.
|
(f) Except for small employer groups as defined in the | ||
Small Employer
Rating, Renewability and Portability Health | ||
Insurance Act and except for
medicare supplement policies as | ||
defined in Section 363 of the Illinois
Insurance Code, a Health | ||
Maintenance Organization may by contract agree with a
group or | ||
other enrollment unit to effect refunds or charge additional | ||
premiums
under the following terms and conditions:
| ||
(i) the amount of, and other terms and conditions with | ||
respect to, the
refund or additional premium are set forth | ||
in the group or enrollment unit
contract agreed in advance | ||
of the period for which a refund is to be paid or
| ||
additional premium is to be charged (which period shall not | ||
be less than one
year); and
| ||
(ii) the amount of the refund or additional premium | ||
shall not exceed 20%
of the Health Maintenance | ||
Organization's profitable or unprofitable experience
with | ||
respect to the group or other enrollment unit for the | ||
period (and, for
purposes of a refund or additional | ||
premium, the profitable or unprofitable
experience shall | ||
be calculated taking into account a pro rata share of the
| ||
Health Maintenance Organization's administrative and | ||
marketing expenses, but
shall not include any refund to be | ||
made or additional premium to be paid
pursuant to this | ||
subsection (f)). The Health Maintenance Organization and | ||
the
group or enrollment unit may agree that the profitable | ||
or unprofitable
experience may be calculated taking into |
account the refund period and the
immediately preceding 2 | ||
plan years.
| ||
The Health Maintenance Organization shall include a | ||
statement in the
evidence of coverage issued to each enrollee | ||
describing the possibility of a
refund or additional premium, | ||
and upon request of any group or enrollment unit,
provide to | ||
the group or enrollment unit a description of the method used | ||
to
calculate (1) the Health Maintenance Organization's | ||
profitable experience with
respect to the group or enrollment | ||
unit and the resulting refund to the group
or enrollment unit | ||
or (2) the Health Maintenance Organization's unprofitable
| ||
experience with respect to the group or enrollment unit and the | ||
resulting
additional premium to be paid by the group or | ||
enrollment unit.
| ||
In no event shall the Illinois Health Maintenance | ||
Organization
Guaranty Association be liable to pay any | ||
contractual obligation of an
insolvent organization to pay any | ||
refund authorized under this Section.
| ||
(g) Rulemaking authority to implement Public Act 95-1045, | ||
if any, is conditioned on the rules being adopted in accordance | ||
with all provisions of the Illinois Administrative Procedure | ||
Act and all rules and procedures of the Joint Committee on | ||
Administrative Rules; any purported rule not so adopted, for | ||
whatever reason, is unauthorized. | ||
(Source: P.A. 95-422, eff. 8-24-07; 95-520, eff. 8-28-07; | ||
95-876, eff. 8-21-08; 95-958, eff. 6-1-09; 95-978, eff. 1-1-09; |
95-1005, eff. 12-12-08; 95-1045, eff. 3-27-09; 95-1049, eff. | ||
1-1-10; 96-328, eff. 8-11-09; 96-639, eff. 1-1-10; 96-833, eff. | ||
6-1-10; 96-1000, eff. 7-2-10.) | ||
Section 15. The Limited Health Service Organization Act is | ||
amended by changing Section 4003 as follows:
| ||
(215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
| ||
Sec. 4003. Illinois Insurance Code provisions. Limited | ||
health service
organizations shall be subject to the provisions | ||
of Sections 133, 134, 136, 137, 139,
140, 141.1, 141.2, 141.3, | ||
143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, | ||
154.7, 154.8, 155.04, 155.37, 355.2, 356v, 356z.10, 368a, 401, | ||
401.1,
402,
403, 403A, 408,
408.2, 409, 412, 444, and 444.1 and | ||
Articles IIA, VIII 1/2, XII, XII 1/2,
XIII,
XIII 1/2, XXV, and | ||
XXVI of the Illinois Insurance Code. For purposes of the
| ||
Illinois Insurance Code, except for Sections 444 and 444.1 and | ||
Articles XIII
and XIII 1/2, limited health service | ||
organizations in the following categories
are deemed to be | ||
domestic companies:
| ||
(1) a corporation under the laws of this State; or
| ||
(2) a corporation organized under the laws of another | ||
state, 30% of more
of the enrollees of which are residents | ||
of this State, except a corporation
subject to | ||
substantially the same requirements in its state of | ||
organization as
is a domestic company under Article VIII |
1/2 of the Illinois Insurance Code.
| ||
(Source: P.A. 95-520, eff. 8-28-07; 95-876, eff. 8-21-08.)
| ||
Section 20. The Voluntary Health Services Plans Act is | ||
amended by changing Section 10 as follows:
| ||
(215 ILCS 165/10) (from Ch. 32, par. 604)
| ||
Sec. 10. Application of Insurance Code provisions. Health | ||
services
plan corporations and all persons interested therein | ||
or dealing therewith
shall be subject to the provisions of | ||
Articles IIA and XII 1/2 and Sections
3.1, 133, 136, 139, 140, | ||
143, 143c, 149, 155.37, 354, 355.2, 356g, 356g.5, 356g.5-1, | ||
356r, 356t, 356u, 356v,
356w, 356x, 356y, 356z.1, 356z.2, | ||
356z.4, 356z.5, 356z.6, 356z.8, 356z.9,
356z.10, 356z.11, | ||
356z.12, 356z.13, 356z.14, 356z.15, 356z.18, 364.01, 367.2, | ||
368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, and | ||
paragraphs (7) and (15) of Section 367 of the Illinois
| ||
Insurance Code.
| ||
Rulemaking authority to implement Public Act 95-1045, if | ||
any, is conditioned on the rules being adopted in accordance | ||
with all provisions of the Illinois Administrative Procedure | ||
Act and all rules and procedures of the Joint Committee on | ||
Administrative Rules; any purported rule not so adopted, for | ||
whatever reason, is unauthorized. | ||
(Source: P.A. 95-189, eff. 8-16-07; 95-331, eff. 8-21-07; | ||
95-422, eff. 8-24-07; 95-520, eff. 8-28-07; 95-876, eff. |
8-21-08; 95-958, eff. 6-1-09; 95-978, eff. 1-1-09; 95-1005, | ||
eff. 12-12-08; 95-1045, eff. 3-27-09; 95-1049, eff. 1-1-10; | ||
96-328, eff. 8-11-09; 96-833, eff. 6-1-10; 96-1000, eff. | ||
7-2-10.)
| ||
(215 ILCS 110/36 rep.)
| ||
(215 ILCS 110/37 rep.)
| ||
Section 25. The Dental Service Plan Act is amended by | ||
repealing Sections 36 and 37.
| ||
(215 ILCS 125/2-7 rep.)
| ||
Section 30. The Health Maintenance Organization Act is | ||
amended by repealing Section 2-7.
| ||
(215 ILCS 130/2007 rep.)
| ||
Section 35. The Limited Health Service Organization Act is | ||
amended by repealing Section 2007.
| ||
(215 ILCS 165/21 rep.)
| ||
(215 ILCS 165/22 rep.)
| ||
Section 40. The Voluntary Health Services Plans Act is | ||
amended by repealing Sections 21 and 22.
|