AUTHORITY: Implementing Section 155.18 of, and authorized by Section 401 of, the Illinois Insurance Code [215 ILCS 5/155.18 and 401].

SOURCE: Adopted at 3 Ill. Reg. 20, p. 47, effective May 13, 1979; codified at 7 Ill. Reg. 2363; amended at 30 Ill. Reg. 19530, effective December 11, 2006; recodified from the Department of Financial and Professional Regulation to the Department of Insurance pursuant to Executive Order 2009-04 at 38 Ill. Reg. 24067; amended at 39 Ill. Reg. 392, effective December 19, 2014.

SUBPART A: GENERAL PROVISIONS AND REPORTING REQUIREMENTS

 

Section 929.10  Authority

 

This Part is promulgated by the Director of the Department of Insurance under Section 401 of the Illinois Insurance Code [215 ILCS 5/401] that empowers the Director to make reasonable rules and regulations as may be necessary for making effective the insurance laws of this State.  This Part implements Section 155.18 of the Illinois Insurance Code [215 ILCS 5/155.18].

 

(Source:  Amended at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.15  Definitions

 

"Code" means the Illinois Insurance Code [215 ILCS 5].

 

"Department" means the Illinois Department of Insurance.

 

"Director" means the Director of the Illinois Department of Insurance.

 

"SERFF" means the National Association of Insurance Commissioners' web based System for Electronic Rate and Form Filing and required by Section 143(2) of the Code that enables insurers and other companies to streamline their rate and form filing process by filing the same electronically at http://www.serff.com/.

 

(Source:  Amended at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.20  Purpose and Scope

 

The purpose of this Part is to implement Section 155.18 of the Illinois Insurance Code.  This Part shall apply to all insurance on risks based upon negligence by a physician, hospital or other health care provider, referred to in the Code and this Part as medical liability insurance, the scope of the implemented legislation.

 

(Source:  Amended at 30 Ill. Reg. 19530, effective December 11, 2006)

 

Section 929.30  Filing Requirements

 

a)         All companies writing medical liability insurance are subject to this Section.  Each company must file with the Director, in a manner prescribed in this Section, under its own name. 

 

b)         Rates – A company must file on its own behalf all rates for medical liability insurance, and:

 

1)         File copies of a Rate Submission Letter using System for Electronic Rate and Form Filing (SERFF) or in another electronic format approved by the Director.  This filing must include:

 

A)        The name of the company making the filing;

 

B)        FEIN of the company making the filing;

 

C)        Identification of the classes of medical liability insurance to which the filing applies;

 

D)        Notification of whether the filing is new or supersedes a present filing. Identification of all changes in superseding filings, as well as identification of all superseded filings is required;

 

E)        The effective date of use; and

 

F)         Certification by an officer of the company and a qualified actuary that the company's rates are based on sound actuarial principles and are not inconsistent with the company's experience.

 

2)         Company Rate Information shall be completed for each company when a filing is being submitted that includes:

 

A)        Overall % Indicated Change.

 

B)        Overall % Rate Impact – This is the statewide average percentage change to the accepted rates for the coverages included for each company.

 

C)        Written premium change for this program – This is the statewide change in written premium based on the proposed overall percentage rate impact for each company.

 

D)        Number of policyholders affected for this program – This is the number of policyholders affected by the overall percentage rate impact for each company.

 

E)        Written premium for this program – This is the statewide written premium for each company.

 

F)         Maximum % Change.

 

G)        Minimum % Change.

 

3)         Maintain documentary data on rate development and changes in order that it be available for review by the Director.

 

c)         Rules – A company must file with the Director, in a manner prescribed in this subsection (c), all underwriting rule manuals that contain rules for applying rates or rating plans, plans for the gathering of statistics or the reporting of statistics to statistical agencies, classifications, or other such schedules used in writing medical liability insurance.  A company may file directly or in conjunction with an advisory organization.

 

1)         A company filing directly must file using SERFF.  The filings must include:

 

A)        The name of the company making the filing;

 

B)        The FEIN of the company making the filing;

 

C)        Identification of the classes of medical liability insurance to which the filing applies;

 

D)        Notification as to whether the filing is new or supersedes a present filing.  Identification of all changes in all superseding filings is required.  The preferred format for identifying changes is to underline the new wording and overstrike the deleted or changed language and give an explanation for the changes being made;

 

E)        The effective date of use; and

 

F)         Certification by an officer of the company and a qualified actuary that the company's rate rules are based on sound actuarial principles and are not inconsistent with the company's experience.

 

2)         A company filing in conjunction with an advisory organization must file in accord with this subsection (c)(2).

 

A)        A company that has authorized an advisory organization to file required materials on the company's behalf must have on file a Rule Authorization Letter, which must include:

 

i)          The name of the company's authorized advisory organization.

 

ii)         The kinds of insurance for which the filing is being made.

 

iii)        Authorization clause or language.

 

iv)        Effective date of authorization.

 

B)        A company deviating from the advisory organization's rules as they have been filed on behalf of the company by the advisory organization under Section 929.30(c)(2)(A) must file with the Director:

 

i)          The manual rule number, which must be the same as the rule number being replaced.

 

ii)         The effective date of use.

 

iii)        Certification of an officer of the company and a qualified actuary that the company's rates are based on sound actuarial principles and are not inconsistent with the company's experience.

 

C)        A company making a filing under this subsection (c)(2) that wants an effective date different from that of the advisory organization's advisory effective date must file either:

 

i)          Manual size exception pages in duplicate establishing an automatic uniform delayed effective date applicable to all future advisory organization rule revisions; or

 

ii)         Copies of the Advisory Organization Checking Slip, in duplicate, establishing a special effective date for a particular advisory organization rule revision.

 

d)        All medical liability rate and rule manuals shall contain separate, clearly marked sections for rates and rules according to class or classes of insurance, such as physicians and surgeons, allied health, nursing homes, hospitals, nurses, dentists and chiropractors.  The rate and rule manuals shall also contain a comprehensive table of contents or index at the front of each manual.

 

e)         All filings must be received using SERFF by the Illinois Department of Insurance, Property and Casualty Compliance Unit, 320 W. Washington, Springfield, Illinois 62767 no later than 30 days after their effective date. Filings will be considered received during the regular business hours from 8:00 am through 5:00 pm Central Standard Time (CST), Monday through Friday, excluding holidays.

 

f)         In addition to the filings required in this Section, the Director may require the filing of statistical data and any other pertinent information necessary to determine the manner the company used to set the filed rates and the reasonableness of those rates, as well as the manner of promulgation and the acceptability or unacceptability of a filing for rules, minimum premiums, rates, forms or any combination of those items.  An insurer shall provide the data or information within 14 calendar days after the Director's request.

 

g)         Groups, associations, organizations or companies authorized to engage in joint underwriting and joint reinsurance activities are prohibited from establishing underwriting rules with respect to rates that in any way inhibit a company from individually underwriting any risks.

 

(Source:  Amended at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.40  Severability Provision (Repealed)

 

(Source:  Repealed at 30 Ill. Reg. 19530, effective December 11, 2006)

 

Section 929.50  Exemption from Filings

 

a)         A company is not required to file under this Part for individual risks in this State that cannot be rated in the normal course of business because of special or unusual characteristics, as provided in Section 456(1)(c) of the Code and that must be rated on the basis of underwriting judgment.

 

b)         A company must maintain documentary information regarding rates determined under subsection (a) for review by the Director.

 

(Source:  Added at 39 Ill. Reg. 392, effective December 19, 2014)

SUBPART B: ADMINISTRATIVE HEARING PROVISIONS

 

Section 929.200  Applicability (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.210  Form of Documents (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.220  Filing (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.230  Computation of Time (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.240  Appearances (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.250  Notice of Hearing (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.260  Publication of the Notice of Hearing (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.270  Bias or Disqualification of Hearing Officer (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.280  Pre-hearing Conferences (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.290  Conduct of the Hearing (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.300 Hearing Officer's Findings, Conclusions and Recommendations (Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)

 

Section 929.310  Order of the Secretary or Director(Repealed)

 

(Source:  Repealed at 39 Ill. Reg. 392, effective December 19, 2014)