Section 2021.10  Purpose

 

The purpose of this Part is to establish requirements for filing group policy forms with the Illinois Department of Insurance pursuant to Section 352(c) of the Illinois Insurance Code [215 ILCS 5/352(c)], to be used for policies where the master contract has situs in this State and where certificates will be issued only to certificateholders who neither reside nor work in Illinois.

 

Section 2021.20  Applicability and Scope

 

This Part applies to all group accident and health insurance policy forms, amendments, or certificate of insurance policy forms submitted pursuant to Section 352(c) of the Code on or after May 1, 2005.

 

Section 2021.30  Definitions

 

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

 

Department means the Illinois Department of Insurance.

 

Director means the Director of the Department of Insurance of the State of Illinois or anyone to whom the Director's responsibilities and authority are lawfully delegated.

 

 

Section 2021.40  Filing and Disclosure Requirements

 

a)         Policies filed pursuant to Section 352(c) of the Code must be accompanied by a statement that the policy does not need to provide State required coverages or services pursuant to this Section for nonresident certificateholders who are not employed in this State and:

 

1)         File informationally, pursuant to 50 Ill. Adm. Code 916.40, a letter specifically listing each state in which certificates will be issued.

 

2)         If certificates are issued in states not identified in subsection (a)(1), insurers must notify the Department in writing within 30 days after issuing the certificate.

 

3)         The letter must state and certify that the certificateholders are being provided the coverages or services that meet Illinois requirements or the applicable requirements of the state in which the certificates will be issued.

 

b)         Disclosure Requirements

            Each certificate issued to a covered person must clearly state that at a minimum the certificateholder is receiving coverages or services as required by applicable Illinois law or the applicable law of the state in which the certificates will be issued.

 

c)         Certificates for which a company requests a formal approval by the Director for use in another state must be filed for approval, must meet the requirements of subsections (a) and (b), and will only be approved by the Director for use in those

specific states.

 

Section 2021.50  Out-of-State Certificate Policy Forms That Require Illinois Approval

 

Where an exemption is not sought under Section 352(c) of the Code, and a master policy is issued in Illinois, policies and certificates issued to persons residing or working out-of-state must be submitted to the Department for approval and must demonstrate compliance with applicable Illinois laws and rules.