PART 3401 SUMMARY DOCUMENT AND DISCLAIMER : Sections Listing

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER ll: LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION
PART 3401 SUMMARY DOCUMENT AND DISCLAIMER


AUTHORITY: Implementing and authorized by Section 531.19 of the Illinois Insurance Code [215 ILCS 5/531.19].

SOURCE: Adopted at 19 Ill. Reg. 9134, effective July 1, 1995; expedited correction at 19 Ill. Reg. 13090, effective July 1, 1995; amended at 24 Ill. Reg. 16344, effective October 23, 2000; amended at 37 Ill. Reg. 15355, effective January 1, 2014; amended at 38 Ill. Reg. 7926, effective March 27, 2014; amended at 43 Ill. Reg. 3290, effective February 25, 2019.

 

Section 3401.10  Applicability

 

This Part shall apply to member insurers that offer policies or contracts described in Section 531.03 of the Illinois Insurance Code [215 ILCS 5/531.03].

 

Section 3401.20  Purpose

 

The purpose of this Part is to establish the form and content of the Summary Document and Disclaimer required by Section 531.19 of the Illinois Insurance Code [215 ILCS 5/531.19] for use prior to, or at the time of, delivery of a policy or contract which is covered by the Illinois Life and Health Insurance Guaranty Association.

 

Section 3401.30  Definitions

 

            Disclaimer means the language required by Section 531.19(c) of the Illinois Insurance Code [215 ILCS 5/531.19(c)], which shall appear conspicuously on the face of the Summary Document.  The Summary Document and Disclaimer are established by Illustration A.

 

            Insurer, for purposes of this Part, means a "Member insurer" as defined in Section 531.05 of the Illinois Insurance Code [215 ILCS 5/531.05].

 

            Summary Document means a document required by Section 531.19(b) of the Illinois Insurance Code [215 ILCS 5/531.19(b)] that describes the general purposes and current limitations of the Illinois Life and Health Insurance Guaranty Association Law.  The Summary Document shall be prepared and revised, as necessary, by the Illinois Life and Health Insurance Guaranty Association. Subsequent revisions will require approval by the Director of Insurance.  The Summary Document shall contain, on its face, the Disclaimer.  The Summary Document and Disclaimer are established in Illustration A.

 

(Source:  Amended at 37 Ill. Reg. 15355, effective January 1, 2014)

 

Section 3401.40  Delivery of Documents Required

 

Sixty days after the effective date of this Part, no insurer shall deliver a policy or contract described in Section 531.03(2)(a) of the Illinois Insurance Code [215 ILCS 5/531.03(2)(a)], and not excluded under Section 531.03(2)(b) of the Illinois Insurance Code [215 ILCS 5/531.03(2)(b)] to a policy or contract holder unless the Summary Document and Disclaimer required by this Part are delivered to the policy or contract holder prior to, or at the time of, delivery of such policy or contract.


Section 3401.ILLUSTRATION A  Summary Document and Disclaimer

 

NOTICE OF

PROTECTION PROVIDED BY

ILLINOIS LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION

 

This notice provides a brief summary description of the Illinois Life and Health Insurance Guaranty Association ("the Association") and the protection it provides for policyholders.  This safety net was created under Illinois law, which determines who and what is covered and the amounts of coverage.

 

The Association was established to provide protection in the unlikely event that your member life, annuity, health maintenance organization or health insurance company becomes financially unable to meet its obligations and is placed into Receivership by the Insurance Department of the state in which the company is domiciled.  If this should happen, the Association will typically arrange to continue coverage, pay claims, or otherwise provide protection in accordance with Illinois law, with funding from assessments paid by other insurance companies and health maintenance organizations.

 

The basic protections provided by the Association per insured in each insolvency are:

 

•     Life Insurance

◦           $300,000 for death benefits

◦           $100,000 for cash surrender or withdrawal values

•     Health Insurance

◦           $500,000 for health benefit plans*

◦           $300,000 for disability insurance benefits

◦           $300,000 for long-term care insurance benefits

◦           $100,000 for other types of health insurance benefits

•     Annuities

◦           $250,000 for withdrawal and cash values

 

*    The maximum amount of protection for each individual, regardless of the number of policies or contracts, is $300,000, except special rules apply with regard to health benefit plan benefits for which the maximum amount of protection is $500,000.

 

Note:   Certain policies and contracts may not be covered or fully covered.  For example, coverage does not extend to any portion of a policy or contract that the insurer does not guarantee, such as certain investment additions to the account value of a variable life insurance policy or a variable annuity contract.  There are also residency requirements and other limitations under Illinois law.

 

To learn more about these protections, as well as protections relating to group contracts or retirement plans, please visit the Association's website at www.ilhiga.org or contact:

 

Illinois Life and Health Insurance Guaranty Association

901 Warrenville Road, Suite 400

Lisle, Illinois 60532-4324

 

 

Illinois Department of Insurance

4th Floor

320 West Washington Street

Springfield, Illinois 62767

 

 

Insurance companies, health maintenance organizations and agents are not allowed by Illinois law to use the existence of the Association or its coverage to encourage you to purchase any form of insurance.  When selecting an insurance company or health maintenance organization, you should not rely on Association coverage.  If there is any inconsistency between this notice and Illinois law, then Illinois law will control.

 

The Association is not an insurance company or health maintenance organization.  If you wish to contact your insurance company or health maintenance organization, please use the phone number found in your policy or contact the Illinois Department of Insurance at DOI.InfoDesk@illinois.gov.

 

(Source:  Amended at 43 Ill. Reg. 3290, effective February 25, 2019)