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Public Act 097-0955 |
HB1577 Enrolled | LRB097 09798 RPM 49945 b |
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AN ACT concerning health.
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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 5. The Illinois Insurance Code is amended by |
changing Sections 35A-15, 445, and 445a as follows:
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(215 ILCS 5/35A-15)
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Sec. 35A-15. Company action level event.
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(a) A company action level event means any of the following |
events:
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(1) The filing of an RBC Report by an insurer that |
indicates that:
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(A) the insurer's total adjusted capital is |
greater than or equal to its
regulatory action level |
RBC, but less than its company action level RBC; or
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(B) the The insurer, if a life, health, or life and |
health insurer, has
total adjusted capital that is |
greater than or equal
to its company action level RBC, |
but less than the product of its authorized
control |
level RBC and 2.5 and has a negative trend ; or .
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(C) the insurer, if a property and casualty |
insurer, has total adjusted capital that is greater |
than or equal
to its company action level RBC, but less |
than the product of its authorized
control level RBC |
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and 3.0 and triggers the trend test determined in |
accordance with the trend test calculation included in |
the property and casualty RBC Instructions.
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(2) The notification by the Director to the insurer of |
an Adjusted RBC
Report that indicates an event described in
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paragraph (1),
provided the insurer does not challenge the |
Adjusted RBC Report under Section
35A-35.
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(3) The notification by the Director to the insurer |
that the Director has,
after a hearing, rejected the |
insurer's challenge under Section 35A-35 to an
Adjusted RBC |
Report that indicates the event described in paragraph (1).
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(b) In the event of a company action level event, the |
insurer shall prepare
and submit to the Director an RBC Plan |
that does
all of the following:
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(1) Identifies the conditions that contribute to the
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company action level event.
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(2) Contains proposed corrective actions that the |
insurer intends to
take and that are expected to result in |
the elimination of the company action
level event.
A health |
organization is not prohibited from
proposing recognition |
of a parental guarantee or a letter of credit to
eliminate |
the company action level event; however the Director shall, |
at his
discretion, determine whether or the extent to which |
the proposed parental
guarantee or letter of credit is an |
acceptable part of a satisfactory RBC Plan
or Revised RBC |
Plan.
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(3) Provides projections of the insurer's financial |
results in the current
year and at least the 4 succeeding |
years, both in the absence of proposed
corrective actions |
and giving effect to the proposed corrective actions,
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including projections of statutory operating income, net |
income, capital, and
surplus. The projections for both new |
and renewal business may include
separate projections for |
each major line of business and separately identify
each |
significant income, expense, and benefit component.
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(4) Identifies the key assumptions affecting the |
insurer's projections
and the sensitivity of the |
projections to the assumptions.
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(5) Identifies the quality of, and problems associated |
with, the insurer's
business including, but not limited to, |
its assets, anticipated business growth
and associated |
surplus strain, extraordinary exposure to risk, mix of |
business,
and use of reinsurance, if any, in each case.
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(c) The insurer shall submit the RBC Plan to the Director |
within 45 days
after the company action
level event occurs or |
within 45 days after the Director notifies the insurer
that the |
Director has, after a hearing, rejected its
challenge under |
Section 35A-35 to an
Adjusted RBC Report.
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(d) Within 60 days after an insurer submits an RBC Plan to |
the
Director, the Director shall notify the insurer whether the |
RBC Plan shall be
implemented or is, in the judgment of the |
Director, unsatisfactory. If the
Director determines the RBC |
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Plan is unsatisfactory,
the notification to the insurer shall |
set forth the reasons for the
determination
and may set forth |
proposed revisions that will render the RBC Plan satisfactory
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in the judgment of the Director. Upon notification from the |
Director, the
insurer shall prepare a Revised RBC Plan, which |
may incorporate by reference
any revisions proposed by the |
Director. The insurer shall submit the Revised
RBC Plan to the |
Director within 45 days after the Director notifies the insurer
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that the RBC Plan is unsatisfactory or within 45 days after the |
Director
notifies the insurer that the Director has, after a |
hearing, rejected its
challenge under Section 35A-35 to the |
determination that the RBC Plan is
unsatisfactory.
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(e) In the event the Director notifies an insurer that its
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RBC Plan or Revised RBC Plan is unsatisfactory, the Director |
may, at
the Director's discretion and subject to the insurer's |
right to a hearing under
Section 35A-35, specify in the |
notification that the notification constitutes a
regulatory |
action level event.
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(f) Every domestic insurer that files an RBC Plan or |
Revised RBC Plan with
the Director shall file a copy of the RBC |
Plan or Revised RBC Plan with the
chief insurance regulatory |
official in any state in which the insurer is
authorized to do |
business if that state has a law substantially similar to the
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confidentiality provisions in subsection (a) of Section 35A-50 |
and if that
official requests in writing a copy of the plan. |
The insurer shall file a copy
of the
RBC Plan or Revised RBC |
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Plan in that state no later than the later of
15 days after |
receiving the written request for the copy or
the date on which |
the RBC Plan or Revised RBC Plan is filed under
subsection (c) |
or (d) of this Section.
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(Source: P.A. 91-549, eff. 8-14-99.)
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(215 ILCS 5/445) (from Ch. 73, par. 1057)
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Sec. 445. Surplus line.
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(1) Definitions. For the purposes of this Section: Surplus |
line defined; surplus line insurer
requirements. "Surplus line |
insurance" means insurance on an Illinois risk of
the kinds |
specified in Classes 2 and 3 of Section 4 of this Code procured
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from an unauthorized insurer
after the insurance producer |
representing the
insured or the surplus line producer is |
unable, after diligent effort, to
procure said insurance from |
authorized insurers.
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"Affiliate" means, with respect to an insured, any entity |
that controls, is controlled by, or is under common control |
with the insured. For the purpose of this definition, an entity |
has control over another entity if: |
(A) the entity directly or indirectly or acting through |
one or more other persons owns, controls, or has the power |
to vote 25% or more of any class of voting securities of |
the other entity; or |
(B) the entity controls in any manner the election of a |
majority of the directors or trustees of the other entity. |
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"Affiliated group" means any group of entities that are all |
affiliated. |
"Authorized insurer" means an insurer that holds a |
certificate of
authority
issued by the Director but, for the |
purposes of this Section, does not
include a
domestic surplus |
line insurer as defined in Section 445a or any
residual market
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mechanism. |
"Exempt commercial purchaser" means any person purchasing |
commercial insurance that, at the time of placement, meets the |
following requirements: |
(A) The person employs or retains a qualified risk |
manager to negotiate insurance coverage. |
(B) The person has paid aggregate nationwide |
commercial property and casualty insurance premiums in |
excess of $100,000 in the immediately preceding 12 months. |
(C) The person meets at least one of the following |
criteria: |
(I) The person possesses a net worth in excess of |
$20,000,000, as such amount is adjusted pursuant to the |
provision in this definition concerning percentage |
change. |
(II) The person generates annual revenues in |
excess of $50,000,000, as such amount is adjusted |
pursuant to the provision in this definition |
concerning percentage change. |
(III) The person employs more than 500 full-time or |
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full-time equivalent employees per individual insured |
or is a member of an affiliated group employing more |
than 1,000 employees in the aggregate. |
(IV) The person is a not-for-profit organization |
or public entity generating annual budgeted |
expenditures of at least $30,000,000, as such amount is |
adjusted pursuant to the provision in this definition |
concerning percentage change. |
(V) The person is a municipality with a population |
in excess of 50,000 persons. |
Effective on January 1, 2015 and each fifth January 1 |
occurring thereafter, the amounts in subitems (I), (II), and |
(IV) of item (C) of this definition shall be adjusted to |
reflect the percentage change for such 5-year period in the |
Consumer Price Index for All Urban Consumers published by the |
Bureau of Labor Statistics of the Department of Labor. |
"Home state" means the following: |
(A) With respect to an insured, except as provided in |
item (B) of this definition: |
(I) the State in which an insured maintains its |
principal place of business or, in the case of an |
individual, the individual's principal residence; or |
(II) if 100% of the insured risk is located out of |
the State referred to in subitem (I), the State to |
which the greatest percentage of the insured's taxable |
premium for that insurance contract is allocated. |
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(B) If more than one insured from an affiliated group |
are named insureds on a single surplus line insurance |
contract, then "home State" means the home State, as |
determined pursuant to item (A) of this definition, of the |
member of the affiliated group that has the largest |
percentage of premium attributed to it under such insurance |
contract. |
"Multi-State risk" means a risk with insured exposures in |
more than one State. |
"NAIC" means the National Association of Insurance |
Commissioners or any successor entity. |
"Qualified risk manager" means, with respect to a |
policyholder of commercial insurance, a person who meets all of |
the following requirements: |
(A) The person is an employee of, or third-party |
consultant retained by, the commercial policyholder. |
(B) The person provides skilled services in loss |
prevention, loss reduction, or risk and insurance coverage |
analysis, and purchase of insurance. |
(C) With regard to the person: |
(I) the person has: |
(a) a bachelor's degree or higher from an |
accredited college or university in risk |
management, business administration, finance, |
economics, or any other field determined by the |
Director or his designee to demonstrate minimum |
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competence in risk management; and |
(b) the following: |
(i) three years of experience in risk |
financing, claims administration, loss |
prevention, risk and insurance analysis, or |
purchasing commercial lines of insurance; or |
(ii) alternatively has: |
(AA) a designation as a Chartered |
Property and Casualty Underwriter (in this |
subparagraph (ii) referred to as "CPCU") |
issued by the American Institute for |
CPCU/Insurance Institute of America; |
(BB) a designation as an Associate in |
Risk Management (ARM) issued by the |
American Institute for CPCU/Insurance |
Institute of America; |
(CC) a designation as Certified Risk |
Manager (CRM) issued by the National |
Alliance for Insurance Education & |
Research; |
(DD) a designation as a RIMS Fellow |
(RF) issued by the Global Risk Management |
Institute; or |
(EE) any other designation, |
certification, or license determined by |
the Director or his designee to |
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demonstrate minimum competency in risk |
management; |
(II) the person has: |
(a) at least 7 years of experience in risk |
financing, claims administration, loss prevention, |
risk and insurance coverage analysis, or |
purchasing commercial lines of insurance; and |
(b) has any one of the designations specified |
in subparagraph (ii) of paragraph (b); |
(III) the person has at least 10 years of |
experience in risk financing, claims administration, |
loss prevention, risk and insurance coverage analysis, |
or purchasing commercial lines of insurance; or |
(IV) the person has a graduate degree from an |
accredited college or university in risk management, |
business administration, finance, economics, or any |
other field determined by the Director or his or her |
designee to demonstrate minimum competence in risk |
management. |
"Residual market mechanism" means an association, |
organization, or other
entity described in Article XXXIII of |
this Code or Section 7-501 of the
Illinois Vehicle Code or any |
similar association, organization, or other
entity. |
"State" means any State of the United States, the District |
of Columbia, the Commonwealth of Puerto Rico, Guam, the |
Northern Mariana Islands, the Virgin Islands, and American |
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Samoa. |
"Surplus line insurance" means insurance on a risk: |
(A) of the kinds specified in Classes 2 and 3 of |
Section 4 of this Code; and |
(B) that is procured from an unauthorized insurer after |
the insurance producer representing the insured or the |
surplus line producer is unable, after diligent effort, to |
procure the insurance from authorized insurers; and |
(C) where Illinois is the home state of the insured, |
for policies effective, renewed or extended on July 21, |
2011 or later and for multiyear policies upon the policy |
anniversary that falls on or after July 21, 2011; and |
(D) that is located in Illinois, for policies effective |
prior to July 21, 2011. |
"Unauthorized insurer" means an insurer that does not hold |
a valid
certificate of authority issued by the Director but, |
for the purposes of this
Section, shall also include a domestic |
surplus line insurer as defined in
Section 445a.
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(1.5) Procuring surplus line insurance; surplus line |
insurer requirements. |
(a) Insurance producers may procure surplus line insurance |
only if licensed
as a surplus line producer under this Section . |
(b) Licensed surplus line producers and may procure surplus |
line that
insurance only from an unauthorized insurer domiciled |
in the United States only if the insurer :
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(i) is permitted in its domiciliary jurisdiction to |
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write the type of insurance involved; and
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(ii) has, (a) that based upon information available to |
the surplus
line producer ,
has a policyholders surplus of |
not less than $15,000,000
determined in
accordance with the |
laws of its domiciliary jurisdiction accounting rules that |
are applicable to
authorized insurers ;
and
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(iii) (b) that has standards of solvency and management |
that are adequate
for the protection of policyholders . ; and
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Where (c) where an unauthorized insurer does not meet the
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standards set forth
in (ii) (a) and (iii) (b) above, a surplus |
line producer may, if necessary, procure
insurance from that |
insurer only if prior written warning of
such fact or
condition |
is given to the insured by the insurance producer or surplus |
line
producer.
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(c) Licensed surplus line producers may procure surplus |
line insurance from an unauthorized insurer domiciled outside |
of the United States only if the insurer is listed on the |
Quarterly Listing of Alien Insurers maintained by the |
International Insurers Department of the NAIC. The Director |
shall make the Quarterly Listing of Alien Insurers available to |
surplus line producers without charge. |
(d) Insurance producers shall not procure from an
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unauthorized insurer an insurance policy: |
(i) that is designed to satisfy the
proof of financial |
responsibility and insurance requirements in any
Illinois |
law where the law requires that the proof of
insurance is |
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issued by an authorized insurer or residual market
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mechanism; |
(ii) that covers the risk of accidental injury to |
employees arising
out of and in the course of employment |
according to the provisions of the
Workers' Compensation |
Act; or |
(iii) that insures any Illinois personal lines risk, as |
defined in
subsection (a), (b), or (c) of Section 143.13 of |
this Code, that is eligible
for residual market mechanism |
coverage, unless the insured or prospective
insured |
requests limits of liability greater than the limits |
provided by the
residual market mechanism. In the course of |
making a diligent effort to
procure insurance from |
authorized insurers, an insurance producer shall not be
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required to submit a risk to a residual market mechanism |
when the risk is not
eligible for coverage or exceeds the |
limits available in the residual market
mechanism. |
Where there is an insurance policy issued by an
authorized |
insurer or residual market mechanism
insuring a risk described |
in item (i), (ii), or (iii)
above, nothing in this paragraph |
shall be construed
to prohibit a surplus line producer from |
procuring
from an unauthorized insurer a policy insuring the
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risk on an excess or umbrella basis where the excess
or |
umbrella policy is written over one or more
underlying |
policies.
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(e) Licensed surplus line producers may procure surplus |
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line insurance from an unauthorized insurer for an exempt |
commercial purchaser without making the required diligent |
effort to procure the insurance from authorized insurers if: |
(i) the producer has disclosed to the exempt commercial |
purchaser that such insurance may or may not be available |
from authorized insurers that may provide greater |
protection with more regulatory oversight; and |
(ii) the exempt commercial purchaser has subsequently |
in writing requested the producer to procure such insurance |
from an unauthorized insurer. |
(2) Surplus line producer; license. Any licensed producer |
who is a
resident of this State, or any nonresident who |
qualifies under Section
500-40, may be licensed as a surplus |
line producer upon :
(a) completing a prelicensing course of |
study. The
course provided for by this Section shall be |
conducted
under rules and
regulations prescribed by the |
Director. The Director may administer the
course or may make |
arrangements, including contracting with
an outside
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educational service, for administering the course and
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collecting the non-refundable application fee provided for in |
this subsection.
Any
charges assessed
by the Director or the |
educational service for administering
the course
shall be paid |
directly by the individual applicants. Each applicant
required |
to take the course shall enclose with the application a |
non-refundable
$20
application
fee payable to the Director plus |
a separate course
administration fee. An applicant who fails to |
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appear for the
course as scheduled, or appears but fails to |
complete the
course, shall not be
entitled to any refund, and |
shall be required to submit a new request to
attend the course |
together with all the requisite fees before being rescheduled
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for another course at a later date; and
(b) payment of an |
annual license fee of $400 ; and
(c) procurement of the surety |
bond required in subsection (4) of this
Section .
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A surplus line producer so licensed shall keep a separate
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account of
the business transacted thereunder which shall be |
open at all times to the
inspection of the Director or his |
representative.
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No later than July 21, 2012, the State of Illinois shall |
participate in the national insurance producer database of the |
NAIC, or any other equivalent uniform national database, for |
the licensure of surplus line producers and the renewal of such |
licenses. |
The prelicensing course of study requirement in (a) above
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shall not apply to insurance
producers who were licensed under |
the Illinois surplus line law on or before
January 1, 2002.
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(3) Taxes and reports.
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(a) Surplus line tax and penalty for late payment.
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The surplus line tax rate for a surplus line insurance |
policy or contract is determined as follows: |
(i) 3% for policies or contracts with an effective |
date prior to July 1, 2003; |
(ii) 3.5% for policies or contracts with an |
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effective date of July 1, 2003 or later.
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A surplus line producer shall file with the Director on |
or
before
February 1 and August 1 of each year a report in |
the form prescribed by the
Director on all surplus line |
insurance procured from unauthorized insurers
during the |
preceding
6 month period ending December 31 or June 30
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respectively, and on the filing of such report shall pay to |
the Director
for the use and benefit of the State a sum |
equal to the surplus line tax rate multiplied by 3.5% of |
the
gross
premiums less returned premiums upon all surplus |
line insurance submitted to the Surplus Line Association of |
Illinois procured
or cancelled during the preceding 6 |
months.
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Any surplus line producer who fails to pay the full |
amount due under this
subsection is liable, in addition to |
the amount due, for such
penalty and interest charges as |
are provided for under Section 412 of
this Code. The |
Director, through the
Attorney General, may
institute an |
action in the name of the People of the State of Illinois, |
in
any court of competent jurisdiction, for the recovery of |
the amount of such
taxes and penalties due, and prosecute |
the same to final judgment, and take
such steps as are |
necessary to collect the same.
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(b) Fire Marshal Tax.
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Each surplus line producer shall file with the Director |
on or before
March 31 of each year a report in the form |
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prescribed by the Director on all
fire insurance procured |
from unauthorized insurers and submitted to the Surplus |
Line Association of Illinois subject to tax under
Section |
12 of the Fire Investigation
Act
and shall pay to the |
Director the fire marshal tax required thereunder.
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(c) Taxes and fees charged to insured. The taxes |
imposed under this
subsection and the countersigning fees |
charged by the Surplus Line
Association of Illinois may be |
charged to and collected from surplus line
insureds.
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(4) (Blank). Bond. Each surplus line producer, as a |
condition to receiving a
surplus line producer's license, shall |
execute and deliver to the Director
a surety bond to the People |
of the State in the penal sum of $20,000, with
a surety which |
is authorized to transact business in this State,
conditioned |
that the surplus line producer will pay to the Director the |
tax,
interest and penalties levied under subsection (3) of this |
Section.
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(5) Submission of documents to Surplus Line Association of |
Illinois.
A surplus line producer shall submit every insurance |
contract
issued
under his or her license to the Surplus Line |
Association of Illinois for
recording and countersignature. |
The submission and countersignature may be
effected through |
electronic means. The submission shall set
forth:
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(a) the name of the insured;
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(b) the description and location of the insured |
property or
risk;
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(c) the amount insured;
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(d) the gross premiums charged or returned;
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(e) the name of the unauthorized insurer from whom |
coverage has been procured;
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(f) the kind or kinds of insurance procured; and
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(g) amount of premium subject to tax required by |
Section 12 of the Fire
Investigation Act.
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Proposals, endorsements, and other documents which are
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incidental to the insurance but which do not affect the premium
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charged
are exempted from filing and countersignature.
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The submission of insuring contracts
to the Surplus Line |
Association of
Illinois constitutes a certification by the |
surplus line producer or by the
insurance producer who |
presented the risk to the surplus line producer for
placement |
as a surplus line risk that
after diligent effort the required |
insurance could not be procured from
authorized insurers and |
that
such procurement was otherwise in accordance with the |
surplus line law.
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(6) Countersignature required. It shall be unlawful for an |
insurance
producer to deliver any unauthorized insurer
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contract unless such
insurance contract is countersigned by the |
Surplus Line Association of
Illinois.
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(7) Inspection of records. A surplus line producer shall
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maintain
separate records of the business transacted under his |
or her license,
including complete copies of surplus line |
insurance contracts maintained on
paper or by electronic means, |
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which
records shall be open at all times for inspection by the |
Director and by
the Surplus Line Association of Illinois.
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(8) Violations and penalties. The Director may suspend or |
revoke or
refuse to renew a surplus line producer license for |
any violation of this Code.
In addition to or in lieu of |
suspension or revocation, the Director may
subject a surplus |
line producer
to a civil penalty of up to $2,000 for each cause |
for suspension
or
revocation. Such penalty is enforceable under |
subsection (5) of Section
403A of this Code.
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(9) Director may declare insurer ineligible. If the
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Director determines
that the further assumption of risks might |
be hazardous to the
policyholders of an unauthorized insurer, |
the Director may
order the
Surplus Line Association of
Illinois |
not to countersign insurance contracts evidencing insurance in
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such insurer and order surplus line producers to cease
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procuring insurance
from such insurer.
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(10) Service of process upon Director. Insurance contracts
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delivered under this Section from unauthorized insurers, other |
than domestic
surplus line insurers as defined in Section 445a,
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shall contain a
provision designating the
Director and his |
successors in office the true and lawful attorney of the
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insurer upon whom may be served all lawful process in any
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action, suit or
proceeding arising out of such insurance.
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Service of process made upon the Director to be valid hereunder |
must state
the name of the insured, the name of the |
unauthorized insurer
and identify
the contract of insurance. |
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The Director at his option is authorized to
forward a copy of |
the process to the Surplus Line Association of Illinois
for |
delivery to the unauthorized insurer or the Director may |
deliver the process to the
unauthorized insurer by other means |
which he considers to be
reasonably
prompt and certain.
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(10.5) Insurance contracts delivered under this Section |
from unauthorized insurers, other than domestic surplus line |
insurers as defined in Section 445a, shall have stamped or |
imprinted on the first page thereof in not less than 12-pt. |
bold face type the following legend: "Notice to Policyholder: |
This contract is issued, pursuant to Section 445 of the |
Illinois Insurance Code, by a company not authorized and |
licensed to transact business in Illinois and as such is not |
covered by the Illinois Insurance Guaranty Fund." Insurance |
contracts delivered under this Section from domestic surplus |
line insurers as defined in Section 445a shall have stamped or |
imprinted on the first page thereof in not less than 12-pt. |
bold face type the following legend: "Notice to Policyholder: |
This contract is issued by a domestic surplus line insurer, as |
defined in Section 445a of the Illinois Insurance Code, |
pursuant to Section 445, and as such is not covered by the |
Illinois Insurance Guaranty Fund."
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(11) The Illinois Surplus Line law does not apply to |
insurance of
property and operations of railroads or aircraft |
engaged in interstate or
foreign commerce, insurance of |
vessels, crafts or hulls, cargoes, marine
builder's risks, |
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marine protection and indemnity, or other risks including
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strikes and war risks insured under ocean or wet marine forms |
of policies.
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(12) Surplus line insurance procured under this Section, |
including
insurance procured from a domestic surplus line |
insurer, is not subject
to the provisions of the Illinois |
Insurance Code other than Sections 123,
123.1, 401, 401.1, 402, |
403, 403A, 408, 412, 445, 445.1, 445.2, 445.3,
445.4, and all |
of the provisions of Article XXXI to the extent that the
|
provisions of Article XXXI are not inconsistent with the terms |
of this Act.
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(Source: P.A. 92-386, eff. 1-1-02; 93-29, eff. 6-20-03; 93-32, |
eff. 7-1-03; 93-876, eff. 8-6-04.)
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(215 ILCS 5/445a)
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Sec. 445a. Domestic surplus line insurer.
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(a) A domestic insurer possessing
policyholder surplus of |
at least $15,000,000 may pursuant to a resolution by
its board |
of directors, and with the written approval of the Director, be
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designated as a "domestic surplus line insurer".
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(b) A domestic surplus line insurer may only insure in this |
State an
Illinois risk only if procured from a surplus line |
producer pursuant to Section 445 of
this Code.
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(c) A domestic surplus line insurer must agree not to issue |
a policy
designed to satisfy the financial responsibility |
requirements of the Illinois
Vehicle Code, the Workers' |
|
Compensation Act, or the Workers' Occupational
Diseases Act. A |
domestic surplus line insurer is not subject to the provisions
|
of Articles XXXIII, XXXIII 1/2, XXXIV, XXXVIIIA, Section 468, |
or Section
478.1 of this Code.
|
(d) For the purposes of the federal Nonadmitted and |
Reinsurance Reform Act of 2010 (15 USC 8201 et seq.), a |
domestic surplus line insurer shall be considered a nonadmitted |
insurer, as the term is defined in the Act, with respect to |
risks insured in this State. |
(Source: P.A. 90-794, eff. 8-14-98.)
|
Section 97. Severability. The provisions of this Act are |
severable under Section 1.31 of the Statute on Statutes. |
Section 99. Effective date. This Act takes effect upon |
becoming law. |