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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Pension Code is amended by | ||||||
5 | changing Sections 1-110.6, 1-110.10, 1-110.15, 1-113.4, | ||||||
6 | 1-113.4a, 1-113.5, 1-113.18, 2-162, 3-110, 4-108, 4-109.3, | ||||||
7 | 18-169, and 22-1004 as follows: | ||||||
8 | (40 ILCS 5/1-110.6)
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9 | Sec. 1-110.6. Transactions prohibited by retirement | ||||||
10 | systems; Republic of the Sudan. | ||||||
11 | (a) The Government of the United States has determined | ||||||
12 | that Sudan is a nation that sponsors terrorism and genocide. | ||||||
13 | The General Assembly finds that acts of terrorism have caused | ||||||
14 | injury and death to Illinois and United States residents who | ||||||
15 | serve in the United States military, and pose a significant | ||||||
16 | threat to safety and health in Illinois. The General Assembly | ||||||
17 | finds that public employees and their families, including | ||||||
18 | police officers and firefighters, are more likely than others | ||||||
19 | to be affected by acts of terrorism. The General Assembly | ||||||
20 | finds that Sudan continues to solicit investment and | ||||||
21 | commercial activities by forbidden entities, including private | ||||||
22 | market funds. The General Assembly finds that investments in | ||||||
23 | forbidden entities are inherently and unduly risky, not in the |
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1 | interests of public pensioners and Illinois taxpayers, and | ||||||
2 | against public policy. The General Assembly finds that Sudan's | ||||||
3 | capacity to sponsor terrorism and genocide depends on or is | ||||||
4 | supported by the activities of forbidden entities. The General | ||||||
5 | Assembly further finds and re-affirms that the people of the | ||||||
6 | State, acting through their representatives, do not want to be | ||||||
7 | associated with forbidden entities, genocide, and terrorism.
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8 | (b) For purposes of this Section: | ||||||
9 | "Business operations" means maintaining, selling, or | ||||||
10 | leasing equipment, facilities, personnel, or any other | ||||||
11 | apparatus of business or commerce in the Republic of the | ||||||
12 | Sudan, including the ownership or possession of real or | ||||||
13 | personal property located in the Republic of the Sudan. | ||||||
14 | "Certifying company" means a company that (1) directly | ||||||
15 | provides asset management services or advice to a retirement | ||||||
16 | system or (2) as directly authorized or requested by a | ||||||
17 | retirement system (A) identifies particular investment options | ||||||
18 | for consideration or approval; (B) chooses particular | ||||||
19 | investment options; or (C) allocates particular amounts to be | ||||||
20 | invested. If no company meets the criteria set forth in this | ||||||
21 | paragraph, then "certifying company" shall mean the retirement | ||||||
22 | system officer who, as designated by the board, executes the | ||||||
23 | investment decisions made by the board, or, in the | ||||||
24 | alternative, the company that the board authorizes to complete | ||||||
25 | the certification as the agent of that officer.
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26 | "Company" is any entity capable of affecting commerce, |
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1 | including but not limited to (i) a government, government | ||||||
2 | agency, natural person, legal person, sole proprietorship, | ||||||
3 | partnership, firm, corporation, subsidiary, affiliate, | ||||||
4 | franchisor, franchisee, joint venture, trade association, | ||||||
5 | financial institution, utility, public franchise, provider of | ||||||
6 | financial services, trust, or enterprise; and (ii) any | ||||||
7 | association thereof. | ||||||
8 | " Division Department " means the Public Pension Division of | ||||||
9 | the Department of Insurance Financial and Professional | ||||||
10 | Regulation .
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11 | "Forbidden entity" means any of the following: | ||||||
12 | (1) The government of the Republic of the Sudan and | ||||||
13 | any of its agencies, including but not limited to | ||||||
14 | political units and subdivisions;
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15 | (2) Any company that is wholly or partially managed or | ||||||
16 | controlled by the government of the Republic of the Sudan | ||||||
17 | and any of its agencies, including but not limited to | ||||||
18 | political units and subdivisions; | ||||||
19 | (3) Any company (i) that is established or organized | ||||||
20 | under the laws of the Republic of the Sudan or (ii) whose | ||||||
21 | principal place of business is in the Republic of the | ||||||
22 | Sudan; | ||||||
23 | (4) Any company (i) identified by the Office of | ||||||
24 | Foreign Assets Control in the United States Department of | ||||||
25 | the Treasury as sponsoring terrorist activities in the | ||||||
26 | Republic of the Sudan; or (ii) fined, penalized, or |
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1 | sanctioned by the Office of Foreign Assets Control in the | ||||||
2 | United States Department of the Treasury for any violation | ||||||
3 | of any United States rules and restrictions relating to | ||||||
4 | the Republic of the Sudan that occurred at any time | ||||||
5 | following the effective date of this Act; | ||||||
6 | (5) Any publicly traded company
that is individually | ||||||
7 | identified by an independent researching firm that | ||||||
8 | specializes in global security risk and that has been | ||||||
9 | retained by a certifying company as provided in subsection | ||||||
10 | (c) of this Section as being a company that owns or | ||||||
11 | controls property or assets located in, has employees or | ||||||
12 | facilities located in, provides goods or services to, | ||||||
13 | obtains goods or services from, has distribution | ||||||
14 | agreements with, issues credits or loans to, purchases | ||||||
15 | bonds or commercial paper issued by, or invests in (A)
the | ||||||
16 | Republic of the Sudan; or (B)
any company domiciled in the | ||||||
17 | Republic of the Sudan; and | ||||||
18 | (6) Any private market fund that fails to satisfy the | ||||||
19 | requirements set forth in subsections (d) and (e) of this | ||||||
20 | Section. | ||||||
21 | Notwithstanding the foregoing, the term "forbidden entity" | ||||||
22 | shall exclude (A) mutual funds that meet the requirements of | ||||||
23 | item (iii) of paragraph (13) of Section 1-113.2 and (B) | ||||||
24 | companies that transact business in the Republic of the Sudan | ||||||
25 | under the law, license, or permit of the United States, | ||||||
26 | including a license from the United States Department of the |
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1 | Treasury, and
companies, except agencies of the Republic of | ||||||
2 | the Sudan, who are certified as Non-Government Organizations | ||||||
3 | by the United Nations, or who engage solely in (i) the | ||||||
4 | provision of goods and services intended to relieve human | ||||||
5 | suffering or to promote welfare, health, religious and | ||||||
6 | spiritual activities, and education or humanitarian purposes; | ||||||
7 | or (ii) journalistic activities. | ||||||
8 | "Private market fund" means any private equity fund, | ||||||
9 | private equity fund of funds, venture capital fund, hedge | ||||||
10 | fund, hedge fund of funds, real estate fund, or other | ||||||
11 | investment vehicle that is not publicly traded.
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12 | "Republic of the Sudan" means those geographic areas of | ||||||
13 | the Republic of Sudan that are subject to sanction or other | ||||||
14 | restrictions placed on commercial activity imposed by the | ||||||
15 | United States Government due to an executive or congressional | ||||||
16 | declaration of genocide.
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17 | "Retirement system" means the State Employees' Retirement | ||||||
18 | System of Illinois, the Judges Retirement System of Illinois, | ||||||
19 | the General Assembly Retirement System, the State Universities | ||||||
20 | Retirement System, and the Teachers' Retirement System of the | ||||||
21 | State of Illinois.
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22 | (c) A retirement system shall not transfer or disburse | ||||||
23 | funds to, deposit into, acquire any bonds or commercial paper | ||||||
24 | from, or otherwise loan to or invest in any entity unless, as | ||||||
25 | provided in this Section, a certifying company
certifies to | ||||||
26 | the retirement system that, (1) with respect to investments in |
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1 | a publicly traded company, the certifying company has relied | ||||||
2 | on information provided by an independent researching firm | ||||||
3 | that specializes in global security risk and (2) 100% of the | ||||||
4 | retirement system's assets for which the certifying company | ||||||
5 | provides services or advice are not and have not been invested | ||||||
6 | or reinvested in any forbidden entity at any time after 4 | ||||||
7 | months after the effective date of this Section. | ||||||
8 | The certifying company shall make the certification | ||||||
9 | required under this subsection (c) to a retirement system 6 | ||||||
10 | months after the effective date of this Section and annually | ||||||
11 | thereafter. A retirement system shall submit the | ||||||
12 | certifications to the Division Department , and the Division | ||||||
13 | Department shall notify the Director of Insurance Secretary of | ||||||
14 | Financial and Professional Regulation if a retirement system | ||||||
15 | fails to do so. | ||||||
16 | (d) With respect to a commitment or investment made | ||||||
17 | pursuant to a written agreement executed prior to the | ||||||
18 | effective date of this Section, each private market fund shall | ||||||
19 | submit to the appropriate certifying company, at no additional | ||||||
20 | cost to the retirement system:
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21 | (1) an affidavit sworn under oath in which an | ||||||
22 | expressly authorized officer of the private market fund | ||||||
23 | avers that the private market fund (A) does not own or | ||||||
24 | control any property or asset located in the Republic of | ||||||
25 | the Sudan and (B) does not conduct business operations in | ||||||
26 | the Republic of the Sudan; or |
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1 | (2) a certificate in which an expressly authorized | ||||||
2 | officer of the private market fund certifies that the | ||||||
3 | private market fund, based on reasonable due diligence, | ||||||
4 | has determined that, other than direct or indirect | ||||||
5 | investments in companies certified as Non-Government | ||||||
6 | Organizations by the United Nations, the private market | ||||||
7 | fund has no direct or indirect investment in any company | ||||||
8 | (A) organized under the laws of the Republic of the Sudan; | ||||||
9 | (B) whose principal place of business is in the Republic | ||||||
10 | of the Sudan; or (C) that conducts business operations in | ||||||
11 | the Republic of the Sudan. Such certificate shall be based | ||||||
12 | upon the periodic reports received by the private market | ||||||
13 | fund, and the private market fund shall agree that the | ||||||
14 | certifying company, directly or through an agent, or the | ||||||
15 | retirement system, as the case may be, may from time to | ||||||
16 | time review the private market fund's certification | ||||||
17 | process.
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18 | (e) With respect to a commitment or investment made | ||||||
19 | pursuant to a written agreement executed after the effective | ||||||
20 | date of this Section, each private market fund shall, at no | ||||||
21 | additional cost to the retirement system:
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22 | (1) submit to the appropriate certifying company an | ||||||
23 | affidavit or certificate consistent with the requirements | ||||||
24 | pursuant to subsection (d) of this Section; or | ||||||
25 | (2) enter into an enforceable written agreement with | ||||||
26 | the retirement system that provides for remedies |
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1 | consistent with those set forth in subsection (g) of this | ||||||
2 | Section if any of the assets of the retirement system | ||||||
3 | shall be transferred, loaned, or otherwise invested in any | ||||||
4 | company that directly or indirectly (A) has facilities or | ||||||
5 | employees in the Republic of the Sudan or (B) conducts | ||||||
6 | business operations in the Republic of the Sudan.
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7 | (f) In addition to any other penalties and remedies | ||||||
8 | available under the law of Illinois and the United States, any | ||||||
9 | transaction, other than a transaction with a private market | ||||||
10 | fund that is governed by subsections (g) and (h) of this | ||||||
11 | Section, that violates the provisions of this Act shall be | ||||||
12 | against public policy and voidable, at the sole discretion of | ||||||
13 | the retirement system.
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14 | (g) If a private market fund fails to provide the | ||||||
15 | affidavit or certification required in subsections (d) and (e) | ||||||
16 | of this Section, then the retirement system shall, within 90 | ||||||
17 | days, divest, or attempt in good faith to divest, the | ||||||
18 | retirement system's interest in the private market fund, | ||||||
19 | provided that the Board of the retirement system confirms | ||||||
20 | through resolution that the divestment does not have a | ||||||
21 | material and adverse impact on the retirement system. The | ||||||
22 | retirement system shall immediately notify the Division | ||||||
23 | Department , and the Division Department shall notify all other | ||||||
24 | retirement systems, as soon as practicable, by posting the | ||||||
25 | name of the private market fund on the Division's Department's | ||||||
26 | Internet website or through e-mail communications. No other |
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1 | retirement system may enter into any agreement under which the | ||||||
2 | retirement system directly or indirectly invests in the | ||||||
3 | private market fund unless the private market fund provides | ||||||
4 | that retirement system with the affidavit or certification | ||||||
5 | required in subsections (d) and (e) of this Section and | ||||||
6 | complies with all other provisions of this Section. | ||||||
7 | (h) If a private market fund fails to fulfill its | ||||||
8 | obligations under any agreement provided for in paragraph (2) | ||||||
9 | of subsection (e) of this Section, the retirement system shall | ||||||
10 | immediately take legal and other action to obtain satisfaction | ||||||
11 | through all remedies and penalties available under the law and | ||||||
12 | the agreement itself. The retirement system shall immediately | ||||||
13 | notify the Division Department , and the Division Department | ||||||
14 | shall notify all other retirement systems, as soon as | ||||||
15 | practicable, by posting the name of the private market fund on | ||||||
16 | the Division's Department's Internet website or through e-mail | ||||||
17 | communications, and no other retirement system may enter into | ||||||
18 | any agreement under which the retirement system directly or | ||||||
19 | indirectly invests in the private market fund.
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20 | (i) This Section shall have full force and effect during | ||||||
21 | any period in which the Republic of the Sudan, or the officials | ||||||
22 | of the government of that Republic, are subject to sanctions | ||||||
23 | authorized under any statute or executive order of the United | ||||||
24 | States or until such time as the State Department of the United | ||||||
25 | States confirms in the federal register or through other means | ||||||
26 | that the Republic of the Sudan is no longer subject to |
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1 | sanctions by the government of the United States. | ||||||
2 | (j) If any provision of this Section or its application to | ||||||
3 | any person or circumstance is held invalid, the invalidity of | ||||||
4 | that provision or application does not affect other provisions | ||||||
5 | or applications of this Section that can be given effect | ||||||
6 | without the invalid provision or application.
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7 | (Source: P.A. 95-521, eff. 8-28-07.) | ||||||
8 | (40 ILCS 5/1-110.10)
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9 | Sec. 1-110.10. Servicer certification. | ||||||
10 | (a) For the purposes of this Section: | ||||||
11 | "Illinois finance entity" means any entity chartered under | ||||||
12 | the Illinois Banking Act, the Savings Bank Act, the Illinois | ||||||
13 | Credit Union Act, or the Illinois Savings and Loan Act of 1985 | ||||||
14 | and any person or entity licensed under the Residential | ||||||
15 | Mortgage License Act of 1987, the Consumer Installment Loan | ||||||
16 | Act, or the Sales Finance Agency Act. | ||||||
17 | "Retirement system or pension fund" means a retirement | ||||||
18 | system or pension fund established under this Code.
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19 | (b) In order for an Illinois finance entity to be eligible | ||||||
20 | for investment or deposit of retirement system or pension fund | ||||||
21 | assets, the Illinois finance entity must annually certify that | ||||||
22 | it complies with the requirements of the High Risk Home Loan | ||||||
23 | Act and the rules adopted pursuant to that Act that are | ||||||
24 | applicable to that Illinois finance entity. For Illinois | ||||||
25 | finance entities with whom the retirement system or pension |
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1 | fund is investing or depositing assets on the effective date | ||||||
2 | of this Section, the initial certification required under this | ||||||
3 | Section shall be completed within 6 months after the effective | ||||||
4 | date of this Section. For Illinois finance entities with whom | ||||||
5 | the retirement system or pension fund is not investing or | ||||||
6 | depositing assets on the effective date of this Section, the | ||||||
7 | initial certification required under this Section must be | ||||||
8 | completed before the retirement system or pension fund may | ||||||
9 | invest or deposit assets with the Illinois finance entity. | ||||||
10 | (c) A retirement system or pension fund shall submit the | ||||||
11 | certifications to the Public Pension Division of the | ||||||
12 | Department of Insurance Financial and Professional Regulation , | ||||||
13 | and the Division shall notify the Director of Insurance | ||||||
14 | Secretary of Financial and Professional Regulation if a | ||||||
15 | retirement system or pension fund fails to do so. | ||||||
16 | (d) If an Illinois finance entity fails to provide an | ||||||
17 | initial certification within 6 months after the effective date | ||||||
18 | of this Section or fails to submit an annual certification, | ||||||
19 | then the retirement system or pension fund shall notify the | ||||||
20 | Illinois finance entity. The Illinois finance entity shall, | ||||||
21 | within 30 days after the date of notification, either (i) | ||||||
22 | notify the retirement system or pension fund of its intention | ||||||
23 | to certify and complete certification or (ii) notify the | ||||||
24 | retirement system or pension fund of its intention to not | ||||||
25 | complete certification. If an Illinois finance entity fails to | ||||||
26 | provide certification, then the retirement system or pension |
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1 | fund shall, within 90 days, divest, or attempt in good faith to | ||||||
2 | divest, the retirement system's or pension fund's assets with | ||||||
3 | that Illinois finance entity. The retirement system or pension | ||||||
4 | fund shall immediately notify the Public Pension Division of | ||||||
5 | the Department of Insurance Department of the Illinois finance | ||||||
6 | entity's failure to provide certification.
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7 | (e) If any provision of this Section or its application to | ||||||
8 | any person or circumstance is held invalid, the invalidity of | ||||||
9 | that provision or application does not affect other provisions | ||||||
10 | or applications of this Section that can be given effect | ||||||
11 | without the invalid provision or application.
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12 | (Source: P.A. 95-521, eff. 8-28-07; 95-876, eff. 8-21-08.) | ||||||
13 | (40 ILCS 5/1-110.15)
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14 | Sec. 1-110.15. Transactions prohibited by retirement | ||||||
15 | systems; Iran.
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16 | (a) As used in this Section: | ||||||
17 | "Active business operations" means all business
operations | ||||||
18 | that are not inactive business operations. | ||||||
19 | "Business operations" means engaging in commerce
in any | ||||||
20 | form in Iran, including, but not limited to,
acquiring, | ||||||
21 | developing, maintaining, owning, selling,
possessing, leasing, | ||||||
22 | or operating equipment, facilities,
personnel, products, | ||||||
23 | services, personal property, real
property, or any other | ||||||
24 | apparatus of business or commerce. | ||||||
25 | "Company" means any sole proprietorship,
organization, |
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1 | association, corporation, partnership, joint
venture, limited | ||||||
2 | partnership, limited liability partnership,
limited liability | ||||||
3 | company, or other entity or business
association, including | ||||||
4 | all wholly owned subsidiaries,
majority-owned subsidiaries, | ||||||
5 | parent companies, or affiliates
of those entities or business | ||||||
6 | associations, that exists for
the purpose of making profit. | ||||||
7 | "Direct holdings" in a company means all
securities of | ||||||
8 | that company that are held directly by the
retirement system | ||||||
9 | or in an account or fund in which the retirement system
owns | ||||||
10 | all shares or interests. | ||||||
11 | "Inactive business operations" means the mere
continued | ||||||
12 | holding or renewal of rights to property previously
operated | ||||||
13 | for the purpose of generating revenues but not
presently | ||||||
14 | deployed for that purpose. | ||||||
15 | "Indirect holdings" in a company means all
securities of | ||||||
16 | that company which are held in an account or
fund, such as a | ||||||
17 | mutual fund, managed by one or more persons
not employed by the | ||||||
18 | retirement system, in which the retirement system owns
shares | ||||||
19 | or interests together with other investors not subject
to the | ||||||
20 | provisions of this Section. | ||||||
21 | "Mineral-extraction activities" include exploring,
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22 | extracting, processing, transporting, or wholesale selling or
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23 | trading of elemental minerals or associated metal alloys or
| ||||||
24 | oxides (ore), including gold, copper, chromium, chromite,
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25 | diamonds, iron, iron ore, silver, tungsten, uranium, and zinc. | ||||||
26 | "Oil-related activities" include, but are not
limited to, |
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1 | owning rights to oil blocks; exporting,
extracting, producing, | ||||||
2 | refining, processing, exploring for,
transporting, selling, or | ||||||
3 | trading of oil; and constructing,
maintaining, or operating a | ||||||
4 | pipeline, refinery, or other
oil-field infrastructure. The | ||||||
5 | mere retail sale of gasoline and
related consumer products is | ||||||
6 | not considered an oil-related
activity. | ||||||
7 | "Petroleum resources" means petroleum, petroleum
| ||||||
8 | byproducts, or natural gas. | ||||||
9 | "Private market fund" means any private equity fund, | ||||||
10 | private equity fund of funds, venture capital fund, hedge | ||||||
11 | fund, hedge fund of funds, real estate fund, or other | ||||||
12 | investment vehicle that is not publicly traded.
| ||||||
13 | "Retirement system" means the State Employees' Retirement | ||||||
14 | System of Illinois, the Judges Retirement System of Illinois, | ||||||
15 | the General Assembly Retirement System, the State Universities | ||||||
16 | Retirement System, and the Teachers' Retirement System of the | ||||||
17 | State of Illinois. | ||||||
18 | "Scrutinized business operations" means business | ||||||
19 | operations that have caused a company to become a scrutinized | ||||||
20 | company.
| ||||||
21 | "Scrutinized company" means the company has
business | ||||||
22 | operations that involve contracts with or provision
of | ||||||
23 | supplies or services to the Government of Iran, companies
in | ||||||
24 | which the Government of Iran has any direct or indirect
equity | ||||||
25 | share, consortiums or projects commissioned by the
Government | ||||||
26 | of Iran, or companies involved in consortiums or
projects |
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1 | commissioned by the Government of Iran and: | ||||||
2 | (1) more than 10% of the company's revenues produced | ||||||
3 | in or assets located in Iran involve oil-related | ||||||
4 | activities or
mineral-extraction activities; less than 75% | ||||||
5 | of the
company's revenues produced in or assets located in | ||||||
6 | Iran involve contracts
with or provision of oil-related or | ||||||
7 | mineral-extraction
products or services to the Government | ||||||
8 | of Iran or a project or
consortium created exclusively by | ||||||
9 | that government; and the
company has failed to take | ||||||
10 | substantial action; or | ||||||
11 | (2) the company has, on or after
August 5, 1996, made | ||||||
12 | an investment of $20 million or more, or
any combination | ||||||
13 | of investments of at least $10 million each
that in the | ||||||
14 | aggregate equals or exceeds $20 million in any
12-month | ||||||
15 | period, that directly or significantly contributes
to the | ||||||
16 | enhancement of Iran's ability to develop petroleum
| ||||||
17 | resources of Iran. | ||||||
18 | "Substantial action" means adopting, publicizing,
and | ||||||
19 | implementing a formal plan to cease scrutinized business
| ||||||
20 | operations within one year and to refrain from any such new
| ||||||
21 | business operations. | ||||||
22 | (b) Within 90 days after the effective date of this
| ||||||
23 | Section, a retirement system shall make its best efforts to | ||||||
24 | identify all scrutinized companies in which the retirement | ||||||
25 | system has direct or indirect holdings. | ||||||
26 | These efforts shall include the following, as appropriate |
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| |||||||
1 | in the retirement system's judgment: | ||||||
2 | (1) reviewing and relying on publicly available | ||||||
3 | information regarding
companies having business operations | ||||||
4 | in Iran, including
information provided by nonprofit | ||||||
5 | organizations, research
firms, international | ||||||
6 | organizations, and government entities; | ||||||
7 | (2) contacting asset managers contracted by the | ||||||
8 | retirement system that invest in companies having business | ||||||
9 | operations in
Iran; and | ||||||
10 | (3) Contacting other institutional investors that have
| ||||||
11 | divested from or engaged with companies that have business
| ||||||
12 | operations in Iran. | ||||||
13 | The retirement system may retain an independent research | ||||||
14 | firm to identify scrutinized companies in which the retirement | ||||||
15 | system has direct or indirect holdings. By the first meeting | ||||||
16 | of the retirement system following
the 90-day period described | ||||||
17 | in this subsection (b), the retirement system
shall assemble | ||||||
18 | all scrutinized companies identified into a
scrutinized | ||||||
19 | companies list. | ||||||
20 | The retirement system shall update the scrutinized
| ||||||
21 | companies list annually based on evolving information from,
| ||||||
22 | among other sources, those listed in this subsection (b). | ||||||
23 | (c) The retirement system shall adhere to
the following | ||||||
24 | procedures for companies on the scrutinized
companies list: | ||||||
25 | (1) The retirement system shall determine the
| ||||||
26 | companies on the scrutinized companies list in which the
|
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| |||||||
1 | retirement system owns direct or indirect holdings. | ||||||
2 | (2) For each company identified in item (1) of this | ||||||
3 | subsection (c) that
has only inactive business operations, | ||||||
4 | the retirement system shall
send a written notice | ||||||
5 | informing the company of this Section and
encouraging it | ||||||
6 | to continue to refrain from initiating active
business | ||||||
7 | operations in Iran until it is able to avoid
scrutinized | ||||||
8 | business operations. The retirement system shall
continue | ||||||
9 | such correspondence semiannually. | ||||||
10 | (3) For each company newly identified in item (1) of | ||||||
11 | this subsection (c) that has active business operations, | ||||||
12 | the retirement system shall send a written notice | ||||||
13 | informing the company of its
scrutinized company status | ||||||
14 | and that it may become subject to
divestment by the | ||||||
15 | retirement system. The notice must inform the
company of | ||||||
16 | the opportunity to clarify its Iran-related
activities and | ||||||
17 | encourage the company, within 90 days, to cease
its | ||||||
18 | scrutinized business operations or convert such operations
| ||||||
19 | to inactive business operations in order to avoid | ||||||
20 | qualifying
for divestment by the retirement system. | ||||||
21 | (4) If, within 90 days after the retirement system's | ||||||
22 | first
engagement with a company pursuant to this | ||||||
23 | subsection (c), that
company ceases scrutinized business | ||||||
24 | operations, the company
shall be removed from the | ||||||
25 | scrutinized companies list and the
provisions of this | ||||||
26 | Section shall cease to apply to it unless it
resumes |
| |||||||
| |||||||
1 | scrutinized business operations. If, within 90 days
after | ||||||
2 | the retirement system's first engagement, the company | ||||||
3 | converts
its scrutinized active business operations to | ||||||
4 | inactive
business operations, the company is subject to | ||||||
5 | all provisions
relating thereto. | ||||||
6 | (d) If, after 90 days following the retirement system's | ||||||
7 | first
engagement with a company pursuant to subsection (c), | ||||||
8 | the
company continues to have scrutinized active business
| ||||||
9 | operations, and only while such company continues to have
| ||||||
10 | scrutinized active business operations, the retirement system | ||||||
11 | shall
sell, redeem, divest, or withdraw all publicly traded
| ||||||
12 | securities of the company, except as provided in paragraph
| ||||||
13 | (f), from the retirement system's assets under management | ||||||
14 | within 12
months after the company's most recent appearance on | ||||||
15 | the
scrutinized companies list. | ||||||
16 | If a company that ceased scrutinized active
business | ||||||
17 | operations following engagement pursuant to subsection (c) | ||||||
18 | resumes such operations, this subsection (d) immediately
| ||||||
19 | applies, and the retirement system shall send a written notice | ||||||
20 | to
the company. The company shall also be immediately
| ||||||
21 | reintroduced onto the scrutinized companies list. | ||||||
22 | (e) The retirement system may not acquire
securities of | ||||||
23 | companies on the scrutinized companies list
that have active | ||||||
24 | business operations, except as provided in
subsection (f). | ||||||
25 | (f) A company that the United States
Government | ||||||
26 | affirmatively declares to be excluded from its
present or any |
| |||||||
| |||||||
1 | future federal sanctions regime relating to
Iran is not | ||||||
2 | subject to divestment or the investment
prohibition pursuant | ||||||
3 | to subsections (d) and (e). | ||||||
4 | (g) Notwithstanding the
provisions of this Section, | ||||||
5 | paragraphs (d) and (e) do not apply to
indirect holdings in a | ||||||
6 | private market fund.
However, the retirement system shall | ||||||
7 | submit letters to the managers
of those investment funds | ||||||
8 | containing companies that have
scrutinized active business | ||||||
9 | operations requesting that they
consider removing the | ||||||
10 | companies from the fund or create a
similar actively managed | ||||||
11 | fund having indirect holdings devoid
of the companies. If the | ||||||
12 | manager creates a similar fund, the
retirement system shall | ||||||
13 | replace all applicable investments with
investments in the | ||||||
14 | similar fund in an expedited timeframe
consistent with prudent | ||||||
15 | investing standards. | ||||||
16 | (h) The retirement system shall file a report with the | ||||||
17 | Public Pension Division of the Department of Insurance | ||||||
18 | Financial and Professional Regulation that includes the | ||||||
19 | scrutinized companies list
within 30 days after the list is | ||||||
20 | created. This report shall be
made available to the public. | ||||||
21 | The retirement system shall file an annual report with the | ||||||
22 | Public Pension Division, which shall be made available to the | ||||||
23 | public, that includes all of the following: | ||||||
24 | (1) A summary of correspondence with companies engaged
| ||||||
25 | by the retirement system under items (2) and (3) of | ||||||
26 | subsection (c). |
| |||||||
| |||||||
1 | (2) All investments sold, redeemed, divested, or
| ||||||
2 | withdrawn in compliance with subsection (d). | ||||||
3 | (3) All prohibited investments under subsection (e). | ||||||
4 | (4) A summary of correspondence with private market | ||||||
5 | funds notified under subsection (g). | ||||||
6 | (i) This Section expires upon the occurrence
of any of the | ||||||
7 | following: | ||||||
8 | (1) The United States revokes all sanctions imposed
| ||||||
9 | against the Government of Iran. | ||||||
10 | (2) The Congress or President of the United States
| ||||||
11 | declares that the Government of Iran has ceased to acquire
| ||||||
12 | weapons of mass destruction and to support international
| ||||||
13 | terrorism. | ||||||
14 | (3) The Congress or President of the United States,
| ||||||
15 | through legislation or executive order, declares that
| ||||||
16 | mandatory divestment of the type provided for in this | ||||||
17 | Section
interferes with the conduct of United States | ||||||
18 | foreign policy. | ||||||
19 | (j) With respect to actions
taken in compliance with this | ||||||
20 | Act, including all good-faith
determinations regarding | ||||||
21 | companies as required by this Act,
the retirement system is | ||||||
22 | exempt from any conflicting statutory or
common law | ||||||
23 | obligations, including any fiduciary duties under this Article | ||||||
24 | and any obligations with
respect to choice of asset managers, | ||||||
25 | investment funds, or
investments for the retirement system's | ||||||
26 | securities portfolios. |
| |||||||
| |||||||
1 | (k) Notwithstanding any
other provision of this Section to | ||||||
2 | the contrary, the retirement system
may cease divesting from | ||||||
3 | scrutinized companies
pursuant to subsection (d) or reinvest | ||||||
4 | in
scrutinized companies from which it divested pursuant to
| ||||||
5 | subsection (d) if clear and convincing evidence shows that the | ||||||
6 | value of investments in scrutinized companies with active | ||||||
7 | scrutinized business operations becomes equal to or less than | ||||||
8 | 0.5% of the market value of all assets under management by the | ||||||
9 | retirement system. Cessation of
divestment, reinvestment, or | ||||||
10 | any subsequent ongoing investment
authorized by this Section | ||||||
11 | is limited to the minimum steps
necessary to avoid the | ||||||
12 | contingency set forth in this
subsection (k). For any | ||||||
13 | cessation of divestment, reinvestment, or
subsequent ongoing | ||||||
14 | investment authorized by this Section, the
retirement system | ||||||
15 | shall provide a written report to the Public Pension Division | ||||||
16 | in advance of initial reinvestment, updated
semiannually | ||||||
17 | thereafter as applicable, setting forth the
reasons and | ||||||
18 | justification, supported by clear and convincing
evidence, for | ||||||
19 | its decisions to cease divestment, reinvest, or
remain | ||||||
20 | invested in companies having scrutinized active
business | ||||||
21 | operations. This Section does not apply to reinvestment
in | ||||||
22 | companies on the grounds that they have ceased to have
| ||||||
23 | scrutinized active business operations. | ||||||
24 | (l) If any provision of this Section or its
application to | ||||||
25 | any person or circumstance is held invalid, the
invalidity | ||||||
26 | does not affect other provisions or applications of
the Act |
| |||||||
| |||||||
1 | which can be given effect without the invalid
provision or | ||||||
2 | application, and to this end the provisions of
this Section | ||||||
3 | are severable.
| ||||||
4 | (Source: P.A. 95-616, eff. 1-1-08; 95-876, eff. 8-21-08.)
| ||||||
5 | (40 ILCS 5/1-113.4)
| ||||||
6 | Sec. 1-113.4. List of additional permitted investments for | ||||||
7 | pension funds
with net assets of $5,000,000 or more. | ||||||
8 | (a) In addition to the items in Sections 1-113.2 and | ||||||
9 | 1-113.3, a pension fund
established under Article 3 or 4 that | ||||||
10 | has net assets of at least $5,000,000 and
has appointed an | ||||||
11 | investment adviser under Section 1-113.5 may, through that
| ||||||
12 | investment adviser, invest a portion of its assets in common | ||||||
13 | and preferred
stocks authorized for investments of trust funds | ||||||
14 | under the laws of the State
of Illinois. The stocks must meet | ||||||
15 | all of the following requirements:
| ||||||
16 | (1) The common stocks are listed on a national | ||||||
17 | securities exchange or
board of trade (as defined in the | ||||||
18 | federal Securities Exchange Act of 1934 and
set forth in | ||||||
19 | subdivision G of Section 3 of the Illinois Securities Law | ||||||
20 | of 1953) or quoted in
the National Association of | ||||||
21 | Securities Dealers Automated Quotation System
National | ||||||
22 | Market System (NASDAQ NMS).
| ||||||
23 | (2) The securities are of a corporation created or | ||||||
24 | existing under the laws
of the United States or any state, | ||||||
25 | district, or territory thereof and the
corporation has |
| |||||||
| |||||||
1 | been in existence for at least 5 years.
| ||||||
2 | (3) The corporation has not been in arrears on payment | ||||||
3 | of dividends on its
preferred stock during the preceding 5 | ||||||
4 | years.
| ||||||
5 | (4) The market value of stock in any one corporation | ||||||
6 | does not exceed 5% of
the cash and invested assets of the | ||||||
7 | pension fund, and the investments in the
stock of any one | ||||||
8 | corporation do not exceed 5% of the total outstanding | ||||||
9 | stock of
that corporation.
| ||||||
10 | (5) The straight preferred stocks or convertible | ||||||
11 | preferred stocks are
issued or guaranteed by a corporation | ||||||
12 | whose common stock qualifies for
investment by the board.
| ||||||
13 | (6) The issuer of the stocks has been subject to the | ||||||
14 | requirements of
Section 12 of the federal Securities | ||||||
15 | Exchange Act of 1934 and has been current
with the filing | ||||||
16 | requirements of Sections 13 and 14 of that Act during the
| ||||||
17 | preceding 3 years.
| ||||||
18 | (b) A pension fund's total investment in the items | ||||||
19 | authorized under this
Section and Section 1-113.3 shall not | ||||||
20 | exceed 35% of the market value of the
pension fund's net | ||||||
21 | present assets stated in its most recent annual report on
file | ||||||
22 | with the Public Pension Division of the Illinois Department of | ||||||
23 | Insurance.
| ||||||
24 | (c) A pension fund that invests funds under this Section | ||||||
25 | shall
electronically file with the Public Pension Division of | ||||||
26 | the Department of Insurance any reports of its investment |
| |||||||
| |||||||
1 | activities
that the Division may require, at the times and in | ||||||
2 | the format required by the
Division.
| ||||||
3 | (Source: P.A. 100-201, eff. 8-18-17.)
| ||||||
4 | (40 ILCS 5/1-113.4a) | ||||||
5 | Sec. 1-113.4a. List of additional permitted investments | ||||||
6 | for Article 3 and 4 pension funds with net assets of | ||||||
7 | $10,000,000 or more. | ||||||
8 | (a) In addition to the items in Sections 1-113.2 and | ||||||
9 | 1-113.3, a pension fund established under Article 3 or 4 that | ||||||
10 | has net assets of at least $10,000,000 and has appointed an | ||||||
11 | investment adviser, as defined under Sections 1-101.4 and | ||||||
12 | 1-113.5, may, through that investment adviser, invest an | ||||||
13 | additional portion of its assets in common and preferred | ||||||
14 | stocks and mutual funds. | ||||||
15 | (b) The stocks must meet all of the following | ||||||
16 | requirements: | ||||||
17 | (1) The common stocks must be listed on a national | ||||||
18 | securities exchange or board of trade (as defined in the | ||||||
19 | Federal Securities Exchange Act of 1934 and set forth in | ||||||
20 | paragraph G of Section 3 of the Illinois Securities Law of | ||||||
21 | 1953) or quoted in the National Association of Securities | ||||||
22 | Dealers Automated Quotation System National Market System. | ||||||
23 | (2) The securities must be of a corporation in | ||||||
24 | existence for at least 5 years. | ||||||
25 | (3) The market value of stock in any one corporation |
| |||||||
| |||||||
1 | may not exceed 5% of the cash and invested assets of the | ||||||
2 | pension fund, and the investments in the stock of any one | ||||||
3 | corporation may not exceed 5% of the total outstanding | ||||||
4 | stock of that corporation. | ||||||
5 | (4) The straight preferred stocks or convertible | ||||||
6 | preferred stocks must be issued or guaranteed by a | ||||||
7 | corporation whose common stock qualifies for investment by | ||||||
8 | the board. | ||||||
9 | (c) The mutual funds must meet the following requirements: | ||||||
10 | (1) The mutual fund must be managed by an investment | ||||||
11 | company registered under the Federal Investment Company | ||||||
12 | Act of 1940 and registered under the Illinois Securities | ||||||
13 | Law of 1953. | ||||||
14 | (2) The mutual fund must have been in operation for at | ||||||
15 | least 5 years. | ||||||
16 | (3) The mutual fund must have total net assets of | ||||||
17 | $250,000,000 or more. | ||||||
18 | (4) The mutual fund must be comprised of a diversified | ||||||
19 | portfolio of common or preferred stocks, bonds, or money | ||||||
20 | market instruments. | ||||||
21 | (d) A pension fund's total investment in the items | ||||||
22 | authorized under this Section and Section 1-113.3 shall not | ||||||
23 | exceed 50% effective July 1, 2011 and 55% effective July 1, | ||||||
24 | 2012 of the market value of the pension fund's net present | ||||||
25 | assets stated in its most recent annual report on file with the | ||||||
26 | Public Pension Division of the Department of Insurance. |
| |||||||
| |||||||
1 | (e) A pension fund that invests funds under this Section | ||||||
2 | shall electronically file with the Public Pension Division of | ||||||
3 | the Department of Insurance any reports of its investment | ||||||
4 | activities that the Division may require, at the time and in | ||||||
5 | the format required by the Division.
| ||||||
6 | (Source: P.A. 96-1495, eff. 1-1-11.)
| ||||||
7 | (40 ILCS 5/1-113.5)
| ||||||
8 | Sec. 1-113.5. Investment advisers and investment services | ||||||
9 | for all Article 3 or 4 pension funds.
| ||||||
10 | (a) The board of trustees of a pension fund may appoint | ||||||
11 | investment advisers
as defined in Section 1-101.4. The board | ||||||
12 | of any pension fund investing in
common or preferred stock | ||||||
13 | under Section 1-113.4 shall appoint an investment
adviser | ||||||
14 | before making such investments.
| ||||||
15 | The investment adviser shall be a fiduciary, as defined in | ||||||
16 | Section 1-101.2,
with respect to the pension fund and shall be | ||||||
17 | one of the following:
| ||||||
18 | (1) an investment adviser registered under the federal | ||||||
19 | Investment Advisers
Act of 1940 and the Illinois | ||||||
20 | Securities Law of 1953;
| ||||||
21 | (2) a bank or trust company authorized to conduct a | ||||||
22 | trust business in
Illinois;
| ||||||
23 | (3) a life insurance company authorized to transact | ||||||
24 | business in Illinois;
or
| ||||||
25 | (4) an investment company as defined and registered |
| |||||||
| |||||||
1 | under the federal
Investment Company Act of 1940 and | ||||||
2 | registered under the Illinois Securities Law
of 1953.
| ||||||
3 | (a-5) Notwithstanding any other provision of law, a person | ||||||
4 | or entity that provides consulting services (referred to as a | ||||||
5 | "consultant" in this Section) to a pension fund with respect | ||||||
6 | to the selection of fiduciaries may not be awarded a contract | ||||||
7 | to provide those consulting services that is more than 5 years | ||||||
8 | in duration. No contract to provide such consulting services | ||||||
9 | may be renewed or extended. At the end of the term of a | ||||||
10 | contract, however, the contractor is eligible to compete for a | ||||||
11 | new contract. No person shall attempt to avoid or contravene | ||||||
12 | the restrictions of this subsection by any means. All offers | ||||||
13 | from responsive offerors shall be accompanied by disclosure of | ||||||
14 | the names and addresses of the following: | ||||||
15 | (1) The offeror. | ||||||
16 | (2) Any entity that is a parent of, or owns a | ||||||
17 | controlling interest in, the offeror. | ||||||
18 | (3) Any entity that is a subsidiary of, or in which a | ||||||
19 | controlling interest is owned by, the offeror. | ||||||
20 | Beginning on July 1, 2008, a person, other than a trustee | ||||||
21 | or an employee of a pension fund or retirement system, may not | ||||||
22 | act as a consultant under this Section unless that person is at | ||||||
23 | least one of the following: (i) registered as an investment | ||||||
24 | adviser under the federal Investment Advisers Act of 1940 (15 | ||||||
25 | U.S.C. 80b-1, et seq.); (ii) registered as an investment | ||||||
26 | adviser under the Illinois Securities Law of 1953; (iii) a |
| |||||||
| |||||||
1 | bank, as defined in the Investment Advisers Act of 1940; or | ||||||
2 | (iv) an insurance company authorized to transact business in | ||||||
3 | this State. | ||||||
4 | (b) All investment advice and services provided by an | ||||||
5 | investment adviser
or a consultant appointed under this | ||||||
6 | Section shall be rendered pursuant to a written contract
| ||||||
7 | between the investment adviser and the board, and in | ||||||
8 | accordance with the
board's investment policy.
| ||||||
9 | The contract shall include all of the following:
| ||||||
10 | (1) acknowledgement in writing by the investment | ||||||
11 | adviser that he or she
is a fiduciary with respect to the | ||||||
12 | pension fund;
| ||||||
13 | (2) the board's investment policy;
| ||||||
14 | (3) full disclosure of direct and indirect fees, | ||||||
15 | commissions, penalties,
and any other compensation that | ||||||
16 | may be received by the investment adviser,
including | ||||||
17 | reimbursement for expenses; and
| ||||||
18 | (4) a requirement that the investment adviser submit | ||||||
19 | periodic written
reports, on at least a quarterly basis, | ||||||
20 | for the board's review at its regularly
scheduled | ||||||
21 | meetings. All returns on investment shall be reported as | ||||||
22 | net returns
after payment of all fees, commissions, and | ||||||
23 | any other compensation.
| ||||||
24 | (b-5) Each contract described in subsection (b) shall also | ||||||
25 | include (i) full disclosure of direct and indirect fees, | ||||||
26 | commissions, penalties, and other compensation, including
|
| |||||||
| |||||||
1 | reimbursement for expenses, that may be paid by or on behalf of | ||||||
2 | the investment adviser or consultant in connection with the | ||||||
3 | provision of services to the pension fund and (ii) a | ||||||
4 | requirement that the investment adviser or consultant update | ||||||
5 | the disclosure promptly after a modification of those payments | ||||||
6 | or an additional payment. | ||||||
7 | Within 30 days after the effective date of this amendatory | ||||||
8 | Act of the 95th General Assembly, each investment adviser and | ||||||
9 | consultant providing services on the effective date or subject | ||||||
10 | to an existing contract for the provision of services must | ||||||
11 | disclose to the board of trustees all direct and indirect | ||||||
12 | fees, commissions, penalties, and other compensation paid by | ||||||
13 | or on
behalf of the investment adviser or consultant in | ||||||
14 | connection with the provision of those services and shall | ||||||
15 | update that disclosure promptly after a modification of those | ||||||
16 | payments or an additional payment. | ||||||
17 | A person required to make a disclosure under subsection | ||||||
18 | (d) is also required to disclose direct and indirect fees, | ||||||
19 | commissions, penalties, or other compensation that shall or | ||||||
20 | may be paid by or on behalf of the person in connection with | ||||||
21 | the rendering of those services. The person shall update the | ||||||
22 | disclosure promptly after a modification of those payments or | ||||||
23 | an additional payment. | ||||||
24 | The disclosures required by this subsection shall be in | ||||||
25 | writing and shall include the date and amount of each payment | ||||||
26 | and the name and address of each recipient of a payment. |
| |||||||
| |||||||
1 | (c) Within 30 days after appointing an investment adviser | ||||||
2 | or consultant, the board shall
submit a copy of the contract to | ||||||
3 | the Public Pension Division of the Department of Insurance of | ||||||
4 | the Department of Financial and Professional Regulation .
| ||||||
5 | (d) Investment services provided by a person other than an | ||||||
6 | investment
adviser appointed under this Section, including but | ||||||
7 | not limited to services
provided by the kinds of persons | ||||||
8 | listed in items (1) through (4) of subsection
(a), shall be | ||||||
9 | rendered only after full written disclosure of direct and
| ||||||
10 | indirect fees, commissions, penalties, and any other | ||||||
11 | compensation that shall or
may be received by the person | ||||||
12 | rendering those services.
| ||||||
13 | (e) The board of trustees of each pension fund shall | ||||||
14 | retain records of
investment transactions in accordance with | ||||||
15 | the rules of the Public Pension Division of the Department of
| ||||||
16 | Insurance Financial and Professional Regulation .
| ||||||
17 | (Source: P.A. 95-950, eff. 8-29-08; 96-6, eff. 4-3-09.)
| ||||||
18 | (40 ILCS 5/1-113.18)
| ||||||
19 | Sec. 1-113.18. Ethics training. All board members of a | ||||||
20 | retirement system, pension fund, or investment board created | ||||||
21 | under this Code must attend ethics training of at least 8 hours | ||||||
22 | per year. The training required under this Section shall | ||||||
23 | include training on ethics, fiduciary duty, and investment | ||||||
24 | issues and any other curriculum that the board of the | ||||||
25 | retirement system, pension fund, or investment board |
| |||||||
| |||||||
1 | establishes as being important for the administration of the | ||||||
2 | retirement system, pension fund, or investment board. The | ||||||
3 | Supreme Court of Illinois shall be responsible for ethics | ||||||
4 | training and curriculum for judges designated by the Court to | ||||||
5 | serve as members of a retirement system, pension fund, or | ||||||
6 | investment board.
Each board shall annually certify its | ||||||
7 | members' compliance with this Section and submit an annual | ||||||
8 | certification to the Public Pension Division of the Department | ||||||
9 | of Insurance of the Department of Financial and Professional | ||||||
10 | Regulation . Judges shall annually certify compliance with the | ||||||
11 | ethics training requirement and shall submit an annual | ||||||
12 | certification to the Chief Justice of the Supreme Court of | ||||||
13 | Illinois. For an elected or appointed trustee under Article 3 | ||||||
14 | or 4 of this Code, fulfillment of the requirements of Section | ||||||
15 | 1-109.3 satisfies the requirements of this Section.
| ||||||
16 | (Source: P.A. 100-904, eff. 8-17-18.) | ||||||
17 | (40 ILCS 5/2-162) | ||||||
18 | (Text of Section WITHOUT the changes made by P.A. 98-599, | ||||||
19 | which has been
held unconstitutional)
| ||||||
20 | Sec. 2-162. Application and expiration of new benefit | ||||||
21 | increases. | ||||||
22 | (a) As used in this Section, "new benefit increase" means | ||||||
23 | an increase in the amount of any benefit provided under this | ||||||
24 | Article, or an expansion of the conditions of eligibility for | ||||||
25 | any benefit under this Article, that results from an amendment |
| |||||||
| |||||||
1 | to this Code that takes effect after the effective date of this | ||||||
2 | amendatory Act of the 94th General Assembly. | ||||||
3 | (b) Notwithstanding any other provision of this Code or | ||||||
4 | any subsequent amendment to this Code, every new benefit | ||||||
5 | increase is subject to this Section and shall be deemed to be | ||||||
6 | granted only in conformance with and contingent upon | ||||||
7 | compliance with the provisions of this Section.
| ||||||
8 | (c) The Public Act enacting a new benefit increase must | ||||||
9 | identify and provide for payment to the System of additional | ||||||
10 | funding at least sufficient to fund the resulting annual | ||||||
11 | increase in cost to the System as it accrues. | ||||||
12 | Every new benefit increase is contingent upon the General | ||||||
13 | Assembly providing the additional funding required under this | ||||||
14 | subsection. The Commission on Government Forecasting and | ||||||
15 | Accountability shall analyze whether adequate additional | ||||||
16 | funding has been provided for the new benefit increase and | ||||||
17 | shall report its analysis to the Public Pension Division of | ||||||
18 | the Department of Insurance Financial and Professional | ||||||
19 | Regulation . A new benefit increase created by a Public Act | ||||||
20 | that does not include the additional funding required under | ||||||
21 | this subsection is null and void. If the Public Pension | ||||||
22 | Division determines that the additional funding provided for a | ||||||
23 | new benefit increase under this subsection is or has become | ||||||
24 | inadequate, it may so certify to the Governor and the State | ||||||
25 | Comptroller and, in the absence of corrective action by the | ||||||
26 | General Assembly, the new benefit increase shall expire at the |
| |||||||
| |||||||
1 | end of the fiscal year in which the certification is made.
| ||||||
2 | (d) Every new benefit increase shall expire 5 years after | ||||||
3 | its effective date or on such earlier date as may be specified | ||||||
4 | in the language enacting the new benefit increase or provided | ||||||
5 | under subsection (c). This does not prevent the General | ||||||
6 | Assembly from extending or re-creating a new benefit increase | ||||||
7 | by law. | ||||||
8 | (e) Except as otherwise provided in the language creating | ||||||
9 | the new benefit increase, a new benefit increase that expires | ||||||
10 | under this Section continues to apply to persons who applied | ||||||
11 | and qualified for the affected benefit while the new benefit | ||||||
12 | increase was in effect and to the affected beneficiaries and | ||||||
13 | alternate payees of such persons, but does not apply to any | ||||||
14 | other person, including without limitation a person who | ||||||
15 | continues in service after the expiration date and did not | ||||||
16 | apply and qualify for the affected benefit while the new | ||||||
17 | benefit increase was in effect.
| ||||||
18 | (Source: P.A. 94-4, eff. 6-1-05.)
| ||||||
19 | (40 ILCS 5/3-110) (from Ch. 108 1/2, par. 3-110)
| ||||||
20 | Sec. 3-110. Creditable service.
| ||||||
21 | (a) "Creditable service" is the time served by a police | ||||||
22 | officer as a member
of a regularly constituted police force of | ||||||
23 | a municipality. In computing
creditable service furloughs | ||||||
24 | without pay exceeding 30 days shall not be
counted, but all | ||||||
25 | leaves of absence for illness or accident, regardless of
|
| |||||||
| |||||||
1 | length, and all periods of disability retirement for which a | ||||||
2 | police officer has
received no disability pension payments | ||||||
3 | under this Article shall be counted.
| ||||||
4 | (a-5) Up to 3 years of time during which the police officer | ||||||
5 | receives
a disability pension under Section 3-114.1, 3-114.2, | ||||||
6 | 3-114.3, or 3-114.6
shall be counted as creditable service, | ||||||
7 | provided that
(i) the police officer returns to active service | ||||||
8 | after the disability for a
period at least equal to the period | ||||||
9 | for which credit is to be established and
(ii) the police | ||||||
10 | officer makes contributions to the fund based on the rates
| ||||||
11 | specified in Section 3-125.1 and the salary upon which the | ||||||
12 | disability pension
is based. These contributions may be paid | ||||||
13 | at any time prior to the
commencement of a retirement pension. | ||||||
14 | The police officer may, but need not,
elect to have the | ||||||
15 | contributions deducted from the disability pension or to
pay | ||||||
16 | them in installments on a schedule approved by the board. If | ||||||
17 | not
deducted from the disability pension, the contributions | ||||||
18 | shall include
interest at the rate of 6% per year, compounded | ||||||
19 | annually, from the date
for which service credit is being | ||||||
20 | established to the date of payment. If
contributions are paid | ||||||
21 | under this subsection (a-5) in excess of those
needed to | ||||||
22 | establish the credit, the excess shall be refunded. This
| ||||||
23 | subsection (a-5) applies to persons receiving a disability | ||||||
24 | pension under
Section 3-114.1, 3-114.2, 3-114.3, or 3-114.6 on | ||||||
25 | the effective date of this
amendatory Act of the 91st General | ||||||
26 | Assembly, as well as persons who begin to
receive such a |
| |||||||
| |||||||
1 | disability pension after that date.
| ||||||
2 | (b) Creditable service includes all periods of service in | ||||||
3 | the military,
naval or air forces of the United States entered | ||||||
4 | upon while an active police
officer of a municipality, | ||||||
5 | provided that upon applying for a permanent pension,
and in | ||||||
6 | accordance with the rules of the board, the police officer | ||||||
7 | pays into the
fund the amount the officer would have | ||||||
8 | contributed if he or she had been a
regular contributor during | ||||||
9 | such period, to the extent that the municipality
which the | ||||||
10 | police officer served has not made such contributions in the
| ||||||
11 | officer's behalf. The total amount of such creditable service | ||||||
12 | shall not
exceed 5 years, except that any police officer who on | ||||||
13 | July 1, 1973 had more
than 5 years of such creditable service | ||||||
14 | shall receive the total amount thereof.
| ||||||
15 | (b-5) Creditable service includes all periods of service | ||||||
16 | in the military, naval, or air forces of the United States | ||||||
17 | entered upon before beginning service as an active police | ||||||
18 | officer of a municipality, provided that, in accordance with | ||||||
19 | the rules of the board, the police officer pays into the fund | ||||||
20 | the amount the police officer would have contributed if he or | ||||||
21 | she had been a regular contributor during such period, plus an | ||||||
22 | amount determined by the Board to be equal to the | ||||||
23 | municipality's normal cost of the benefit, plus interest at | ||||||
24 | the actuarially assumed rate calculated from the date the | ||||||
25 | employee last became a police officer under this Article. The | ||||||
26 | total amount of such creditable service shall not exceed 2 |
| |||||||
| |||||||
1 | years. | ||||||
2 | (c) Creditable service also includes service rendered by a | ||||||
3 | police
officer while on leave of absence from a police | ||||||
4 | department to serve as an
executive of an organization whose | ||||||
5 | membership consists of members of a
police department, subject | ||||||
6 | to the following conditions: (i) the police
officer is a | ||||||
7 | participant of a fund established under this Article with at
| ||||||
8 | least 10 years of service as a police officer; (ii) the police | ||||||
9 | officer
received no credit for such service under any other | ||||||
10 | retirement system,
pension fund, or annuity and benefit fund | ||||||
11 | included in this Code; (iii)
pursuant to the rules of the board | ||||||
12 | the police officer pays to the fund the
amount he or she would | ||||||
13 | have contributed had the officer been an active
member of the | ||||||
14 | police department; (iv) the organization pays a
contribution | ||||||
15 | equal to the municipality's normal cost for that
period of | ||||||
16 | service; and (v) for all leaves of absence under this | ||||||
17 | subsection (c), including those beginning before the effective | ||||||
18 | date of this amendatory Act of the 97th General Assembly, the | ||||||
19 | police officer continues to remain in sworn status, subject to | ||||||
20 | the professional standards of the public employer or those | ||||||
21 | terms established in statute.
| ||||||
22 | (d)(1) Creditable service also includes periods of | ||||||
23 | service originally
established in another police pension | ||||||
24 | fund under this Article or in the Fund
established under | ||||||
25 | Article 7 of this Code for which (i) the contributions | ||||||
26 | have
been transferred under Section 3-110.7 or Section |
| |||||||
| |||||||
1 | 7-139.9 and (ii) any
additional contribution required | ||||||
2 | under paragraph (2) of this subsection has
been paid in | ||||||
3 | full in accordance with the requirements of this | ||||||
4 | subsection (d).
| ||||||
5 | (2) If the board of the pension fund to which | ||||||
6 | creditable service and
related
contributions are | ||||||
7 | transferred under Section 7-139.9 determines that
the | ||||||
8 | amount transferred is less than the true cost to the | ||||||
9 | pension fund of
allowing that creditable service to be | ||||||
10 | established, then in order to establish
that creditable | ||||||
11 | service the police officer must pay to the pension fund, | ||||||
12 | within
the payment period specified in paragraph (3) of | ||||||
13 | this subsection, an additional
contribution equal to the | ||||||
14 | difference, as determined by the board in accordance
with | ||||||
15 | the rules and procedures adopted under paragraph (6) of | ||||||
16 | this subsection. If the board of the pension fund to which | ||||||
17 | creditable service and
related
contributions are | ||||||
18 | transferred under Section 3-110.7 determines that
the | ||||||
19 | amount transferred is less than the true cost to the | ||||||
20 | pension fund of
allowing that creditable service to be | ||||||
21 | established, then the police officer may elect (A) to | ||||||
22 | establish
that creditable service by paying to the pension | ||||||
23 | fund, within
the payment period specified in paragraph (3) | ||||||
24 | of this subsection (d), an additional
contribution equal | ||||||
25 | to the difference, as determined by the board in | ||||||
26 | accordance
with the rules and procedures adopted under |
| |||||||
| |||||||
1 | paragraph (6) of this subsection (d) or (B) to have his or | ||||||
2 | her creditable service reduced by an amount equal to the | ||||||
3 | difference between the amount transferred under Section | ||||||
4 | 3-110.7 and the true cost to the pension fund of allowing | ||||||
5 | that creditable service to be established, as determined | ||||||
6 | by the board in accordance with the rules and procedures | ||||||
7 | adopted under paragraph (6) of this subsection (d).
| ||||||
8 | (3) Except as provided in paragraph (4), the | ||||||
9 | additional
contribution that is required or elected under | ||||||
10 | paragraph (2) of this subsection (d) must be paid to the | ||||||
11 | board (i) within 5 years from the date of the
transfer of | ||||||
12 | contributions under Section 3-110.7 or 7-139.9 and (ii) | ||||||
13 | before the
police officer terminates service with the | ||||||
14 | fund. The additional contribution
may be paid in a lump | ||||||
15 | sum or in accordance with a schedule of installment
| ||||||
16 | payments authorized by the board.
| ||||||
17 | (4) If the police officer dies in service before | ||||||
18 | payment in full has been
made and before the expiration of | ||||||
19 | the 5-year payment period, the surviving
spouse of the | ||||||
20 | officer may elect to pay the unpaid amount on the | ||||||
21 | officer's
behalf within 6 months after the date of death, | ||||||
22 | in which case the creditable
service shall be granted as | ||||||
23 | though the deceased police officer had paid the
remaining | ||||||
24 | balance on the day before the date of death.
| ||||||
25 | (5) If the additional contribution that is required or | ||||||
26 | elected under paragraph (2) of this subsection (d) is not |
| |||||||
| |||||||
1 | paid in full within the
required time, the creditable | ||||||
2 | service shall not be granted and the
police officer (or | ||||||
3 | the officer's surviving spouse or estate) shall be | ||||||
4 | entitled
to receive a refund of (i) any partial payment of | ||||||
5 | the additional contribution
that has been made by the | ||||||
6 | police officer and (ii) those portions of the amounts
| ||||||
7 | transferred under subdivision (a)(1) of Section 3-110.7 or | ||||||
8 | subdivisions (a)(1)
and (a)(3) of Section 7-139.9 that | ||||||
9 | represent employee contributions paid by the
police | ||||||
10 | officer (but not the accumulated interest on those | ||||||
11 | contributions) and
interest paid by the police officer to | ||||||
12 | the prior pension fund in order to
reinstate service | ||||||
13 | terminated by acceptance of a refund.
| ||||||
14 | At the time of paying a refund under this item (5), the | ||||||
15 | pension fund
shall also repay to the pension fund from | ||||||
16 | which the contributions were
transferred under Section | ||||||
17 | 3-110.7 or 7-139.9 the amount originally transferred
under | ||||||
18 | subdivision (a)(2) of that Section, plus interest at the | ||||||
19 | rate of 6% per
year, compounded annually, from the date of | ||||||
20 | the original transfer to the date
of repayment. Amounts | ||||||
21 | repaid to the Article 7 fund under this provision shall
be | ||||||
22 | credited to the appropriate municipality.
| ||||||
23 | Transferred credit that is not granted due to failure | ||||||
24 | to pay the additional
contribution within the required | ||||||
25 | time is lost; it may not be transferred to
another pension | ||||||
26 | fund and may not be reinstated in the pension fund from |
| |||||||
| |||||||
1 | which
it was transferred.
| ||||||
2 | (6) The Public Employee Pension Fund Division of the | ||||||
3 | Department of
Insurance
shall establish by rule the manner | ||||||
4 | of making the calculation required under
paragraph (2) of | ||||||
5 | this subsection, taking into account the appropriate | ||||||
6 | actuarial
assumptions; the police officer's service, age, | ||||||
7 | and salary history; the level
of funding of the pension | ||||||
8 | fund to which the credits are being transferred; and
any | ||||||
9 | other factors that the Division determines to be relevant. | ||||||
10 | The rules may
require that all calculations made under | ||||||
11 | paragraph (2) be reported to the
Division by the board | ||||||
12 | performing the calculation, together with documentation
of | ||||||
13 | the creditable service to be transferred, the amounts of | ||||||
14 | contributions and
interest to be transferred, the manner | ||||||
15 | in which the calculation was performed,
the numbers relied | ||||||
16 | upon in making the calculation, the results of the
| ||||||
17 | calculation, and any other information the Division may | ||||||
18 | deem useful.
| ||||||
19 | (e)(1) Creditable service also includes periods of | ||||||
20 | service originally
established in the Fund
established | ||||||
21 | under Article 7 of this Code for which the contributions | ||||||
22 | have
been transferred under Section 7-139.11.
| ||||||
23 | (2) If the board of the pension fund to which | ||||||
24 | creditable service and
related
contributions are | ||||||
25 | transferred under Section 7-139.11 determines that
the | ||||||
26 | amount transferred is less than the true cost to the |
| |||||||
| |||||||
1 | pension fund of
allowing that creditable service to be | ||||||
2 | established, then the amount of creditable service the | ||||||
3 | police officer may establish under this subsection (e) | ||||||
4 | shall be reduced by an amount equal to the difference, as | ||||||
5 | determined by the board in accordance
with the rules and | ||||||
6 | procedures adopted under paragraph (3) of this subsection.
| ||||||
7 | (3) The Public Pension Division of the Department of
| ||||||
8 | Insurance Financial and Professional Regulation
shall | ||||||
9 | establish by rule the manner of making the calculation | ||||||
10 | required under
paragraph (2) of this subsection, taking | ||||||
11 | into account the appropriate actuarial
assumptions; the | ||||||
12 | police officer's service, age, and salary history; the | ||||||
13 | level
of funding of the pension fund to which the credits | ||||||
14 | are being transferred; and
any other factors that the | ||||||
15 | Division determines to be relevant. The rules may
require | ||||||
16 | that all calculations made under paragraph (2) be reported | ||||||
17 | to the
Division by the board performing the calculation, | ||||||
18 | together with documentation
of the creditable service to | ||||||
19 | be transferred, the amounts of contributions and
interest | ||||||
20 | to be transferred, the manner in which the calculation was | ||||||
21 | performed,
the numbers relied upon in making the | ||||||
22 | calculation, the results of the
calculation, and any other | ||||||
23 | information the Division may deem useful.
| ||||||
24 | (4) Until January 1, 2010, a police officer who | ||||||
25 | transferred service from the Fund established under | ||||||
26 | Article 7 of this Code under the provisions of Public Act |
| |||||||
| |||||||
1 | 94-356 may establish additional credit, but only for the | ||||||
2 | amount of the service credit reduction in that transfer, | ||||||
3 | as calculated under paragraph (3) of this subsection (e). | ||||||
4 | This credit may be established upon payment by the police | ||||||
5 | officer of an amount to be determined by the board, equal | ||||||
6 | to (1) the amount that would have been contributed as | ||||||
7 | employee and employer contributions had all of the service | ||||||
8 | been as an employee under this Article, plus interest | ||||||
9 | thereon at the rate of 6% per year, compounded annually | ||||||
10 | from the date of service to the date of transfer, less (2) | ||||||
11 | the total amount transferred from the Article 7 Fund, plus | ||||||
12 | (3) interest on the difference at the rate of 6% per year, | ||||||
13 | compounded annually, from the date of the transfer to the | ||||||
14 | date of payment. The additional service credit is allowed | ||||||
15 | under this amendatory Act of the 95th General Assembly | ||||||
16 | notwithstanding the provisions of Article 7 terminating | ||||||
17 | all transferred credits on the date of transfer. | ||||||
18 | (Source: P.A. 96-297, eff. 8-11-09; 96-1260, eff. 7-23-10; | ||||||
19 | 97-651, eff. 1-5-12.)
| ||||||
20 | (40 ILCS 5/4-108) (from Ch. 108 1/2, par. 4-108)
| ||||||
21 | Sec. 4-108. Creditable service.
| ||||||
22 | (a) Creditable service is the time served as a firefighter | ||||||
23 | of a
municipality. In computing creditable service, furloughs | ||||||
24 | and leaves of
absence without pay exceeding 30 days in any one | ||||||
25 | year shall not be counted,
but leaves of absence for illness or |
| |||||||
| |||||||
1 | accident regardless of length, and
periods of disability for | ||||||
2 | which a firefighter received no disability
pension payments | ||||||
3 | under this Article, shall be counted.
| ||||||
4 | (b) Furloughs and leaves of absence of 30 days or less in | ||||||
5 | any one year may
be counted as creditable service, if the | ||||||
6 | firefighter makes the contribution
to the fund that would have | ||||||
7 | been required had he or she not been
on furlough or leave of | ||||||
8 | absence. To qualify for this creditable service,
the | ||||||
9 | firefighter must pay the required contributions to the fund | ||||||
10 | not more
than 90 days subsequent to the termination of the | ||||||
11 | furlough or leave of
absence, to the extent that the | ||||||
12 | municipality has not made such contribution
on his or her | ||||||
13 | behalf.
| ||||||
14 | (c) Creditable service includes:
| ||||||
15 | (1) Service in the military, naval or air forces of | ||||||
16 | the
United States entered upon when the person was an | ||||||
17 | active
firefighter, provided
that, upon applying for a | ||||||
18 | permanent pension, and in accordance with the
rules of the | ||||||
19 | board the firefighter pays into the fund the amount that | ||||||
20 | would
have been contributed had he or she been a regular | ||||||
21 | contributor during such
period of service, if and to the | ||||||
22 | extent that the municipality which the
firefighter served | ||||||
23 | made no such contributions in his or her behalf. The
total | ||||||
24 | amount of such creditable service shall not exceed 5 | ||||||
25 | years, except
that any firefighter who on July 1, 1973 had | ||||||
26 | more than 5 years of such
creditable service shall receive |
| |||||||
| |||||||
1 | the total amount thereof as of that date.
| ||||||
2 | (1.5) Up to 24 months of service in the military, | ||||||
3 | naval, or air forces of the United States that was served | ||||||
4 | prior to employment by a municipality or fire protection | ||||||
5 | district as a firefighter. To receive the credit for the | ||||||
6 | military service prior to the employment as a firefighter, | ||||||
7 | the firefighter must apply in writing to the fund and must | ||||||
8 | make contributions to the fund equal to (i) the employee | ||||||
9 | contributions that would have been required had the | ||||||
10 | service been rendered as a member, plus (ii) an amount | ||||||
11 | determined by the fund to be equal to the employer's | ||||||
12 | normal cost of the benefits accrued for that military | ||||||
13 | service, plus (iii) interest at the actuarially assumed | ||||||
14 | rate provided by the Public Pension Division of the | ||||||
15 | Department of Insurance Financial and Professional | ||||||
16 | Regulation , compounded annually from the first date of | ||||||
17 | membership in the fund to the date of payment on items (i) | ||||||
18 | and (ii). The changes to this paragraph (1.5) by this | ||||||
19 | amendatory Act of the 95th General Assembly apply only to | ||||||
20 | participating employees in service on or after its | ||||||
21 | effective date. | ||||||
22 | (2) Service prior to July 1, 1976 by a firefighter | ||||||
23 | initially excluded
from participation by reason of age who | ||||||
24 | elected to participate and paid
the required contributions | ||||||
25 | for such service.
| ||||||
26 | (3) Up to 8 years of service by a firefighter as an |
| |||||||
| |||||||
1 | officer in a statewide
firefighters' association when he | ||||||
2 | is on a leave of absence from a
municipality's payroll, | ||||||
3 | provided that (i) the firefighter has at least 10
years of | ||||||
4 | creditable service as an active firefighter, (ii) the | ||||||
5 | firefighter
contributes to the fund the amount that he | ||||||
6 | would have contributed had he
remained an active member of | ||||||
7 | the fund, (iii) the employee or statewide
firefighter | ||||||
8 | association contributes to the fund an amount equal to the
| ||||||
9 | employer's required contribution as determined by the | ||||||
10 | board, and (iv) for all leaves of absence under this | ||||||
11 | subdivision (3), including those beginning before the | ||||||
12 | effective date of this amendatory Act of the 97th General | ||||||
13 | Assembly, the firefighter continues to remain in sworn | ||||||
14 | status, subject to the professional standards of the | ||||||
15 | public employer or those terms established in statute.
| ||||||
16 | (4) Time spent as an on-call fireman for a | ||||||
17 | municipality,
calculated at the rate of one year of | ||||||
18 | creditable service for each 5 years
of time spent as an | ||||||
19 | on-call fireman, provided that (i) the firefighter has
at | ||||||
20 | least 18 years of creditable service as an active | ||||||
21 | firefighter, (ii) the
firefighter spent at least 14 years | ||||||
22 | as an on-call firefighter for the
municipality, (iii) the | ||||||
23 | firefighter applies for such creditable service
within 30 | ||||||
24 | days after the effective date of this amendatory Act of | ||||||
25 | 1989,
(iv) the firefighter contributes to the Fund an | ||||||
26 | amount representing
employee contributions for the number |
| |||||||
| |||||||
1 | of years of creditable service
granted under this | ||||||
2 | subdivision (4), based on the salary and contribution
rate | ||||||
3 | in effect for the firefighter at the date of entry into the | ||||||
4 | Fund, to
be determined by the board, and (v) not more than | ||||||
5 | 3 years of creditable
service may be granted under this | ||||||
6 | subdivision (4).
| ||||||
7 | Except as provided in Section 4-108.5, creditable | ||||||
8 | service shall not
include time
spent as a volunteer | ||||||
9 | firefighter, whether or not any compensation was received
| ||||||
10 | therefor. The change made in this Section by Public Act | ||||||
11 | 83-0463 is intended
to be a restatement and clarification | ||||||
12 | of existing law, and does not imply
that creditable | ||||||
13 | service was previously allowed under this Article for time
| ||||||
14 | spent as a volunteer firefighter.
| ||||||
15 | (5) Time served between July 1, 1976 and July 1, 1988 | ||||||
16 | in
the position of protective inspection officer or | ||||||
17 | administrative assistant
for fire services, for a | ||||||
18 | municipality with a population under 10,000 that is
| ||||||
19 | located in a county with a population over 3,000,000 and | ||||||
20 | that maintains a
firefighters' pension fund under this | ||||||
21 | Article, if the position included
firefighting duties, | ||||||
22 | notwithstanding that the person may not have held an
| ||||||
23 | appointment as a firefighter, provided that application is | ||||||
24 | made to the
pension fund within 30 days after the | ||||||
25 | effective date of this amendatory Act
of 1991, and the | ||||||
26 | corresponding contributions are paid for the number of
|
| |||||||
| |||||||
1 | years of service granted, based upon the salary and | ||||||
2 | contribution rate in
effect for the firefighter at the | ||||||
3 | date of entry into the pension fund, as
determined by the | ||||||
4 | Board.
| ||||||
5 | (6) Service before becoming a participant by a | ||||||
6 | firefighter initially
excluded from participation by | ||||||
7 | reason of age who becomes a participant
under the | ||||||
8 | amendment to Section 4-107 made by this amendatory Act of | ||||||
9 | 1993 and
pays the required contributions for such service.
| ||||||
10 | (7) Up to 3 years of time during which the firefighter | ||||||
11 | receives a
disability pension under Section 4-110, | ||||||
12 | 4-110.1, or 4-111, provided that (i)
the firefighter | ||||||
13 | returns to active service after the disability for a | ||||||
14 | period at
least equal to the period for which credit is to | ||||||
15 | be established and (ii) the
firefighter makes | ||||||
16 | contributions to the fund based on the rates specified in
| ||||||
17 | Section 4-118.1 and the salary upon which the disability | ||||||
18 | pension is based.
These contributions may be paid at any | ||||||
19 | time prior to the commencement of a
retirement pension. | ||||||
20 | The firefighter may, but need not, elect to have the
| ||||||
21 | contributions deducted from the disability pension or to | ||||||
22 | pay them in
installments on a schedule approved by the | ||||||
23 | board. If not deducted from the
disability pension, the | ||||||
24 | contributions
shall include interest at the rate of 6% per | ||||||
25 | year, compounded annually, from
the date for which service | ||||||
26 | credit is being established to the date of payment.
If |
| |||||||
| |||||||
1 | contributions are paid under this subdivision (c)(7) in | ||||||
2 | excess of those
needed to establish the credit, the excess | ||||||
3 | shall be refunded. This
subdivision (c)(7) applies to | ||||||
4 | persons receiving a disability pension under
Section | ||||||
5 | 4-110, 4-110.1, or 4-111 on the effective date of this | ||||||
6 | amendatory Act
of the 91st General Assembly, as well as | ||||||
7 | persons who begin to receive such a
disability pension | ||||||
8 | after that date.
| ||||||
9 | (8) Up to 6 years of service as a police officer and | ||||||
10 | participant in an Article 3 police pension fund | ||||||
11 | administered by the unit of local government that employs | ||||||
12 | the firefighter under this Article, provided that the | ||||||
13 | service has been transferred to, and the required payment | ||||||
14 | received by, the Article 4 fund in accordance with | ||||||
15 | subsection (a) of Section 3-110.12 of this Code. | ||||||
16 | (9) Up to 8 years of service as a police officer and
| ||||||
17 | participant in an Article 3 police pension fund | ||||||
18 | administered by a unit of local government, provided that | ||||||
19 | the service has been transferred to, and the required | ||||||
20 | payment received by, the Article 4 fund in accordance with | ||||||
21 | subsection (a-5) of Section 3-110.12 of this Code. | ||||||
22 | (Source: P.A. 102-63, eff. 7-9-21.)
| ||||||
23 | (40 ILCS 5/4-109.3)
| ||||||
24 | Sec. 4-109.3. Employee creditable service. | ||||||
25 | (a) As used in this Section:
|
| |||||||
| |||||||
1 | "Final monthly salary" means the monthly salary attached | ||||||
2 | to the rank held by
the firefighter at the time of his or her | ||||||
3 | last withdrawal from service under a
particular pension fund.
| ||||||
4 | "Last pension fund" means the pension fund in which the | ||||||
5 | firefighter was
participating at the time of his or her last | ||||||
6 | withdrawal from service.
| ||||||
7 | (b) The benefits provided under this Section are available | ||||||
8 | only to a
firefighter who:
| ||||||
9 | (1) is a firefighter at the time of withdrawal from | ||||||
10 | the last
pension fund and for at least the final 3 years of | ||||||
11 | employment prior to that
withdrawal;
| ||||||
12 | (2) has established service credit with at least one | ||||||
13 | pension fund
established under this Article other than the | ||||||
14 | last pension fund;
| ||||||
15 | (3) has a total of at least 20 years of service under | ||||||
16 | the various
pension funds established under this Article | ||||||
17 | and has attained age 50; and
| ||||||
18 | (4) is in service on or after the effective date of | ||||||
19 | this amendatory Act of
the 93rd General Assembly.
| ||||||
20 | (c) A firefighter who is eligible for benefits under this | ||||||
21 | Section may elect
to receive a retirement pension from each | ||||||
22 | pension fund under this Article in
which the firefighter has | ||||||
23 | at least one year of service credit but has not received a | ||||||
24 | refund under Section 4-116 (unless the firefighter repays that | ||||||
25 | refund under subsection (g)) or subsection (c) of Section | ||||||
26 | 4-118.1, by applying in
writing and paying the contribution |
| |||||||
| |||||||
1 | required under subsection (i).
| ||||||
2 | (d) From each such pension fund other than the last | ||||||
3 | pension fund, in lieu
of any retirement pension otherwise | ||||||
4 | payable under this Article, a firefighter
to whom this Section | ||||||
5 | applies may elect to receive a monthly pension of 1/12th
of | ||||||
6 | 2.5% of his or her final monthly salary under that fund for | ||||||
7 | each month of
service in that fund, subject to a maximum of 75% | ||||||
8 | of that final monthly salary.
| ||||||
9 | (e) From the last pension fund, in lieu of any retirement | ||||||
10 | pension otherwise
payable under this Article, a firefighter to | ||||||
11 | whom this Section applies may
elect to receive a monthly | ||||||
12 | pension calculated as follows:
| ||||||
13 | The last pension fund shall calculate the retirement | ||||||
14 | pension that
would be payable to the firefighter under Section | ||||||
15 | 4-109 as if he
or she had
participated in that last pension | ||||||
16 | fund during his or her entire period of
service under all | ||||||
17 | pension funds established under this Article (excluding any | ||||||
18 | period of service for which the firefighter has received a | ||||||
19 | refund under Section 4-116, unless the firefighter repays that | ||||||
20 | refund under subsection (g), or for which the firefighter has | ||||||
21 | received a refund under subsection (c) of Section 4-118.1).
| ||||||
22 | From this hypothetical pension there shall be subtracted the | ||||||
23 | original amounts
of the retirement pensions payable to the | ||||||
24 | firefighter by all other pension
funds under subsection (d). | ||||||
25 | The remainder is the retirement pension payable
to the | ||||||
26 | firefighter by the last pension fund under this subsection |
| |||||||
| |||||||
1 | (e).
| ||||||
2 | (f) Pensions elected under this Section shall be subject | ||||||
3 | to increases as
provided in Section 4-109.1.
| ||||||
4 | (g) A current firefighter may reinstate creditable service | ||||||
5 | in a
pension fund established under this Article that was | ||||||
6 | terminated upon receipt of
a refund, by payment to that | ||||||
7 | pension fund of the amount of the refund together
with | ||||||
8 | interest thereon at the rate of 6% per year, compounded | ||||||
9 | annually, from the
date of the refund to the date of payment. A | ||||||
10 | repayment of a refund under this
Section may be made in equal | ||||||
11 | installments over a period of up to 10 years, but
must be paid | ||||||
12 | in full prior to retirement.
| ||||||
13 | (h) As a condition of being eligible for the benefits | ||||||
14 | provided in this Section, a person who is hired to a position | ||||||
15 | as a firefighter on or after July 1, 2004 must, within 21 | ||||||
16 | months after being hired, notify
the new employer, all of his | ||||||
17 | or her previous employers under this Article, and
the Public | ||||||
18 | Pension Division of the Department Division of Insurance of | ||||||
19 | the Department of Financial and Professional Regulation of his | ||||||
20 | or her intent to receive the benefits provided under this | ||||||
21 | Section.
| ||||||
22 | As a condition of being eligible for the benefits provided | ||||||
23 | in this Section, a person who first becomes a firefighter | ||||||
24 | under this Article after December 31, 2010 must (1) within 21 | ||||||
25 | months after being hired or within 21 months after the | ||||||
26 | effective date of this amendatory Act of the 102nd General |
| |||||||
| |||||||
1 | Assembly, whichever is later, notify the new employer, all of | ||||||
2 | his or her previous employers under this Article, and the | ||||||
3 | Public Pension Division of the Department of Insurance of his | ||||||
4 | or her intent to receive the benefits provided under this | ||||||
5 | Section; and (2) make the required contributions with | ||||||
6 | applicable interest. A person who first becomes a firefighter | ||||||
7 | under this Article after December 31, 2010 and who, before the | ||||||
8 | effective date of this amendatory Act of the 102nd General | ||||||
9 | Assembly, notified the new employer, all of his or her | ||||||
10 | previous employers under this Article, and the Public Pension | ||||||
11 | Division of the Department of Insurance of his or her intent to | ||||||
12 | receive the benefits provided under this Section shall be | ||||||
13 | deemed to have met the notice requirement under item (1) of the | ||||||
14 | preceding sentence. The changes made to this Section by this | ||||||
15 | amendatory Act of the 102nd General Assembly apply | ||||||
16 | retroactively, notwithstanding Section 1-103.1. | ||||||
17 | (i) In order to receive a pension under this Section or an | ||||||
18 | occupational disease disability pension for which he or she | ||||||
19 | becomes eligible due to the application of subsection (m) of | ||||||
20 | this Section, a firefighter must
pay to each pension fund from | ||||||
21 | which he or she has elected to receive a pension under this | ||||||
22 | Section a contribution equal to 1% of
monthly salary for each | ||||||
23 | month of service credit that the firefighter has in
that fund | ||||||
24 | (other than service credit for which the firefighter has | ||||||
25 | already
paid the additional contribution required under | ||||||
26 | subsection (c) of Section
4-118.1), together with interest |
| |||||||
| |||||||
1 | thereon at the rate of 6% per annum, compounded
annually, from | ||||||
2 | the firefighter's first day of employment with that fund or | ||||||
3 | the first day of the fiscal year of that fund that immediately | ||||||
4 | precedes the firefighter's first day of employment with that | ||||||
5 | fund, whichever is earlier. | ||||||
6 | In order for a firefighter who, as of the effective date of | ||||||
7 | this amendatory Act of the 93rd General Assembly, has not | ||||||
8 | begun to receive a pension under this Section or an | ||||||
9 | occupational disease disability pension under subsection (m) | ||||||
10 | of this Section and who has contributed 1/12th of 1% of monthly | ||||||
11 | salary for each month of service credit that the firefighter | ||||||
12 | has in
that fund (other than service credit for which the | ||||||
13 | firefighter has already
paid the additional contribution | ||||||
14 | required under subsection (c) of Section
4-118.1), together | ||||||
15 | with the required interest thereon, to receive a pension under | ||||||
16 | this Section or an occupational disease disability pension for | ||||||
17 | which he or she becomes eligible due to the application of | ||||||
18 | subsection (m) of this Section, the firefighter must, within | ||||||
19 | one year after the effective date of this amendatory Act of the | ||||||
20 | 93rd General Assembly, make an additional contribution equal | ||||||
21 | to 11/12ths of 1% of
monthly salary for each month of service | ||||||
22 | credit that the firefighter has in
that fund (other than | ||||||
23 | service credit for which the firefighter has already
paid the | ||||||
24 | additional contribution required under subsection (c) of | ||||||
25 | Section
4-118.1), together with interest thereon at the rate | ||||||
26 | of 6% per annum, compounded
annually, from the firefighter's |
| |||||||
| |||||||
1 | first day of employment with that fund or the first day of the | ||||||
2 | fiscal year of that fund that immediately precedes the | ||||||
3 | firefighter's first day of employment with the fund, whichever | ||||||
4 | is earlier. A firefighter who, as of the effective date of this | ||||||
5 | amendatory Act of the 93rd General Assembly, has not begun to | ||||||
6 | receive a pension under this Section or an occupational | ||||||
7 | disease disability pension under subsection (m) of this | ||||||
8 | Section and who has contributed 1/12th of 1% of monthly salary | ||||||
9 | for each month of service credit that the firefighter has in
| ||||||
10 | that fund (other than service credit for which the firefighter | ||||||
11 | has already
paid the additional contribution required under | ||||||
12 | subsection (c) of Section
4-118.1), together with the required | ||||||
13 | interest thereon, in order to receive a pension under this | ||||||
14 | Section or an occupational disease disability pension under | ||||||
15 | subsection (m) of this Section, may elect, within one year | ||||||
16 | after the effective date of this amendatory Act of the 93rd | ||||||
17 | General Assembly to forfeit the benefits provided under this | ||||||
18 | Section and receive a refund of that contribution.
| ||||||
19 | (j) A retired firefighter who is receiving pension | ||||||
20 | payments under Section 4-109 may reenter active service under | ||||||
21 | this Article. Subject to the provisions of Section 4-117, the | ||||||
22 | firefighter may receive credit for service performed after the | ||||||
23 | reentry if the firefighter (1) applies to receive credit for | ||||||
24 | that service, (2) suspends his or her pensions under this | ||||||
25 | Section,
and (3) makes the contributions required under | ||||||
26 | subsection (i).
|
| |||||||
| |||||||
1 | (k) A firefighter who is newly hired or promoted to a | ||||||
2 | position as a
firefighter shall not be denied participation in | ||||||
3 | a fund under this Article
based on his or her age. | ||||||
4 | (l) If a firefighter who elects to make contributions | ||||||
5 | under subsection (c) of Section 4-118.1 for the pension | ||||||
6 | benefits provided under this Section becomes entitled to a | ||||||
7 | disability pension under Section 4-110, the last pension fund | ||||||
8 | is responsible to pay that disability pension and the amount | ||||||
9 | of that disability pension shall be based only on the | ||||||
10 | firefighter's service with the last pension fund. | ||||||
11 | (m) Notwithstanding any provision in Section 4-110.1 to | ||||||
12 | the contrary, if a firefighter who elects to make | ||||||
13 | contributions under subsection (c) of Section 4-118.1 for the | ||||||
14 | pension benefits provided under this Section becomes entitled | ||||||
15 | to an occupational disease disability pension under Section | ||||||
16 | 4-110.1, each pension fund to which the firefighter has made | ||||||
17 | contributions under subsection (c) of Section 4-118.1 must pay | ||||||
18 | a portion of that occupational disease disability pension | ||||||
19 | equal to the proportion that the firefighter's service credit | ||||||
20 | with that pension fund for which the contributions under | ||||||
21 | subsection (c) of Section 4-118.1 have been made bears to the | ||||||
22 | firefighter's total service credit with all of the pension | ||||||
23 | funds for which the contributions under subsection (c) of | ||||||
24 | Section 4-118.1 have been made. A firefighter who has made | ||||||
25 | contributions under subsection (c) of Section 4-118.1 for at | ||||||
26 | least 5 years of creditable service shall be deemed to have met |
| |||||||
| |||||||
1 | the 5-year creditable service requirement under Section | ||||||
2 | 4-110.1, regardless of whether the firefighter has 5 years of | ||||||
3 | creditable service with the last pension fund. | ||||||
4 | (n) If a firefighter who elects to make contributions | ||||||
5 | under subsection (c) of Section 4-118.1 for the pension | ||||||
6 | benefits provided under this Section becomes entitled to a | ||||||
7 | disability pension under Section 4-111, the last pension fund | ||||||
8 | is responsible to pay that disability pension, provided that | ||||||
9 | the firefighter has at least 7 years of creditable service | ||||||
10 | with the last pension fund.
In the event a firefighter began | ||||||
11 | employment with a new employer as a result of an | ||||||
12 | intergovernmental agreement that resulted in the elimination | ||||||
13 | of the previous employer's fire department, the firefighter | ||||||
14 | shall not be required to have 7 years of creditable service | ||||||
15 | with the last pension fund to qualify for a disability pension | ||||||
16 | under Section 4-111. Under this circumstance, a firefighter | ||||||
17 | shall be required to have 7 years of total combined creditable | ||||||
18 | service time to qualify for a disability pension under Section | ||||||
19 | 4-111. The disability pension received pursuant to this | ||||||
20 | Section shall be paid by the previous employer and new | ||||||
21 | employer in proportion to the firefighter's years of service | ||||||
22 | with each employer.
| ||||||
23 | (Source: P.A. 102-81, eff. 7-9-21.)
| ||||||
24 | (40 ILCS 5/18-169)
| ||||||
25 | Sec. 18-169. Application and expiration of new benefit |
| |||||||
| |||||||
1 | increases. | ||||||
2 | (a) As used in this Section, "new benefit increase" means | ||||||
3 | an increase in the amount of any benefit provided under this | ||||||
4 | Article, or an expansion of the conditions of eligibility for | ||||||
5 | any benefit under this Article, that results from an amendment | ||||||
6 | to this Code that takes effect after the effective date of this | ||||||
7 | amendatory Act of the 94th General Assembly. | ||||||
8 | (b) Notwithstanding any other provision of this Code or | ||||||
9 | any subsequent amendment to this Code, every new benefit | ||||||
10 | increase is subject to this Section and shall be deemed to be | ||||||
11 | granted only in conformance with and contingent upon | ||||||
12 | compliance with the provisions of this Section.
| ||||||
13 | (c) The Public Act enacting a new benefit increase must | ||||||
14 | identify and provide for payment to the System of additional | ||||||
15 | funding at least sufficient to fund the resulting annual | ||||||
16 | increase in cost to the System as it accrues. | ||||||
17 | Every new benefit increase is contingent upon the General | ||||||
18 | Assembly providing the additional funding required under this | ||||||
19 | subsection. The Commission on Government Forecasting and | ||||||
20 | Accountability shall analyze whether adequate additional | ||||||
21 | funding has been provided for the new benefit increase and | ||||||
22 | shall report its analysis to the Public Pension Division of | ||||||
23 | the Department of Insurance Financial and Professional | ||||||
24 | Regulation . A new benefit increase created by a Public Act | ||||||
25 | that does not include the additional funding required under | ||||||
26 | this subsection is null and void. If the Public Pension |
| |||||||
| |||||||
1 | Division determines that the additional funding provided for a | ||||||
2 | new benefit increase under this subsection is or has become | ||||||
3 | inadequate, it may so certify to the Governor and the State | ||||||
4 | Comptroller and, in the absence of corrective action by the | ||||||
5 | General Assembly, the new benefit increase shall expire at the | ||||||
6 | end of the fiscal year in which the certification is made.
| ||||||
7 | (d) Every new benefit increase shall expire 5 years after | ||||||
8 | its effective date or on such earlier date as may be specified | ||||||
9 | in the language enacting the new benefit increase or provided | ||||||
10 | under subsection (c). This does not prevent the General | ||||||
11 | Assembly from extending or re-creating a new benefit increase | ||||||
12 | by law. | ||||||
13 | (e) Except as otherwise provided in the language creating | ||||||
14 | the new benefit increase, a new benefit increase that expires | ||||||
15 | under this Section continues to apply to persons who applied | ||||||
16 | and qualified for the affected benefit while the new benefit | ||||||
17 | increase was in effect and to the affected beneficiaries and | ||||||
18 | alternate payees of such persons, but does not apply to any | ||||||
19 | other person, including without limitation a person who | ||||||
20 | continues in service after the expiration date and did not | ||||||
21 | apply and qualify for the affected benefit while the new | ||||||
22 | benefit increase was in effect.
| ||||||
23 | (Source: P.A. 94-4, eff. 6-1-05.) | ||||||
24 | (40 ILCS 5/22-1004)
| ||||||
25 | Sec. 22-1004. Commission on Government Forecasting and |
| |||||||
| |||||||
1 | Accountability report on Articles 3 and 4 funds. Each odd | ||||||
2 | numbered year, the Commission on Government Forecasting and | ||||||
3 | Accountability shall analyze data submitted by the Public | ||||||
4 | Pension Division of the Illinois Department of Insurance | ||||||
5 | Financial and Professional Regulation pertaining to the | ||||||
6 | pension systems established under Article 3 and Article 4 of | ||||||
7 | this Code. The Commission shall issue a formal report during | ||||||
8 | such years, the content of which is, to the extent | ||||||
9 | practicable, to be similar in nature to that required under | ||||||
10 | Section 22-1003. In addition to providing aggregate analyses | ||||||
11 | of both systems, the report shall analyze the fiscal status | ||||||
12 | and provide forecasting projections for selected individual | ||||||
13 | funds in each system. To the fullest extent practicable, the | ||||||
14 | report shall analyze factors that affect each selected | ||||||
15 | individual fund's unfunded liability and any actuarial gains | ||||||
16 | and losses caused by salary increases, investment returns, | ||||||
17 | employer contributions, benefit increases, change in | ||||||
18 | assumptions, the difference in employer contributions and the | ||||||
19 | normal cost plus interest, and any other applicable factors. | ||||||
20 | In analyzing net investment returns, the report shall analyze | ||||||
21 | the assumed investment return compared to the actual | ||||||
22 | investment return over the preceding 10 fiscal years. The | ||||||
23 | Public Pension Division of the Department of Insurance | ||||||
24 | Financial and Professional Regulation shall provide to the | ||||||
25 | Commission any assistance that the Commission may request with | ||||||
26 | respect to its report under this Section.
|
| |||||||
| |||||||
1 | (Source: P.A. 95-950, eff. 8-29-08.) | ||||||
2 | Section 10. The Illinois Insurance Code is amended by | ||||||
3 | changing Sections 143.20a, 155.18, 155.19, 155.36, 370c, 412, | ||||||
4 | 500-140, and 1204 as follows:
| ||||||
5 | (215 ILCS 5/143.20a) (from Ch. 73, par. 755.20a)
| ||||||
6 | Sec. 143.20a. Cancellation of Fire and Marine Policies. | ||||||
7 | (1) Policies
covering property, except policies described in | ||||||
8 | subsection (b) of Section 143.13 143.13b , of this
Code, issued | ||||||
9 | for the kinds of business enumerated in Class 3 of Section
4 of | ||||||
10 | this Code may be cancelled 10 days following receipt of | ||||||
11 | written notice
by the named insureds if the insured property | ||||||
12 | is found to consist of one
or more of the following:
| ||||||
13 | (a) Buildings to which, following a fire loss, permanent | ||||||
14 | repairs have
not commenced within 60 days after satisfactory | ||||||
15 | adjustment of loss, unless
such delay is a direct result of a | ||||||
16 | labor dispute or weather conditions.
| ||||||
17 | (b) Buildings which have been unoccupied 60 consecutive | ||||||
18 | days, except
buildings which have a seasonal occupancy and | ||||||
19 | buildings which are undergoing
construction, repair or | ||||||
20 | reconstruction and are properly secured against
unauthorized | ||||||
21 | entry.
| ||||||
22 | (c) Buildings on which, because of their physical | ||||||
23 | condition, there is
an outstanding order to vacate, an | ||||||
24 | outstanding demolition order, or which
have been declared |
| |||||||
| |||||||
1 | unsafe in accordance with applicable law.
| ||||||
2 | (d) Buildings on which heat, water, sewer service or | ||||||
3 | public lighting have
not been connected for 30 consecutive | ||||||
4 | days or more.
| ||||||
5 | (2) All notices of cancellation under this Section shall | ||||||
6 | be sent by
certified mail and regular mail to the address of | ||||||
7 | record of the named insureds.
| ||||||
8 | (3) All cancellations made pursuant to this Section shall | ||||||
9 | be
on a pro rata basis.
| ||||||
10 | (Source: P.A. 86-437.)
| ||||||
11 | (215 ILCS 5/155.18) (from Ch. 73, par. 767.18)
| ||||||
12 | (Text of Section WITHOUT the changes made by P.A. 94-677, | ||||||
13 | which has been held
unconstitutional) | ||||||
14 | Sec. 155.18. (a) This Section shall apply to insurance on | ||||||
15 | risks based
upon negligence by a physician, hospital or other | ||||||
16 | health care provider,
referred to herein as medical liability | ||||||
17 | insurance. This Section shall not
apply to contracts of | ||||||
18 | reinsurance, nor to any farm, county, district or
township | ||||||
19 | mutual insurance company transacting business under an Act | ||||||
20 | entitled
"An Act relating to local mutual district, county and | ||||||
21 | township insurance
companies", approved March 13, 1936, as now | ||||||
22 | or hereafter amended, nor to
any such company operating under | ||||||
23 | a special charter.
| ||||||
24 | (b) The following standards shall apply to the making and | ||||||
25 | use of rates
pertaining to all classes of medical liability |
| |||||||
| |||||||
1 | insurance:
| ||||||
2 | (1) Rates shall not be excessive or inadequate, as | ||||||
3 | herein defined, nor
shall they be unfairly discriminatory. | ||||||
4 | No rate shall be held to be excessive
unless such rate is | ||||||
5 | unreasonably high for the insurance provided, and a
| ||||||
6 | reasonable degree of competition does not exist in the | ||||||
7 | area with respect
to the classification to which such rate | ||||||
8 | is applicable.
| ||||||
9 | No rate shall be held inadequate unless it is | ||||||
10 | unreasonably low for the
insurance provided and continued | ||||||
11 | use of it would endanger solvency of the company.
| ||||||
12 | (2) Consideration shall be given, to the extent | ||||||
13 | applicable, to past and
prospective loss experience within | ||||||
14 | and outside this State, to a reasonable
margin for | ||||||
15 | underwriting profit and contingencies, to past and | ||||||
16 | prospective
expenses both countrywide and those especially | ||||||
17 | applicable to this State,
and to all other factors, | ||||||
18 | including judgment factors, deemed relevant within
and | ||||||
19 | outside this State.
| ||||||
20 | Consideration may also be given in the making and use | ||||||
21 | of rates to dividends,
savings or unabsorbed premium | ||||||
22 | deposits allowed or returned by companies
to their | ||||||
23 | policyholders, members or subscribers.
| ||||||
24 | (3) The systems of expense provisions included in the | ||||||
25 | rates for use by
any company or group of companies may | ||||||
26 | differ from those of other companies
or groups of |
| |||||||
| |||||||
1 | companies to reflect the operating methods of any such | ||||||
2 | company
or group with respect to any kind of insurance, or | ||||||
3 | with respect to any subdivision
or combination thereof.
| ||||||
4 | (4) Risks may be grouped by classifications for the | ||||||
5 | establishment of rates
and minimum premiums. | ||||||
6 | Classification rates may be modified to produce
rates for | ||||||
7 | individual risks in accordance with rating plans which | ||||||
8 | establish
standards for measuring variations in hazards or | ||||||
9 | expense provisions, or
both. Such standards may measure | ||||||
10 | any difference among risks that have a
probable effect | ||||||
11 | upon losses or expenses. Such classifications or | ||||||
12 | modifications
of classifications of risks may be | ||||||
13 | established based upon size, expense,
management, | ||||||
14 | individual experience, location or dispersion of hazard, | ||||||
15 | or
any other reasonable considerations and shall apply to | ||||||
16 | all risks under the
same or substantially the same | ||||||
17 | circumstances or conditions.
The rate for
an established | ||||||
18 | classification should be related generally to the | ||||||
19 | anticipated
loss and expense factors of the class.
| ||||||
20 | (c) Every company writing medical liability insurance | ||||||
21 | shall file with
the
Director of Insurance the rates and rating | ||||||
22 | schedules it uses for medical
liability insurance.
| ||||||
23 |
(1) This filing shall occur
at least annually
and as | ||||||
24 | often as the rates
are changed or amended.
| ||||||
25 |
(2) For the purposes of this Section any change in | ||||||
26 | premium to the company's
insureds as a result of a change |
| |||||||
| |||||||
1 | in the company's base rates or a change
in its increased | ||||||
2 | limits factors shall constitute a change in rates and | ||||||
3 | shall
require a filing with the
Director.
| ||||||
4 |
(3) It shall be certified in such filing by an officer of | ||||||
5 | the company
and a qualified actuary that the company's rates
| ||||||
6 | are based on sound actuarial
principles and are not | ||||||
7 | inconsistent with the company's experience.
| ||||||
8 | (d) If after
a hearing the
Director finds:
| ||||||
9 | (1) that any rate, rating plan or rating system | ||||||
10 | violates the provisions
of this Section applicable to it, | ||||||
11 | he
may issue an order to the company which
has been the | ||||||
12 | subject of the hearing specifying in what respects such | ||||||
13 | violation
exists and
stating when, within a reasonable | ||||||
14 | period of time, the further
use of such rate or rating | ||||||
15 | system by such company in contracts of insurance
made | ||||||
16 | thereafter shall be prohibited;
| ||||||
17 | (2) that the violation of any of the provisions of | ||||||
18 | this Section applicable
to it by any company which has | ||||||
19 | been the subject of hearing was wilful, he
may
suspend or | ||||||
20 | revoke, in whole or in part, the certificate of authority
| ||||||
21 | of such company with respect to the class of insurance | ||||||
22 | which has been the
subject of the hearing.
| ||||||
23 | (Source: P.A. 79-1434.)
| ||||||
24 | (215 ILCS 5/155.19) (from Ch. 73, par. 767.19)
| ||||||
25 | (Text of Section WITHOUT the changes made by P.A. 94-677, |
| |||||||
| |||||||
1 | which has been held
unconstitutional) | ||||||
2 | Sec. 155.19. All claims filed after December 31, 1976 with | ||||||
3 | any insurer
and all suits filed after December 31, 1976 in any | ||||||
4 | court in this State,
alleging liability on the part of any | ||||||
5 | physician, hospital or other health
care provider for | ||||||
6 | medically related injuries, shall be reported to the
Director
| ||||||
7 | of Insurance in such form and under such terms and conditions | ||||||
8 | as may be
prescribed by the
Director. The
Director shall | ||||||
9 | maintain complete and accurate
records of all such claims and | ||||||
10 | suits including their nature, amount, disposition
and other | ||||||
11 | information as he may deem useful or desirable in observing | ||||||
12 | and
reporting on health care provider liability trends in this | ||||||
13 | State. The Director
shall release to appropriate disciplinary | ||||||
14 | and licensing agencies any such
data or information which may | ||||||
15 | assist such agencies in
improving the quality of health care | ||||||
16 | or which may be useful to such agencies
for the purpose of | ||||||
17 | professional discipline.
| ||||||
18 | With due regard for appropriate maintenance of the | ||||||
19 | confidentiality thereof,
the
Director
may
release
from time to | ||||||
20 | time to the Governor, the General
Assembly and the general | ||||||
21 | public statistical reports based on such data and information.
| ||||||
22 | The
Director may promulgate such rules and regulations as | ||||||
23 | may be necessary
to carry out the provisions of this Section.
| ||||||
24 | (Source: P.A. 79-1434.)
| ||||||
25 | (215 ILCS 5/155.36)
|
| |||||||
| |||||||
1 | Sec. 155.36. Managed Care Reform and Patient Rights Act. | ||||||
2 | Insurance
companies that transact the kinds of insurance | ||||||
3 | authorized under Class 1(b) or
Class 2(a) of Section 4 of this | ||||||
4 | Code shall comply
with Sections 25, 45, 45.1, 45.2, 45.3, 65, | ||||||
5 | 70, and 85, subsection (d) of Section 30, and the definition of | ||||||
6 | the term "emergency medical
condition" in Section
10 of the | ||||||
7 | Managed Care Reform and Patient Rights Act.
| ||||||
8 | (Source: P.A. 101-608, eff. 1-1-20; 102-409, eff. 1-1-22 .)
| ||||||
9 | (215 ILCS 5/370c) (from Ch. 73, par. 982c)
| ||||||
10 | Sec. 370c. Mental and emotional disorders.
| ||||||
11 | (a)(1) On and after January 1, 2022 (the effective date of | ||||||
12 | Public Act 102-579),
every insurer that amends, delivers, | ||||||
13 | issues, or renews
group accident and health policies providing | ||||||
14 | coverage for hospital or medical treatment or
services for | ||||||
15 | illness on an expense-incurred basis shall provide coverage | ||||||
16 | for the medically necessary treatment of mental, emotional, | ||||||
17 | nervous, or substance use disorders or conditions consistent | ||||||
18 | with the parity requirements of Section 370c.1 of this Code.
| ||||||
19 | (2) Each insured that is covered for mental, emotional, | ||||||
20 | nervous, or substance use
disorders or conditions shall be | ||||||
21 | free to select the physician licensed to
practice medicine in | ||||||
22 | all its branches, licensed clinical psychologist,
licensed | ||||||
23 | clinical social worker, licensed clinical professional | ||||||
24 | counselor, licensed marriage and family therapist, licensed | ||||||
25 | speech-language pathologist, or other licensed or certified |
| |||||||
| |||||||
1 | professional at a program licensed pursuant to the Substance | ||||||
2 | Use Disorder Act of
his or her choice to treat such disorders, | ||||||
3 | and
the insurer shall pay the covered charges of such | ||||||
4 | physician licensed to
practice medicine in all its branches, | ||||||
5 | licensed clinical psychologist,
licensed clinical social | ||||||
6 | worker, licensed clinical professional counselor, licensed | ||||||
7 | marriage and family therapist, licensed speech-language | ||||||
8 | pathologist, or other licensed or certified professional at a | ||||||
9 | program licensed pursuant to the Substance Use Disorder Act up
| ||||||
10 | to the limits of coverage, provided (i)
the disorder or | ||||||
11 | condition treated is covered by the policy, and (ii) the
| ||||||
12 | physician, licensed psychologist, licensed clinical social | ||||||
13 | worker, licensed
clinical professional counselor, licensed | ||||||
14 | marriage and family therapist, licensed speech-language | ||||||
15 | pathologist, or other licensed or certified professional at a | ||||||
16 | program licensed pursuant to the Substance Use Disorder Act is
| ||||||
17 | authorized to provide said services under the statutes of this | ||||||
18 | State and in
accordance with accepted principles of his or her | ||||||
19 | profession.
| ||||||
20 | (3) Insofar as this Section applies solely to licensed | ||||||
21 | clinical social
workers, licensed clinical professional | ||||||
22 | counselors, licensed marriage and family therapists, licensed | ||||||
23 | speech-language pathologists, and other licensed or certified | ||||||
24 | professionals at programs licensed pursuant to the Substance | ||||||
25 | Use Disorder Act, those persons who may
provide services to | ||||||
26 | individuals shall do so
after the licensed clinical social |
| |||||||
| |||||||
1 | worker, licensed clinical professional
counselor, licensed | ||||||
2 | marriage and family therapist, licensed speech-language | ||||||
3 | pathologist, or other licensed or certified professional at a | ||||||
4 | program licensed pursuant to the Substance Use Disorder Act | ||||||
5 | has informed the patient of the
desirability of the patient | ||||||
6 | conferring with the patient's primary care
physician.
| ||||||
7 | (4) "Mental, emotional, nervous, or substance use disorder | ||||||
8 | or condition" means a condition or disorder that involves a | ||||||
9 | mental health condition or substance use disorder that falls | ||||||
10 | under any of the diagnostic categories listed in the mental | ||||||
11 | and behavioral disorders chapter of the current edition of the | ||||||
12 | World Health Organization's International Classification of | ||||||
13 | Disease or that is listed in the most recent version of the | ||||||
14 | American Psychiatric Association's Diagnostic and Statistical | ||||||
15 | Manual of Mental Disorders. "Mental, emotional, nervous, or | ||||||
16 | substance use disorder or condition" includes any mental | ||||||
17 | health condition that occurs during pregnancy or during the | ||||||
18 | postpartum period and includes, but is not limited to, | ||||||
19 | postpartum depression. | ||||||
20 | (5) Medically necessary treatment and medical necessity | ||||||
21 | determinations shall be interpreted and made in a manner that | ||||||
22 | is consistent with and pursuant to subsections (h) through | ||||||
23 | (t). | ||||||
24 | (b)(1) (Blank).
| ||||||
25 | (2) (Blank).
| ||||||
26 | (2.5) (Blank). |
| |||||||
| |||||||
1 | (3) Unless otherwise prohibited by federal law and | ||||||
2 | consistent with the parity requirements of Section 370c.1 of | ||||||
3 | this Code, the reimbursing insurer that amends, delivers, | ||||||
4 | issues, or renews a group or individual policy of accident and | ||||||
5 | health insurance, a qualified health plan offered through the | ||||||
6 | health insurance marketplace, or a provider of treatment of | ||||||
7 | mental, emotional, nervous,
or substance use disorders or | ||||||
8 | conditions shall furnish medical records or other necessary | ||||||
9 | data
that substantiate that initial or continued treatment is | ||||||
10 | at all times medically
necessary. An insurer shall provide a | ||||||
11 | mechanism for the timely review by a
provider holding the same | ||||||
12 | license and practicing in the same specialty as the
patient's | ||||||
13 | provider, who is unaffiliated with the insurer, jointly | ||||||
14 | selected by
the patient (or the patient's next of kin or legal | ||||||
15 | representative if the
patient is unable to act for himself or | ||||||
16 | herself), the patient's provider, and
the insurer in the event | ||||||
17 | of a dispute between the insurer and patient's
provider | ||||||
18 | regarding the medical necessity of a treatment proposed by a | ||||||
19 | patient's
provider. If the reviewing provider determines the | ||||||
20 | treatment to be medically
necessary, the insurer shall provide | ||||||
21 | reimbursement for the treatment. Future
contractual or | ||||||
22 | employment actions by the insurer regarding the patient's
| ||||||
23 | provider may not be based on the provider's participation in | ||||||
24 | this procedure.
Nothing prevents
the insured from agreeing in | ||||||
25 | writing to continue treatment at his or her
expense. When | ||||||
26 | making a determination of the medical necessity for a |
| |||||||
| |||||||
1 | treatment
modality for mental, emotional, nervous, or | ||||||
2 | substance use disorders or conditions, an insurer must make | ||||||
3 | the determination in a
manner that is consistent with the | ||||||
4 | manner used to make that determination with
respect to other | ||||||
5 | diseases or illnesses covered under the policy, including an
| ||||||
6 | appeals process. Medical necessity determinations for | ||||||
7 | substance use disorders shall be made in accordance with | ||||||
8 | appropriate patient placement criteria established by the | ||||||
9 | American Society of Addiction Medicine. No additional criteria | ||||||
10 | may be used to make medical necessity determinations for | ||||||
11 | substance use disorders.
| ||||||
12 | (4) A group health benefit plan amended, delivered, | ||||||
13 | issued, or renewed on or after January 1, 2019 (the effective | ||||||
14 | date of Public Act 100-1024) or an individual policy of | ||||||
15 | accident and health insurance or a qualified health plan | ||||||
16 | offered through the health insurance marketplace amended, | ||||||
17 | delivered, issued, or renewed on or after January 1, 2019 (the | ||||||
18 | effective date of Public Act 100-1024):
| ||||||
19 | (A) shall provide coverage based upon medical | ||||||
20 | necessity for the
treatment of a mental, emotional, | ||||||
21 | nervous, or substance use disorder or condition consistent | ||||||
22 | with the parity requirements of Section 370c.1 of this | ||||||
23 | Code; provided, however, that in each calendar year | ||||||
24 | coverage shall not be less than the following:
| ||||||
25 | (i) 45 days of inpatient treatment; and
| ||||||
26 | (ii) beginning on June 26, 2006 (the effective |
| |||||||
| |||||||
1 | date of Public Act 94-921), 60 visits for outpatient | ||||||
2 | treatment including group and individual
outpatient | ||||||
3 | treatment; and | ||||||
4 | (iii) for plans or policies delivered, issued for | ||||||
5 | delivery, renewed, or modified after January 1, 2007 | ||||||
6 | (the effective date of Public Act 94-906),
20 | ||||||
7 | additional outpatient visits for speech therapy for | ||||||
8 | treatment of pervasive developmental disorders that | ||||||
9 | will be in addition to speech therapy provided | ||||||
10 | pursuant to item (ii) of this subparagraph (A); and
| ||||||
11 | (B) may not include a lifetime limit on the number of | ||||||
12 | days of inpatient
treatment or the number of outpatient | ||||||
13 | visits covered under the plan.
| ||||||
14 | (C) (Blank).
| ||||||
15 | (5) An issuer of a group health benefit plan or an | ||||||
16 | individual policy of accident and health insurance or a | ||||||
17 | qualified health plan offered through the health insurance | ||||||
18 | marketplace may not count toward the number
of outpatient | ||||||
19 | visits required to be covered under this Section an outpatient
| ||||||
20 | visit for the purpose of medication management and shall cover | ||||||
21 | the outpatient
visits under the same terms and conditions as | ||||||
22 | it covers outpatient visits for
the treatment of physical | ||||||
23 | illness.
| ||||||
24 | (5.5) An individual or group health benefit plan amended, | ||||||
25 | delivered, issued, or renewed on or after September 9, 2015 | ||||||
26 | (the effective date of Public Act 99-480) shall offer coverage |
| |||||||
| |||||||
1 | for medically necessary acute treatment services and medically | ||||||
2 | necessary clinical stabilization services. The treating | ||||||
3 | provider shall base all treatment recommendations and the | ||||||
4 | health benefit plan shall base all medical necessity | ||||||
5 | determinations for substance use disorders in accordance with | ||||||
6 | the most current edition of the Treatment Criteria for | ||||||
7 | Addictive, Substance-Related, and Co-Occurring Conditions | ||||||
8 | established by the American Society of Addiction Medicine. The | ||||||
9 | treating provider shall base all treatment recommendations and | ||||||
10 | the health benefit plan shall base all medical necessity | ||||||
11 | determinations for medication-assisted treatment in accordance | ||||||
12 | with the most current Treatment Criteria for Addictive, | ||||||
13 | Substance-Related, and Co-Occurring Conditions established by | ||||||
14 | the American Society of Addiction Medicine. | ||||||
15 | As used in this subsection: | ||||||
16 | "Acute treatment services" means 24-hour medically | ||||||
17 | supervised addiction treatment that provides evaluation and | ||||||
18 | withdrawal management and may include biopsychosocial | ||||||
19 | assessment, individual and group counseling, psychoeducational | ||||||
20 | groups, and discharge planning. | ||||||
21 | "Clinical stabilization services" means 24-hour treatment, | ||||||
22 | usually following acute treatment services for substance | ||||||
23 | abuse, which may include intensive education and counseling | ||||||
24 | regarding the nature of addiction and its consequences, | ||||||
25 | relapse prevention, outreach to families and significant | ||||||
26 | others, and aftercare planning for individuals beginning to |
| |||||||
| |||||||
1 | engage in recovery from addiction. | ||||||
2 | (6) An issuer of a group health benefit
plan may provide or | ||||||
3 | offer coverage required under this Section through a
managed | ||||||
4 | care plan.
| ||||||
5 | (6.5) An individual or group health benefit plan amended, | ||||||
6 | delivered, issued, or renewed on or after January 1, 2019 (the | ||||||
7 | effective date of Public Act 100-1024): | ||||||
8 | (A) shall not impose prior authorization requirements, | ||||||
9 | other than those established under the Treatment Criteria | ||||||
10 | for Addictive, Substance-Related, and Co-Occurring | ||||||
11 | Conditions established by the American Society of | ||||||
12 | Addiction Medicine, on a prescription medication approved | ||||||
13 | by the United States Food and Drug Administration that is | ||||||
14 | prescribed or administered for the treatment of substance | ||||||
15 | use disorders; | ||||||
16 | (B) shall not impose any step therapy requirements, | ||||||
17 | other than those established under the Treatment Criteria | ||||||
18 | for Addictive, Substance-Related, and Co-Occurring | ||||||
19 | Conditions established by the American Society of | ||||||
20 | Addiction Medicine, before authorizing coverage for a | ||||||
21 | prescription medication approved by the United States Food | ||||||
22 | and Drug Administration that is prescribed or administered | ||||||
23 | for the treatment of substance use disorders; | ||||||
24 | (C) shall place all prescription medications approved | ||||||
25 | by the United States Food and Drug Administration | ||||||
26 | prescribed or administered for the treatment of substance |
| |||||||
| |||||||
1 | use disorders on, for brand medications, the lowest tier | ||||||
2 | of the drug formulary developed and maintained by the | ||||||
3 | individual or group health benefit plan that covers brand | ||||||
4 | medications and, for generic medications, the lowest tier | ||||||
5 | of the drug formulary developed and maintained by the | ||||||
6 | individual or group health benefit plan that covers | ||||||
7 | generic medications; and | ||||||
8 | (D) shall not exclude coverage for a prescription | ||||||
9 | medication approved by the United States Food and Drug | ||||||
10 | Administration for the treatment of substance use | ||||||
11 | disorders and any associated counseling or wraparound | ||||||
12 | services on the grounds that such medications and services | ||||||
13 | were court ordered. | ||||||
14 | (7) (Blank).
| ||||||
15 | (8)
(Blank).
| ||||||
16 | (9) With respect to all mental, emotional, nervous, or | ||||||
17 | substance use disorders or conditions, coverage for inpatient | ||||||
18 | treatment shall include coverage for treatment in a | ||||||
19 | residential treatment center certified or licensed by the | ||||||
20 | Department of Public Health or the Department of Human | ||||||
21 | Services. | ||||||
22 | (c) This Section shall not be interpreted to require | ||||||
23 | coverage for speech therapy or other habilitative services for | ||||||
24 | those individuals covered under Section 356z.15
of this Code. | ||||||
25 | (d) With respect to a group or individual policy of | ||||||
26 | accident and health insurance or a qualified health plan |
| |||||||
| |||||||
1 | offered through the health insurance marketplace, the | ||||||
2 | Department and, with respect to medical assistance, the | ||||||
3 | Department of Healthcare and Family Services shall each | ||||||
4 | enforce the requirements of this Section and Sections 356z.23 | ||||||
5 | and 370c.1 of this Code, the Paul Wellstone and Pete Domenici | ||||||
6 | Mental Health Parity and Addiction Equity Act of 2008, 42 | ||||||
7 | U.S.C. 18031(j), and any amendments to, and federal guidance | ||||||
8 | or regulations issued under, those Acts, including, but not | ||||||
9 | limited to, final regulations issued under the Paul Wellstone | ||||||
10 | and Pete Domenici Mental Health Parity and Addiction Equity | ||||||
11 | Act of 2008 and final regulations applying the Paul Wellstone | ||||||
12 | and Pete Domenici Mental Health Parity and Addiction Equity | ||||||
13 | Act of 2008 to Medicaid managed care organizations, the | ||||||
14 | Children's Health Insurance Program, and alternative benefit | ||||||
15 | plans. Specifically, the Department and the Department of | ||||||
16 | Healthcare and Family Services shall take action: | ||||||
17 | (1) proactively ensuring compliance by individual and | ||||||
18 | group policies, including by requiring that insurers | ||||||
19 | submit comparative analyses, as set forth in paragraph (6) | ||||||
20 | of subsection (k) of Section 370c.1, demonstrating how | ||||||
21 | they design and apply nonquantitative treatment | ||||||
22 | limitations, both as written and in operation, for mental, | ||||||
23 | emotional, nervous, or substance use disorder or condition | ||||||
24 | benefits as compared to how they design and apply | ||||||
25 | nonquantitative treatment limitations, as written and in | ||||||
26 | operation, for medical and surgical benefits; |
| |||||||
| |||||||
1 | (2) evaluating all consumer or provider complaints | ||||||
2 | regarding mental, emotional, nervous, or substance use | ||||||
3 | disorder or condition coverage for possible parity | ||||||
4 | violations; | ||||||
5 | (3) performing parity compliance market conduct | ||||||
6 | examinations or, in the case of the Department of | ||||||
7 | Healthcare and Family Services, parity compliance audits | ||||||
8 | of individual and group plans and policies, including, but | ||||||
9 | not limited to, reviews of: | ||||||
10 | (A) nonquantitative treatment limitations, | ||||||
11 | including, but not limited to, prior authorization | ||||||
12 | requirements, concurrent review, retrospective review, | ||||||
13 | step therapy, network admission standards, | ||||||
14 | reimbursement rates, and geographic restrictions; | ||||||
15 | (B) denials of authorization, payment, and | ||||||
16 | coverage; and | ||||||
17 | (C) other specific criteria as may be determined | ||||||
18 | by the Department. | ||||||
19 | The findings and the conclusions of the parity compliance | ||||||
20 | market conduct examinations and audits shall be made public. | ||||||
21 | The Director may adopt rules to effectuate any provisions | ||||||
22 | of the Paul Wellstone and Pete Domenici Mental Health Parity | ||||||
23 | and Addiction Equity Act of 2008 that relate to the business of | ||||||
24 | insurance. | ||||||
25 | (e) Availability of plan information. | ||||||
26 | (1) The criteria for medical necessity determinations |
| |||||||
| |||||||
1 | made under a group health plan, an individual policy of | ||||||
2 | accident and health insurance, or a qualified health plan | ||||||
3 | offered through the health insurance marketplace with | ||||||
4 | respect to mental health or substance use disorder | ||||||
5 | benefits (or health insurance coverage offered in | ||||||
6 | connection with the plan with respect to such benefits) | ||||||
7 | must be made available by the plan administrator (or the | ||||||
8 | health insurance issuer offering such coverage) to any | ||||||
9 | current or potential participant, beneficiary, or | ||||||
10 | contracting provider upon request. | ||||||
11 | (2) The reason for any denial under a group health | ||||||
12 | benefit plan, an individual policy of accident and health | ||||||
13 | insurance, or a qualified health plan offered through the | ||||||
14 | health insurance marketplace (or health insurance coverage | ||||||
15 | offered in connection with such plan or policy) of | ||||||
16 | reimbursement or payment for services with respect to | ||||||
17 | mental, emotional, nervous, or substance use disorders or | ||||||
18 | conditions benefits in the case of any participant or | ||||||
19 | beneficiary must be made available within a reasonable | ||||||
20 | time and in a reasonable manner and in readily | ||||||
21 | understandable language by the plan administrator (or the | ||||||
22 | health insurance issuer offering such coverage) to the | ||||||
23 | participant or beneficiary upon request. | ||||||
24 | (f) As used in this Section, "group policy of accident and | ||||||
25 | health insurance" and "group health benefit plan" includes (1) | ||||||
26 | State-regulated employer-sponsored group health insurance |
| |||||||
| |||||||
1 | plans written in Illinois or which purport to provide coverage | ||||||
2 | for a resident of this State; and (2) State employee health | ||||||
3 | plans. | ||||||
4 | (g) (1) As used in this subsection: | ||||||
5 | "Benefits", with respect to insurers, means
the benefits | ||||||
6 | provided for treatment services for inpatient and outpatient | ||||||
7 | treatment of substance use disorders or conditions at American | ||||||
8 | Society of Addiction Medicine levels of treatment 2.1 | ||||||
9 | (Intensive Outpatient), 2.5 (Partial Hospitalization), 3.1 | ||||||
10 | (Clinically Managed Low-Intensity Residential), 3.3 | ||||||
11 | (Clinically Managed Population-Specific High-Intensity | ||||||
12 | Residential), 3.5 (Clinically Managed High-Intensity | ||||||
13 | Residential), and 3.7 (Medically Monitored Intensive | ||||||
14 | Inpatient) and OMT (Opioid Maintenance Therapy) services. | ||||||
15 | "Benefits", with respect to managed care organizations, | ||||||
16 | means the benefits provided for treatment services for | ||||||
17 | inpatient and outpatient treatment of substance use disorders | ||||||
18 | or conditions at American Society of Addiction Medicine levels | ||||||
19 | of treatment 2.1 (Intensive Outpatient), 2.5 (Partial | ||||||
20 | Hospitalization), 3.5 (Clinically Managed High-Intensity | ||||||
21 | Residential), and 3.7 (Medically Monitored Intensive | ||||||
22 | Inpatient) and OMT (Opioid Maintenance Therapy) services. | ||||||
23 | "Substance use disorder treatment provider or facility" | ||||||
24 | means a licensed physician, licensed psychologist, licensed | ||||||
25 | psychiatrist, licensed advanced practice registered nurse, or | ||||||
26 | licensed, certified, or otherwise State-approved facility or |
| |||||||
| |||||||
1 | provider of substance use disorder treatment. | ||||||
2 | (2) A group health insurance policy, an individual health | ||||||
3 | benefit plan, or qualified health plan that is offered through | ||||||
4 | the health insurance marketplace, small employer group health | ||||||
5 | plan, and large employer group health plan that is amended, | ||||||
6 | delivered, issued, executed, or renewed in this State, or | ||||||
7 | approved for issuance or renewal in this State, on or after | ||||||
8 | January 1, 2019 (the effective date of Public Act 100-1023) | ||||||
9 | shall comply with the requirements of this Section and Section | ||||||
10 | 370c.1. The services for the treatment and the ongoing | ||||||
11 | assessment of the patient's progress in treatment shall follow | ||||||
12 | the requirements of 77 Ill. Adm. Code 2060. | ||||||
13 | (3) Prior authorization shall not be utilized for the | ||||||
14 | benefits under this subsection. The substance use disorder | ||||||
15 | treatment provider or facility shall notify the insurer of the | ||||||
16 | initiation of treatment. For an insurer that is not a managed | ||||||
17 | care organization, the substance use disorder treatment | ||||||
18 | provider or facility notification shall occur for the | ||||||
19 | initiation of treatment of the covered person within 2 | ||||||
20 | business days. For managed care organizations, the substance | ||||||
21 | use disorder treatment provider or facility notification shall | ||||||
22 | occur in accordance with the protocol set forth in the | ||||||
23 | provider agreement for initiation of treatment within 24 | ||||||
24 | hours. If the managed care organization is not capable of | ||||||
25 | accepting the notification in accordance with the contractual | ||||||
26 | protocol during the 24-hour period following admission, the |
| |||||||
| |||||||
1 | substance use disorder treatment provider or facility shall | ||||||
2 | have one additional business day to provide the notification | ||||||
3 | to the appropriate managed care organization. Treatment plans | ||||||
4 | shall be developed in accordance with the requirements and | ||||||
5 | timeframes established in 77 Ill. Adm. Code 2060. If the | ||||||
6 | substance use disorder treatment provider or facility fails to | ||||||
7 | notify the insurer of the initiation of treatment in | ||||||
8 | accordance with these provisions, the insurer may follow its | ||||||
9 | normal prior authorization processes. | ||||||
10 | (4) For an insurer that is not a managed care | ||||||
11 | organization, if an insurer determines that benefits are no | ||||||
12 | longer medically necessary, the insurer shall notify the | ||||||
13 | covered person, the covered person's authorized | ||||||
14 | representative, if any, and the covered person's health care | ||||||
15 | provider in writing of the covered person's right to request | ||||||
16 | an external review pursuant to the Health Carrier External | ||||||
17 | Review Act. The notification shall occur within 24 hours | ||||||
18 | following the adverse determination. | ||||||
19 | Pursuant to the requirements of the Health Carrier | ||||||
20 | External Review Act, the covered person or the covered | ||||||
21 | person's authorized representative may request an expedited | ||||||
22 | external review.
An expedited external review may not occur if | ||||||
23 | the substance use disorder treatment provider or facility | ||||||
24 | determines that continued treatment is no longer medically | ||||||
25 | necessary. Under this subsection, a request for expedited | ||||||
26 | external review must be initiated within 24 hours following |
| |||||||
| |||||||
1 | the adverse determination notification by the insurer. Failure | ||||||
2 | to request an expedited external review within 24 hours shall | ||||||
3 | preclude a covered person or a covered person's authorized | ||||||
4 | representative from requesting an expedited external review. | ||||||
5 | If an expedited external review request meets the criteria | ||||||
6 | of the Health Carrier External Review Act, an independent | ||||||
7 | review organization shall make a final determination of | ||||||
8 | medical necessity within 72 hours. If an independent review | ||||||
9 | organization upholds an adverse determination, an insurer | ||||||
10 | shall remain responsible to provide coverage of benefits | ||||||
11 | through the day following the determination of the independent | ||||||
12 | review organization. A decision to reverse an adverse | ||||||
13 | determination shall comply with the Health Carrier External | ||||||
14 | Review Act. | ||||||
15 | (5) The substance use disorder treatment provider or | ||||||
16 | facility shall provide the insurer with 7 business days' | ||||||
17 | advance notice of the planned discharge of the patient from | ||||||
18 | the substance use disorder treatment provider or facility and | ||||||
19 | notice on the day that the patient is discharged from the | ||||||
20 | substance use disorder treatment provider or facility. | ||||||
21 | (6) The benefits required by this subsection shall be | ||||||
22 | provided to all covered persons with a diagnosis of substance | ||||||
23 | use disorder or conditions. The presence of additional related | ||||||
24 | or unrelated diagnoses shall not be a basis to reduce or deny | ||||||
25 | the benefits required by this subsection. | ||||||
26 | (7) Nothing in this subsection shall be construed to |
| |||||||
| |||||||
1 | require an insurer to provide coverage for any of the benefits | ||||||
2 | in this subsection. | ||||||
3 | (h) As used in this Section: | ||||||
4 | "Generally accepted standards of mental, emotional, | ||||||
5 | nervous, or substance use disorder or condition care" means | ||||||
6 | standards of care and clinical practice that are generally | ||||||
7 | recognized by health care providers practicing in relevant | ||||||
8 | clinical specialties such as psychiatry, psychology, clinical | ||||||
9 | sociology, social work, addiction medicine and counseling, and | ||||||
10 | behavioral health treatment. Valid, evidence-based sources | ||||||
11 | reflecting generally accepted standards of mental, emotional, | ||||||
12 | nervous, or substance use disorder or condition care include | ||||||
13 | peer-reviewed scientific studies and medical literature, | ||||||
14 | recommendations of nonprofit health care provider professional | ||||||
15 | associations and specialty societies, including, but not | ||||||
16 | limited to, patient placement criteria and clinical practice | ||||||
17 | guidelines, recommendations of federal government agencies, | ||||||
18 | and drug labeling approved by the United States Food and Drug | ||||||
19 | Administration. | ||||||
20 | "Medically necessary treatment of mental, emotional, | ||||||
21 | nervous, or substance use disorders or conditions" means a | ||||||
22 | service or product addressing the specific needs of that | ||||||
23 | patient, for the purpose of screening, preventing, diagnosing, | ||||||
24 | managing, or treating an illness, injury, or condition or its | ||||||
25 | symptoms and comorbidities, including minimizing the | ||||||
26 | progression of an illness, injury, or condition or its |
| |||||||
| |||||||
1 | symptoms and comorbidities in a manner that is all of the | ||||||
2 | following: | ||||||
3 | (1) in accordance with the generally accepted | ||||||
4 | standards of mental, emotional, nervous, or substance use | ||||||
5 | disorder or condition care; | ||||||
6 | (2) clinically appropriate in terms of type, | ||||||
7 | frequency, extent, site, and duration; and | ||||||
8 | (3) not primarily for the economic benefit of the | ||||||
9 | insurer, purchaser, or for the convenience of the patient, | ||||||
10 | treating physician, or other health care provider. | ||||||
11 | "Utilization review" means either of the following: | ||||||
12 | (1) prospectively, retrospectively, or concurrently | ||||||
13 | reviewing and approving, modifying, delaying, or denying, | ||||||
14 | based in whole or in part on medical necessity, requests | ||||||
15 | by health care providers, insureds, or their authorized | ||||||
16 | representatives for coverage of health care services | ||||||
17 | before, retrospectively, or concurrently with the | ||||||
18 | provision of health care services to insureds. | ||||||
19 | (2) evaluating the medical necessity, appropriateness, | ||||||
20 | level of care, service intensity, efficacy, or efficiency | ||||||
21 | of health care services, benefits, procedures, or | ||||||
22 | settings, under any circumstances, to determine whether a | ||||||
23 | health care service or benefit subject to a medical | ||||||
24 | necessity coverage requirement in an insurance policy is | ||||||
25 | covered as medically necessary for an insured. | ||||||
26 | "Utilization review criteria" means patient placement |
| |||||||
| |||||||
1 | criteria or any criteria, standards, protocols, or guidelines | ||||||
2 | used by an insurer to conduct utilization review. | ||||||
3 | (i)(1) Every insurer that amends, delivers, issues, or | ||||||
4 | renews a group or individual policy of accident and health | ||||||
5 | insurance or a qualified health plan offered through the | ||||||
6 | health insurance marketplace in this State and Medicaid | ||||||
7 | managed care organizations providing coverage for hospital or | ||||||
8 | medical treatment on or after January 1, 2023 shall, pursuant | ||||||
9 | to subsections (h) through (s), provide coverage for medically | ||||||
10 | necessary treatment of mental, emotional, nervous, or | ||||||
11 | substance use disorders or conditions. | ||||||
12 | (2) An insurer shall not set a specific limit on the | ||||||
13 | duration of benefits or coverage of medically necessary | ||||||
14 | treatment of mental, emotional, nervous, or substance use | ||||||
15 | disorders or conditions or limit coverage only to alleviation | ||||||
16 | of the insured's current symptoms. | ||||||
17 | (3) All medical necessity determinations made by the | ||||||
18 | insurer concerning service intensity, level of care placement, | ||||||
19 | continued stay, and transfer or discharge of insureds | ||||||
20 | diagnosed with mental, emotional, nervous, or substance use | ||||||
21 | disorders or conditions shall be conducted in accordance with | ||||||
22 | the requirements of subsections (k) through (u). | ||||||
23 | (4) An insurer that authorizes a specific type of | ||||||
24 | treatment by a provider pursuant to this Section shall not | ||||||
25 | rescind or modify the authorization after that provider | ||||||
26 | renders the health care service in good faith and pursuant to |
| |||||||
| |||||||
1 | this authorization for any reason, including, but not limited | ||||||
2 | to, the insurer's subsequent cancellation or modification of | ||||||
3 | the insured's or policyholder's contract, or the insured's or | ||||||
4 | policyholder's eligibility. Nothing in this Section shall | ||||||
5 | require the insurer to cover a treatment when the | ||||||
6 | authorization was granted based on a material | ||||||
7 | misrepresentation by the insured, the policyholder, or the | ||||||
8 | provider. Nothing in this Section shall require Medicaid | ||||||
9 | managed care organizations to pay for services if the | ||||||
10 | individual was not eligible for Medicaid at the time the | ||||||
11 | service was rendered. Nothing in this Section shall require an | ||||||
12 | insurer to pay for services if the individual was not the | ||||||
13 | insurer's enrollee at the time services were rendered. As used | ||||||
14 | in this paragraph, "material" means a fact or situation that | ||||||
15 | is not merely technical in nature and results in or could | ||||||
16 | result in a substantial change in the situation. | ||||||
17 | (j) An insurer shall not limit benefits or coverage for | ||||||
18 | medically necessary services on the basis that those services | ||||||
19 | should be or could be covered by a public entitlement program, | ||||||
20 | including, but not limited to, special education or an | ||||||
21 | individualized education program, Medicaid, Medicare, | ||||||
22 | Supplemental Security Income, or Social Security Disability | ||||||
23 | Insurance, and shall not include or enforce a contract term | ||||||
24 | that excludes otherwise covered benefits on the basis that | ||||||
25 | those services should be or could be covered by a public | ||||||
26 | entitlement program. Nothing in this subsection shall be |
| |||||||
| |||||||
1 | construed to require an insurer to cover benefits that have | ||||||
2 | been authorized and provided for a covered person by a public | ||||||
3 | entitlement program. Medicaid managed care organizations are | ||||||
4 | not subject to this subsection. | ||||||
5 | (k) An insurer shall base any medical necessity | ||||||
6 | determination or the utilization review criteria that the | ||||||
7 | insurer, and any entity acting on the insurer's behalf, | ||||||
8 | applies to determine the medical necessity of health care | ||||||
9 | services and benefits for the diagnosis, prevention, and | ||||||
10 | treatment of mental, emotional, nervous, or substance use | ||||||
11 | disorders or conditions on current generally accepted | ||||||
12 | standards of mental, emotional, nervous, or substance use | ||||||
13 | disorder or condition care. All denials and appeals shall be | ||||||
14 | reviewed by a professional with experience or expertise | ||||||
15 | comparable to the provider requesting the authorization. | ||||||
16 | (l) For medical necessity determinations relating to level | ||||||
17 | of care placement, continued stay, and transfer or discharge | ||||||
18 | of insureds diagnosed with mental, emotional, and nervous | ||||||
19 | disorders or conditions, an insurer shall apply the patient | ||||||
20 | placement criteria set forth in the most recent version of the | ||||||
21 | treatment criteria developed by an unaffiliated nonprofit | ||||||
22 | professional association for the relevant clinical specialty | ||||||
23 | or, for Medicaid managed care organizations, patient placement | ||||||
24 | criteria determined by the Department of Healthcare and Family | ||||||
25 | Services that are consistent with generally accepted standards | ||||||
26 | of mental, emotional, nervous or substance use disorder or |
| |||||||
| |||||||
1 | condition care. Pursuant to subsection (b), in conducting | ||||||
2 | utilization review of all covered services and benefits for | ||||||
3 | the diagnosis, prevention, and treatment of substance use | ||||||
4 | disorders an insurer shall use the most recent edition of the | ||||||
5 | patient placement criteria established by the American Society | ||||||
6 | of Addiction Medicine. | ||||||
7 | (m) For medical necessity determinations relating to level | ||||||
8 | of care placement, continued stay, and transfer or discharge | ||||||
9 | that are within the scope of the sources specified in | ||||||
10 | subsection (l), an insurer shall not apply different, | ||||||
11 | additional, conflicting, or more restrictive utilization | ||||||
12 | review criteria than the criteria set forth in those sources. | ||||||
13 | For all level of care placement decisions, the insurer shall | ||||||
14 | authorize placement at the level of care consistent with the | ||||||
15 | assessment of the insured using the relevant patient placement | ||||||
16 | criteria as specified in subsection (l). If that level of | ||||||
17 | placement is not available, the insurer shall authorize the | ||||||
18 | next higher level of care. In the event of disagreement, the | ||||||
19 | insurer shall provide full detail of its assessment using the | ||||||
20 | relevant criteria as specified in subsection (l) to the | ||||||
21 | provider of the service and the patient. | ||||||
22 | Nothing in this subsection or subsection (l) prohibits an | ||||||
23 | insurer from applying utilization review criteria that were | ||||||
24 | developed in accordance with subsection (k) to health care | ||||||
25 | services and benefits for mental, emotional, and nervous | ||||||
26 | disorders or conditions that are not related to medical |
| |||||||
| |||||||
1 | necessity determinations for level of care placement, | ||||||
2 | continued stay, and transfer or discharge. If an insurer | ||||||
3 | purchases or licenses utilization review criteria pursuant to | ||||||
4 | this subsection, the insurer shall verify and document before | ||||||
5 | use that the criteria were developed in accordance with | ||||||
6 | subsection (k). | ||||||
7 | (n) In conducting utilization review that is outside the | ||||||
8 | scope of the criteria as specified in subsection (l) or | ||||||
9 | relates to the advancements in technology or in the types or | ||||||
10 | levels of care that are not addressed in the most recent | ||||||
11 | versions of the sources specified in subsection (l), an | ||||||
12 | insurer shall conduct utilization review in accordance with | ||||||
13 | subsection (k). | ||||||
14 | (o) This Section does not in any way limit the rights of a | ||||||
15 | patient under the Medical Patient Rights Act. | ||||||
16 | (p) This Section does not in any way limit early and | ||||||
17 | periodic screening, diagnostic, and treatment benefits as | ||||||
18 | defined under 42 U.S.C. 1396d(r). | ||||||
19 | (q) To ensure the proper use of the criteria described in | ||||||
20 | subsection (l), every insurer shall do all of the following: | ||||||
21 | (1) Educate the insurer's staff, including any third | ||||||
22 | parties contracted with the insurer to review claims, | ||||||
23 | conduct utilization reviews, or make medical necessity | ||||||
24 | determinations about the utilization review criteria. | ||||||
25 | (2) Make the educational program available to other | ||||||
26 | stakeholders, including the insurer's participating or |
| |||||||
| |||||||
1 | contracted providers and potential participants, | ||||||
2 | beneficiaries, or covered lives. The education program | ||||||
3 | must be provided at least once a year, in-person or | ||||||
4 | digitally, or recordings of the education program must be | ||||||
5 | made available to the aforementioned stakeholders. | ||||||
6 | (3) Provide, at no cost, the utilization review | ||||||
7 | criteria and any training material or resources to | ||||||
8 | providers and insured patients upon request. For | ||||||
9 | utilization review criteria not concerning level of care | ||||||
10 | placement, continued stay, and transfer or discharge used | ||||||
11 | by the insurer pursuant to subsection (m), the insurer may | ||||||
12 | place the criteria on a secure, password-protected website | ||||||
13 | so long as the access requirements of the website do not | ||||||
14 | unreasonably restrict access to insureds or their | ||||||
15 | providers. No restrictions shall be placed upon the | ||||||
16 | insured's or treating provider's access right to | ||||||
17 | utilization review criteria obtained under this paragraph | ||||||
18 | at any point in time, including before an initial request | ||||||
19 | for authorization. | ||||||
20 | (4) Track, identify, and analyze how the utilization | ||||||
21 | review criteria are used to certify care, deny care, and | ||||||
22 | support the appeals process. | ||||||
23 | (5) Conduct interrater reliability testing to ensure | ||||||
24 | consistency in utilization review decision making that | ||||||
25 | covers how medical necessity decisions are made; this | ||||||
26 | assessment shall cover all aspects of utilization review |
| |||||||
| |||||||
1 | as defined in subsection (h). | ||||||
2 | (6) Run interrater reliability reports about how the | ||||||
3 | clinical guidelines are used in conjunction with the | ||||||
4 | utilization review process and parity compliance | ||||||
5 | activities. | ||||||
6 | (7) Achieve interrater reliability pass rates of at | ||||||
7 | least 90% and, if this threshold is not met, immediately | ||||||
8 | provide for the remediation of poor interrater reliability | ||||||
9 | and interrater reliability testing for all new staff | ||||||
10 | before they can conduct utilization review without | ||||||
11 | supervision. | ||||||
12 | (8) Maintain documentation of interrater reliability | ||||||
13 | testing and the remediation actions taken for those with | ||||||
14 | pass rates lower than 90% and submit to the Department of | ||||||
15 | Insurance or, in the case of Medicaid managed care | ||||||
16 | organizations, the Department of Healthcare and Family | ||||||
17 | Services the testing results and a summary of remedial | ||||||
18 | actions as part of parity compliance reporting set forth | ||||||
19 | in subsection (k) of Section 370c.1. | ||||||
20 | (r) This Section applies to all health care services and | ||||||
21 | benefits for the diagnosis, prevention, and treatment of | ||||||
22 | mental, emotional, nervous, or substance use disorders or | ||||||
23 | conditions covered by an insurance policy, including | ||||||
24 | prescription drugs. | ||||||
25 | (s) This Section applies to an insurer that amends, | ||||||
26 | delivers, issues, or renews a group or individual policy of |
| |||||||
| |||||||
1 | accident and health insurance or a qualified health plan | ||||||
2 | offered through the health insurance marketplace in this State | ||||||
3 | providing coverage for hospital or medical treatment and | ||||||
4 | conducts utilization review as defined in this Section, | ||||||
5 | including Medicaid managed care organizations, and any entity | ||||||
6 | or contracting provider that performs utilization review or | ||||||
7 | utilization management functions on an insurer's behalf. | ||||||
8 | (t) If the Director determines that an insurer has | ||||||
9 | violated this Section, the Director may, after appropriate | ||||||
10 | notice and opportunity for hearing, by order, assess a civil | ||||||
11 | penalty between $1,000 and $5,000 for each violation. Moneys | ||||||
12 | collected from penalties shall be deposited into the Parity | ||||||
13 | Advancement Fund established in subsection (i) of Section | ||||||
14 | 370c.1. | ||||||
15 | (u) An insurer shall not adopt, impose, or enforce terms | ||||||
16 | in its policies or provider agreements, in writing or in | ||||||
17 | operation, that undermine, alter, or conflict with the | ||||||
18 | requirements of this Section. | ||||||
19 | (v) The provisions of this Section are severable. If any | ||||||
20 | provision of this Section or its application is held invalid, | ||||||
21 | that invalidity shall not affect other provisions or | ||||||
22 | applications that can be given effect without the invalid | ||||||
23 | provision or application. | ||||||
24 | (Source: P.A. 101-81, eff. 7-12-19; 101-386, eff. 8-16-19; | ||||||
25 | 102-558, eff. 8-20-21; 102-579, eff. 1-1-22; 102-813, eff. | ||||||
26 | 5-13-22.)
|
| |||||||
| |||||||
1 | (215 ILCS 5/412) (from Ch. 73, par. 1024)
| ||||||
2 | Sec. 412. Refunds; penalties; collection.
| ||||||
3 | (1)(a) Whenever it appears to
the satisfaction of the | ||||||
4 | Director that because of some mistake of fact,
error in | ||||||
5 | calculation, or erroneous interpretation of a statute of this
| ||||||
6 | or any other state, any authorized company, surplus line | ||||||
7 | producer, or industrial insured has paid to him, pursuant to
| ||||||
8 | any provision of law, taxes, fees, or other charges
in excess | ||||||
9 | of the
amount legally chargeable against it, during the 6 year | ||||||
10 | period
immediately preceding the discovery of such | ||||||
11 | overpayment, he shall have
power to refund to such company, | ||||||
12 | surplus line producer, or industrial insured the amount of the | ||||||
13 | excess or excesses by
applying the amount or amounts thereof | ||||||
14 | toward
the payment of taxes, fees, or other charges already | ||||||
15 | due, or which may
thereafter become due from that company | ||||||
16 | until such excess or excesses have been
fully
refunded, or | ||||||
17 | upon a written request from the authorized company, surplus | ||||||
18 | line producer, or industrial insured, the
Director shall | ||||||
19 | provide a cash refund within
120 days after receipt of the | ||||||
20 | written request if all necessary information has
been filed | ||||||
21 | with the Department in order for it to perform an audit of the
| ||||||
22 | tax report for the transaction or period or annual return for | ||||||
23 | the year in which the overpayment occurred or within 120 days
| ||||||
24 | after the date the Department receives all the necessary | ||||||
25 | information to perform
such audit. The Director shall not |
| |||||||
| |||||||
1 | provide a cash refund if there are
insufficient funds in the | ||||||
2 | Insurance Premium Tax Refund Fund to provide a cash
refund, if | ||||||
3 | the amount of the overpayment is less than $100, or if the | ||||||
4 | amount of
the overpayment can be fully offset against the | ||||||
5 | taxpayer's estimated liability
for the year following the year | ||||||
6 | of the cash refund request. Any cash refund
shall be paid from | ||||||
7 | the Insurance Premium Tax Refund Fund, a special fund hereby
| ||||||
8 | created in the
State treasury.
| ||||||
9 | (b) As determined by the Director pursuant to paragraph | ||||||
10 | (a) of this subsection, the Department shall deposit an amount | ||||||
11 | of cash refunds approved by the Director for payment as a | ||||||
12 | result of overpayment of tax liability
collected under | ||||||
13 | Sections 121-2.08, 409, 444, 444.1, and 445 of
this
Code into | ||||||
14 | the Insurance Premium Tax Refund Fund.
| ||||||
15 | (c) Beginning July 1, 1999, moneys in the Insurance | ||||||
16 | Premium Tax Refund
Fund
shall be expended exclusively for the | ||||||
17 | purpose of paying cash refunds resulting
from overpayment of | ||||||
18 | tax liability under Sections 121-2.08, 409, 444, 444.1, and | ||||||
19 | 445 of this
Code
as
determined by the Director pursuant to | ||||||
20 | subsection 1(a) of this Section. Cash
refunds made in | ||||||
21 | accordance with this Section may be made from the Insurance
| ||||||
22 | Premium Tax Refund Fund only to the extent that amounts have | ||||||
23 | been deposited and
retained in the Insurance Premium Tax | ||||||
24 | Refund Fund.
| ||||||
25 | (d) This Section shall constitute an irrevocable and | ||||||
26 | continuing
appropriation from the Insurance Premium Tax Refund |
| |||||||
| |||||||
1 | Fund for the purpose of
paying cash refunds pursuant to the | ||||||
2 | provisions of this Section.
| ||||||
3 | (2)(a) When any insurance company fails to
file any tax | ||||||
4 | return required under Sections 408.1, 409, 444, and 444.1 of
| ||||||
5 | this Code or Section 12 of the Fire Investigation Act on the | ||||||
6 | date
prescribed, including any extensions, there shall be | ||||||
7 | added as a penalty
$400 or 10% of the amount of such tax, | ||||||
8 | whichever is
greater, for each month
or part of a month of | ||||||
9 | failure to file, the entire penalty not to exceed
$2,000 or 50% | ||||||
10 | of the tax due, whichever is greater.
| ||||||
11 | (b) When any industrial insured or surplus line producer | ||||||
12 | fails to file any tax return or report required under Sections | ||||||
13 | 121-2.08 and 445 of this Code or Section 12 of the Fire | ||||||
14 | Investigation Act on the date prescribed, including any | ||||||
15 | extensions, there shall be added: | ||||||
16 | (i) as a late fee, if the return or report is received | ||||||
17 | at least one day but not more than 15 7 days after the | ||||||
18 | prescribed due date, $50 $400 or 5% 10% of the tax due, | ||||||
19 | whichever is greater, the entire fee not to exceed $1,000; | ||||||
20 | (ii) as a late fee, if the return or report is received | ||||||
21 | at least 8 days but not more than 14 days after the | ||||||
22 | prescribed due date, $400 or 10% of the tax due, whichever | ||||||
23 | is greater, the entire fee not to exceed $1,500; | ||||||
24 | (ii) (iii) as a late fee, if the return or report is | ||||||
25 | received at least 16 15 days but not more than 30 21 days | ||||||
26 | after the prescribed due date, $100 $400 or 5% 10% of the |
| |||||||
| |||||||
1 | tax due, whichever is greater, the entire fee not to | ||||||
2 | exceed $2,000; or | ||||||
3 | (iii) (iv) as a penalty, if the return or report is | ||||||
4 | received more than 30 21 days after the prescribed due | ||||||
5 | date, $100 $400 or 5% 10% of the tax due, whichever is | ||||||
6 | greater, for each month or part of a month of failure to | ||||||
7 | file, the entire penalty not to exceed $500 $2,000 or 30% | ||||||
8 | 50% of the tax due, whichever is greater. | ||||||
9 | A tax return or report shall be deemed received as of the | ||||||
10 | date mailed as evidenced by a postmark, proof of mailing on a | ||||||
11 | recognized United States Postal Service form or a form | ||||||
12 | acceptable to the United States Postal Service or other | ||||||
13 | commercial mail delivery service, or other evidence acceptable | ||||||
14 | to the Director.
| ||||||
15 | (3)(a) When any insurance company
fails to pay the full | ||||||
16 | amount due under the provisions of this Section,
Sections | ||||||
17 | 408.1, 409, 444, or 444.1 of this Code, or Section 12 of the
| ||||||
18 | Fire Investigation Act, there shall be added to the amount due | ||||||
19 | as a penalty
an amount equal to 10% of the deficiency.
| ||||||
20 | (a-5) When any industrial insured or surplus line producer | ||||||
21 | fails to pay the full amount due under the provisions of this | ||||||
22 | Section, Sections 121-2.08 or 445 of this Code, or Section 12 | ||||||
23 | of the Fire Investigation Act on the date prescribed, there | ||||||
24 | shall be added: | ||||||
25 | (i) as a late fee, if the payment is received at least | ||||||
26 | one day but not more than 7 days after the prescribed due |
| |||||||
| |||||||
1 | date, 10% of the tax due, the entire fee not to exceed | ||||||
2 | $1,000; | ||||||
3 | (ii) as a late fee, if the payment is received at least | ||||||
4 | 8 days but not more than 14 days after the prescribed due | ||||||
5 | date, 10% of the tax due, the entire fee not to exceed | ||||||
6 | $1,500; | ||||||
7 | (iii) as a late fee, if the payment is received at | ||||||
8 | least 15 days but not more than 21 days after the | ||||||
9 | prescribed due date, 10% of the tax due, the entire fee not | ||||||
10 | to exceed $2,000; or | ||||||
11 | (iv) as a penalty, if the return or report is received | ||||||
12 | more than 21 days after the prescribed due date, 10% of the | ||||||
13 | tax due. | ||||||
14 | A tax payment shall be deemed received as of the date | ||||||
15 | mailed as evidenced by a postmark, proof of mailing on a | ||||||
16 | recognized United States Postal Service form or a form | ||||||
17 | acceptable to the United States Postal Service or other | ||||||
18 | commercial mail delivery service, or other evidence acceptable | ||||||
19 | to the Director.
| ||||||
20 | (b) If such failure to pay is determined by the Director to | ||||||
21 | be wilful,
after a hearing under Sections 402 and 403, there | ||||||
22 | shall be added to the tax
as a penalty an amount equal to the | ||||||
23 | greater of 50% of the
deficiency or 10%
of the amount due and | ||||||
24 | unpaid for each month or part of a month that the
deficiency | ||||||
25 | remains unpaid commencing with the date that the amount | ||||||
26 | becomes
due. Such amount shall be in lieu of any determined |
| |||||||
| |||||||
1 | under paragraph (a) or (a-5).
| ||||||
2 | (4) Any insurance company, industrial insured, or surplus | ||||||
3 | line producer that
fails to pay the full amount due under this | ||||||
4 | Section or Sections 121-2.08, 408.1, 409,
444, 444.1, or 445 | ||||||
5 | of this Code, or Section 12 of the Fire Investigation
Act is | ||||||
6 | liable, in addition to the tax and any late fees and penalties, | ||||||
7 | for interest
on such deficiency at the rate of 12% per annum, | ||||||
8 | or at such higher adjusted
rates as are or may be established | ||||||
9 | under subsection (b) of Section 6621
of the Internal Revenue | ||||||
10 | Code, from the date that payment of any such tax
was due, | ||||||
11 | determined without regard to any extensions, to the date of | ||||||
12 | payment
of such amount.
| ||||||
13 | (5) The Director, through the Attorney
General, may | ||||||
14 | institute an action in the name of the People of the State
of | ||||||
15 | Illinois, in any court of competent jurisdiction, for the | ||||||
16 | recovery of
the amount of such taxes, fees, and penalties due, | ||||||
17 | and prosecute the same to
final judgment, and take such steps | ||||||
18 | as are necessary to collect the same.
| ||||||
19 | (6) In the event that the certificate of authority of a | ||||||
20 | foreign or
alien company is revoked for any cause or the | ||||||
21 | company withdraws from
this State prior to the renewal date of | ||||||
22 | the certificate of authority as
provided in Section 114, the | ||||||
23 | company may recover the amount of any such
tax paid in advance. | ||||||
24 | Except as provided in this subsection, no
revocation or | ||||||
25 | withdrawal excuses payment of or constitutes grounds for
the | ||||||
26 | recovery of any taxes or penalties imposed by this Code.
|
| |||||||
| |||||||
1 | (7) When an insurance company or domestic affiliated group | ||||||
2 | fails to pay
the full amount of any fee of $200 or more due | ||||||
3 | under
Section 408 of this Code, there shall be added to the | ||||||
4 | amount due as
a penalty the greater of $100 or an amount equal | ||||||
5 | to 10%
of the deficiency for
each month or part of
a month that | ||||||
6 | the deficiency remains unpaid.
| ||||||
7 | (8) The Department shall have a lien for the taxes, fees, | ||||||
8 | charges, fines, penalties, interest, other charges, or any | ||||||
9 | portion thereof, imposed or assessed pursuant to this Code, | ||||||
10 | upon all the real and personal property of any company or | ||||||
11 | person to whom the assessment or final order has been issued or | ||||||
12 | whenever a tax return is filed without payment of the tax or | ||||||
13 | penalty shown therein to be due, including all such property | ||||||
14 | of the company or person acquired after receipt of the | ||||||
15 | assessment, issuance of the order, or filing of the return. | ||||||
16 | The company or person is liable for the filing fee incurred by | ||||||
17 | the Department for filing the lien and the filing fee incurred | ||||||
18 | by the Department to file the release of that lien. The filing | ||||||
19 | fees shall be paid to the Department in addition to payment of | ||||||
20 | the tax, fee, charge, fine, penalty, interest, other charges, | ||||||
21 | or any portion thereof, included in the amount of the lien. | ||||||
22 | However, where the lien arises because of the issuance of a | ||||||
23 | final order of the Director or tax assessment by the | ||||||
24 | Department, the lien shall not attach and the notice referred | ||||||
25 | to in this Section shall not be filed until all administrative | ||||||
26 | proceedings or proceedings in court for review of the final |
| |||||||
| |||||||
1 | order or assessment have terminated or the time for the taking | ||||||
2 | thereof has expired without such proceedings being instituted. | ||||||
3 | Upon the granting of Department review after a lien has | ||||||
4 | attached, the lien shall remain in full force except to the | ||||||
5 | extent to which the final assessment may be reduced by a | ||||||
6 | revised final assessment following the rehearing or review. | ||||||
7 | The lien created by the issuance of a final assessment shall | ||||||
8 | terminate, unless a notice of lien is filed, within 3 years | ||||||
9 | after the date all proceedings in court for the review of the | ||||||
10 | final assessment have terminated or the time for the taking | ||||||
11 | thereof has expired without such proceedings being instituted, | ||||||
12 | or (in the case of a revised final assessment issued pursuant | ||||||
13 | to a rehearing or review by the Department) within 3 years | ||||||
14 | after the date all proceedings in court for the review of such | ||||||
15 | revised final assessment have terminated or the time for the | ||||||
16 | taking thereof has expired without such proceedings being | ||||||
17 | instituted. Where the lien results from the filing of a tax | ||||||
18 | return without payment of the tax or penalty shown therein to | ||||||
19 | be due, the lien shall terminate, unless a notice of lien is | ||||||
20 | filed, within 3 years after the date when the return is filed | ||||||
21 | with the Department. | ||||||
22 | The time limitation period on the Department's right to | ||||||
23 | file a notice of lien shall not run during any period of time | ||||||
24 | in which the order of any court has the effect of enjoining or | ||||||
25 | restraining the Department from filing such notice of lien. If | ||||||
26 | the Department finds that a company or person is about to |
| |||||||
| |||||||
1 | depart from the State, to conceal himself or his property, or | ||||||
2 | to do any other act tending to prejudice or to render wholly or | ||||||
3 | partly ineffectual proceedings to collect the amount due and | ||||||
4 | owing to the Department unless such proceedings are brought | ||||||
5 | without delay, or if the Department finds that the collection | ||||||
6 | of the amount due from any company or person will be | ||||||
7 | jeopardized by delay, the Department shall give the company or | ||||||
8 | person notice of such findings and shall make demand for | ||||||
9 | immediate return and payment of the amount, whereupon the | ||||||
10 | amount shall become immediately due and payable. If the | ||||||
11 | company or person, within 5 days after the notice (or within | ||||||
12 | such extension of time as the Department may grant), does not | ||||||
13 | comply with the notice or show to the Department that the | ||||||
14 | findings in the notice are erroneous, the Department may file | ||||||
15 | a notice of jeopardy assessment lien in the office of the | ||||||
16 | recorder of the county in which any property of the company or | ||||||
17 | person may be located and shall notify the company or person of | ||||||
18 | the filing. The jeopardy assessment lien shall have the same | ||||||
19 | scope and effect as the statutory lien provided for in this | ||||||
20 | Section. If the company or person believes that the company or | ||||||
21 | person does not owe some or all of the tax for which the | ||||||
22 | jeopardy assessment lien against the company or person has | ||||||
23 | been filed, or that no jeopardy to the revenue in fact exists, | ||||||
24 | the company or person may protest within 20 days after being | ||||||
25 | notified by the Department of the filing of the jeopardy | ||||||
26 | assessment lien and request a hearing, whereupon the |
| |||||||
| |||||||
1 | Department shall hold a hearing in conformity with the | ||||||
2 | provisions of this Code and, pursuant thereto, shall notify | ||||||
3 | the company or person of its findings as to whether or not the | ||||||
4 | jeopardy assessment lien will be released. If not, and if the | ||||||
5 | company or person is aggrieved by this decision, the company | ||||||
6 | or person may file an action for judicial review of the final | ||||||
7 | determination of the Department in accordance with the | ||||||
8 | Administrative Review Law. If, pursuant to such hearing (or | ||||||
9 | after an independent determination of the facts by the | ||||||
10 | Department without a hearing), the Department determines that | ||||||
11 | some or all of the amount due covered by the jeopardy | ||||||
12 | assessment lien is not owed by the company or person, or that | ||||||
13 | no jeopardy to the revenue exists, or if on judicial review the | ||||||
14 | final judgment of the court is that the company or person does | ||||||
15 | not owe some or all of the amount due covered by the jeopardy | ||||||
16 | assessment lien against them, or that no jeopardy to the | ||||||
17 | revenue exists, the Department shall release its jeopardy | ||||||
18 | assessment lien to the extent of such finding of nonliability | ||||||
19 | for the amount, or to the extent of such finding of no jeopardy | ||||||
20 | to the revenue. The Department shall also release its jeopardy | ||||||
21 | assessment lien against the company or person whenever the | ||||||
22 | amount due and owing covered by the lien, plus any interest | ||||||
23 | which may be due, are paid and the company or person has paid | ||||||
24 | the Department in cash or by guaranteed remittance an amount | ||||||
25 | representing the filing fee for the lien and the filing fee for | ||||||
26 | the release of that lien. The Department shall file that |
| |||||||
| |||||||
1 | release of lien with the recorder of the county where that lien | ||||||
2 | was filed. | ||||||
3 | Nothing in this Section shall be construed to give the | ||||||
4 | Department a preference over the rights of any bona fide | ||||||
5 | purchaser, holder of a security interest, mechanics | ||||||
6 | lienholder, mortgagee, or judgment lien creditor arising prior | ||||||
7 | to the filing of a regular notice of lien or a notice of | ||||||
8 | jeopardy assessment lien in the office of the recorder in the | ||||||
9 | county in which the property subject to the lien is located. | ||||||
10 | For purposes of this Section, "bona fide" shall not include | ||||||
11 | any mortgage of real or personal property or any other credit | ||||||
12 | transaction that results in the mortgagee or the holder of the | ||||||
13 | security acting as trustee for unsecured creditors of the | ||||||
14 | company or person mentioned in the notice of lien who executed | ||||||
15 | such chattel or real property mortgage or the document | ||||||
16 | evidencing such credit transaction. The lien shall be inferior | ||||||
17 | to the lien of general taxes, special assessments, and special | ||||||
18 | taxes levied by any political subdivision of this State. In | ||||||
19 | case title to land to be affected by the notice of lien or | ||||||
20 | notice of jeopardy assessment lien is registered under the | ||||||
21 | provisions of the Registered Titles (Torrens) Act, such notice | ||||||
22 | shall be filed in the office of the Registrar of Titles of the | ||||||
23 | county within which the property subject to the lien is | ||||||
24 | situated and shall be entered upon the register of titles as a | ||||||
25 | memorial or charge upon each folium of the register of titles | ||||||
26 | affected by such notice, and the Department shall not have a |
| |||||||
| |||||||
1 | preference over the rights of any bona fide purchaser, | ||||||
2 | mortgagee, judgment creditor, or other lienholder arising | ||||||
3 | prior to the registration of such notice. The regular lien or | ||||||
4 | jeopardy assessment lien shall not be effective against any | ||||||
5 | purchaser with respect to any item in a retailer's stock in | ||||||
6 | trade purchased from the retailer in the usual course of the | ||||||
7 | retailer's business. | ||||||
8 | (Source: P.A. 102-775, eff. 5-13-22.)
| ||||||
9 | (215 ILCS 5/500-140)
| ||||||
10 | (Section scheduled to be repealed on January 1, 2027)
| ||||||
11 | Sec. 500-140. Injunctive relief. A person required to be | ||||||
12 | licensed under
this Article but failing to
obtain a valid and | ||||||
13 | current license under this Article constitutes a public
| ||||||
14 | nuisance. The Director
may report the failure to obtain a | ||||||
15 | license to the Attorney General, whose duty
it is to apply
| ||||||
16 | forthwith by complaint on relation of the Director in the name | ||||||
17 | of the people of
the State of
Illinois, for injunctive relief | ||||||
18 | in the circuit court of the county where the
failure to obtain | ||||||
19 | a license
occurred to enjoin that person from acting in any | ||||||
20 | capacity that requires such a license failing to obtain a | ||||||
21 | license . Upon the
filing of a verified
petition in the court, | ||||||
22 | the court, if satisfied by affidavit or otherwise that
the | ||||||
23 | person is required to
have a license and does not
have a valid | ||||||
24 | and current license, may enter a temporary restraining
order | ||||||
25 | without notice or bond,
enjoining the defendant from acting in |
| |||||||
| |||||||
1 | any capacity that requires such
license. A copy of the | ||||||
2 | verified
complaint shall be served upon the defendant, and the
| ||||||
3 | proceedings shall thereafter be
conducted as in other civil | ||||||
4 | cases. If it is established that the
defendant has been, or is | ||||||
5 | engaged
in any unlawful practice, the court may enter an order | ||||||
6 | or
judgment perpetually enjoining the
defendant from further | ||||||
7 | engaging in such practice. In all
proceedings brought under | ||||||
8 | this Section,
the court, in its discretion, may apportion the | ||||||
9 | costs
among the parties, including the cost of
filing the | ||||||
10 | complaint, service of process, witness fees and
expenses, | ||||||
11 | court reporter charges, and
reasonable attorney fees. In case | ||||||
12 | of the violation of any
injunctive order entered under the | ||||||
13 | provisions of this Section,
the court may summarily try and
| ||||||
14 | punish the offender for contempt of court. The injunctive | ||||||
15 | relief
available
under this Section is in
addition to and not | ||||||
16 | in lieu of all other penalties and remedies provided in
this | ||||||
17 | Code.
| ||||||
18 | (Source: P.A. 92-386, eff. 1-1-02 .)
| ||||||
19 | (215 ILCS 5/1204) (from Ch. 73, par. 1065.904)
| ||||||
20 | (Text of Section WITHOUT the changes made by P.A. 94-677, | ||||||
21 | which has been held
unconstitutional) | ||||||
22 | Sec. 1204. (A) The Director shall promulgate rules and | ||||||
23 | regulations
which shall require each insurer licensed to write | ||||||
24 | property or casualty
insurance in the State and each syndicate | ||||||
25 | doing business on the Illinois
Insurance Exchange to record |
| |||||||
| |||||||
1 | and report its loss and expense experience
and other data as | ||||||
2 | may be necessary to assess the relationship of
insurance | ||||||
3 | premiums and related income as compared to insurance costs and
| ||||||
4 | expenses. The Director may designate one or more rate service
| ||||||
5 | organizations or advisory organizations to gather and compile | ||||||
6 | such
experience and data. The Director shall require each | ||||||
7 | insurer licensed to
write property or casualty insurance in | ||||||
8 | this State and each syndicate doing
business on the Illinois | ||||||
9 | Insurance Exchange to submit a report, on
a form furnished by | ||||||
10 | the Director, showing its direct writings in this
State and | ||||||
11 | companywide.
| ||||||
12 | (B) Such report required by subsection (A) of this Section | ||||||
13 | may include,
but not be limited to, the following specific | ||||||
14 | types of insurance written by
such insurer:
| ||||||
15 | (1) Political subdivision liability insurance reported | ||||||
16 | separately in the
following categories:
| ||||||
17 | (a) municipalities;
| ||||||
18 | (b) school districts;
| ||||||
19 | (c) other political subdivisions;
| ||||||
20 | (2) Public official liability insurance;
| ||||||
21 | (3) Dram shop liability insurance;
| ||||||
22 | (4) Day care center liability insurance;
| ||||||
23 | (5) Labor, fraternal or religious organizations | ||||||
24 | liability insurance;
| ||||||
25 | (6) Errors and omissions liability insurance;
| ||||||
26 | (7) Officers and directors liability insurance |
| |||||||
| |||||||
1 | reported separately as
follows:
| ||||||
2 | (a) non-profit entities;
| ||||||
3 | (b) for-profit entities;
| ||||||
4 | (8) Products liability insurance;
| ||||||
5 | (9) Medical malpractice insurance;
| ||||||
6 | (10) Attorney malpractice insurance;
| ||||||
7 | (11) Architects and engineers malpractice insurance; | ||||||
8 | and
| ||||||
9 | (12) Motor vehicle insurance reported separately for | ||||||
10 | commercial and
private passenger vehicles as follows:
| ||||||
11 | (a) motor vehicle physical damage insurance;
| ||||||
12 | (b) motor vehicle liability insurance.
| ||||||
13 | (C) Such report may include, but need not be limited to the | ||||||
14 | following data,
both
specific to this State and companywide, | ||||||
15 | in the aggregate or by type of
insurance for the previous year | ||||||
16 | on a calendar year basis:
| ||||||
17 | (1) Direct premiums written;
| ||||||
18 | (2) Direct premiums earned;
| ||||||
19 | (3) Number of policies;
| ||||||
20 | (4) Net investment income, using appropriate estimates | ||||||
21 | where necessary;
| ||||||
22 | (5) Losses paid;
| ||||||
23 | (6) Losses incurred;
| ||||||
24 | (7) Loss reserves:
| ||||||
25 | (a) Losses unpaid on reported claims;
| ||||||
26 | (b) Losses unpaid on incurred but not reported |
| |||||||
| |||||||
1 | claims;
| ||||||
2 | (8) Number of claims:
| ||||||
3 | (a) Paid claims;
| ||||||
4 | (b) Arising claims;
| ||||||
5 | (9) Loss adjustment expenses:
| ||||||
6 | (a) Allocated loss adjustment expenses;
| ||||||
7 | (b) Unallocated loss adjustment expenses;
| ||||||
8 | (10) Net underwriting gain or loss;
| ||||||
9 | (11) Net operation gain or loss, including net | ||||||
10 | investment income;
| ||||||
11 | (12) Any other information requested by the Director.
| ||||||
12 | (C-3) Additional information by an advisory organization | ||||||
13 | as defined in Section 463 of this Code. | ||||||
14 | (1) An advisory organization as defined in Section 463 | ||||||
15 | of this Code shall report annually the following | ||||||
16 | information in such format as may be prescribed by the | ||||||
17 | Secretary: | ||||||
18 | (a) paid and incurred losses for each of the past | ||||||
19 | 10 years; | ||||||
20 | (b) medical payments and medical charges, if | ||||||
21 | collected, for each of the past 10 years; | ||||||
22 | (c) the following indemnity payment information:
| ||||||
23 | cumulative payments by accident year by calendar year | ||||||
24 | of
development. This array will show payments made and | ||||||
25 | frequency of claims in the following categories: | ||||||
26 | medical only, permanent partial disability (PPD), |
| |||||||
| |||||||
1 | permanent total
disability (PTD), temporary total | ||||||
2 | disability (TTD), and fatalities; | ||||||
3 | (d) injuries by frequency and severity; | ||||||
4 | (e) by class of employee. | ||||||
5 | (2) The report filed with the Secretary of Financial | ||||||
6 | and Professional Regulation under paragraph (1) of this
| ||||||
7 | subsection (C-3) shall be made available, on an aggregate | ||||||
8 | basis, to the General
Assembly and to the general public. | ||||||
9 | The identity of the petitioner, the respondent, the | ||||||
10 | attorneys, and the insurers shall not be disclosed.
| ||||||
11 | (3) Reports required under this
subsection (C-3) shall | ||||||
12 | be filed with the Secretary no later than September 1 in | ||||||
13 | 2006 and no later than September 1 of each year | ||||||
14 | thereafter.
| ||||||
15 | (D) In addition to the information which may be requested | ||||||
16 | under
subsection (C), the Director may also request on a | ||||||
17 | companywide, aggregate
basis, Federal Income Tax recoverable, | ||||||
18 | net realized capital gain or loss,
net unrealized capital gain | ||||||
19 | or loss, and all other expenses not requested
in subsection | ||||||
20 | (C) above.
| ||||||
21 | (E) Violations - Suspensions - Revocations.
| ||||||
22 | (1) Any company or person
subject to this Article, who | ||||||
23 | willfully or repeatedly fails to observe or who
otherwise | ||||||
24 | violates any of the provisions of this Article or any rule | ||||||
25 | or
regulation promulgated by the Director under authority | ||||||
26 | of this Article or any
final order of the Director entered |
| |||||||
| |||||||
1 | under the authority of this Article shall
by civil penalty | ||||||
2 | forfeit to the State of Illinois a sum not to exceed
| ||||||
3 | $2,000. Each day during which a violation occurs | ||||||
4 | constitutes a
separate
offense.
| ||||||
5 | (2) No forfeiture liability under paragraph (1) of | ||||||
6 | this subsection may
attach unless a written notice of | ||||||
7 | apparent liability has been issued by the
Director and | ||||||
8 | received by the respondent, or the Director sends written
| ||||||
9 | notice of apparent liability by registered or certified | ||||||
10 | mail, return
receipt requested, to the last known address | ||||||
11 | of the respondent. Any
respondent so notified must be | ||||||
12 | granted an opportunity to request a hearing
within 10 days | ||||||
13 | from receipt of notice, or to show in writing, why he | ||||||
14 | should
not be held liable. A notice issued under this | ||||||
15 | Section must set forth the
date, facts and nature of the | ||||||
16 | act or omission with which the respondent is
charged and | ||||||
17 | must specifically identify the particular provision of | ||||||
18 | this
Article, rule, regulation or order of which a | ||||||
19 | violation is charged.
| ||||||
20 | (3) No forfeiture liability under paragraph (1) of | ||||||
21 | this subsection may
attach for any violation occurring | ||||||
22 | more than 2 years prior to the date of
issuance of the | ||||||
23 | notice of apparent liability and in no event may the total
| ||||||
24 | civil penalty forfeiture imposed for the acts or omissions | ||||||
25 | set forth in any
one notice of apparent liability exceed | ||||||
26 | $100,000.
|
| |||||||
| |||||||
1 | (4) All administrative hearings conducted pursuant to | ||||||
2 | this Article are
subject to 50 Ill. Adm. Code 2402 and all | ||||||
3 | administrative hearings are
subject to the Administrative | ||||||
4 | Review Law.
| ||||||
5 | (5) The civil penalty forfeitures provided for in this | ||||||
6 | Section are
payable to the General Revenue Fund of the | ||||||
7 | State of Illinois, and may be
recovered in a civil suit in | ||||||
8 | the name of the State of Illinois brought in
the Circuit | ||||||
9 | Court in Sangamon County or in the Circuit Court of the | ||||||
10 | county
where the respondent is domiciled or has its | ||||||
11 | principal operating office.
| ||||||
12 | (6) In any case where the Director issues a notice of | ||||||
13 | apparent liability
looking toward the imposition of a | ||||||
14 | civil penalty forfeiture under this
Section that fact may | ||||||
15 | not be used in any other proceeding before the
Director to | ||||||
16 | the prejudice of the respondent to whom the notice was | ||||||
17 | issued,
unless (a) the civil penalty forfeiture has been | ||||||
18 | paid, or (b) a court has
ordered payment of the civil | ||||||
19 | penalty forfeiture and that order has become
final.
| ||||||
20 | (7) When any person or company has a license or | ||||||
21 | certificate of authority
under this Code and knowingly | ||||||
22 | fails or refuses to comply with a lawful
order of the | ||||||
23 | Director requiring compliance with this Article, entered | ||||||
24 | after
notice and hearing, within the period of time | ||||||
25 | specified in the order, the
Director may, in addition to | ||||||
26 | any other penalty or authority
provided, revoke or refuse |
| |||||||
| |||||||
1 | to renew the license or certificate of authority
of such | ||||||
2 | person
or company, or may suspend the license or | ||||||
3 | certificate of authority
of such
person or company until | ||||||
4 | compliance with such order has been obtained.
| ||||||
5 | (8) When any person or company has a license or | ||||||
6 | certificate of authority
under this Code and knowingly | ||||||
7 | fails or refuses to comply with any
provisions of this | ||||||
8 | Article, the Director may, after notice and hearing, in
| ||||||
9 | addition to any other penalty provided, revoke or refuse | ||||||
10 | to renew the
license or certificate of authority of such | ||||||
11 | person or company, or may
suspend the license or | ||||||
12 | certificate of authority of such person or company,
until | ||||||
13 | compliance with such provision of this Article has been | ||||||
14 | obtained.
| ||||||
15 | (9) No suspension or revocation under this Section may | ||||||
16 | become effective
until 5 days from the date that the | ||||||
17 | notice of suspension or revocation has
been personally | ||||||
18 | delivered or delivered by registered or certified mail to
| ||||||
19 | the company or person. A suspension or revocation under | ||||||
20 | this Section is
stayed upon the filing, by the company or | ||||||
21 | person, of a petition for
judicial review under the | ||||||
22 | Administrative Review Law.
| ||||||
23 | (Source: P.A. 94-277, eff. 7-20-05; 95-331, eff. 8-21-07.) | ||||||
24 | (215 ILCS 5/155.18a rep.) | ||||||
25 | Section 15. The Illinois Insurance Code is amended by |
| |||||||
| |||||||
1 | repealing Section 155.18a. | ||||||
2 | Section 20. The Small Employer Health Insurance Rating Act | ||||||
3 | is amended by changing Section 15 as follows:
| ||||||
4 | (215 ILCS 93/15)
| ||||||
5 | Sec. 15. Applicability and scope. | ||||||
6 | (a) This Act shall apply to each
health benefit plan for a | ||||||
7 | small employer that is delivered, issued for
delivery, | ||||||
8 | renewed, or continued in this State after July 1, 2000. For
| ||||||
9 | purposes of this Section, the date a plan is continued shall be | ||||||
10 | the first
rating period which commences after July 1, 2000. | ||||||
11 | The Act shall apply to
any such health benefit plan which | ||||||
12 | provides coverage to employees of a small
employer, except | ||||||
13 | that the Act shall not apply to individual health insurance
| ||||||
14 | policies. | ||||||
15 | (b) This Act shall not apply to any health benefit plan for | ||||||
16 | a small employer that is delivered, issued, renewed, or | ||||||
17 | continued in this State on or after January 1, 2022. However, | ||||||
18 | if 42 U.S.C. 18032(c)(2) or any successor law is repealed, | ||||||
19 | then this Act shall apply to each health benefit plan for a | ||||||
20 | small employer that is delivered, issued, renewed, or | ||||||
21 | continued in this State on or after the date that law ceases to | ||||||
22 | apply to such plans.
| ||||||
23 | (Source: P.A. 91-510, eff. 1-1-00; 92-16, eff. 6-28-01.)
|
| |||||||
| |||||||
1 | Section 25. The Health Maintenance Organization Act is | ||||||
2 | amended by changing Section 5-3 as follows:
| ||||||
3 | (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
| ||||||
4 | Sec. 5-3. Insurance Code provisions.
| ||||||
5 | (a) Health Maintenance Organizations
shall be subject to | ||||||
6 | the provisions of Sections 133, 134, 136, 137, 139, 140, | ||||||
7 | 141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, | ||||||
8 | 154, 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, | ||||||
9 | 355.3, 355b, 355c, 356f, 356g.5-1, 356m, 356q, 356v, 356w, | ||||||
10 | 356x, 356y,
356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6, | ||||||
11 | 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, | ||||||
12 | 356z.15, 356z.17, 356z.18, 356z.19, 356z.20, 356z.21, 356z.22, | ||||||
13 | 356z.23, 356z.24, 356z.25, 356z.26, 356z.28, 356z.29, 356z.30, | ||||||
14 | 356z.30a, 356z.31, 356z.32, 356z.33, 356z.34, 356z.35, | ||||||
15 | 356z.36, 356z.37, 356z.38, 356z.39, 356z.40, 356z.41, 356z.44, | ||||||
16 | 356z.45, 356z.46, 356z.47, 356z.48, 356z.49, 356z.50, 356z.51, | ||||||
17 | 356z.53 256z.53 , 356z.54, 356z.55, 356z.56, 356z.57, 356z.58, | ||||||
18 | 356z.59, 356z.60, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, | ||||||
19 | 368a, 368b, 368c, 368d, 368e, 370c,
370c.1, 401, 401.1, 402, | ||||||
20 | 403, 403A,
408, 408.2, 409, 412, 444,
and
444.1,
paragraph (c) | ||||||
21 | of subsection (2) of Section 367, and Articles IIA, VIII 1/2,
| ||||||
22 | XII,
XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the | ||||||
23 | Illinois Insurance Code.
| ||||||
24 | (b) For purposes of the Illinois Insurance Code, except | ||||||
25 | for Sections 444
and 444.1 and Articles XIII and XIII 1/2, |
| |||||||
| |||||||
1 | Health Maintenance Organizations in
the following categories | ||||||
2 | are deemed to be "domestic companies":
| ||||||
3 | (1) a corporation authorized under the
Dental Service | ||||||
4 | Plan Act or the Voluntary Health Services Plans Act;
| ||||||
5 | (2) a corporation organized under the laws of this | ||||||
6 | State; or
| ||||||
7 | (3) a corporation organized under the laws of another | ||||||
8 | state, 30% or more
of the enrollees of which are residents | ||||||
9 | of this State, except a
corporation subject to | ||||||
10 | substantially the same requirements in its state of
| ||||||
11 | organization as is a "domestic company" under Article VIII | ||||||
12 | 1/2 of the
Illinois Insurance Code.
| ||||||
13 | (c) In considering the merger, consolidation, or other | ||||||
14 | acquisition of
control of a Health Maintenance Organization | ||||||
15 | pursuant to Article VIII 1/2
of the Illinois Insurance Code,
| ||||||
16 | (1) the Director shall give primary consideration to | ||||||
17 | the continuation of
benefits to enrollees and the | ||||||
18 | financial conditions of the acquired Health
Maintenance | ||||||
19 | Organization after the merger, consolidation, or other
| ||||||
20 | acquisition of control takes effect;
| ||||||
21 | (2)(i) the criteria specified in subsection (1)(b) of | ||||||
22 | Section 131.8 of
the Illinois Insurance Code shall not | ||||||
23 | apply and (ii) the Director, in making
his determination | ||||||
24 | with respect to the merger, consolidation, or other
| ||||||
25 | acquisition of control, need not take into account the | ||||||
26 | effect on
competition of the merger, consolidation, or |
| |||||||
| |||||||
1 | other acquisition of control;
| ||||||
2 | (3) the Director shall have the power to require the | ||||||
3 | following
information:
| ||||||
4 | (A) certification by an independent actuary of the | ||||||
5 | adequacy
of the reserves of the Health Maintenance | ||||||
6 | Organization sought to be acquired;
| ||||||
7 | (B) pro forma financial statements reflecting the | ||||||
8 | combined balance
sheets of the acquiring company and | ||||||
9 | the Health Maintenance Organization sought
to be | ||||||
10 | acquired as of the end of the preceding year and as of | ||||||
11 | a date 90 days
prior to the acquisition, as well as pro | ||||||
12 | forma financial statements
reflecting projected | ||||||
13 | combined operation for a period of 2 years;
| ||||||
14 | (C) a pro forma business plan detailing an | ||||||
15 | acquiring party's plans with
respect to the operation | ||||||
16 | of the Health Maintenance Organization sought to
be | ||||||
17 | acquired for a period of not less than 3 years; and
| ||||||
18 | (D) such other information as the Director shall | ||||||
19 | require.
| ||||||
20 | (d) The provisions of Article VIII 1/2 of the Illinois | ||||||
21 | Insurance Code
and this Section 5-3 shall apply to the sale by | ||||||
22 | any health maintenance
organization of greater than 10% of its
| ||||||
23 | enrollee population (including without limitation the health | ||||||
24 | maintenance
organization's right, title, and interest in and | ||||||
25 | to its health care
certificates).
| ||||||
26 | (e) In considering any management contract or service |
| |||||||
| |||||||
1 | agreement subject
to Section 141.1 of the Illinois Insurance | ||||||
2 | Code, the Director (i) shall, in
addition to the criteria | ||||||
3 | specified in Section 141.2 of the Illinois
Insurance Code, | ||||||
4 | take into account the effect of the management contract or
| ||||||
5 | service agreement on the continuation of benefits to enrollees | ||||||
6 | and the
financial condition of the health maintenance | ||||||
7 | organization to be managed or
serviced, and (ii) need not take | ||||||
8 | into account the effect of the management
contract or service | ||||||
9 | agreement on competition.
| ||||||
10 | (f) Except for small employer groups as defined in the | ||||||
11 | Small Employer
Rating, Renewability and Portability Health | ||||||
12 | Insurance Act and except for
medicare supplement policies as | ||||||
13 | defined in Section 363 of the Illinois
Insurance Code, a | ||||||
14 | Health Maintenance Organization may by contract agree with a
| ||||||
15 | group or other enrollment unit to effect refunds or charge | ||||||
16 | additional premiums
under the following terms and conditions:
| ||||||
17 | (i) the amount of, and other terms and conditions with | ||||||
18 | respect to, the
refund or additional premium are set forth | ||||||
19 | in the group or enrollment unit
contract agreed in advance | ||||||
20 | of the period for which a refund is to be paid or
| ||||||
21 | additional premium is to be charged (which period shall | ||||||
22 | not be less than one
year); and
| ||||||
23 | (ii) the amount of the refund or additional premium | ||||||
24 | shall not exceed 20%
of the Health Maintenance | ||||||
25 | Organization's profitable or unprofitable experience
with | ||||||
26 | respect to the group or other enrollment unit for the |
| |||||||
| |||||||
1 | period (and, for
purposes of a refund or additional | ||||||
2 | premium, the profitable or unprofitable
experience shall | ||||||
3 | be calculated taking into account a pro rata share of the
| ||||||
4 | Health Maintenance Organization's administrative and | ||||||
5 | marketing expenses, but
shall not include any refund to be | ||||||
6 | made or additional premium to be paid
pursuant to this | ||||||
7 | subsection (f)). The Health Maintenance Organization and | ||||||
8 | the
group or enrollment unit may agree that the profitable | ||||||
9 | or unprofitable
experience may be calculated taking into | ||||||
10 | account the refund period and the
immediately preceding 2 | ||||||
11 | plan years.
| ||||||
12 | The Health Maintenance Organization shall include a | ||||||
13 | statement in the
evidence of coverage issued to each enrollee | ||||||
14 | describing the possibility of a
refund or additional premium, | ||||||
15 | and upon request of any group or enrollment unit,
provide to | ||||||
16 | the group or enrollment unit a description of the method used | ||||||
17 | to
calculate (1) the Health Maintenance Organization's | ||||||
18 | profitable experience with
respect to the group or enrollment | ||||||
19 | unit and the resulting refund to the group
or enrollment unit | ||||||
20 | or (2) the Health Maintenance Organization's unprofitable
| ||||||
21 | experience with respect to the group or enrollment unit and | ||||||
22 | the resulting
additional premium to be paid by the group or | ||||||
23 | enrollment unit.
| ||||||
24 | In no event shall the Illinois Health Maintenance | ||||||
25 | Organization
Guaranty Association be liable to pay any | ||||||
26 | contractual obligation of an
insolvent organization to pay any |
| |||||||
| |||||||
1 | refund authorized under this Section.
| ||||||
2 | (g) Rulemaking authority to implement Public Act 95-1045, | ||||||
3 | if any, is conditioned on the rules being adopted in | ||||||
4 | accordance with all provisions of the Illinois Administrative | ||||||
5 | Procedure Act and all rules and procedures of the Joint | ||||||
6 | Committee on Administrative Rules; any purported rule not so | ||||||
7 | adopted, for whatever reason, is unauthorized. | ||||||
8 | (Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; | ||||||
9 | 101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff. | ||||||
10 | 1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, | ||||||
11 | eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; | ||||||
12 | 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. | ||||||
13 | 1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, | ||||||
14 | eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; | ||||||
15 | 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. | ||||||
16 | 1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, | ||||||
17 | eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.) | ||||||
18 | Section 30. The Managed Care Reform and Patient Rights Act | ||||||
19 | is amended by changing Section 10 as follows:
| ||||||
20 | (215 ILCS 134/10)
| ||||||
21 | Sec. 10. Definitions.
| ||||||
22 | "Adverse determination" means a determination by a health | ||||||
23 | care plan under
Section 45 or by a utilization review program | ||||||
24 | under Section
85 that
a health care service is not medically |
| |||||||
| |||||||
1 | necessary.
| ||||||
2 | "Clinical peer" means a health care professional who is in | ||||||
3 | the same
profession and the same or similar specialty as the | ||||||
4 | health care provider who
typically manages the medical | ||||||
5 | condition, procedures, or treatment under
review.
| ||||||
6 | "Department" means the Department of Insurance.
| ||||||
7 | "Emergency medical condition" means a medical condition | ||||||
8 | manifesting itself by
acute symptoms of sufficient severity, | ||||||
9 | regardless of the final diagnosis given, such that a prudent
| ||||||
10 | layperson, who possesses an average knowledge of health and | ||||||
11 | medicine, could
reasonably expect the absence of immediate | ||||||
12 | medical attention to result in:
| ||||||
13 | (1) placing the health of the individual (or, with | ||||||
14 | respect to a pregnant
woman, the
health of the woman or her | ||||||
15 | unborn child) in serious jeopardy;
| ||||||
16 | (2) serious
impairment to bodily functions;
| ||||||
17 | (3) serious dysfunction of any bodily organ
or part;
| ||||||
18 | (4) inadequately controlled pain; or | ||||||
19 | (5) with respect to a pregnant woman who is having | ||||||
20 | contractions: | ||||||
21 | (A) inadequate time to complete a safe transfer to | ||||||
22 | another hospital before delivery; or | ||||||
23 | (B) a transfer to another hospital may pose a | ||||||
24 | threat to the health or safety of the woman or unborn | ||||||
25 | child. | ||||||
26 | "Emergency medical screening examination" means a medical |
| |||||||
| |||||||
1 | screening
examination and
evaluation by a physician licensed | ||||||
2 | to practice medicine in all its branches, or
to the extent | ||||||
3 | permitted
by applicable laws, by other appropriately licensed | ||||||
4 | personnel under the
supervision of or in
collaboration with a | ||||||
5 | physician licensed to practice medicine in all its
branches to | ||||||
6 | determine whether
the need for emergency services exists.
| ||||||
7 | "Emergency services" means, with respect to an enrollee of | ||||||
8 | a health care
plan,
transportation services, including but not | ||||||
9 | limited to ambulance services, and
covered inpatient and | ||||||
10 | outpatient hospital services
furnished by a provider
qualified | ||||||
11 | to furnish those services that are needed to evaluate or | ||||||
12 | stabilize an
emergency medical condition. "Emergency services" | ||||||
13 | does not
refer to post-stabilization medical services.
| ||||||
14 | "Enrollee" means any person and his or her dependents | ||||||
15 | enrolled in or covered
by a health care plan.
| ||||||
16 | "Health care plan" means a plan, including, but not | ||||||
17 | limited to, a health maintenance organization, a managed care | ||||||
18 | community network as defined in the Illinois Public Aid Code, | ||||||
19 | or an accountable care entity as defined in the Illinois | ||||||
20 | Public Aid Code that receives capitated payments to cover | ||||||
21 | medical services from the Department of Healthcare and Family | ||||||
22 | Services, that establishes, operates, or maintains a
network | ||||||
23 | of health care providers that has entered into an agreement | ||||||
24 | with the
plan to provide health care services to enrollees to | ||||||
25 | whom the plan has the
ultimate obligation to arrange for the | ||||||
26 | provision of or payment for services
through organizational |
| |||||||
| |||||||
1 | arrangements for ongoing quality assurance,
utilization review | ||||||
2 | programs, or dispute resolution.
Nothing in this definition | ||||||
3 | shall be construed to mean that an independent
practice | ||||||
4 | association or a physician hospital organization that | ||||||
5 | subcontracts
with
a health care plan is, for purposes of that | ||||||
6 | subcontract, a health care plan.
| ||||||
7 | For purposes of this definition, "health care plan" shall | ||||||
8 | not include the
following:
| ||||||
9 | (1) indemnity health insurance policies including | ||||||
10 | those using a contracted
provider network;
| ||||||
11 | (2) health care plans that offer only dental or only | ||||||
12 | vision coverage;
| ||||||
13 | (3) preferred provider administrators, as defined in | ||||||
14 | Section 370g(g) of
the
Illinois Insurance Code;
| ||||||
15 | (4) employee or employer self-insured health benefit | ||||||
16 | plans under the
federal Employee Retirement Income | ||||||
17 | Security Act of 1974;
| ||||||
18 | (5) health care provided pursuant to the Workers' | ||||||
19 | Compensation Act or the
Workers' Occupational Diseases | ||||||
20 | Act; and
| ||||||
21 | (6) except with respect to subsections (a) and (b) of | ||||||
22 | Section 65 and subsection (a-5) of Section 70, | ||||||
23 | not-for-profit voluntary health services plans with health | ||||||
24 | maintenance
organization
authority in existence as of | ||||||
25 | January 1, 1999 that are affiliated with a union
and that
| ||||||
26 | only extend coverage to union members and their |
| |||||||
| |||||||
1 | dependents.
| ||||||
2 | "Health care professional" means a physician, a registered | ||||||
3 | professional
nurse,
or other individual appropriately licensed | ||||||
4 | or registered
to provide health care services.
| ||||||
5 | "Health care provider" means any physician, hospital | ||||||
6 | facility, facility licensed under the Nursing Home Care Act, | ||||||
7 | long-term care facility as defined in Section 1-113 of the | ||||||
8 | Nursing Home Care Act, or other
person that is licensed or | ||||||
9 | otherwise authorized to deliver health care
services. Nothing | ||||||
10 | in this
Act shall be construed to define Independent Practice | ||||||
11 | Associations or
Physician-Hospital Organizations as health | ||||||
12 | care providers.
| ||||||
13 | "Health care services" means any services included in the | ||||||
14 | furnishing to any
individual of medical care, or the
| ||||||
15 | hospitalization incident to the furnishing of such care, as | ||||||
16 | well as the
furnishing to any person of
any and all other | ||||||
17 | services for the purpose of preventing,
alleviating, curing, | ||||||
18 | or healing human illness or injury including behavioral | ||||||
19 | health, mental health, home health,
and pharmaceutical | ||||||
20 | services and products.
| ||||||
21 | "Medical director" means a physician licensed in any state | ||||||
22 | to practice
medicine in all its
branches appointed by a health | ||||||
23 | care plan.
| ||||||
24 | "Person" means a corporation, association, partnership,
| ||||||
25 | limited liability company, sole proprietorship, or any other | ||||||
26 | legal entity.
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 | "Physician" means a person licensed under the Medical
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
2 | Practice Act of 1987.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3 | "Post-stabilization medical services" means health care | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
4 | services
provided to an enrollee that are furnished in a | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
5 | licensed hospital by a provider
that is qualified to furnish | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
6 | such services, and determined to be medically
necessary and | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
7 | directly related to the emergency medical condition following
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
8 | stabilization.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
9 | "Stabilization" means, with respect to an emergency | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
10 | medical condition, to
provide such medical treatment of the | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
11 | condition as may be necessary to assure,
within reasonable | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
12 | medical probability, that no material deterioration
of the | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
13 | condition is likely to result.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
14 | "Utilization review" means the evaluation of the medical | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 | necessity,
appropriateness, and efficiency of the use of | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
16 | health care services, procedures,
and facilities.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
17 | "Utilization review program" means a program established | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
18 | by a person to
perform utilization review.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
19 | (Source: P.A. 101-452, eff. 1-1-20; 102-409, eff. 1-1-22 .)
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
20 | Section 99. Effective date. This Act takes effect July 1, | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
21 | 2023.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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