Full Text of SB2876 97th General Assembly
SB2876enr 97TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning insurance.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. If and only if House Bill 3443 of the 97th | 5 | | General Assembly becomes law in the form in which it left the | 6 | | House, then the Illinois Insurance Code is amended by changing | 7 | | Section 4 as follows:
| 8 | | (215 ILCS 5/4) (from Ch. 73, par. 616)
| 9 | | Sec. 4. Classes of insurance. Insurance and insurance | 10 | | business shall
be classified as follows:
| 11 | | Class 1. Life, Accident and Health.
| 12 | | (a) Life. Insurance on the lives of persons and every | 13 | | insurance
appertaining thereto or connected therewith and | 14 | | granting, purchasing or
disposing of annuities. Policies of | 15 | | life or endowment insurance or
annuity contracts or contracts | 16 | | supplemental thereto which contain
provisions for additional | 17 | | benefits in case of death by accidental means
and provisions | 18 | | operating to safeguard such policies or contracts against
| 19 | | lapse, to give a special surrender value, or special benefit, | 20 | | or an
annuity, in the event, that the insured or annuitant | 21 | | shall become
totally and permanently disabled as defined by the | 22 | | policy or contract,
or which contain benefits providing | 23 | | acceleration of life or endowment or
annuity benefits in |
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| 1 | | advance of the time they would otherwise be
payable, as an | 2 | | indemnity for long term care which is certified or
ordered by a | 3 | | physician, including but not limited to, professional nursing
| 4 | | care, medical care expenses, custodial nursing care, | 5 | | non-nursing custodial
care provided in a nursing home or at a | 6 | | residence of the insured, or
which contain benefits providing | 7 | | acceleration of life or endowment or
annuity benefits in | 8 | | advance of the time they would otherwise be payable, at
any | 9 | | time during the insured's
lifetime, as an indemnity for a | 10 | | terminal illness shall be deemed to be
policies of life or | 11 | | endowment insurance or annuity contracts within the
intent of | 12 | | this clause.
| 13 | | Also to be deemed as policies of life or endowment | 14 | | insurance or annuity
contracts within the intent of this clause | 15 | | shall be those policies or
riders that provide for the payment | 16 | | of up to 75% of the face amount
of
benefits in advance of the | 17 | | time they would otherwise be payable upon a
diagnosis by a | 18 | | physician licensed to practice medicine in all of its
branches | 19 | | that the insured has incurred a covered
condition listed
in the | 20 | | policy or rider.
| 21 | | "Covered condition", as used in this clause, means:
heart | 22 | | attack, stroke, coronary artery surgery,
life threatening | 23 | | cancer, renal failure,
alzheimer's disease,
paraplegia, major | 24 | | organ transplantation, total and permanent
disability, and any | 25 | | other medical condition that the Department may approve for
any | 26 | | particular filing.
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| 1 | | The Director may issue rules that specify prohibited policy | 2 | | provisions,
not otherwise specifically prohibited by law, | 3 | | which in the opinion of the
Director are unjust, unfair, or | 4 | | unfairly discriminatory to the
policyholder,
any person | 5 | | insured under the policy, or beneficiary.
| 6 | | (b) Accident and health. Insurance against bodily injury,
| 7 | | disablement or death by accident and against disablement | 8 | | resulting from
sickness or old age and every insurance | 9 | | appertaining thereto, including
stop-loss insurance. Stop-loss | 10 | | insurance is insurance against the risk of
economic loss issued | 11 | | to a single employer self-funded employee disability
benefit | 12 | | plan or an employee welfare benefit plan as described in 29 | 13 | | U.S.C. 100
et seq. The insurance laws of this State, including
| 14 | | this Code, do not apply to arrangements between a religious | 15 | | organization and the organization's members
or participants | 16 | | when the arrangement and organization meet all of the
following | 17 | | criteria:
| 18 | | (i) the organization is described in Section 501(c)(3) | 19 | | of the Internal Revenue Code and is exempt from taxation | 20 | | under Section 501(a) of the Internal Revenue Code; | 21 | | (ii) members of the organization share a common set of | 22 | | ethical or religious beliefs and share medical expenses | 23 | | among members in accordance with those beliefs and without | 24 | | regard to the state in which a member resides or is | 25 | | employed; | 26 | | (iii) no funds that have been given for the purpose of |
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| 1 | | the sharing of medical expenses among members described in | 2 | | paragraph (ii) of this subsection (b) are held by the | 3 | | organization in an off-shore trust or bank account; | 4 | | (iv) the organization provides at least monthly to all | 5 | | of its members a written statement listing the dollar | 6 | | amount of qualified medical expenses that members have | 7 | | submitted for sharing, as well as the amount of expenses | 8 | | actually shared among the members; | 9 | | (v) (iii) members of the organization retain | 10 | | membership even after they develop a medical condition; | 11 | | (vi) (iv) the organization or a predecessor | 12 | | organization has been in existence at all times since | 13 | | December 31, 1999, and medical expenses of its members have | 14 | | been shared continuously and without interruption since at | 15 | | least December 31, 1999; | 16 | | (vii) (v) the organization conducts an annual audit | 17 | | that is performed by an independent certified public | 18 | | accounting firm in accordance with generally accepted | 19 | | accounting principles and is made available to the public | 20 | | upon request; | 21 | | (viii) (vi) the organization includes the following | 22 | | statement, in writing, on or accompanying all applications | 23 | | and guideline materials: | 24 | | "Notice: The organization facilitating the sharing of | 25 | | medical expenses is not an insurance company, and | 26 | | neither its guidelines nor plan of operation |
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| 1 | | constitute or create an insurance policy. Any | 2 | | assistance you receive with your medical bills will be | 3 | | totally voluntary. Neither the organization nor any | 4 | | other participant can be compelled by law to contribute | 5 | | toward your medical bills. As such, participation in | 6 | | the organization or a subscription to any of its | 7 | | documents should never be considered to be insurance. | 8 | | Whether or not you receive any payments for medical | 9 | | expenses and whether or not this organization | 10 | | continues to operate, you are always personally | 11 | | responsible for the payment of your own medical | 12 | | bills."; and | 13 | | (ix) (vii) any membership card or similar document | 14 | | issued by the organization and any written communication | 15 | | sent by the organization to a hospital, physician, or other | 16 | | health care provider shall include a statement that the | 17 | | organization does not issue health insurance and that the | 18 | | member or participant is personally liable for payment of | 19 | | his or her medical bills ; . | 20 | | (x) the organization provides to a participant, within | 21 | | 30 days after the participant joins, a complete set of its | 22 | | rules for the sharing of medical expenses, appeals of | 23 | | decisions made by the organization, and the filing of | 24 | | complaints; | 25 | | (xi) the organization does not offer any other services | 26 | | that are regulated under any provision of the Illinois |
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| 1 | | Insurance Code or other insurance laws of this State; and | 2 | | (xii) the organization does not amass funds as reserves | 3 | | intended for payment of medical services, rather the | 4 | | organization facilitates the payments provided for in this | 5 | | subsection (b) through payments made directly from one | 6 | | participant to another. | 7 | | (c) Legal Expense Insurance. Insurance which involves
the | 8 | | assumption of a contractual obligation to reimburse the | 9 | | beneficiary
against or pay on behalf of the beneficiary, all or | 10 | | a portion of his fees,
costs, or expenses related to or arising | 11 | | out of services performed by or
under the supervision of an | 12 | | attorney licensed to practice in the jurisdiction
wherein the | 13 | | services are performed, regardless of whether the payment is | 14 | | made
by the beneficiaries individually or by a third person for | 15 | | them, but does
not include the provision of or reimbursement | 16 | | for legal services incidental
to other insurance coverages. The | 17 | | insurance laws of this State, including
this Act do not apply | 18 | | to:
| 19 | | (i) Retainer contracts made by attorneys at law with | 20 | | individual clients
with fees based on estimates of the | 21 | | nature and amount of services to be
provided to the | 22 | | specific client, and similar contracts made with a group
of | 23 | | clients involved in the same or closely related legal | 24 | | matters;
| 25 | | (ii) Plans owned or operated by attorneys who are the | 26 | | providers of legal
services to the plan;
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| 1 | | (iii) Plans providing legal service benefits to groups | 2 | | where such plans
are owned or operated by authority of a | 3 | | state, county, local or other bar
association;
| 4 | | (iv) Any lawyer referral service authorized or | 5 | | operated by a state,
county, local or other bar | 6 | | association;
| 7 | | (v) The furnishing of legal assistance by labor unions | 8 | | and other employee
organizations to their members in | 9 | | matters relating to employment or occupation;
| 10 | | (vi) The furnishing of legal assistance to members or | 11 | | dependents, by
churches, consumer organizations, | 12 | | cooperatives, educational institutions,
credit unions, or | 13 | | organizations of employees, where such organizations | 14 | | contract
directly with lawyers or law firms for the | 15 | | provision of legal services,
and the administration and | 16 | | marketing of such legal services is wholly conducted
by the | 17 | | organization or its subsidiary;
| 18 | | (vii) Legal services provided by an employee welfare | 19 | | benefit plan defined
by the Employee Retirement Income | 20 | | Security Act of 1974;
| 21 | | (viii) Any collectively bargained plan for legal | 22 | | services between a labor
union and an employer negotiated | 23 | | pursuant to Section 302 of the Labor
Management Relations | 24 | | Act as now or hereafter amended, under which plan
legal | 25 | | services will be provided for employees of the employer | 26 | | whether or
not payments for such services are funded to or |
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| 1 | | through an insurance company.
| 2 | | Class 2. Casualty, Fidelity and Surety.
| 3 | | (a) Accident and health. Insurance against bodily injury,
| 4 | | disablement or death by accident and against disablement | 5 | | resulting from
sickness or old age and every insurance | 6 | | appertaining thereto, including
stop-loss insurance. Stop-loss | 7 | | insurance is insurance against the risk of
economic loss issued | 8 | | to a single employer self-funded employee disability
benefit | 9 | | plan or
an employee welfare benefit plan as described in 29 | 10 | | U.S.C. 1001 et seq.
| 11 | | (b) Vehicle. Insurance against any loss or liability | 12 | | resulting from
or incident to the ownership, maintenance or use | 13 | | of any vehicle (motor
or otherwise), draft animal or aircraft. | 14 | | Any policy insuring against any
loss or liability on account of | 15 | | the bodily injury or death of any person
may contain a | 16 | | provision for payment of disability benefits to injured
persons | 17 | | and death benefits to dependents, beneficiaries or personal
| 18 | | representatives of persons who are killed, including the named | 19 | | insured,
irrespective of legal liability of the insured, if the | 20 | | injury or death
for which benefits are provided is caused by | 21 | | accident and sustained
while in or upon or while entering into | 22 | | or alighting from or through
being struck by a vehicle (motor | 23 | | or otherwise), draft animal or
aircraft, and such provision | 24 | | shall not be deemed to be accident
insurance.
| 25 | | (c) Liability. Insurance against the liability of the | 26 | | insured for
the death, injury or disability of an employee or |
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| 1 | | other person, and
insurance against the liability of the | 2 | | insured for damage to or
destruction of another person's | 3 | | property.
| 4 | | (d) Workers' compensation. Insurance of the obligations | 5 | | accepted by
or imposed upon employers under laws for workers' | 6 | | compensation.
| 7 | | (e) Burglary and forgery. Insurance against loss or damage | 8 | | by
burglary, theft, larceny, robbery, forgery, fraud or | 9 | | otherwise;
including all householders' personal property | 10 | | floater risks.
| 11 | | (f) Glass. Insurance against loss or damage to glass | 12 | | including
lettering, ornamentation and fittings from any | 13 | | cause.
| 14 | | (g) Fidelity and surety. Become surety or guarantor for any | 15 | | person,
copartnership or corporation in any position or place | 16 | | of trust or as
custodian of money or property, public or | 17 | | private; or, becoming a surety
or guarantor for the performance | 18 | | of any person, copartnership or
corporation of any lawful | 19 | | obligation, undertaking, agreement or contract
of any kind, | 20 | | except contracts or policies of insurance; and underwriting
| 21 | | blanket bonds. Such obligations shall be known and treated as | 22 | | suretyship
obligations and such business shall be known as | 23 | | surety business.
| 24 | | (h) Miscellaneous. Insurance against loss or damage to | 25 | | property and
any liability of the insured caused by accidents | 26 | | to boilers, pipes,
pressure containers, machinery and |
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| 1 | | apparatus of any kind and any
apparatus connected thereto, or | 2 | | used for creating, transmitting or
applying power, light, heat, | 3 | | steam or refrigeration, making inspection
of and issuing | 4 | | certificates of inspection upon elevators, boilers,
machinery | 5 | | and apparatus of any kind and all mechanical apparatus and
| 6 | | appliances appertaining thereto; insurance against loss or | 7 | | damage by
water entering through leaks or openings in | 8 | | buildings, or from the
breakage or leakage of a sprinkler, | 9 | | pumps, water pipes, plumbing and all
tanks, apparatus, conduits | 10 | | and containers designed to bring water into
buildings or for | 11 | | its storage or utilization therein, or caused by the
falling of | 12 | | a tank, tank platform or supports, or against loss or damage
| 13 | | from any cause (other than causes specifically enumerated under | 14 | | Class 3
of this Section) to such sprinkler, pumps, water pipes, | 15 | | plumbing, tanks,
apparatus, conduits or containers; insurance | 16 | | against loss or damage
which may result from the failure of | 17 | | debtors to pay their obligations to
the insured; and insurance | 18 | | of the payment of money for personal services
under contracts | 19 | | of hiring.
| 20 | | (i) Other casualty risks. Insurance against any other | 21 | | casualty risk
not otherwise specified under Classes 1 or 3, | 22 | | which may lawfully be the
subject of insurance and may properly | 23 | | be classified under Class 2.
| 24 | | (j) Contingent losses. Contingent, consequential and | 25 | | indirect
coverages wherein the proximate cause of the loss is | 26 | | attributable to any
one of the causes enumerated under Class 2. |
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| 1 | | Such coverages shall, for
the purpose of classification, be | 2 | | included in the specific grouping of
the kinds of insurance | 3 | | wherein such cause is specified.
| 4 | | (k) Livestock and domestic animals. Insurance against | 5 | | mortality,
accident and health of livestock and domestic | 6 | | animals.
| 7 | | (l) Legal expense insurance. Insurance against risk | 8 | | resulting from the
cost of legal services as defined under | 9 | | Class 1(c).
| 10 | | Class 3. Fire and Marine, etc.
| 11 | | (a) Fire. Insurance against loss or damage by fire, smoke | 12 | | and
smudge, lightning or other electrical disturbances.
| 13 | | (b) Elements. Insurance against loss or damage by | 14 | | earthquake,
windstorms, cyclone, tornado, tempests, hail, | 15 | | frost, snow, ice, sleet,
flood, rain, drought or other weather | 16 | | or climatic conditions including
excess or deficiency of | 17 | | moisture, rising of the waters of the ocean or
its tributaries.
| 18 | | (c) War, riot and explosion. Insurance against loss or | 19 | | damage by
bombardment, invasion, insurrection, riot, strikes, | 20 | | civil war or
commotion, military or usurped power, or explosion | 21 | | (other than explosion
of steam boilers and the breaking of fly | 22 | | wheels on premises owned,
controlled, managed, or maintained by | 23 | | the insured.)
| 24 | | (d) Marine and transportation. Insurance against loss or | 25 | | damage to
vessels, craft, aircraft, vehicles of every kind, | 26 | | (excluding vehicles
operating under their own power or while in |
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| 1 | | storage not incidental to
transportation) as well as all goods, | 2 | | freights, cargoes, merchandise,
effects, disbursements, | 3 | | profits, moneys, bullion, precious stones,
securities, chooses | 4 | | in action, evidences of debt, valuable papers,
bottomry and | 5 | | respondentia interests and all other kinds of property and
| 6 | | interests therein, in respect to, appertaining to or in | 7 | | connection with
any or all risks or perils of navigation, | 8 | | transit, or transportation,
including war risks, on or under | 9 | | any seas or other waters, on land or in
the air, or while being | 10 | | assembled, packed, crated, baled, compressed or
similarly | 11 | | prepared for shipment or while awaiting the same or during any
| 12 | | delays, storage, transshipment, or reshipment incident | 13 | | thereto,
including marine builder's risks and all personal | 14 | | property floater
risks; and for loss or damage to persons or | 15 | | property in connection with
or appertaining to marine, inland | 16 | | marine, transit or transportation
insurance, including | 17 | | liability for loss of or damage to either arising
out of or in | 18 | | connection with the construction, repair, operation,
| 19 | | maintenance, or use of the subject matter of such insurance, | 20 | | (but not
including life insurance or surety bonds); but, except | 21 | | as herein
specified, shall not mean insurances against loss by | 22 | | reason of bodily
injury to the person; and insurance against | 23 | | loss or damage to precious
stones, jewels, jewelry, gold, | 24 | | silver and other precious metals whether
used in business or | 25 | | trade or otherwise and whether the same be in course
of | 26 | | transportation or otherwise, which shall include jewelers' |
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| 1 | | block
insurance; and insurance against loss or damage to | 2 | | bridges, tunnels and
other instrumentalities of transportation | 3 | | and communication (excluding
buildings, their furniture and | 4 | | furnishings, fixed contents and supplies
held in storage) | 5 | | unless fire, tornado, sprinkler leakage, hail,
explosion, | 6 | | earthquake, riot and civil commotion are the only hazards to
be | 7 | | covered; and to piers, wharves, docks and slips, excluding the | 8 | | risks
of fire, tornado, sprinkler leakage, hail, explosion, | 9 | | earthquake, riot
and civil commotion; and to other aids to | 10 | | navigation and transportation,
including dry docks and marine | 11 | | railways, against all risk.
| 12 | | (e) Vehicle. Insurance against loss or liability resulting | 13 | | from or
incident to the ownership, maintenance or use of any | 14 | | vehicle (motor or
otherwise), draft animal or aircraft, | 15 | | excluding the liability of the
insured for the death, injury or | 16 | | disability of another person.
| 17 | | (f) Property damage, sprinkler leakage and crop. Insurance | 18 | | against
the liability of the insured for loss or damage to | 19 | | another person's
property or property interests from any cause | 20 | | enumerated in this class;
insurance against loss or damage by | 21 | | water entering through leaks or
openings in buildings, or from | 22 | | the breakage or leakage of a sprinkler,
pumps, water pipes, | 23 | | plumbing and all tanks, apparatus, conduits and
containers | 24 | | designed to bring water into buildings or for its storage or
| 25 | | utilization therein, or caused by the falling of a tank, tank | 26 | | platform
or supports or against loss or damage from any cause |
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| 1 | | to such sprinklers,
pumps, water pipes, plumbing, tanks, | 2 | | apparatus, conduits or containers;
insurance against loss or | 3 | | damage from insects, diseases or other causes to
trees, crops | 4 | | or other products of the soil.
| 5 | | (g) Other fire and marine risks. Insurance against any | 6 | | other
property risk not otherwise specified under Classes 1 or | 7 | | 2, which may
lawfully be the subject of insurance and may | 8 | | properly be classified
under Class 3.
| 9 | | (h) Contingent losses. Contingent, consequential and | 10 | | indirect
coverages wherein the proximate cause of the loss is | 11 | | attributable to any
of the causes enumerated under Class 3. | 12 | | Such coverages shall, for the
purpose of classification, be | 13 | | included in the specific grouping of the
kinds of insurance | 14 | | wherein such cause is specified.
| 15 | | (i) Legal expense insurance. Insurance against risk | 16 | | resulting from the
cost of legal services as defined under | 17 | | Class 1(c).
| 18 | | (Source: 09700HB3443eng.)
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