Full Text of HB1552 98th General Assembly
HB1552eng 98TH 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. The Illinois Insurance Code is amended by | 5 | | changing Sections 143, 356z.12, and 1202 as follows:
| 6 | | (215 ILCS 5/143) (from Ch. 73, par. 755)
| 7 | | Sec. 143. Policy forms.
| 8 | | (1) Life, accident and health. No company
transacting the | 9 | | kind or kinds of business enumerated in Classes 1 (a), 1
(b) | 10 | | and 2 (a) of Section 4 shall issue or deliver in this State a | 11 | | policy
or certificate of insurance or evidence of coverage, | 12 | | attach an
endorsement or rider thereto,
incorporate by | 13 | | reference bylaws or other matter therein or use an
application | 14 | | blank in this State until the form and content of such
policy, | 15 | | certificate, evidence of coverage, endorsement, rider, bylaw | 16 | | or
other matter
incorporated by reference or application blank | 17 | | has been filed electronically
with the Director, either through | 18 | | the System for Electronic Rate and Form Filing (SERFF) or as | 19 | | otherwise prescribed by the Director, and
approved by the | 20 | | Director. The Department shall mail a quarterly invoice to the | 21 | | company for the appropriate filing fees required under Section | 22 | | 408. Any such endorsement or rider
that unilaterally reduces | 23 | | benefits and is to be attached to a
policy subsequent to the |
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| 1 | | date the policy is
issued must be filed with, reviewed, and | 2 | | formally approved by the
Director prior to the date it is | 3 | | attached to a policy issued or
delivered in this State. It | 4 | | shall be the duty of the Director to
withhold approval of any | 5 | | such policy, certificate, endorsement, rider,
bylaw or other | 6 | | matter incorporated by reference or application blank
filed | 7 | | with him if it contains provisions which encourage
| 8 | | misrepresentation or are unjust, unfair, inequitable, | 9 | | ambiguous,
misleading, inconsistent, deceptive, contrary to | 10 | | law or to the public
policy of this State, or contains | 11 | | exceptions and conditions that
unreasonably or deceptively | 12 | | affect the risk purported to be assumed in
the general coverage | 13 | | of the policy. In all cases the Director shall
approve or | 14 | | disapprove any such form within 60 days after submission
unless | 15 | | the Director extends by not more than an additional 30 days the
| 16 | | period within which he shall approve or disapprove any such | 17 | | form by
giving written notice to the insurer of such extension | 18 | | before expiration
of the initial 60 days period. The Director | 19 | | shall withdraw his approval
of a policy, certificate, evidence | 20 | | of coverage, endorsement, rider,
bylaw, or other matter | 21 | | incorporated
by reference or application blank if he | 22 | | subsequently determines that such
policy, certificate, | 23 | | evidence of coverage, endorsement, rider, bylaw,
other matter, | 24 | | or application
blank is misrepresentative, unjust, unfair, | 25 | | inequitable, ambiguous, misleading,
inconsistent, deceptive, | 26 | | contrary to law or public policy of this State,
or contains |
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| 1 | | exceptions or conditions which unreasonably or deceptively | 2 | | affect
the risk purported to be assumed in the general coverage | 3 | | of the policy or
evidence of coverage.
| 4 | | If a previously approved policy, certificate, evidence of
| 5 | | coverage, endorsement, rider, bylaw
or other matter | 6 | | incorporated by reference or application blank is withdrawn
for | 7 | | use, the Director shall serve upon the company an order of | 8 | | withdrawal
of use, either personally or by mail, and if by | 9 | | mail, such service shall
be completed if such notice be | 10 | | deposited in the post office, postage prepaid,
addressed to the | 11 | | company's last known address specified in the records
of the | 12 | | Department of Insurance. The order of withdrawal of use shall | 13 | | take
effect 30 days from the date of mailing but shall be | 14 | | stayed if within the
30-day period a written request for | 15 | | hearing is filed with the Director.
Such hearing shall be held | 16 | | at such time and place as designated in the order
given by the | 17 | | Director. The hearing may be held either in the City of | 18 | | Springfield,
the City of Chicago or in the county where the | 19 | | principal business address
of the company is located.
The | 20 | | action of the Director in
disapproving or withdrawing such form | 21 | | shall be subject to judicial review under
the
Administrative | 22 | | Review Law.
| 23 | | This subsection shall not apply to riders or endorsements | 24 | | issued or
made at the request of the individual policyholder | 25 | | relating to the
manner of distribution of benefits or to the | 26 | | reservation of rights and
benefits under his life insurance |
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| 1 | | policy.
| 2 | | (2) Casualty, fire, and marine. The Director shall require | 3 | | the
filing of all policy forms issued or delivered by any | 4 | | company transacting
the kind or
kinds of business enumerated in | 5 | | Classes 2 (except Class 2 (a)) and 3 of
Section 4 in an | 6 | | electronic format either through the System for Electronic Rate | 7 | | and Form Filing (SERFF) or as otherwise prescribed and approved | 8 | | by the Director. In addition, he may require the filing of any
| 9 | | generally used riders, endorsements, certificates, application | 10 | | blanks, and
other matter
incorporated by reference in any such | 11 | | policy or contract of insurance. The Department shall mail a | 12 | | quarterly invoice to the company for the appropriate filing | 13 | | fees required under Section 408.
Companies that are members of | 14 | | an organization, bureau, or association may
have the same filed | 15 | | for them by the organization, bureau, or association. If
the | 16 | | Director shall find from an examination of any such policy | 17 | | form,
rider, endorsement, certificate, application blank, or | 18 | | other matter
incorporated by
reference in any such policy so | 19 | | filed that it (i) violates any provision of
this Code, (ii) | 20 | | contains inconsistent, ambiguous, or misleading clauses, or
| 21 | | (iii) contains exceptions and conditions that will | 22 | | unreasonably or deceptively
affect the risks that are purported | 23 | | to be assumed by the policy, he
shall order the company or | 24 | | companies issuing these forms to discontinue
their use. Nothing | 25 | | in this subsection shall require a company
transacting the kind | 26 | | or kinds of business enumerated in Classes 2
(except Class 2 |
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| 1 | | (a)) and 3 of Section 4 to obtain approval of these forms
| 2 | | before they are issued nor in any way affect the legality of | 3 | | any
policy that has been issued and found to be in conflict | 4 | | with this
subsection, but such policies shall be subject to the | 5 | | provisions of
Section 442.
| 6 | | (3) This Section shall not apply (i) to surety contracts or | 7 | | fidelity
bonds, (ii) to policies issued to an industrial | 8 | | insured as defined in Section
121-2.08 except for workers' | 9 | | compensation policies, nor (iii) to riders
or
endorsements | 10 | | prepared to meet special, unusual,
peculiar, or extraordinary | 11 | | conditions applying to an individual risk.
| 12 | | (Source: P.A. 97-486, eff. 1-1-12.)
| 13 | | (215 ILCS 5/356z.12) | 14 | | Sec. 356z.12. Dependent coverage. | 15 | | (a) A group or individual policy of accident and health | 16 | | insurance or managed care plan that provides coverage for | 17 | | dependents and that is amended, delivered, issued, or renewed | 18 | | after the effective date of this amendatory Act of the 95th | 19 | | General Assembly shall not terminate coverage or deny the | 20 | | election of coverage for an unmarried dependent by reason of | 21 | | the dependent's age before the dependent's 26th birthday. | 22 | | (b) A policy or plan subject to this Section shall, upon | 23 | | amendment, delivery, issuance, or renewal, establish an | 24 | | initial enrollment period of not less than 90 days during which | 25 | | an insured may make a written election for coverage of an |
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| 1 | | unmarried person as a dependent under this Section. After the | 2 | | initial enrollment period, enrollment by a dependent pursuant | 3 | | to this Section shall be consistent with the enrollment terms | 4 | | of the plan or policy. | 5 | | (c) A policy or plan subject to this Section shall allow | 6 | | for dependent coverage during the annual open enrollment date | 7 | | or the annual renewal date if the dependent, as of the date on | 8 | | which the insured elects dependent coverage under this | 9 | | subsection, has: | 10 | | (1) a period of continuous creditable coverage of 90 | 11 | | days or more; and | 12 | | (2) not been without creditable coverage for more than | 13 | | 63 days. | 14 | | An insured may elect coverage for a dependent who does not meet | 15 | | the continuous creditable coverage requirements of this | 16 | | subsection (c) and that dependent shall not be denied coverage | 17 | | due to age. | 18 | | For purposes of this subsection (c), "creditable coverage" | 19 | | shall have the meaning provided under subsection (C)(1) of | 20 | | Section 20 of the Illinois Health Insurance Portability and | 21 | | Accountability Act. | 22 | | (d) Military personnel. A group or individual policy of | 23 | | accident and health insurance or managed care plan that | 24 | | provides coverage for dependents and that is amended, | 25 | | delivered, issued, or renewed after the effective date of this | 26 | | amendatory Act of the 95th General Assembly shall not terminate |
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| 1 | | coverage or deny the election of coverage for an unmarried | 2 | | dependent by reason of the dependent's age before the | 3 | | dependent's 30th birthday if the dependent (i) is an Illinois | 4 | | resident, (ii) served as a member of the active or reserve | 5 | | components of any of the branches of the Armed Forces of the | 6 | | United States, and (iii) has received a release or discharge | 7 | | other than a dishonorable discharge. To be eligible for | 8 | | coverage under this subsection (d), the eligible dependent | 9 | | shall submit to the insurer a form approved by the Illinois | 10 | | Department of Veterans' Affairs stating the date on which the | 11 | | dependent was released from service. | 12 | | (e) Calculation of the cost of coverage provided to an | 13 | | unmarried dependent under this Section shall be identical. | 14 | | (f) Nothing in this Section shall prohibit an employer from | 15 | | requiring an employee to pay all or part of the cost of | 16 | | coverage provided under this Section. | 17 | | (g) No exclusions or limitations may be applied to coverage | 18 | | elected pursuant to this Section that do not apply to all | 19 | | dependents covered under the policy. | 20 | | (h) A policy or plan subject to this Section shall not | 21 | | condition eligibility for dependent coverage provided pursuant | 22 | | to this Section on enrollment in any educational institution. | 23 | | (i) Notice regarding coverage for a dependent as provided | 24 | | pursuant to this Section shall be provided to an insured by the | 25 | | insurer: | 26 | | (1) upon application or enrollment; |
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| 1 | | (2) in the certificate of coverage or equivalent | 2 | | document prepared for an insured and delivered on or about | 3 | | the date on which the coverage commences; and | 4 | | (3) (blank) in a notice delivered to an insured on a | 5 | | semi-annual basis .
| 6 | | (Source: P.A. 95-958, eff. 6-1-09 .)
| 7 | | (215 ILCS 5/1202) (from Ch. 73, par. 1065.902)
| 8 | | Sec. 1202. Duties. The Director shall:
| 9 | | (a) determine the relationship of insurance premiums and | 10 | | related income
as compared to insurance costs and expenses and | 11 | | provide such information to
the General Assembly and the | 12 | | general public;
| 13 | | (b) study the insurance system in the State of Illinois, | 14 | | and recommend
to the General Assembly what it deems to be the | 15 | | most appropriate and
comprehensive cost containment system for | 16 | | the State;
| 17 | | (c) respond to the requests by agencies of government and | 18 | | the General
Assembly for special studies and analysis of data | 19 | | collected pursuant to
this Article. Such reports shall be made | 20 | | available in a form prescribed by
the Director. The Director | 21 | | may also determine a fee to be charged to the
requesting agency | 22 | | to cover the direct and indirect costs for producing such
a | 23 | | report, and shall permit affected insurers the right to review | 24 | | the
accuracy of the report before it is released. The fees | 25 | | shall
be deposited
into the Statistical Services Revolving Fund |
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| 1 | | and credited to the account
of the Department of Insurance;
| 2 | | (d) make an interim report to the General Assembly no later | 3 | | than August
15, 1987, and a annual report to the General | 4 | | Assembly no later than July 1 April 15
every year thereafter | 5 | | which shall include the Director's findings and
| 6 | | recommendations regarding its duties as provided under | 7 | | subsections (a),
(b), and (c) of this Section.
| 8 | | (Source: P.A. 91-357, eff. 7-29-99.)
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