Full Text of SB1729 098th General Assembly
SB1729enr 98TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 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 35A-5, 35A-10, 35A-15, 35A-30, and 35A-60 as | 6 | | follows:
| 7 | | (215 ILCS 5/35A-5)
| 8 | | Sec. 35A-5. Definitions. As used in this Article, the terms | 9 | | listed in
this Section have the meaning given herein.
| 10 | | "Adjusted RBC Report" means an RBC Report that has been | 11 | | adjusted by the
Director in accordance with subsection (f) of | 12 | | Section 35A-10.
| 13 | | "Authorized control level RBC" means the number determined | 14 | | under the
risk-based capital formula in accordance with the RBC | 15 | | Instructions.
| 16 | | "Company action level RBC" means the product of 2.0 and the | 17 | | insurer's
authorized control level RBC.
| 18 | | "Corrective Order" means an order issued by the Director in | 19 | | accordance with
Article XII 1/2 specifying
corrective actions | 20 | | that the Director determines are required.
| 21 | | "Domestic insurer" means any insurance company domiciled | 22 | | in this State
under Article II, Article III, Article III 1/2, | 23 | | or Article IV
or a health organization as defined by this |
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| 1 | | Article, except this shall
include only those health | 2 | | maintenance organizations that are "domestic
companies" in | 3 | | accordance with Section 5-3 of the Health Maintenance
| 4 | | Organization Act and only those limited health service | 5 | | organizations that are
"domestic companies" in accordance with | 6 | | Section 4003 of the Limited Health
Service Organization Act.
| 7 | | "Fraternal benefit society" means any insurance company | 8 | | licensed under Article XVII of this Code. | 9 | | "Foreign insurer" means any foreign or alien insurance | 10 | | company licensed
under Article VI
that is not domiciled in this | 11 | | State
and any health maintenance organization that is not a | 12 | | "domestic company" in
accordance with Section 5-3 of the Health | 13 | | Maintenance Organization Act and any
limited health service | 14 | | organization that is not a "domestic company" in
accordance | 15 | | with Section 4003 of the Limited Health Service Organization | 16 | | Act.
| 17 | | "Health organization" means an entity operating under a | 18 | | certificate of
authority issued pursuant to the
Health | 19 | | Maintenance Organization Act, the Dental Service Plan Act, the | 20 | | Limited
Health Service Organization Act, or the Voluntary | 21 | | Health Services Plans Act,
unless the entity is otherwise | 22 | | defined as a "life, health, or life and health
insurer" | 23 | | pursuant to this Act.
| 24 | | "Life, health, or life and health insurer" means an | 25 | | insurance company
that has authority to transact the kinds of
| 26 | | insurance described in either or both clause (a) or clause (b) |
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| 1 | | of Class 1 of
Section 4 or a licensed property and casualty | 2 | | insurer writing only accident and
health insurance.
| 3 | | "Mandatory control level RBC" means the product of 0.70 and | 4 | | the insurer's
authorized control level RBC.
| 5 | | "NAIC" means the National Association of Insurance | 6 | | Commissioners.
| 7 | | "Negative trend" means, with respect to a life, health, or | 8 | | life and
health
insurer or a fraternal benefit society , a | 9 | | negative trend over a period of time, as determined
in | 10 | | accordance with the trend test calculation included in the Life | 11 | | or Fraternal RBC Instructions.
| 12 | | "Property and casualty insurer" means an insurance company
| 13 | | that has authority to transact the kinds of insurance in
either | 14 | | or both Class 2 or Class 3 of Section 4 or a licensed insurer | 15 | | writing
only insurance authorized under clause (c) of
Class 1, | 16 | | but does not include monoline
mortgage guaranty insurers, | 17 | | financial guaranty insurers, and title insurers.
| 18 | | "RBC" means risk-based capital.
| 19 | | "RBC Instructions" means the RBC Report including | 20 | | risk-based capital
instructions adopted by the NAIC as those | 21 | | instructions may be amended by the
NAIC from time to time in | 22 | | accordance with the procedures adopted by the NAIC.
| 23 | | "RBC level" means an insurer's company action level RBC, | 24 | | regulatory action
level RBC, authorized control level RBC, or | 25 | | mandatory control level RBC.
| 26 | | "RBC Plan" means a comprehensive financial plan containing |
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| 1 | | the elements
specified in subsection (b) of Section 35A-15.
| 2 | | "RBC Report" means the risk-based capital report required | 3 | | under Section
35A-10.
| 4 | | "Receivership" means conservation, rehabilitation, or | 5 | | liquidation under
Article XIII.
| 6 | | "Regulatory action level RBC" means the product of 1.5 and | 7 | | the insurer's
authorized control level RBC.
| 8 | | "Revised RBC Plan" means an RBC Plan rejected by the | 9 | | Director and revised by
the insurer with or without the | 10 | | Director's recommendations.
| 11 | | "Total adjusted capital" means the sum of (1) an insurer's | 12 | | statutory capital
and surplus and (2) any other items that the | 13 | | RBC Instructions may provide.
| 14 | | (Source: P.A. 90-794, eff. 8-14-98; 91-549, eff. 8-14-99.)
| 15 | | (215 ILCS 5/35A-10)
| 16 | | Sec. 35A-10. RBC Reports.
| 17 | | (a) On or before each March 1 (the "filing date"), every | 18 | | domestic
insurer
shall prepare and submit to the Director a | 19 | | report of its RBC levels as of the
end of the previous calendar | 20 | | year in the form and containing the information
required by the | 21 | | RBC Instructions. Every domestic insurer shall also file its
| 22 | | RBC Report with the NAIC in accordance with the RBC | 23 | | Instructions. In addition,
if requested in writing by the chief | 24 | | insurance regulatory official of any state
in which it
is | 25 | | authorized to do business, every domestic insurer shall file |
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| 1 | | its RBC Report
with that official no later than the later of 15 | 2 | | days after the insurer
receives the written request
or the | 3 | | filing date.
| 4 | | (b) A life, health, or life and health insurer's or | 5 | | fraternal benefit society's RBC shall be
determined under the | 6 | | formula set
forth in the RBC Instructions. The formula shall | 7 | | take into account (and may
adjust for the covariance between):
| 8 | | (1) the risk with respect to the insurer's assets;
| 9 | | (2) the risk of adverse insurance experience with | 10 | | respect to the insurer's
liabilities and obligations;
| 11 | | (3) the interest rate risk with respect to the | 12 | | insurer's business; and
| 13 | | (4) all other business risks and other relevant risks | 14 | | set forth in the RBC
Instructions.
| 15 | | These risks shall be determined in each case by applying
the | 16 | | factors in the
manner set forth in the RBC Instructions.
| 17 | | (c) A property and casualty insurer's RBC shall be | 18 | | determined in
accordance
with the formula set forth in the RBC | 19 | | Instructions. The formula shall take
into account (and may | 20 | | adjust for the covariance between):
| 21 | | (1) asset risk;
| 22 | | (2) credit risk;
| 23 | | (3) underwriting risk; and
| 24 | | (4) all other business risks and other relevant risks | 25 | | set
forth in the RBC Instructions.
| 26 | | These risks shall be determined in each case by applying the |
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| 1 | | factors in the
manner
set forth in the RBC Instructions.
| 2 | | (d) A health organization's RBC shall be determined in | 3 | | accordance with the
formula set forth in the RBC Instructions. | 4 | | The formula shall take the
following into account (and may | 5 | | adjust for the covariance between):
| 6 | | (1) asset risk;
| 7 | | (2) credit risk;
| 8 | | (3) underwriting risk; and
| 9 | | (4) all other business risks and other relevant risks | 10 | | set forth in the RBC
Instructions.
| 11 | | These risks shall be determined in each case by applying the | 12 | | factors in the
manner set forth in the RBC Instructions.
| 13 | | (e) An excess of capital over the amount produced by the
| 14 | | risk-based
capital requirements contained in this Code and the | 15 | | formulas, schedules, and
instructions referenced in this Code | 16 | | is desirable in the business of insurance.
Accordingly, | 17 | | insurers should seek to maintain capital above the RBC levels
| 18 | | required by this Code. Additional capital is used and useful in | 19 | | the insurance
business and helps to secure an insurer against | 20 | | various risks inherent in, or
affecting, the business of | 21 | | insurance and not accounted for or only partially
measured by | 22 | | the risk-based capital requirements contained in this Code.
| 23 | | (f) If a domestic insurer files an RBC Report that, in the
| 24 | | judgment of the
Director, is inaccurate, the Director shall | 25 | | adjust the RBC Report to correct
the inaccuracy and shall | 26 | | notify the insurer of the adjustment. The notice
shall contain |
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| 1 | | a statement of the reason for the adjustment.
| 2 | | (Source: P.A. 91-549, eff. 8-14-99 .)
| 3 | | (215 ILCS 5/35A-15)
| 4 | | Sec. 35A-15. Company action level event.
| 5 | | (a) A company action level event means any of the following | 6 | | events:
| 7 | | (1) The filing of an RBC Report by an insurer that | 8 | | indicates that:
| 9 | | (A) the insurer's total adjusted capital is | 10 | | greater than or equal to its
regulatory action level | 11 | | RBC, but less than its company action level RBC;
| 12 | | (B) the insurer, if a life, health, or life and | 13 | | health insurer or a fraternal benefit society , has
| 14 | | total adjusted capital that is greater than or equal
to | 15 | | its company action level RBC, but less than the product | 16 | | of its authorized
control level RBC and 3.0 2.5 and has | 17 | | a negative trend; or
| 18 | | (C) the insurer, if a property and casualty | 19 | | insurer, has total adjusted capital that is greater | 20 | | than or equal
to its company action level RBC, but less | 21 | | than the product of its authorized
control level RBC | 22 | | and 3.0 and triggers the trend test determined in | 23 | | accordance with the trend test calculation included in | 24 | | the property and casualty RBC Instructions.
| 25 | | (2) The notification by the Director to the insurer of |
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| 1 | | an Adjusted RBC
Report that indicates an event described in
| 2 | | paragraph (1),
provided the insurer does not challenge the | 3 | | Adjusted RBC Report under Section
35A-35.
| 4 | | (3) The notification by the Director to the insurer | 5 | | that the Director has,
after a hearing, rejected the | 6 | | insurer's challenge under Section 35A-35 to an
Adjusted RBC | 7 | | Report that indicates the event described in paragraph (1).
| 8 | | (b) In the event of a company action level event, the | 9 | | insurer shall prepare
and submit to the Director an RBC Plan | 10 | | that does
all of the following:
| 11 | | (1) Identifies the conditions that contribute to the
| 12 | | company action level event.
| 13 | | (2) Contains proposed corrective actions that the | 14 | | insurer intends to
take and that are expected to result in | 15 | | the elimination of the company action
level event.
A health | 16 | | organization is not prohibited from
proposing recognition | 17 | | of a parental guarantee or a letter of credit to
eliminate | 18 | | the company action level event; however the Director shall, | 19 | | at his
discretion, determine whether or the extent to which | 20 | | the proposed parental
guarantee or letter of credit is an | 21 | | acceptable part of a satisfactory RBC Plan
or Revised RBC | 22 | | Plan.
| 23 | | (3) Provides projections of the insurer's financial | 24 | | results in the current
year and at least the 4 succeeding | 25 | | years, both in the absence of proposed
corrective actions | 26 | | and giving effect to the proposed corrective actions,
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| 1 | | including projections of statutory operating income, net | 2 | | income, capital, and
surplus. The projections for both new | 3 | | and renewal business may include
separate projections for | 4 | | each major line of business and separately identify
each | 5 | | significant income, expense, and benefit component.
| 6 | | (4) Identifies the key assumptions affecting the | 7 | | insurer's projections
and the sensitivity of the | 8 | | projections to the assumptions.
| 9 | | (5) Identifies the quality of, and problems associated | 10 | | with, the insurer's
business including, but not limited to, | 11 | | its assets, anticipated business growth
and associated | 12 | | surplus strain, extraordinary exposure to risk, mix of | 13 | | business,
and use of reinsurance, if any, in each case.
| 14 | | (c) The insurer shall submit the RBC Plan to the Director | 15 | | within 45 days
after the company action
level event occurs or | 16 | | within 45 days after the Director notifies the insurer
that the | 17 | | Director has, after a hearing, rejected its
challenge under | 18 | | Section 35A-35 to an
Adjusted RBC Report.
| 19 | | (d) Within 60 days after an insurer submits an RBC Plan to | 20 | | the
Director, the Director shall notify the insurer whether the | 21 | | RBC Plan shall be
implemented or is, in the judgment of the | 22 | | Director, unsatisfactory. If the
Director determines the RBC | 23 | | Plan is unsatisfactory,
the notification to the insurer shall | 24 | | set forth the reasons for the
determination
and may set forth | 25 | | proposed revisions that will render the RBC Plan satisfactory
| 26 | | in the judgment of the Director. Upon notification from the |
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| 1 | | Director, the
insurer shall prepare a Revised RBC Plan, which | 2 | | may incorporate by reference
any revisions proposed by the | 3 | | Director. The insurer shall submit the Revised
RBC Plan to the | 4 | | Director within 45 days after the Director notifies the insurer
| 5 | | that the RBC Plan is unsatisfactory or within 45 days after the | 6 | | Director
notifies the insurer that the Director has, after a | 7 | | hearing, rejected its
challenge under Section 35A-35 to the | 8 | | determination that the RBC Plan is
unsatisfactory.
| 9 | | (e) In the event the Director notifies an insurer that its
| 10 | | RBC Plan or Revised RBC Plan is unsatisfactory, the Director | 11 | | may, at
the Director's discretion and subject to the insurer's | 12 | | right to a hearing under
Section 35A-35, specify in the | 13 | | notification that the notification constitutes a
regulatory | 14 | | action level event.
| 15 | | (f) Every domestic insurer that files an RBC Plan or | 16 | | Revised RBC Plan with
the Director shall file a copy of the RBC | 17 | | Plan or Revised RBC Plan with the
chief insurance regulatory | 18 | | official in any state in which the insurer is
authorized to do | 19 | | business if that state has a law substantially similar to the
| 20 | | confidentiality provisions in subsection (a) of Section 35A-50 | 21 | | and if that
official requests in writing a copy of the plan. | 22 | | The insurer shall file a copy
of the
RBC Plan or Revised RBC | 23 | | Plan in that state no later than the later of
15 days after | 24 | | receiving the written request for the copy or
the date on which | 25 | | the RBC Plan or Revised RBC Plan is filed under
subsection (c) | 26 | | or (d) of this Section.
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| 1 | | (Source: P.A. 97-955, eff. 8-14-12.)
| 2 | | (215 ILCS 5/35A-30)
| 3 | | Sec. 35A-30. Mandatory control level event.
| 4 | | (a) A mandatory control level event means any of the | 5 | | following events:
| 6 | | (1) The filing of an RBC Report that indicates that the | 7 | | insurer's total
adjusted capital is less than its mandatory | 8 | | control level RBC.
| 9 | | (2) The notification by the Director to the insurer of | 10 | | an Adjusted RBC
Report that indicates the event described | 11 | | in paragraph (1), provided the
insurer does not challenge | 12 | | the Adjusted RBC Report under Section 35A-35.
| 13 | | (3) The notification by the Director to the insurer | 14 | | that the Director has,
after a hearing, rejected the | 15 | | insurer's challenge under Section 35A-35 to the
Adjusted | 16 | | RBC Report that indicates the event described in paragraph | 17 | | (1).
| 18 | | (b) In the
event of a mandatory control level event with | 19 | | respect to a life, health, or
life and health insurer or a | 20 | | fraternal benefit society , the Director shall take
actions | 21 | | necessary to place the insurer in
receivership under
Article | 22 | | XIII. In that event, the mandatory control level event shall be | 23 | | deemed
sufficient grounds for the Director to take action under | 24 | | Article XIII, and the
Director shall have the rights, powers, | 25 | | and duties with respect to the insurer
that
are set forth in |
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| 1 | | Article XIII. If the Director takes
action
under this | 2 | | subsection regarding an Adjusted RBC Report, the insurer shall | 3 | | be
entitled to the protections
of Article XIII.
If the Director | 4 | | finds that there is a
reasonable expectation that the mandatory | 5 | | control level event may be eliminated
within 90 days after it | 6 | | occurs, the Director may delay action for not more
than 90 days | 7 | | after the mandatory control level event.
| 8 | | (c) In the case of a mandatory control level event with | 9 | | respect to a
property and casualty insurer, the Director shall
| 10 | | take the actions necessary to place the insurer in receivership | 11 | | under Article
XIII or, in the case of an insurer that is | 12 | | writing no business and that is
running-off its existing | 13 | | business, may allow the insurer to continue its
run-off under | 14 | | the supervision of the Director. In either case, the mandatory
| 15 | | control level event is deemed sufficient grounds for the | 16 | | Director to take
action under Article XIII, and the Director | 17 | | has the rights, powers, and
duties with respect to the insurer | 18 | | that are set forth in Article XIII. If the
Director takes | 19 | | action regarding an Adjusted RBC Report, the insurer shall be
| 20 | | entitled to the protections of Article XIII. If the Director | 21 | | finds that there
is a reasonable expectation that
the mandatory | 22 | | control level event may be eliminated within 90 days after it
| 23 | | occurs, the Director may delay action for not more than 90 days | 24 | | after the
mandatory control level event.
| 25 | | (d) In the case of a mandatory control level event with | 26 | | respect to a
health organization, the Director shall take the |
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| 1 | | actions necessary to place the
insurer in receivership under | 2 | | Article XIII or, in the case of an insurer that
is writing no | 3 | | business and that is running-off its existing business, may | 4 | | allow
the insurer to
continue its run-off under the supervision | 5 | | of the Director. In either case,
the mandatory control level | 6 | | event is deemed sufficient grounds for the Director
to take | 7 | | action under Article XIII, and the Director has the rights, | 8 | | powers, and
duties with respect to the insurer that are set | 9 | | forth in Article XIII. If the
Director takes action regarding | 10 | | an Adjusted RBC Report, the insurer shall be
entitled to the | 11 | | protections of Article XIII. If the Director finds that there
| 12 | | is a reasonable expectation that the mandatory control level | 13 | | event may be
eliminated within 90 days after it occurs, the | 14 | | Director may delay action for
not more than 90 days after the | 15 | | mandatory control level event.
| 16 | | (Source: P.A. 91-549, eff. 8-14-99.)
| 17 | | (215 ILCS 5/35A-60)
| 18 | | Sec. 35A-60. Phase-in of Article.
| 19 | | (a) For RBC Reports filed
with
respect to
the December 31, | 20 | | 1993 annual statement, instead of the provisions of Sections
| 21 | | 35A-15, 35A-20, 35A-25, and 35A-30,
the following provisions | 22 | | apply:
| 23 | | (1) In the event of a company action level event, the | 24 | | Director shall take
no
action under this Article.
| 25 | | (2) In the event of a regulatory action level event |
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| 1 | | under paragraph (1),
(2), or (3) of subsection (a) of | 2 | | Section 35A-20, the Director shall take the
actions | 3 | | required under Section 35A-15.
| 4 | | (3) In the event of a regulatory action level event | 5 | | under paragraph (4),
(5), (6), (7), (8), or (9) of | 6 | | subsection (a) of Section 35A-20 or an
authorized control | 7 | | level event, the Director shall take the actions
required | 8 | | under Section 35A-20.
| 9 | | (4) In the event of a mandatory control level event, | 10 | | the Director shall
take
the actions required under Section | 11 | | 35A-25.
| 12 | | (b) For RBC Reports required to be filed by property and | 13 | | casualty
insurers with respect to the December 31, 1995 annual | 14 | | statement, instead of the
provisions of Section 35A-15, 35A-20, | 15 | | 35A-25, and 35A-30,
the following provisions apply:
| 16 | | (1) In the event of a company action level event with | 17 | | respect to a
domestic insurer, the Director shall take no | 18 | | regulatory action under this
Article.
| 19 | | (2) In the event of
a regulatory action level event | 20 | | under paragraph
(1), (2) or (3) of subsection (a) of | 21 | | Section 35A-20, the Director shall
take the actions | 22 | | required under
Section 35A-15.
| 23 | | (3) In the event of
a regulatory action level event | 24 | | under paragraph
(4), (5), (6), (7), (8), or (9) of | 25 | | subsection (a) of Section 35A-20 or
an authorized control | 26 | | level event, the
Director shall take the actions required |
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| 1 | | under Section 35A-20.
| 2 | | (4) In the event of a mandatory control level event,
| 3 | | the Director shall take the actions required under Section | 4 | | 35A-25.
| 5 | | (c) For RBC Reports required to be filed by health | 6 | | organizations with
respect to the December 31, 1999 annual | 7 | | statement and the December 31, 2000
annual statement, instead | 8 | | of the provisions of
Sections 35A-15, 35A-20, 35A-25, and | 9 | | 35A-30, the following provisions apply:
| 10 | | (1) In the event of a company action level event with | 11 | | respect to a
domestic
insurer, the Director shall take no | 12 | | regulatory action under this Article.
| 13 | | (2) In the event of a regulatory action level event | 14 | | under paragraph (1),
(2), or (3) of subsection (a) of | 15 | | Section 35A-20, the Director shall take the
actions | 16 | | required under Section 35A-15.
| 17 | | (3) In the event of a regulatory action level event | 18 | | under paragraph (4),
(5), (6), (7), (8), or (9) of | 19 | | subsection (a) of Section 35A-20 or an authorized
control | 20 | | level event, the Director shall take the actions required | 21 | | under Section
35A-20.
| 22 | | (4) In the event of a mandatory control level event, | 23 | | the Director shall
take the actions required under Section | 24 | | 35A-25.
| 25 | | This subsection does not apply to a health organization | 26 | | that provides or
arranges for a health care plan under which |
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| 1 | | enrollees may access health care
services from contracted | 2 | | providers without a referral from their primary care
physician.
| 3 | | Nothing in this subsection shall preclude or limit other | 4 | | powers or duties of
the Director under any other laws.
| 5 | | (d) For RBC Reports required to be filed by fraternal | 6 | | benefit societies with respect to the December 31, 2013 annual
| 7 | | statement and the December 31, 2014 annual statement, instead
| 8 | | of the provisions of Sections 35A-15, 35A-20, 35A-25, and
| 9 | | 35A-30, the following provisions apply: | 10 | | (1) In the event of a company action level event with
| 11 | | respect to a domestic insurer, the Director shall take no
| 12 | | regulatory action under this Article. | 13 | | (2) In the event of a regulatory action level event
| 14 | | under paragraph (1), (2), or (3) of subsection (a) of
| 15 | | Section 35A-20, the Director shall take the actions
| 16 | | required under Section 35A-15. | 17 | | (3) In the event of a regulatory action level event
| 18 | | under paragraph (4), (5), (6), (7), (8), or (9) of
| 19 | | subsection (a) of Section 35A-20 or an authorized control
| 20 | | level event, the Director shall take the actions required
| 21 | | under Section 35A-20. | 22 | | (4) In the event of a mandatory control level event,
| 23 | | the Director shall take the actions required under Section
| 24 | | 35A-25. | 25 | | Nothing in this subsection shall preclude or limit other | 26 | | powers or duties of
the Director under any other laws. |
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| 1 | | (Source: P.A. 91-549, eff. 8-14-99.)
| 2 | | Section 99. Effective date. This Act takes effect upon | 3 | | becoming law.
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