Illinois General Assembly - Illinois Compiled Statutes

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215 ILCS 125/2-5

(215 ILCS 125/2-5) (from Ch. 111 1/2, par. 1406.1)

Sec. 2-5.

Claims Liabilities.

Every Health
Maintenance Organization shall, at all times,
maintain liabilities in an amount estimated in the aggregate to provide for
the payment of all claims incurred and any due and unpaid provider
capitation, whether reported or unreported, which
are unpaid and for which such organization is or may be liable, and to
provide for the expense of adjustment or settlement of such claims.  Such
liabilities shall be computed in accordance with regulations promulgated by
the Director upon reasonable consideration of the ascertained experience
and character of such business for the purpose of adequately protecting
enrollees and securing the solvency of such organizations.

Whenever the claim and claim expense experience of any such organization
shows the liabilities calculated in accordance with such regulations to be
inadequate, the Director may require such organization to maintain
additional liabilities.

(Source: P.A. 86-620.)