20 ILCS 1405/ Civil Administrative Code of Illinois. (Department of Insurance Law)

(20 ILCS 1405/Art. 1405 heading) ARTICLE 1405. DEPARTMENT OF INSURANCE

(20 ILCS 1405/1405-1)

Sec. 1405-1. Article short title. This Article 1405 of the Civil Administrative Code of Illinois may be cited as the Department of Insurance Law.

(Source: P.A. 91-239, eff. 1-1-00.)

(20 ILCS 1405/1405-5) (was 20 ILCS 1405/56)

Sec. 1405-5. General powers. The Department of Insurance has the following powers:

(1) To exercise the rights, powers, and duties vested by law in the insurance superintendent and the superintendent's officers and employees.

(2) To exercise the rights, powers, and duties that have been vested by law in the Department of Trade and Commerce as the successor of the insurance superintendent and the superintendent's officers and employees.

(3) To exercise the rights, powers, and duties heretofore vested by law in the Department of Trade and Commerce or in the Director of Trade and Commerce by:

(A) all laws in relation to insurance; and

(B) Article 22 of the Illinois Pension Code.

(4) To execute and administer all laws heretofore or hereafter enacted relating to insurance.

(5) To transfer jurisdiction of any realty under the control of the Department to any other department of the State Government or to acquire or accept federal lands when the transfer, acquisition, or acceptance is advantageous to the State and is approved in writing by the Governor.

(Source: P.A. 91-239, eff. 1-1-00.)

(20 ILCS 1405/1405-10) (was 20 ILCS 1405/56.1)

Sec. 1405-10. Child health insurance plan study. The Department of Insurance shall cooperate with and provide consultation to the Department of Public Health in studying the feasibility of a child health insurance plan as provided in Section 2310-275 of the Department of Public Health Powers and Duties Law (20 ILCS 2310/2310-275).

(Source: P.A. 91-239, eff. 1-1-00.)

(20 ILCS 1405/1405-15) (was 20 ILCS 1405/56.2)

Sec. 1405-15. Senior citizen assistance and information program.

(a) The Department of Insurance shall administer and operate a program to provide assistance and information to senior citizens in relation to insurance matters. The program may include, but is not limited to, counseling for senior citizens in the evaluation, comparison, or selection of Medicare options, Medicare supplement insurance, and long-term care insurance.

(b) The Department shall recruit and train volunteers to provide the following:

(i) one-on-one counseling on insurance matters; and

(ii) education on insurance matters to senior citizens through public forums.

(c) The Department shall solicit the volunteers for their input and advice on the success and accessibility of the program.

(d) The Department shall strive to assure that all seniors residing in Illinois have access to the program.

(e) The Department of Insurance may promulgate reasonable rules necessary to implement this Section.

(Source: P.A. 91-239, eff. 1-1-00.)

(20 ILCS 1405/1405-20) (was 20 ILCS 1405/56.3)

Sec. 1405-20. Investigational cancer treatments; study.

(a) The Department of Insurance shall conduct an analysis and study of costs and benefits derived from the implementation of the coverage requirements for investigational cancer treatments established under Section 356y of the Illinois Insurance Code. The study shall cover the years 2000, 2001, and 2002. The study shall include an analysis of the effect of the coverage requirements on the cost of insurance and health care, the results of the treatments to patients, the mortality rate among cancer patients, any improvements in care of patients, and any improvements in the quality of life of patients.

(b) The Department shall report the results of its study to the General Assembly and the Governor on or before March 1, 2003.

(Source: P.A. 91-406, eff. 1-1-00; 92-16, eff. 6-28-01.)

(20 ILCS 1405/1405-25)

Sec. 1405-25. Uninsured Ombudsman Program.

(a) The Department of Insurance shall establish and operate an Ombudsman Program for uninsured individuals to provide assistance and education to those individuals regarding health insurance benefits options and rights under State and federal law. The program may include, but is not limited to, counseling for uninsured individuals in the discovery, evaluation, and comparison of options for obtaining health insurance coverage.

(b) The Department may recruit and train volunteers to assist in the Ombudsman Program. The volunteers may provide one-on-one counseling on health insurance availability matters and provide education to uninsured individuals through public forums.

(c) The Department may issue reasonable rules necessary to implement this Section.

(Source: P.A. 92-331, eff. 1-1-02.)

(20 ILCS 1405/1405-30)

Sec. 1405-30. Mental health insurance study.

(a) The Department of Insurance shall conduct an analysis and study of costs and benefits derived from the implementation of the coverage requirements for treatment of mental disorders established under Section 370c of the Illinois Insurance Code. The study shall cover the years 2002, 2003, and 2004. The study shall include an analysis of the effect of the coverage requirements on the cost of insurance and health care, the results of the treatments to patients, any improvements in care of patients, and any improvements in the quality of life of patients.

(b) The Department shall report the results of its study to the General Assembly and the Governor on or before March 1, 2005.

(Source: P.A. 92-185, eff. 1-1-02.)

(20 ILCS 1405/1405-32)

Sec. 1405-32. (Repealed).

(Source: P.A. 101-640, eff. 6-12-20. Repealed internally, eff. 12-31-21)

(20 ILCS 1405/1405-35)

Sec. 1405-35. The Department of Insurance.

(a) Executive Order No. 2004-6 is hereby superseded by this amendatory Act of the 96th General Assembly to the extent that Executive Order No. 2004-6 transfers the powers, duties, rights, and responsibilities of the Department of Insurance to the Division of Insurance within the Department of Financial and Professional Regulation.

(b) The Division of Insurance within the Department of Financial and Professional Regulation is hereby abolished and the Department of Insurance is created as an independent department. On July 1, 2009, all powers, duties, rights, and responsibilities of the Division of Insurance within the Department of Financial and Professional Regulation shall be transferred to the Department of Insurance.

(c) The personnel of the Division of Insurance within the Department of Financial and Professional Regulation shall be transferred to the Department of Insurance. The status and rights of such employees under the Personnel Code shall not be affected by the transfer. The rights of the employees and the State of Illinois and its agencies under the Personnel Code and applicable collective bargaining agreements or under any pension, retirement, or annuity plan shall not be affected by this amendatory Act. To the extent that an employee performs duties for the Division of Insurance within the Department of Financial and Professional Regulation and the Department of Financial and Professional Regulation itself or any other division or agency within the Department of Financial and Professional Regulation, that employee shall be transferred at the Governor's discretion.

(d) All books, records, papers, documents, property (real and personal), contracts, causes of action, and pending business pertaining to the powers, duties, rights, and responsibilities transferred by this amendatory Act from the Division of Insurance within the Department of Financial and Professional Regulation to the Department of Insurance, including, but not limited to, material in electronic or magnetic format and necessary computer hardware and software, shall be transferred to the Department of Insurance.

(e) All unexpended appropriations and balances and other funds available for use by the Division of Insurance within the Department of Financial and Professional Regulation shall be transferred for use by the Department of Insurance pursuant to the direction of the Governor. Unexpended balances so transferred shall be expended only for the purpose for which the appropriations were originally made.

(f) The powers, duties, rights, and responsibilities transferred from the Division of Insurance within the Department of Financial and Professional Regulation by this amendatory Act shall be vested in and shall be exercised by the Department of Insurance.

(g) Whenever reports or notices are now required to be made or given or papers or documents furnished or served by any person to or upon the Division of Insurance within the Department of Financial and Professional Regulation in connection with any of the powers, duties, rights, and responsibilities transferred by this amendatory Act, the same shall be made, given, furnished, or served in the same manner to or upon the Department of Insurance.

(h) This amendatory Act does not affect any act done, ratified, or canceled or any right occurring or established or any action or proceeding had or commenced in an administrative, civil, or criminal cause by the Division of Insurance within the Department of Financial and Professional Regulation before this amendatory Act takes effect; such actions or proceedings may be prosecuted and continued by the Department of Insurance.

(i) Any rules of the Division of Insurance within the Department of Financial and Professional Regulation, including any rules of its predecessor Department of Insurance, that relate to its powers, duties, rights, and responsibilities and are in full force on the effective date of this amendatory Act shall become the rules of the recreated Department of Insurance. This amendatory Act does not affect the legality of any such rules in the Illinois Administrative Code.

Any proposed rules filed with the Secretary of State by the Division of Insurance within the Department of Financial and Professional Regulation that are pending in the rulemaking process on the effective date of this amendatory Act and pertain to the powers, duties, rights, and responsibilities transferred, shall be deemed to have been filed by the Department of Insurance. As soon as practicable hereafter, the Department of Insurance shall revise and clarify the rules transferred to it under this amendatory Act to reflect the reorganization of powers, duties, rights, and responsibilities affected by this amendatory Act, using the procedures for recodification of rules available under the Illinois Administrative Procedure Act, except that existing title, part, and section numbering for the affected rules may be retained. The Department of Insurance may propose and adopt under the Illinois Administrative Procedure Act such other rules of the Division of Insurance within the Department of Financial and Professional Regulation that will now be administered by the Department of Insurance.

To the extent that, prior to July 1, 2009, the Director of the Division of Insurance within the Department of Financial and Professional Regulation had been empowered to prescribe rules or had other rulemaking authority jointly with the Secretary of the Department of Financial and Professional Regulation with regard to the powers, duties, rights, and responsibilities of the Division of Insurance within the Department of Financial and Professional Regulation, such duties shall be exercised from and after July 1, 2009 solely by the Director of the Department of Insurance.

(Source: P.A. 96-811, eff. 10-30-09; 97-333, eff. 8-12-11.)

(20 ILCS 1405/1405-40)

Sec. 1405-40. Transfer of functions.

(a) On July 1, 2021 (the effective date of Public Act 102-37), all powers, duties, rights, and responsibilities of the Insurance Compliance Division within the Illinois Workers' Compensation Commission are transferred to the Department of Insurance. The personnel of the Insurance Compliance Division are transferred to the Department of Insurance. The status and rights of such personnel under the Personnel Code are not affected by the transfer. The rights of the employees and the State of Illinois and its agencies under the Personnel Code and applicable collective bargaining agreements or under any pension, retirement, or annuity plan are not affected by Public Act 102-37. All books, records, papers, documents, property (real and personal), contracts, causes of action, and pending business pertaining to the powers, duties, rights, and responsibilities transferred by Public Act 102-37 from the Insurance Compliance Division to the Department of Insurance, including, but not limited to, material in electronic or magnetic format and necessary computer hardware and software, are transferred to the Department of Insurance. The powers, duties, rights, and responsibilities relating to the Insurance Compliance Division transferred by Public Act 102-37 are vested in the Department of Insurance.

(b) Whenever reports or notices are required to be made or given or papers or documents furnished or served by any person to or upon the Insurance Compliance Division in connection with any of the powers, duties, rights, and responsibilities transferred by Public Act 102-37, the Department of Insurance shall make, give, furnish, or serve them.

(c) Public Act 102-37 does not affect any act done, ratified, or canceled, any right occurring or established, or any action or proceeding had or commenced in an administrative, civil, or criminal cause by the Insurance Compliance Division before July 1, 2021 (the effective date of Public Act 102-37). Such actions or proceedings may be prosecuted and continued by the Department of Insurance.

(d) Any rules that relate to its powers, duties, rights, and responsibilities of the Insurance Compliance Division and are in force on July 1, 2021 (the effective date of Public Act 102-37) become the rules of the Department of Insurance. Public Act 102-37 does not affect the legality of any such rules.

(e) Any proposed rules filed with the Secretary of State by the Illinois Workers' Compensation Commission that are pending in the rulemaking process on July 1, 2021 (the effective date of Public Act 102-37) and pertain to the transferred powers, duties, rights, and responsibilities are deemed to have been filed by the Department of Insurance. As soon as practicable, the Department of Insurance shall revise and clarify the rules transferred to it under Public Act 102-37 t to reflect the reorganization of powers, duties, rights, and responsibilities affected by Public Act 102-37, using the procedures for recodification of rules available under the Illinois Administrative Procedure Act, except that existing title, part, and section numbering for the affected rules may be retained. The Department of Insurance may propose and adopt under the Illinois Administrative Procedure Act other rules of the Illinois Workers' Compensation Commission pertaining to Public Act 102-37 that are administered by the Department of Insurance.

(Source: P.A. 102-37, eff. 7-1-21; 102-813, eff. 5-13-22.)

(20 ILCS 1405/1405-45)

Sec. 1405-45. Transfer of the Illinois Comprehensive Health Insurance Plan. Upon entry of an Order of Rehabilitation or Liquidation against the Comprehensive Health Insurance Plan in accordance with Article XIII of the Illinois Insurance Code, all powers, duties, rights, and responsibilities of the Illinois Comprehensive Health Insurance Plan and the Illinois Comprehensive Health Insurance Board under the Comprehensive Health Insurance Plan Act shall be transferred to and vested in the Director of Insurance as rehabilitator or liquidator as provided in the provisions of Public Act 102-159.

(Source: P.A. 102-159, eff. 7-23-21; 102-813, eff. 5-13-22.)

(20 ILCS 1405/1405-50)

Sec. 1405-50. Marketplace Director of the Illinois Health Benefits Exchange. The Governor shall appoint, with the advice and consent of the Senate, a person within the Department of Insurance to serve as the Marketplace Director of the Illinois Health Benefits Exchange. The Marketplace Director shall serve for a term of 2 years, and until a successor is appointed and qualified; except that the term of the first Marketplace Director appointed under this Law shall expire on the third Monday in January 2027. The Marketplace Director may serve for more than one term. The Governor may make a temporary appointment until the next meeting of the Senate. The Marketplace Director shall receive an annual salary as set by the Governor and shall be paid out of the appropriations to the Department. The Marketplace Director shall be subject to the Personnel Code. The Marketplace Director, under the direction of the Director, shall manage the operations and staff of the Illinois Health Benefits Exchange to ensure optimal exchange performance.

(Source: P.A. 103-103, eff. 6-27-23; 103-605, eff. 7-1-24; 103-777, eff. 8-2-24.)

(20 ILCS 1405/1405-51)

Sec. 1405-51. Health insurance coverage, affordability, and cost transparency annual report.

(a) On or before May 1, 2026, and each May 1 thereafter, the Department of Insurance shall report to the Governor and the General Assembly on health insurance coverage, affordability, and cost trends, including:

(1) medical cost trends by major service category, including prescription drugs;

(2) utilization patterns of services by major service categories;

(3) impact of benefit changes, including essential health benefits and non-essential health benefits;

(4) enrollment trends;

(5) demographic shifts;

(6) geographic factors and variations, including changes in provider availability;

(7) health care quality improvement initiatives;

(8) inflation and other factors impacting this State's economic condition;

(9) the availability of financial assistance and tax credits to pay for health insurance coverage for individuals and small businesses;

(10) trends in out-of-pocket costs for consumers; and

(11) factors contributing to costs that are not otherwise specified in paragraphs (1) through (10) of this subsection.

(b) This report shall not attribute any information or trend to a specific company and shall not disclose any information otherwise considered confidential or proprietary.

(Source: P.A. 103-106, eff. 1-1-24; 103-605, eff. 7-1-24.)