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Public Act 103-0897 |
SB1479 Enrolled | LRB103 05817 BMS 50837 b |
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AN ACT concerning regulation. |
Be it enacted by the People of the State of Illinois, |
represented in the General Assembly: |
Section 5. The Illinois Insurance Code is amended by |
changing Sections 132, 132.5, 155.35, 402, 408, 511.109, |
512-3, 512-5, and 513b3 and by adding Section 512-11 as |
follows: |
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(215 ILCS 5/132) (from Ch. 73, par. 744) |
Sec. 132. Market conduct actions and market analysis and |
non-financial examinations . |
(a) Definitions. As used in this Section: |
"Data call" means a written solicitation by the Director |
to 2 or more regulated companies or persons seeking existing |
data or other existing information to be provided within a |
reasonable time period for a narrow and targeted regulatory |
oversight purpose for market analysis. "Data call" does not |
include an information request in a market conduct action or |
any data or information that the Director shall or may |
specifically require under any other law, except as provided |
by the other law. |
"Desk examination" means an examination that is conducted |
by market conduct surveillance personnel at a location other |
than the regulated company's or person's premises. "Desk |
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examination" includes an examination performed at the |
Department's offices with the company or person providing |
requested documents by hard copy, microfiche, or discs or |
other electronic media for review without an on-site |
examination. |
"Market analysis" means a process whereby market conduct |
surveillance personnel collect and analyze information from |
filed schedules, surveys, required reports, data calls, and |
other sources to develop a baseline understanding of the |
marketplace and to identify patterns or practices of regulated |
persons that deviate significantly from the norm or that may |
pose a potential risk to insurance consumers. |
"Market conduct action" means any activity, other than |
market analysis, that the Director may initiate to assess and |
address the market and nonfinancial practices of regulated |
persons, including market conduct examinations. The |
Department's consumer complaint process outlined in 50 Ill. |
Adm. Code 926 is not a market conduct action for purposes of |
this Section; however, the Department may initiate market |
conduct actions based on information gathered during that |
process. "Market conduct action" includes: |
(1) correspondence with the company or person; |
(2) interviews with the company or person; |
(3) information gathering; |
(4) policy and procedure reviews; |
(5) interrogatories; |
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(6) review of company or person self-evaluations and |
voluntary compliance programs; |
(7) self-audits; and |
(8) market conduct examinations. |
"Market conduct examination" or "examination" means any |
type of examination, other than a financial examination, that |
assesses a regulated person's compliance with the laws, rules, |
and regulations applicable to the examinee. "Market conduct |
examination" includes comprehensive examinations, targeted |
examinations, and follow-up examinations, which may be |
conducted as desk examinations, on-site examinations, or a |
combination of those 2 methods. |
"Market conduct surveillance" means market analysis or a |
market conduct action. |
"Market conduct surveillance personnel" means those |
individuals employed or retained by the Department and |
designated by the Director to collect, analyze, review, or act |
on information in the insurance marketplace that identifies |
patterns or practices of persons subject to the Director's |
jurisdiction. "Market conduct surveillance personnel" includes |
all persons identified as an examiner in the insurance laws or |
rules of this State if the Director has designated them to |
assist her or him in ascertaining the nonfinancial business |
practices, performance, and operations of a company or person |
subject to the Director's jurisdiction. |
"On-site examination" means an examination conducted at |
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the company's or person's home office or the location where |
the records under review are stored. |
"SOFR rate" means the Secured Overnight Financing Rate |
published by the Federal Reserve Bank of New York every |
business day. |
(b) Companies and persons subject to surveillance. The |
Director, for the purposes of ascertaining the nonfinancial |
business practices, performance, and operations of any person |
subject to the Director's jurisdiction or within the |
marketplace, may engage in market conduct actions or market |
analysis relating to: |
(1) any company transacting or being organized to |
transact business in this State; |
(2) any person engaged in or proposing to be engaged |
in the organization, promotion, or solicitation of shares |
or capital contributions to or aiding in the formation of |
a company; |
(3) any person having a written or oral contract |
pertaining to the management or control of a company as |
general agent, managing agent, or attorney-in-fact; |
(4) any licensed or registered producer, firm, |
pharmacy benefit manager, administrator, or any person |
making application for any license, certificate, or |
registration; |
(5) any person engaged in the business of adjusting |
losses or financing premiums; or |
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(6) any person, organization, trust, or corporation |
having custody or control of information reasonably |
related to the operation, performance, or conduct of a |
company or person subject to the Director's jurisdiction, |
but only as to the operation, performance, or conduct of a |
company or person subject to the Director's jurisdiction. |
(c) Market analysis and market conduct actions. |
(1) The Director may perform market analysis by |
gathering and analyzing information from data currently |
available to the Director, information from surveys, data |
call responses, or reports that are submitted to the |
Director, information collected by the NAIC, and |
information from a variety of other sources to develop a |
baseline understanding of the marketplace and to identify |
for further review companies or practices that deviate |
from the norm or that may pose a potential risk to |
insurance consumers. The Director shall use the most |
recent NAIC Market Regulation Handbook as a guide in |
performing market analysis. The Director may also employ |
other guidelines or procedures as the Director may deem |
appropriate. |
(2) The Director may initiate a market conduct action |
subject to the following: |
(A) If the Director determines that further |
inquiry into a particular person or practice is |
needed, then the Director may consider undertaking a |
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market conduct action. The Director shall inform the |
examinee of the initiation of the market conduct |
action and shall use the most recent NAIC Market |
Regulation Handbook as a guide in performing the |
market conduct action. The Director may also employ |
other guidelines or procedures as the Director may |
deem appropriate. |
(B) For an examination, the Director shall conduct |
a pre-examination conference with the examinee to |
clarify expectations before commencement of the |
examination. At the pre-examination conference, the |
Director or the market conduct surveillance personnel |
shall disclose the basis of the examination, including |
the statutes, regulations, or business practices at |
issue. The Director shall provide at least 30 days' |
advance notice of the date of the pre-examination |
conference unless circumstances warrant that the |
examination proceed more quickly. |
(C) The Director may coordinate a market conduct |
action and findings of this State with market conduct |
actions and findings of other states. |
(3) Nothing in this Section requires the Director to |
undertake market analysis before initiating any market |
conduct action. |
(4) Nothing in this Section restricts the Director to |
the type of market conduct action he or she initially |
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selected. |
(5) A regulated person is required to respond to a |
market analysis data call or to an information request in |
a market conduct action on the terms and conditions |
established by the Director. The Department shall |
establish reasonable timelines that are commensurate with |
the volume and nature of the data required to be collected |
in the information request. |
(6) Without limiting the contents of any examination |
report, market conduct actions taken as a result of a |
market analysis shall focus primarily on the general |
business practices and compliance activities of companies |
or persons rather than identifying infrequent or |
unintentional random errors that do not cause significant |
consumer harm. The Director may give a company or person |
an opportunity to resolve matters that are identified as a |
result of a market analysis to the Director's satisfaction |
before undertaking a market conduct action against the |
company or person. |
(d) Access to books and records. Every examinee and its |
officers, directors, and agents must provide to the Director |
convenient and free access at all reasonable hours at its |
office or location to all books, records, and documents and |
any or all papers relating to the business, performance, |
operations, and affairs of the examinee. The officers, |
directors, and agents of the examinee must facilitate the |
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market conduct action and aid in the action so far as it is in |
their power to do so. The Director and any authorized market |
conduct surveillance personnel have the power to administer |
oaths and examine under oath any person relevant to the |
business of the examinee. A failure to produce requested |
books, records, or documents by the deadline shall not be a |
violation until after the later of: |
(1) 5 business days after the initial response |
deadline set by the Director or authorized personnel; or |
(2) an extended deadline granted by the Director or |
authorized personnel. |
(e) Examination report. The market conduct surveillance |
personnel designated by the Director under Section 402 must |
make a full and true report of every examination made by them |
that contains only facts ascertained from the books, papers, |
records, documents, and other evidence obtained by |
investigation and examined by them or ascertained from the |
testimony of officers, agents, or other persons examined under |
oath concerning the business, affairs, conduct, and |
performance of the examinee. The report of examination must be |
verified by the oath of the examiner in charge thereof, and |
when so verified is prima facie evidence in any action or |
proceeding in the name of the State against the examinee, its |
officers, directors, or agents upon the facts stated therein. |
(f) Examinee response to examination report. The |
Department and the examinee shall comply with the following |
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timeline, unless a mutual agreement is reached to modify the |
timeline: |
(1) The Department shall deliver a draft report to the |
examinee as soon as reasonably practicable. Nothing in |
this Section prevents the Department from sharing an |
earlier draft of the report with the examinee before |
confirming that the examination is completed. |
(2) If the examinee chooses to respond with written |
submissions or rebuttals, then the examinee must do so |
within 30 days after receipt of any draft report delivered |
after the completion of the examination. |
(3) As soon as reasonably practicable after receipt of |
any written submissions or rebuttals, the Department shall |
issue a final report. Whenever the Department has made |
substantive changes to a previously shared draft report, |
unless those changes remove part or all of an alleged |
violation or were proposed by the examinee, the Department |
shall deliver the revised version to the examinee as a new |
draft and shall allow the examinee 30 days to respond |
before the Department issues a final report. |
(4) The examinee shall, within 10 days after the |
issuance of the final report, accept the final report or |
request a hearing in writing, unless granted an extension |
by mutual agreement. Failure to take either action within |
10 days or the mutually agreed extension shall be deemed |
an acceptance of the final report. If the examinee accepts |
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the examination report, the Director shall continue to |
hold the content of the examination report as private and |
confidential for a period of 30 days. Thereafter, the |
Director shall open the final report for public |
inspection. |
(g) Hearing; final examination report. Notwithstanding |
anything to the contrary in this Code or Department rules, if |
the examinee requests a hearing, then the following procedures |
apply: |
(1) The examinee must request the hearing in writing |
and must specify the issues in the final report that the |
examinee is challenging. The examinee is limited to |
challenging the issues that were previously challenged in |
the examinee's written submission and rebuttal or |
supplemental submission and rebuttal pursuant to |
paragraphs (2) and (3) of subsection (f). |
(2) Except as permitted in paragraphs (3) and (8) of |
this subsection, the hearing shall be limited to the |
written arguments submitted by the parties to the |
designated hearing officer. The designated hearing officer |
may, however, grant a live hearing upon the request of |
either party. |
(3) Discovery is limited to the market conduct |
surveillance personnel's work papers that are relevant to |
the issues the examinee is challenging. The relevant |
market conduct surveillance personnel's work papers shall |
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be admitted into the record. No other forms of discovery, |
including depositions and interrogatories, are allowed, |
except upon written agreement of the examinee and the |
Department when necessary to conduct a fair hearing or as |
otherwise provided in this subsection. |
(4) Only the examinee and the Department may submit |
written arguments. |
(5) The examinee must submit its written argument and |
any supporting evidence within 30 days after the |
Department serves a formal notice of hearing. |
(6) The Department must submit its written response |
and any supporting evidence within 30 days after the |
examinee submits its written argument. |
(7) The designated hearing officer may allow |
additional written submissions if necessary or useful to |
the fair resolution of the hearing. |
(8) If either the examinee or the Department submit |
written testimony or affidavits, then the opposing party |
shall be given the opportunity to cross-examine the |
witness and to submit the cross-examination to the hearing |
officer before a decision. |
(9) The Director shall issue a decision accompanied by |
findings and conclusions. The Director's order is a final |
administrative decision and shall be served upon the |
examinee together with a copy of the final report within |
90 days after the conclusion of the hearing. The hearing |
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is deemed concluded on the later of the last date of any |
live hearing or the final deadline date for written |
submissions to the hearing officer, including any |
continuances or supplemental briefings permitted by the |
hearing officer. |
(10) Any portion of the final examination report that |
was not challenged by the examinee is incorporated into |
the decision of the Director. |
(11) Findings of fact and conclusions of law in the |
Director's final administrative decision are prima facie |
evidence in any legal or regulatory action. |
(12) If an examinee has requested a hearing, then the |
Director shall continue to hold the final report and any |
related decision as private and confidential for a period |
of 49 days after the final administrative decision. After |
the 49-day period expires, the Director shall open the |
final report and any related decision for public |
inspection if a court of competent jurisdiction has not |
stayed its publication. |
(h) Disclosure. So long as the recipient agrees to and |
verifies in writing its legal authority to hold the |
information confidential in a manner consistent with this |
Section, nothing in this Section prevents the Director from |
disclosing at any time the content of an examination report, |
preliminary examination report, or results, or any matter |
relating to a report or results, to: |
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(1) the insurance regulatory authorities of any other |
state; or |
(2) any agency or office of the federal government. |
(i) Confidentiality. |
(1) The Director and any other person in the course of |
market conduct surveillance shall keep confidential all |
documents, including working papers, third-party models, |
or products; complaint logs; copies of any documents |
created, produced, obtained by, or disclosed to the |
Director, market conduct surveillance personnel, or any |
other person in the course of market conduct surveillance |
conducted pursuant to this Section; and all documents |
obtained by the NAIC pursuant to this Section. The |
documents shall remain confidential after the termination |
of the market conduct surveillance, are not subject to |
subpoena, are not subject to discovery or admissible as |
evidence in private civil litigation, are not subject to |
disclosure under the Freedom of Information Act, and must |
not be made public at any time or used by the Director or |
any other person, except as provided in paragraphs (3), |
(4), and (6) of this subsection (i) and in subsection (k). |
(2) The Director and any other person in the course of |
market conduct surveillance shall keep confidential any |
self-evaluation or voluntary compliance program documents |
disclosed to the Director or other person by an examinee |
and the data collected via the NAIC market conduct annual |
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statement. The documents are not subject to subpoena, are |
not subject to discovery or admissible as evidence in |
private civil litigation, are not subject to disclosure |
under the Freedom of Information Act, and they shall not |
be made public or used by the Director or any other person, |
except as provided in paragraphs (3) and (4) of this |
subsection (i), in subsection (k), or in Section 155.35. |
Nothing in this Section shall supersede the restrictions |
on disclosure under Section 155.35. |
(3) Notwithstanding paragraphs (1) and (2) of this |
subsection (i), and consistent with paragraph (5) of this |
subsection (i), in order to assist in the performance of |
the Director's duties, the Director may: |
(A) share documents, materials, communications, or |
other information, including the confidential and |
privileged documents, materials, or information |
described in this subsection (i), with other State, |
federal, alien, and international regulatory agencies |
and law enforcement authorities and the NAIC, its |
affiliates, and subsidiaries, if the recipient agrees |
to and verifies in writing its legal authority to |
maintain the confidentiality and privileged status of |
the document, material, communication, or other |
information; |
(B) receive documents, materials, communications, |
or information, including otherwise confidential and |
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privileged documents, materials, or information, from |
the NAIC and its affiliates or subsidiaries, and from |
regulatory and law enforcement officials of other |
State, federal, alien, or international jurisdictions, |
authorities, and agencies, and shall maintain as |
confidential or privileged any document, material, |
communication, or information received with notice or |
the understanding that it is confidential or |
privileged under the laws of the jurisdiction that is |
the source of the document, material, communication, |
or information; and |
(C) enter into agreements governing the sharing |
and use of information consistent with this Section. |
(4) Nothing in this Section limits: |
(A) the Director's authority to use, if consistent |
with subsection (5) of Section 188.1, as applicable, |
any final or preliminary examination report, any |
market conduct surveillance or examinee work papers or |
other documents, or any other information discovered |
or developed during the course of any market conduct |
surveillance in the furtherance of any legal or |
regulatory action initiated by the Director that the |
Director may, in the Director's sole discretion, deem |
appropriate; however, confidential or privileged |
information about a company or person that is used in |
the legal or regulatory action shall not be made |
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public except by order of a court of competent |
jurisdiction or with the written consent of the |
company or person; or |
(B) the ability of an examinee to conduct |
discovery in accordance with paragraph (3) of |
subsection (g). |
(5) Disclosure to or by the Director of documents, |
materials, communications, or information required as part |
of any type of market conduct surveillance does not waive |
any applicable privilege or claim of confidentiality in |
the documents, materials, communications, or information. |
(6) Notwithstanding the confidentiality requirements |
of this Section or otherwise imposed by State law, if the |
Director performs a data call, other than the collection |
of data for the NAIC market conduct annual statement, the |
Director may make the results of the data call available |
for public inspection in an aggregated format that does |
not disclose information or data attributed to any |
specific company or person, including the name of any |
company or person who responded to the data call, so long |
as the Director provides all companies or persons that |
responded to the data call 15 days' notice identifying the |
information to be publicly released. Nothing in this |
Section requires the Director to publish results from any |
data call. |
(j) Corrective actions. |
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(1) As a result of any market conduct action, the |
Director may take any action the Director considers |
necessary or appropriate in accordance with the report of |
examination or any hearing thereon for acts in violation |
of any law, rule, or prior lawful order of the Director. No |
corrective action, including a penalty, shall be ordered |
with respect to violations in transactions with consumers |
or other entities that are isolated occurrences or that |
occur with such low frequency as to fall below a |
reasonable margin of error. Such actions include, but are |
not limited to: |
(A) requiring the regulated person to undertake |
corrective actions to cease and desist an identified |
violation or institute processes and practices to |
comply with applicable standards; |
(B) requiring reimbursement or restitution of any |
actual losses or damages to persons harmed by the |
regulated person's violation with interest from the |
date that the actual loss or damage was incurred, |
which shall be calculated at the SOFR rate applicable |
on the date that the actual loss or damage was incurred |
plus 2%; and |
(C) imposing civil penalties as provided in this |
subsection (j). |
(2) The Director may order a penalty of up to $2,000 |
for each violation of any law, rule, or prior lawful order |
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of the Director. Any failure to respond to an information |
request in a market conduct action or violation of |
subsection (d) may carry a fine of up to $1,000 per day up |
to a maximum of $50,000. Fines and penalties shall be |
consistent, reasonable, and justifiable, and the Director |
may consider reasonable criteria in ordering the fines and |
penalties, including, but not limited to, consumer harm, |
the intentionality of any violations, or remedial actions |
already undertaken by the examinee. The Director shall |
communicate to the examinee the basis for any assessed |
fine or penalty. |
(3) If any other provision of this Code or any other |
law or rule under the Director's jurisdiction prescribes |
an amount or range of monetary penalty for a violation of a |
particular statute or rule or a maximum penalty in the |
aggregate for repeated violations, the Director shall |
assess penalties pursuant to the terms of the statute or |
rule allowing the largest penalty. |
(4) If any other provision of this Code or any other |
law or rule under the Director's jurisdiction prescribes |
or specifies a method by which the Director is to |
determine a violation, then compliance with the process |
set forth herein shall be deemed to comply with the method |
prescribed or specified in the other provision. |
(5) If the Director imposes any sanctions or |
corrective actions described in subparagraphs (A) through |
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(C) of paragraph (1) of this subsection (j) based on the |
final report, the Director shall include those actions in |
a proposed stipulation and consent order enclosed with the |
final report issued to the examinee under subsection (f). |
The examinee shall have 10 days to sign the order or |
request a hearing in writing on the actions proposed in |
the order regardless of whether the examinee requests a |
hearing on the contents of the report under subsection |
(f). If the examinee does not sign the order or request a |
hearing on the proposed actions or the final report within |
10 days, the Director may issue a final order imposing the |
sanctions or corrective actions. Nothing in this Section |
prevents the Department from sharing an earlier draft of |
the proposed order with the examinee before issuing the |
final report. |
(6) If the examinee accepts the order and the final |
report, the Director shall hold the content of the order |
and report as private and confidential for a period of 30 |
days. Thereafter, the Director shall open the order and |
report for public inspection. |
(7) If the examinee makes a timely request for a |
hearing on the order, the request must specify the |
sanctions or corrective actions in the order that the |
examinee is challenging. Any hearing shall follow the |
procedures set forth in paragraphs (2) through (7) of |
subsection (g). |
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(8) If the examinee has also requested a hearing on |
the contents of the report, then that hearing shall be |
consolidated with the hearing on the order. The Director |
shall not impose sanctions or corrective actions under |
this Section until the conclusion of the hearing. |
(9) The Director shall issue a decision accompanied by |
findings and conclusions along with any corrective actions |
or sanctions. Any sanctions or corrective actions shall be |
based on the final report accepted by the examinee or |
adopted by the Director under paragraph (9) of subsection |
(g). The Director's order is a final administrative |
decision and shall be served upon the examinee together |
with a copy of the final report within 90 days after the |
conclusion of the hearing or within 10 days after the |
examinee's acceptance of the proposed order and final |
report, as applicable. The hearing is deemed concluded on |
the later of the last date of any live hearing or the final |
deadline date for written submissions to the hearing |
officer, including any continuances or supplemental |
briefings permitted by the hearing officer. |
(10) If an examinee has requested a hearing under this |
subsection (i), the Director shall continue to hold the |
final order and examination report as private and |
confidential for a period of 49 days after the final |
administrative decision. After the 49-day period expires, |
the Director shall open the final order and examination |
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report if a court of competent jurisdiction has not stayed |
their publication. |
(k) National market conduct databases. The Director shall |
collect and report market data to the NAIC's market |
information systems, including, but not limited to, the |
Complaint Database System, the Examination Tracking System, |
and the Regulatory Information Retrieval System, or other |
successor NAIC products as determined by the Director. |
Information collected and maintained by the Department for |
inclusion in these NAIC market information systems shall be |
compiled in a manner that meets the requirements of the NAIC. |
Confidential or privileged information collected, reported, or |
maintained under this subsection (k) shall be subject to the |
protections and restrictions on disclosure in subsection (i). |
(l) Immunity of market conduct surveillance personnel. |
(1) No cause of action shall arise nor shall any |
liability be imposed against the Director, the Director's |
authorized representatives, market conduct surveillance |
personnel, or an examiner appointed by the Director for |
any statements made or conduct performed in good faith |
while carrying out the provisions of this Section. |
(2) No cause of action shall arise nor shall any |
liability be imposed against any person for the act of |
communicating or delivering information or data to the |
Director, the Director's authorized representative, market |
conduct surveillance personnel, or examiner pursuant to an |
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examination made under this Section, if the act of |
communication or delivery was performed in good faith and |
without fraudulent intent or the intent to deceive. |
(3) A person identified in paragraph (1) of this |
subsection (l) shall be entitled to an award of attorney's |
fees and costs if he or she is the prevailing party in a |
civil cause of action for libel, slander, or any other |
relevant tort arising out of activities in carrying out |
the provisions of this Section and the party bringing the |
action was not substantially justified in doing so. As |
used in this paragraph, a proceeding is substantially |
justified if it had a reasonable basis in law or fact at |
the time it was initiated. |
(4) This subsection (l) does not abrogate or modify in |
any way any common law or statutory privilege or immunity |
heretofore enjoyed by any person identified in paragraph |
(1) of this subsection (l). |
(1) The Director, for the purposes of ascertaining the |
non-financial business practices, performance, and operations |
of any company, may make examinations of: |
(a) any company transacting or being organized to |
transact business in this State; |
(b) any person engaged in or proposing to be engaged |
in the organization, promotion, or solicitation of shares |
or capital contributions to or aiding in the formation of |
a company; |
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(c) any person having a contract, written or oral, |
pertaining to the management or control of a company as |
general agent, managing agent, or attorney-in-fact; |
(d) any licensed or registered producer, firm, or |
administrator, or any person, organization, or corporation |
making application for any licenses or registration; |
(e) any person engaged in the business of adjusting |
losses or financing premiums; or |
(f) any person, organization, trust, or corporation |
having custody or control of information reasonably |
related to the operation, performance, or conduct of a |
company or person subject to the jurisdiction of the |
Director. |
(2) Every company or person being examined and its |
officers, directors, and agents must provide to the Director |
convenient and free access at all reasonable hours at its |
office or location to all books, records, documents, and any |
or all papers relating to the business, performance, |
operations, and affairs of the company. The officers, |
directors, and agents of the company or person must facilitate |
the examination and aid in the examination so far as it is in |
their power to do so. |
The Director and any authorized examiner have the power to |
administer oaths and examine under oath any person relative to |
the business of the company being examined. |
(3) The examiners designated by the Director under Section |
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402 must make a full and true report of every examination made |
by them, which contains only facts ascertained from the books, |
papers, records, or documents, and other evidence obtained by |
investigation and examined by them or ascertained from the |
testimony of officers or agents or other persons examined |
under oath concerning the business, affairs, conduct, and |
performance of the company or person. The report of |
examination must be verified by the oath of the examiner in |
charge thereof, and when so verified is prima facie evidence |
in any action or proceeding in the name of the State against |
the company, its officers, or agents upon the facts stated |
therein. |
(4) The Director must notify the company or person made |
the subject of any examination hereunder of the contents of |
the verified examination report before filing it and making |
the report public of any matters relating thereto, and must |
afford the company or person an opportunity to demand a |
hearing with reference to the facts and other evidence therein |
contained. |
The company or person may request a hearing within 10 days |
after receipt of the examination report by giving the Director |
written notice of that request, together with a statement of |
its objections. The Director must then conduct a hearing in |
accordance with Sections 402 and 403. He must issue a written |
order based upon the examination report and upon the hearing |
within 90 days after the report is filed or within 90 days |
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after the hearing. |
If the examination reveals that the company is operating |
in violation of any law, regulation, or prior order, the |
Director in the written order may require the company or |
person to take any action he considers necessary or |
appropriate in accordance with the report of examination or |
any hearing thereon. The order is subject to judicial review |
under the Administrative Review Law. The Director may withhold |
any report from public inspection for such time as he may deem |
proper and may, after filing the same, publish any part or all |
of the report as he considers to be in the interest of the |
public, in one or more newspapers in this State, without |
expense to the company. |
(5) Any company which or person who violates or aids and |
abets any violation of a written order issued under this |
Section shall be guilty of a business offense and may be fined |
not more than $5,000. The penalty shall be paid into the |
General Revenue fund of the State of Illinois. |
(Source: P.A. 87-108.) |
|
(215 ILCS 5/132.5) (from Ch. 73, par. 744.5) |
Sec. 132.5. Examination reports. |
(a) General description. All examination reports shall be |
comprised of only facts appearing upon the books, records, or |
other documents of the company, its agents, or other persons |
examined or as ascertained from the testimony of its officers, |
|
agents, or other persons examined concerning its affairs and |
the conclusions and recommendations as the examiners find |
reasonably warranted from those facts. |
(b) Filing of examination report. No later than 60 days |
following completion of the examination, the examiner in |
charge shall file with the Department a verified written |
report of examination under oath. Upon receipt of the verified |
report, the Department shall transmit the report to the |
company examined, together with a notice that affords the |
company examined a reasonable opportunity of not more than 30 |
days to make a written submission or rebuttal with respect to |
any matters contained in the examination report. |
(c) Adoption of the report on examination. Within 30 days |
of the end of the period allowed for the receipt of written |
submissions or rebuttals, the Director shall fully consider |
and review the report, together with any written submissions |
or rebuttals and any relevant portions of the examiners work |
papers and enter an order: |
(1) Adopting the examination report as filed or with |
modification or corrections. If the examination report |
reveals that the company is operating in violation of any |
law, regulation, or prior order of the Director, the |
Director may order the company to take any action the |
Director considers necessary and appropriate to cure the |
violation. |
(2) Rejecting the examination report with directions |
|
to the examiners to reopen the examination for purposes of |
obtaining additional data, documentation, or information |
and refiling under subsection (b). |
(3) Calling for an investigatory hearing with no less |
than 20 days notice to the company for purposes of |
obtaining additional documentation, data, information, and |
testimony. |
(d) Order and procedures. All orders entered under |
paragraph (1) of subsection (c) shall be accompanied by |
findings and conclusions resulting from the Director's |
consideration and review of the examination report, relevant |
examiner work papers, and any written submissions or |
rebuttals. The order shall be considered a final |
administrative decision and may be appealed in accordance with |
the Administrative Review Law. The order shall be served upon |
the company by certified mail, together with a copy of the |
adopted examination report. Within 30 days of the issuance of |
the adopted report, the company shall file affidavits executed |
by each of its directors stating under oath that they have |
received a copy of the adopted report and related orders. |
Any hearing conducted under paragraph (3) of subsection |
(c) by the Director or an authorized representative shall be |
conducted as a nonadversarial confidential investigatory |
proceeding as necessary for the resolution of any |
inconsistencies, discrepancies, or disputed issues apparent |
upon the face of the filed examination report or raised by or |
|
as a result of the Director's review of relevant work papers or |
by the written submission or rebuttal of the company. Within |
20 days of the conclusion of any hearing, the Director shall |
enter an order under paragraph (1) of subsection (c). |
The Director shall not appoint an examiner as an |
authorized representative to conduct the hearing. The hearing |
shall proceed expeditiously with discovery by the company |
limited to the examiner's work papers that tend to |
substantiate any assertions set forth in any written |
submission or rebuttal. The Director or his representative may |
issue subpoenas for the attendance of any witnesses or the |
production of any documents deemed relevant to the |
investigation, whether under the control of the Department, |
the company, or other persons. The documents produced shall be |
included in the record, and testimony taken by the Director or |
his representative shall be under oath and preserved for the |
record. Nothing contained in this Section shall require the |
Department to disclose any information or records that would |
indicate or show the existence or content of any investigation |
or activity of a criminal justice agency. |
The hearing shall proceed with the Director or his |
representative posing questions to the persons subpoenaed. |
Thereafter , the company and the Department may present |
testimony relevant to the investigation. Cross-examination |
shall be conducted only by the Director or his representative. |
The company and the Department shall be permitted to make |
|
closing statements and may be represented by counsel of their |
choice. |
(e) Publication and use. Upon the adoption of the |
examination report under paragraph (1) of subsection (c), the |
Director shall continue to hold the content of the examination |
report as private and confidential information for a period of |
35 days, except to the extent provided in subsection (b). |
Thereafter, the Director may open the report for public |
inspection so long as no court of competent jurisdiction has |
stayed its publication. |
Nothing contained in this Code shall prevent or be |
construed as prohibiting the Director from disclosing the |
content of an examination report, preliminary examination |
report or results, or any matter relating thereto, to the |
insurance department of any other state or country or to law |
enforcement officials of this or any other state or agency of |
the federal government at any time, so long as the agency or |
office receiving the report or matters relating thereto agrees |
in writing to hold it confidential and in a manner consistent |
with this Code. |
In the event the Director determines that regulatory |
action is appropriate as a result of any examination, he may |
initiate any proceedings or actions as provided by law. |
(f) Confidentiality of ancillary information. All working |
papers, recorded information, documents, and copies thereof |
produced by, obtained by, or disclosed to the Director or any |
|
other person in the course of any examination must be given |
confidential treatment, are not subject to subpoena, and may |
not be made public by the Director or any other persons, except |
to the extent provided in subsection (e). Access may also be |
granted to the National Association of Insurance |
Commissioners. Those parties must agree in writing before |
receiving the information to provide to it the same |
confidential treatment as required by this Section, unless the |
prior written consent of the company to which it pertains has |
been obtained. |
This subsection (f) applies to market conduct examinations |
described in Section 132 of this Code. |
(g) Disclosure. Nothing contained in this Code shall |
prevent or be construed as prohibiting the Director from |
disclosing the information described in subsections (e) and |
(f) to the Illinois Insurance Guaranty Fund regarding any |
member company defined in Section 534.5 if the member company |
has an authorized control level event as defined in Section |
35A-25. The Director may disclose the information described in |
this subsection so long as the Fund agrees in writing to hold |
that information confidential, in a manner consistent with |
this Code, and uses that information to prepare for the |
possible liquidation of the member company. Access to the |
information disclosed by the Director to the Fund shall be |
limited to the Fund's staff and its counsel. The Board of |
Directors of the Fund may have access to the information |
|
disclosed by the Director to the Fund once the member company |
is subject to a delinquency proceeding under Article XIII |
subject to any terms and conditions established by the |
Director. |
(Source: P.A. 102-929, eff. 5-27-22.) |
|
(215 ILCS 5/155.35) |
Sec. 155.35. Insurance compliance self-evaluative |
privilege. |
(a) To encourage insurance companies and persons |
conducting activities regulated under this Code, both to |
conduct voluntary internal audits of their compliance programs |
and management systems and to assess and improve compliance |
with State and federal statutes, rules, and orders, an |
insurance compliance self-evaluative privilege is recognized |
to protect the confidentiality of communications relating to |
voluntary internal compliance audits. The General Assembly |
hereby finds and declares that protection of insurance |
consumers is enhanced by companies' voluntary compliance with |
this State's insurance and other laws and that the public will |
benefit from incentives to identify and remedy insurance and |
other compliance issues. It is further declared that limited |
expansion of the protection against disclosure will encourage |
voluntary compliance and improve insurance market conduct |
quality and that the voluntary provisions of this Section will |
not inhibit the exercise of the regulatory authority by those |
|
entrusted with protecting insurance consumers. |
(b)(1) An insurance compliance self-evaluative audit |
document is privileged information and is not admissible as |
evidence in any legal action in any civil, criminal, or |
administrative proceeding, except as provided in subsections |
(c) and (d) of this Section. Documents, communications, data, |
reports, or other information created as a result of a claim |
involving personal injury or workers' compensation made |
against an insurance policy are not insurance compliance |
self-evaluative audit documents and are admissible as evidence |
in civil proceedings as otherwise provided by applicable rules |
of evidence or civil procedure, subject to any applicable |
statutory or common law privilege, including , but not limited |
to , the work product doctrine, the attorney-client privilege, |
or the subsequent remedial measures exclusion. |
(2) If any company, person, or entity performs or directs |
the performance of an insurance compliance audit, an officer |
or employee involved with the insurance compliance audit, or |
any consultant who is hired for the purpose of performing the |
insurance compliance audit, may not be examined in any civil, |
criminal, or administrative proceeding as to the insurance |
compliance audit or any insurance compliance self-evaluative |
audit document, as defined in this Section. This subsection |
(b)(2) does not apply if the privilege set forth in subsection |
(b)(1) of this Section is determined under subsection (c) or |
(d) not to apply. |
|
(3) A company may voluntarily submit, in connection with |
examinations conducted under this Article, an insurance |
compliance self-evaluative audit document to the Director, or |
his or her designee, as a confidential document under |
subsection (i) of Section 132 or subsection (f) of Section |
132.5 of this Code without waiving the privilege set forth in |
this Section to which the company would otherwise be entitled; |
provided, however, that the provisions in Sections 132 and |
subsection (f) of Section 132.5 permitting the Director to |
make confidential documents public pursuant to subsection (e) |
of Section 132.5 and grant access to the National Association |
of Insurance Commissioners shall not apply to the insurance |
compliance self-evaluative audit document so voluntarily |
submitted. Nothing contained in this subsection shall give the |
Director any authority to compel a company to disclose |
involuntarily or otherwise provide an insurance compliance |
self-evaluative audit document. |
(c)(1) The privilege set forth in subsection (b) of this |
Section does not apply to the extent that it is expressly |
waived by the company that prepared or caused to be prepared |
the insurance compliance self-evaluative audit document. |
(2) In a civil or administrative proceeding, a court of |
record may, after an in camera review, require disclosure of |
material for which the privilege set forth in subsection (b) |
of this Section is asserted, if the court determines one of the |
following: |
|
(A) the privilege is asserted for a fraudulent |
purpose; |
(B) the material is not subject to the privilege; or |
(C) even if subject to the privilege, the material |
shows evidence of noncompliance with State and federal |
statutes, rules and orders and the company failed to |
undertake reasonable corrective action or eliminate the |
noncompliance within a reasonable time. |
(3) In a criminal proceeding, a court of record may, after |
an in camera review, require disclosure of material for which |
the privilege described in subsection (b) of this Section is |
asserted, if the court determines one of the following: |
(A) the privilege is asserted for a fraudulent |
purpose; |
(B) the material is not subject to the privilege; |
(C) even if subject to the privilege, the material |
shows evidence of noncompliance with State and federal |
statutes, rules and orders and the company failed to |
undertake reasonable corrective action or eliminate such |
noncompliance within a reasonable time; or |
(D) the material contains evidence relevant to |
commission of a criminal offense under this Code, and all |
of the following factors are present: |
(i) the Director, State's Attorney, or Attorney |
General has a compelling need for the information; |
(ii) the information is not otherwise available; |
|
and |
(iii) the Director, State's Attorney, or Attorney |
General is unable to obtain the substantial equivalent |
of the information by any means without incurring |
unreasonable cost and delay. |
(d)(1) Within 30 days after the Director, State's |
Attorney, or Attorney General makes a written request by |
certified mail for disclosure of an insurance compliance |
self-evaluative audit document under this subsection, the |
company that prepared or caused the document to be prepared |
may file with the appropriate court a petition requesting an |
in camera hearing on whether the insurance compliance |
self-evaluative audit document or portions of the document are |
privileged under this Section or subject to disclosure. The |
court has jurisdiction over a petition filed by a company |
under this subsection requesting an in camera hearing on |
whether the insurance compliance self-evaluative audit |
document or portions of the document are privileged or subject |
to disclosure. Failure by the company to file a petition |
waives the privilege. |
(2) A company asserting the insurance compliance |
self-evaluative privilege in response to a request for |
disclosure under this subsection shall include in its request |
for an in camera hearing all of the information set forth in |
subsection (d)(5) of this Section. |
(3) Upon the filing of a petition under this subsection, |
|
the court shall issue an order scheduling, within 45 days |
after the filing of the petition, an in camera hearing to |
determine whether the insurance compliance self-evaluative |
audit document or portions of the document are privileged |
under this Section or subject to disclosure. |
(4) The court, after an in camera review, may require |
disclosure of material for which the privilege in subsection |
(b) of this Section is asserted if the court determines, based |
upon its in camera review, that any one of the conditions set |
forth in subsection (c)(2)(A) through (C) is applicable as to |
a civil or administrative proceeding or that any one of the |
conditions set forth in subsection (c)(3)(A) through (D) is |
applicable as to a criminal proceeding. Upon making such a |
determination, the court may only compel the disclosure of |
those portions of an insurance compliance self-evaluative |
audit document relevant to issues in dispute in the underlying |
proceeding. Any compelled disclosure will not be considered to |
be a public document or be deemed to be a waiver of the |
privilege for any other civil, criminal, or administrative |
proceeding. A party unsuccessfully opposing disclosure may |
apply to the court for an appropriate order protecting the |
document from further disclosure. |
(5) A company asserting the insurance compliance |
self-evaluative privilege in response to a request for |
disclosure under this subsection (d) shall provide to the |
Director, State's Attorney, or Attorney General, as the case |
|
may be, at the time of filing any objection to the disclosure, |
all of the following information: |
(A) The date of the insurance compliance |
self-evaluative audit document. |
(B) The identity of the entity conducting the audit. |
(C) The general nature of the activities covered by |
the insurance compliance audit. |
(D) An identification of the portions of the insurance |
compliance self-evaluative audit document for which the |
privilege is being asserted. |
(e) (1) A company asserting the insurance compliance |
self-evaluative privilege set forth in subsection (b) of this |
Section has the burden of demonstrating the applicability of |
the privilege. Once a company has established the |
applicability of the privilege, a party seeking disclosure |
under subsections (c)(2)(A) or (C) of this Section has the |
burden of proving that the privilege is asserted for a |
fraudulent purpose or that the company failed to undertake |
reasonable corrective action or eliminate the noncompliance |
with a reasonable time. The Director, State's Attorney, or |
Attorney General seeking disclosure under subsection (c)(3) of |
this Section has the burden of proving the elements set forth |
in subsection (c)(3) of this Section. |
(2) The parties may at any time stipulate in proceedings |
under subsections (c) or (d) of this Section to entry of an |
order directing that specific information contained in an |
|
insurance compliance self-evaluative audit document is or is |
not subject to the privilege provided under subsection (b) of |
this Section. |
(f) The privilege set forth in subsection (b) of this |
Section shall not extend to any of the following: |
(1) documents, communications, data, reports, or other |
information required to be collected, developed, |
maintained, reported, or otherwise made available to a |
regulatory agency pursuant to this Code, or other federal |
or State law, rule, or order; |
(2) information obtained by observation or monitoring |
by any regulatory agency; or |
(3) information obtained from a source independent of |
the insurance compliance audit. |
(g) As used in this Section: |
(1) "Insurance compliance audit" means a voluntary, |
internal evaluation, review, assessment, or audit not |
otherwise expressly required by law of a company or an |
activity regulated under this Code, or other State or |
federal law applicable to a company, or of management |
systems related to the company or activity, that is |
designed to identify and prevent noncompliance and to |
improve compliance with those statutes, rules, or orders. |
An insurance compliance audit may be conducted by the |
company, its employees, or by independent contractors. |
(2) "Insurance compliance self-evaluative audit |
|
document" means documents prepared as a result of or in |
connection with and not prior to an insurance compliance |
audit. An insurance compliance self-evaluation audit |
document may include a written response to the findings of |
an insurance compliance audit. An insurance compliance |
self-evaluative audit document may include, but is not |
limited to, as applicable, field notes and records of |
observations, findings, opinions, suggestions, |
conclusions, drafts, memoranda, drawings, photographs, |
computer-generated or electronically recorded |
information, phone records, maps, charts, graphs, and |
surveys, provided this supporting information is collected |
or developed for the primary purpose and in the course of |
an insurance compliance audit. An insurance compliance |
self-evaluative audit document may also include any of the |
following: |
(A) an insurance compliance audit report prepared |
by an auditor, who may be an employee of the company or |
an independent contractor, which may include the scope |
of the audit, the information gained in the audit, and |
conclusions and recommendations, with exhibits and |
appendices; |
(B) memoranda and documents analyzing portions or |
all of the insurance compliance audit report and |
discussing potential implementation issues; |
(C) an implementation plan that addresses |
|
correcting past noncompliance, improving current |
compliance, and preventing future noncompliance; or |
(D) analytic data generated in the course of |
conducting the insurance compliance audit. |
(3) "Company" has the same meaning as provided in |
Section 2 of this Code. |
(h) Nothing in this Section shall limit, waive, or |
abrogate the scope or nature of any statutory or common law |
privilege including, but not limited to, the work product |
doctrine, the attorney-client privilege, or the subsequent |
remedial measures exclusion. |
(Source: P.A. 90-499, eff. 8-19-97; 90-655, eff. 7-30-98.) |
|
(215 ILCS 5/402) (from Ch. 73, par. 1014) |
Sec. 402. Examinations, investigations and hearings. (1) |
All examinations, investigations and hearings provided for by |
this Code may be conducted either by the Director personally, |
or by one or more of the actuaries, technical advisors, |
deputies, supervisors or examiners employed or retained by the |
Department and designated by the Director for such purpose. |
When necessary to supplement its examination procedures, the |
Department may retain independent actuaries deemed competent |
by the Director, independent certified public accountants, or |
qualified examiners of insurance companies , or other qualified |
outside professional assistance deemed competent by the |
Director, or any combination of the foregoing, the cost of |
|
which shall be borne by the company or person being examined. |
The Director may compensate independent actuaries, certified |
public accountants , and qualified examiners , and other |
qualified outside professional assistance retained for |
supplementing examination procedures in amounts not to exceed |
the reasonable and customary charges for such services. The |
Director may also accept as a part of the Department's |
examination of any company or person (a) a report by an |
independent actuary deemed competent by the Director or (b) a |
report of an audit made by an independent certified public |
accountant. Neither those persons so designated nor any |
members of their immediate families shall be officers of, |
connected with, or financially interested in any company other |
than as policyholders, nor shall they be financially |
interested in any other corporation or person affected by the |
examination, investigation or hearing. |
(2) All hearings provided for in this Code shall, unless |
otherwise specially provided, be held at such time and place |
as shall be designated in a notice which shall be given by the |
Director in writing to the person or company whose interests |
are affected, at least 10 days before the date designated |
therein. The notice shall state the subject of inquiry and the |
specific charges, if any. The hearings shall be held in the |
City of Springfield, the City of Chicago, or in the county |
where the principal business address of the person or company |
affected is located. |
|
(Source: P.A. 87-757.) |
|
(215 ILCS 5/408) (from Ch. 73, par. 1020) |
(Text of Section before amendment by P.A. 103-75 ) |
Sec. 408. Fees and charges. |
(1) The Director shall charge, collect and give proper |
acquittances for the payment of the following fees and |
charges: |
(a) For filing all documents submitted for the |
incorporation or organization or certification of a |
domestic company, except for a fraternal benefit society, |
$2,000. |
(b) For filing all documents submitted for the |
incorporation or organization of a fraternal benefit |
society, $500. |
(c) For filing amendments to articles of incorporation |
and amendments to declaration of organization, except for |
a fraternal benefit society, a mutual benefit association, |
a burial society or a farm mutual, $200. |
(d) For filing amendments to articles of incorporation |
of a fraternal benefit society, a mutual benefit |
association or a burial society, $100. |
(e) For filing amendments to articles of incorporation |
of a farm mutual, $50. |
(f) For filing bylaws or amendments thereto, $50. |
(g) For filing agreement of merger or consolidation: |
|
(i) for a domestic company, except for a fraternal |
benefit society, a mutual benefit association, a |
burial society, or a farm mutual, $2,000. |
(ii) for a foreign or alien company, except for a |
fraternal benefit society, $600. |
(iii) for a fraternal benefit society, a mutual |
benefit association, a burial society, or a farm |
mutual, $200. |
(h) For filing agreements of reinsurance by a domestic |
company, $200. |
(i) For filing all documents submitted by a foreign or |
alien company to be admitted to transact business or |
accredited as a reinsurer in this State, except for a |
fraternal benefit society, $5,000. |
(j) For filing all documents submitted by a foreign or |
alien fraternal benefit society to be admitted to transact |
business in this State, $500. |
(k) For filing declaration of withdrawal of a foreign |
or alien company, $50. |
(l) For filing annual statement by a domestic company, |
except a fraternal benefit society, a mutual benefit |
association, a burial society, or a farm mutual, $200. |
(m) For filing annual statement by a domestic |
fraternal benefit society, $100. |
(n) For filing annual statement by a farm mutual, a |
mutual benefit association, or a burial society, $50. |
|
(o) For issuing a certificate of authority or renewal |
thereof except to a foreign fraternal benefit society, |
$400. |
(p) For issuing a certificate of authority or renewal |
thereof to a foreign fraternal benefit society, $200. |
(q) For issuing an amended certificate of authority, |
$50. |
(r) For each certified copy of certificate of |
authority, $20. |
(s) For each certificate of deposit, or valuation, or |
compliance or surety certificate, $20. |
(t) For copies of papers or records per page, $1. |
(u) For each certification to copies of papers or |
records, $10. |
(v) For multiple copies of documents or certificates |
listed in subparagraphs (r), (s), and (u) of paragraph (1) |
of this Section, $10 for the first copy of a certificate of |
any type and $5 for each additional copy of the same |
certificate requested at the same time, unless, pursuant |
to paragraph (2) of this Section, the Director finds these |
additional fees excessive. |
(w) For issuing a permit to sell shares or increase |
paid-up capital: |
(i) in connection with a public stock offering, |
$300; |
(ii) in any other case, $100. |
|
(x) For issuing any other certificate required or |
permissible under the law, $50. |
(y) For filing a plan of exchange of the stock of a |
domestic stock insurance company, a plan of |
demutualization of a domestic mutual company, or a plan of |
reorganization under Article XII, $2,000. |
(z) For filing a statement of acquisition of a |
domestic company as defined in Section 131.4 of this Code, |
$2,000. |
(aa) For filing an agreement to purchase the business |
of an organization authorized under the Dental Service |
Plan Act or the Voluntary Health Services Plans Act or of a |
health maintenance organization or a limited health |
service organization, $2,000. |
(bb) For filing a statement of acquisition of a |
foreign or alien insurance company as defined in Section |
131.12a of this Code, $1,000. |
(cc) For filing a registration statement as required |
in Sections 131.13 and 131.14, the notification as |
required by Sections 131.16, 131.20a, or 141.4, or an |
agreement or transaction required by Sections 124.2(2), |
141, 141a, or 141.1, $200. |
(dd) For filing an application for licensing of: |
(i) a religious or charitable risk pooling trust |
or a workers' compensation pool, $1,000; |
(ii) a workers' compensation service company, |
|
$500; |
(iii) a self-insured automobile fleet, $200; or |
(iv) a renewal of or amendment of any license |
issued pursuant to (i), (ii), or (iii) above, $100. |
(ee) For filing articles of incorporation for a |
syndicate to engage in the business of insurance through |
the Illinois Insurance Exchange, $2,000. |
(ff) For filing amended articles of incorporation for |
a syndicate engaged in the business of insurance through |
the Illinois Insurance Exchange, $100. |
(gg) For filing articles of incorporation for a |
limited syndicate to join with other subscribers or |
limited syndicates to do business through the Illinois |
Insurance Exchange, $1,000. |
(hh) For filing amended articles of incorporation for |
a limited syndicate to do business through the Illinois |
Insurance Exchange, $100. |
(ii) For a permit to solicit subscriptions to a |
syndicate or limited syndicate, $100. |
(jj) For the filing of each form as required in |
Section 143 of this Code, $50 per form. Informational and |
advertising filings shall be $25 per filing. The fee for |
advisory and rating organizations shall be $200 per form. |
(i) For the purposes of the form filing fee, |
filings made on insert page basis will be considered |
one form at the time of its original submission. |
|
Changes made to a form subsequent to its approval |
shall be considered a new filing. |
(ii) Only one fee shall be charged for a form, |
regardless of the number of other forms or policies |
with which it will be used. |
(iii) Fees charged for a policy filed as it will be |
issued regardless of the number of forms comprising |
that policy shall not exceed $1,500. For advisory or |
rating organizations, fees charged for a policy filed |
as it will be issued regardless of the number of forms |
comprising that policy shall not exceed $2,500. |
(iv) The Director may by rule exempt forms from |
such fees. |
(kk) For filing an application for licensing of a |
reinsurance intermediary, $500. |
(ll) For filing an application for renewal of a |
license of a reinsurance intermediary, $200. |
(mm) For filing a plan of division of a domestic stock |
company under Article IIB, $10,000. |
(nn) For filing all documents submitted by a foreign |
or alien company to be a certified reinsurer in this |
State, except for a fraternal benefit society, $1,000. |
(oo) For filing a renewal by a foreign or alien |
company to be a certified reinsurer in this State, except |
for a fraternal benefit society, $400. |
(pp) For filing all documents submitted by a reinsurer |
|
domiciled in a reciprocal jurisdiction, $1,000. |
(qq) For filing a renewal by a reinsurer domiciled in |
a reciprocal jurisdiction, $400. |
(rr) For registering a captive management company or |
renewal thereof, $50. |
(2) When printed copies or numerous copies of the same |
paper or records are furnished or certified, the Director may |
reduce such fees for copies if he finds them excessive. He may, |
when he considers it in the public interest, furnish without |
charge to state insurance departments and persons other than |
companies, copies or certified copies of reports of |
examinations and of other papers and records. |
(3) (a) The expenses incurred in any performance |
examination authorized by law shall be paid by the company or |
person being examined. The charge shall be consistent with |
that otherwise authorized by law and shall be reasonably |
related to the cost of the examination including but not |
limited to compensation of examiners, electronic data |
processing costs, supervision and preparation of an |
examination report and lodging and travel expenses. All |
lodging and travel expenses shall be in accord with the |
applicable travel regulations as published by the Department |
of Central Management Services and approved by the Governor's |
Travel Control Board, except that out-of-state lodging and |
travel expenses related to examinations authorized under |
Section 132 shall be in accordance with travel rates |
|
prescribed under paragraph 301-7.2 of the Federal Travel |
Regulations, 41 C.F.R. 301-7.2, for reimbursement of |
subsistence expenses incurred during official travel. All |
lodging and travel expenses may be reimbursed directly upon |
authorization of the Director. With the exception of the |
direct reimbursements authorized by the Director, all |
performance examination charges collected by the Department |
shall be paid to the Insurance Producer Administration Fund, |
however, the electronic data processing costs incurred by the |
Department in the performance of any examination shall be |
billed directly to the company being examined for payment to |
the Technology Management Revolving Fund. |
(b) The costs and fees incurred in a market conduct |
examination shall be itemized and bills shall be provided to |
the examinee on a monthly basis for review prior to submission |
for payment. The Director shall review and affirmatively |
endorse detailed billings from any contracted, qualified |
outside professional assistance retained under Section 402 for |
market conduct examinations before the detailed billings are |
sent to the examinee. Before any qualified outside |
professional assistance conducts billable work on an |
examination, the Department shall disclose to the examinee the |
terms of the contracts with the qualified outside professional |
assistance that will be used, including the fees and hourly |
rates that can be charged. |
(4) At the time of any service of process on the Director |
|
as attorney for such service, the Director shall charge and |
collect the sum of $40, which may be recovered as taxable costs |
by the party to the suit or action causing such service to be |
made if he prevails in such suit or action. |
(5) (a) The costs incurred by the Department of Insurance |
in conducting any hearing authorized by law shall be assessed |
against the parties to the hearing in such proportion as the |
Director of Insurance may determine upon consideration of all |
relevant circumstances including: (1) the nature of the |
hearing; (2) whether the hearing was instigated by, or for the |
benefit of a particular party or parties; (3) whether there is |
a successful party on the merits of the proceeding; and (4) the |
relative levels of participation by the parties. |
(b) For purposes of this subsection (5) costs incurred |
shall mean the hearing officer fees, court reporter fees, and |
travel expenses of Department of Insurance officers and |
employees; provided however, that costs incurred shall not |
include hearing officer fees or court reporter fees unless the |
Department has retained the services of independent |
contractors or outside experts to perform such functions. |
(c) The Director shall make the assessment of costs |
incurred as part of the final order or decision arising out of |
the proceeding; provided, however, that such order or decision |
shall include findings and conclusions in support of the |
assessment of costs. This subsection (5) shall not be |
construed as permitting the payment of travel expenses unless |
|
calculated in accordance with the applicable travel |
regulations of the Department of Central Management Services, |
as approved by the Governor's Travel Control Board. The |
Director as part of such order or decision shall require all |
assessments for hearing officer fees and court reporter fees, |
if any, to be paid directly to the hearing officer or court |
reporter by the party(s) assessed for such costs. The |
assessments for travel expenses of Department officers and |
employees shall be reimbursable to the Director of Insurance |
for deposit to the fund out of which those expenses had been |
paid. |
(d) The provisions of this subsection (5) shall apply in |
the case of any hearing conducted by the Director of Insurance |
not otherwise specifically provided for by law. |
(6) The Director shall charge and collect an annual |
financial regulation fee from every domestic company for |
examination and analysis of its financial condition and to |
fund the internal costs and expenses of the Interstate |
Insurance Receivership Commission as may be allocated to the |
State of Illinois and companies doing an insurance business in |
this State pursuant to Article X of the Interstate Insurance |
Receivership Compact. The fee shall be the greater fixed |
amount based upon the combination of nationwide direct premium |
income and nationwide reinsurance assumed premium income or |
upon admitted assets calculated under this subsection as |
follows: |
|
(a) Combination of nationwide direct premium income |
and nationwide reinsurance assumed premium. |
(i) $150, if the premium is less than $500,000 and |
there is no reinsurance assumed premium; |
(ii) $750, if the premium is $500,000 or more, but |
less than $5,000,000 and there is no reinsurance |
assumed premium; or if the premium is less than |
$5,000,000 and the reinsurance assumed premium is less |
than $10,000,000; |
(iii) $3,750, if the premium is less than |
$5,000,000 and the reinsurance assumed premium is |
$10,000,000 or more; |
(iv) $7,500, if the premium is $5,000,000 or more, |
but less than $10,000,000; |
(v) $18,000, if the premium is $10,000,000 or |
more, but less than $25,000,000; |
(vi) $22,500, if the premium is $25,000,000 or |
more, but less than $50,000,000; |
(vii) $30,000, if the premium is $50,000,000 or |
more, but less than $100,000,000; |
(viii) $37,500, if the premium is $100,000,000 or |
more. |
(b) Admitted assets. |
(i) $150, if admitted assets are less than |
$1,000,000; |
(ii) $750, if admitted assets are $1,000,000 or |
|
more, but less than $5,000,000; |
(iii) $3,750, if admitted assets are $5,000,000 or |
more, but less than $25,000,000; |
(iv) $7,500, if admitted assets are $25,000,000 or |
more, but less than $50,000,000; |
(v) $18,000, if admitted assets are $50,000,000 or |
more, but less than $100,000,000; |
(vi) $22,500, if admitted assets are $100,000,000 |
or more, but less than $500,000,000; |
(vii) $30,000, if admitted assets are $500,000,000 |
or more, but less than $1,000,000,000; |
(viii) $37,500, if admitted assets are |
$1,000,000,000 or more. |
(c) The sum of financial regulation fees charged to |
the domestic companies of the same affiliated group shall |
not exceed $250,000 in the aggregate in any single year |
and shall be billed by the Director to the member company |
designated by the group. |
(7) The Director shall charge and collect an annual |
financial regulation fee from every foreign or alien company, |
except fraternal benefit societies, for the examination and |
analysis of its financial condition and to fund the internal |
costs and expenses of the Interstate Insurance Receivership |
Commission as may be allocated to the State of Illinois and |
companies doing an insurance business in this State pursuant |
to Article X of the Interstate Insurance Receivership Compact. |
|
The fee shall be a fixed amount based upon Illinois direct |
premium income and nationwide reinsurance assumed premium |
income in accordance with the following schedule: |
(a) $150, if the premium is less than $500,000 and |
there is no reinsurance assumed premium; |
(b) $750, if the premium is $500,000 or more, but less |
than $5,000,000 and there is no reinsurance assumed |
premium; or if the premium is less than $5,000,000 and the |
reinsurance assumed premium is less than $10,000,000; |
(c) $3,750, if the premium is less than $5,000,000 and |
the reinsurance assumed premium is $10,000,000 or more; |
(d) $7,500, if the premium is $5,000,000 or more, but |
less than $10,000,000; |
(e) $18,000, if the premium is $10,000,000 or more, |
but less than $25,000,000; |
(f) $22,500, if the premium is $25,000,000 or more, |
but less than $50,000,000; |
(g) $30,000, if the premium is $50,000,000 or more, |
but less than $100,000,000; |
(h) $37,500, if the premium is $100,000,000 or more. |
The sum of financial regulation fees under this subsection |
(7) charged to the foreign or alien companies within the same |
affiliated group shall not exceed $250,000 in the aggregate in |
any single year and shall be billed by the Director to the |
member company designated by the group. |
(8) Beginning January 1, 1992, the financial regulation |
|
fees imposed under subsections (6) and (7) of this Section |
shall be paid by each company or domestic affiliated group |
annually. After January 1, 1994, the fee shall be billed by |
Department invoice based upon the company's premium income or |
admitted assets as shown in its annual statement for the |
preceding calendar year. The invoice is due upon receipt and |
must be paid no later than June 30 of each calendar year. All |
financial regulation fees collected by the Department shall be |
paid to the Insurance Financial Regulation Fund. The |
Department may not collect financial examiner per diem charges |
from companies subject to subsections (6) and (7) of this |
Section undergoing financial examination after June 30, 1992. |
(9) In addition to the financial regulation fee required |
by this Section, a company undergoing any financial |
examination authorized by law shall pay the following costs |
and expenses incurred by the Department: electronic data |
processing costs, the expenses authorized under Section 131.21 |
and subsection (d) of Section 132.4 of this Code, and lodging |
and travel expenses. |
Electronic data processing costs incurred by the |
Department in the performance of any examination shall be |
billed directly to the company undergoing examination for |
payment to the Technology Management Revolving Fund. Except |
for direct reimbursements authorized by the Director or direct |
payments made under Section 131.21 or subsection (d) of |
Section 132.4 of this Code, all financial regulation fees and |
|
all financial examination charges collected by the Department |
shall be paid to the Insurance Financial Regulation Fund. |
All lodging and travel expenses shall be in accordance |
with applicable travel regulations published by the Department |
of Central Management Services and approved by the Governor's |
Travel Control Board, except that out-of-state lodging and |
travel expenses related to examinations authorized under |
Sections 132.1 through 132.7 shall be in accordance with |
travel rates prescribed under paragraph 301-7.2 of the Federal |
Travel Regulations, 41 C.F.R. 301-7.2, for reimbursement of |
subsistence expenses incurred during official travel. All |
lodging and travel expenses may be reimbursed directly upon |
the authorization of the Director. |
In the case of an organization or person not subject to the |
financial regulation fee, the expenses incurred in any |
financial examination authorized by law shall be paid by the |
organization or person being examined. The charge shall be |
reasonably related to the cost of the examination including, |
but not limited to, compensation of examiners and other costs |
described in this subsection. |
(10) Any company, person, or entity failing to make any |
payment of $150 or more as required under this Section shall be |
subject to the penalty and interest provisions provided for in |
subsections (4) and (7) of Section 412. |
(11) Unless otherwise specified, all of the fees collected |
under this Section shall be paid into the Insurance Financial |
|
Regulation Fund. |
(12) For purposes of this Section: |
(a) "Domestic company" means a company as defined in |
Section 2 of this Code which is incorporated or organized |
under the laws of this State, and in addition includes a |
not-for-profit corporation authorized under the Dental |
Service Plan Act or the Voluntary Health Services Plans |
Act, a health maintenance organization, and a limited |
health service organization. |
(b) "Foreign company" means a company as defined in |
Section 2 of this Code which is incorporated or organized |
under the laws of any state of the United States other than |
this State and in addition includes a health maintenance |
organization and a limited health service organization |
which is incorporated or organized under the laws of any |
state of the United States other than this State. |
(c) "Alien company" means a company as defined in |
Section 2 of this Code which is incorporated or organized |
under the laws of any country other than the United |
States. |
(d) "Fraternal benefit society" means a corporation, |
society, order, lodge or voluntary association as defined |
in Section 282.1 of this Code. |
(e) "Mutual benefit association" means a company, |
association or corporation authorized by the Director to |
do business in this State under the provisions of Article |
|
XVIII of this Code. |
(f) "Burial society" means a person, firm, |
corporation, society or association of individuals |
authorized by the Director to do business in this State |
under the provisions of Article XIX of this Code. |
(g) "Farm mutual" means a district, county and |
township mutual insurance company authorized by the |
Director to do business in this State under the provisions |
of the Farm Mutual Insurance Company Act of 1986. |
(Source: P.A. 102-775, eff. 5-13-22.) |
(Text of Section after amendment by P.A. 103-75 ) |
Sec. 408. Fees and charges. |
(1) The Director shall charge, collect and give proper |
acquittances for the payment of the following fees and |
charges: |
(a) For filing all documents submitted for the |
incorporation or organization or certification of a |
domestic company, except for a fraternal benefit society, |
$2,000. |
(b) For filing all documents submitted for the |
incorporation or organization of a fraternal benefit |
society, $500. |
(c) For filing amendments to articles of incorporation |
and amendments to declaration of organization, except for |
a fraternal benefit society, a mutual benefit association, |
|
a burial society or a farm mutual, $200. |
(d) For filing amendments to articles of incorporation |
of a fraternal benefit society, a mutual benefit |
association or a burial society, $100. |
(e) For filing amendments to articles of incorporation |
of a farm mutual, $50. |
(f) For filing bylaws or amendments thereto, $50. |
(g) For filing agreement of merger or consolidation: |
(i) for a domestic company, except for a fraternal |
benefit society, a mutual benefit association, a |
burial society, or a farm mutual, $2,000. |
(ii) for a foreign or alien company, except for a |
fraternal benefit society, $600. |
(iii) for a fraternal benefit society, a mutual |
benefit association, a burial society, or a farm |
mutual, $200. |
(h) For filing agreements of reinsurance by a domestic |
company, $200. |
(i) For filing all documents submitted by a foreign or |
alien company to be admitted to transact business or |
accredited as a reinsurer in this State, except for a |
fraternal benefit society, $5,000. |
(j) For filing all documents submitted by a foreign or |
alien fraternal benefit society to be admitted to transact |
business in this State, $500. |
(k) For filing declaration of withdrawal of a foreign |
|
or alien company, $50. |
(l) For filing annual statement by a domestic company, |
except a fraternal benefit society, a mutual benefit |
association, a burial society, or a farm mutual, $200. |
(m) For filing annual statement by a domestic |
fraternal benefit society, $100. |
(n) For filing annual statement by a farm mutual, a |
mutual benefit association, or a burial society, $50. |
(o) For issuing a certificate of authority or renewal |
thereof except to a foreign fraternal benefit society, |
$400. |
(p) For issuing a certificate of authority or renewal |
thereof to a foreign fraternal benefit society, $200. |
(q) For issuing an amended certificate of authority, |
$50. |
(r) For each certified copy of certificate of |
authority, $20. |
(s) For each certificate of deposit, or valuation, or |
compliance or surety certificate, $20. |
(t) For copies of papers or records per page, $1. |
(u) For each certification to copies of papers or |
records, $10. |
(v) For multiple copies of documents or certificates |
listed in subparagraphs (r), (s), and (u) of paragraph (1) |
of this Section, $10 for the first copy of a certificate of |
any type and $5 for each additional copy of the same |
|
certificate requested at the same time, unless, pursuant |
to paragraph (2) of this Section, the Director finds these |
additional fees excessive. |
(w) For issuing a permit to sell shares or increase |
paid-up capital: |
(i) in connection with a public stock offering, |
$300; |
(ii) in any other case, $100. |
(x) For issuing any other certificate required or |
permissible under the law, $50. |
(y) For filing a plan of exchange of the stock of a |
domestic stock insurance company, a plan of |
demutualization of a domestic mutual company, or a plan of |
reorganization under Article XII, $2,000. |
(z) For filing a statement of acquisition of a |
domestic company as defined in Section 131.4 of this Code, |
$2,000. |
(aa) For filing an agreement to purchase the business |
of an organization authorized under the Dental Service |
Plan Act or the Voluntary Health Services Plans Act or of a |
health maintenance organization or a limited health |
service organization, $2,000. |
(bb) For filing a statement of acquisition of a |
foreign or alien insurance company as defined in Section |
131.12a of this Code, $1,000. |
(cc) For filing a registration statement as required |
|
in Sections 131.13 and 131.14, the notification as |
required by Sections 131.16, 131.20a, or 141.4, or an |
agreement or transaction required by Sections 124.2(2), |
141, 141a, or 141.1, $200. |
(dd) For filing an application for licensing of: |
(i) a religious or charitable risk pooling trust |
or a workers' compensation pool, $1,000; |
(ii) a workers' compensation service company, |
$500; |
(iii) a self-insured automobile fleet, $200; or |
(iv) a renewal of or amendment of any license |
issued pursuant to (i), (ii), or (iii) above, $100. |
(ee) For filing articles of incorporation for a |
syndicate to engage in the business of insurance through |
the Illinois Insurance Exchange, $2,000. |
(ff) For filing amended articles of incorporation for |
a syndicate engaged in the business of insurance through |
the Illinois Insurance Exchange, $100. |
(gg) For filing articles of incorporation for a |
limited syndicate to join with other subscribers or |
limited syndicates to do business through the Illinois |
Insurance Exchange, $1,000. |
(hh) For filing amended articles of incorporation for |
a limited syndicate to do business through the Illinois |
Insurance Exchange, $100. |
(ii) For a permit to solicit subscriptions to a |
|
syndicate or limited syndicate, $100. |
(jj) For the filing of each form as required in |
Section 143 of this Code, $50 per form. Informational and |
advertising filings shall be $25 per filing. The fee for |
advisory and rating organizations shall be $200 per form. |
(i) For the purposes of the form filing fee, |
filings made on insert page basis will be considered |
one form at the time of its original submission. |
Changes made to a form subsequent to its approval |
shall be considered a new filing. |
(ii) Only one fee shall be charged for a form, |
regardless of the number of other forms or policies |
with which it will be used. |
(iii) Fees charged for a policy filed as it will be |
issued regardless of the number of forms comprising |
that policy shall not exceed $1,500. For advisory or |
rating organizations, fees charged for a policy filed |
as it will be issued regardless of the number of forms |
comprising that policy shall not exceed $2,500. |
(iv) The Director may by rule exempt forms from |
such fees. |
(kk) For filing an application for licensing of a |
reinsurance intermediary, $500. |
(ll) For filing an application for renewal of a |
license of a reinsurance intermediary, $200. |
(mm) For filing a plan of division of a domestic stock |
|
company under Article IIB, $10,000. |
(nn) For filing all documents submitted by a foreign |
or alien company to be a certified reinsurer in this |
State, except for a fraternal benefit society, $1,000. |
(oo) For filing a renewal by a foreign or alien |
company to be a certified reinsurer in this State, except |
for a fraternal benefit society, $400. |
(pp) For filing all documents submitted by a reinsurer |
domiciled in a reciprocal jurisdiction, $1,000. |
(qq) For filing a renewal by a reinsurer domiciled in |
a reciprocal jurisdiction, $400. |
(rr) For registering a captive management company or |
renewal thereof, $50. |
(ss) For filing an insurance business transfer plan |
under Article XLVII, $25,000. |
(2) When printed copies or numerous copies of the same |
paper or records are furnished or certified, the Director may |
reduce such fees for copies if he finds them excessive. He may, |
when he considers it in the public interest, furnish without |
charge to state insurance departments and persons other than |
companies, copies or certified copies of reports of |
examinations and of other papers and records. |
(3) (a) The expenses incurred in any performance |
examination authorized by law shall be paid by the company or |
person being examined. The charge shall be consistent with |
that otherwise authorized by law and shall be reasonably |
|
related to the cost of the examination including but not |
limited to compensation of examiners, electronic data |
processing costs, supervision and preparation of an |
examination report and lodging and travel expenses. All |
lodging and travel expenses shall be in accord with the |
applicable travel regulations as published by the Department |
of Central Management Services and approved by the Governor's |
Travel Control Board, except that out-of-state lodging and |
travel expenses related to examinations authorized under |
Section 132 shall be in accordance with travel rates |
prescribed under paragraph 301-7.2 of the Federal Travel |
Regulations, 41 C.F.R. 301-7.2, for reimbursement of |
subsistence expenses incurred during official travel. All |
lodging and travel expenses may be reimbursed directly upon |
authorization of the Director. With the exception of the |
direct reimbursements authorized by the Director, all |
performance examination charges collected by the Department |
shall be paid to the Insurance Producer Administration Fund, |
however, the electronic data processing costs incurred by the |
Department in the performance of any examination shall be |
billed directly to the company being examined for payment to |
the Technology Management Revolving Fund. |
(b) The costs and fees incurred in a market conduct |
examination shall be itemized and bills shall be provided to |
the examinee on a monthly basis for review prior to submission |
for payment. The Director shall review and affirmatively |
|
endorse detailed billings from any contracted, qualified |
outside professional assistance retained under Section 402 for |
market conduct examinations before the detailed billings are |
sent to the examinee. Before any qualified outside |
professional assistance conducts billable work on an |
examination, the Department shall disclose to the examinee the |
terms of the contracts with the qualified outside professional |
assistance that will be used, including the fees and hourly |
rates that can be charged. |
(4) At the time of any service of process on the Director |
as attorney for such service, the Director shall charge and |
collect the sum of $40, which may be recovered as taxable costs |
by the party to the suit or action causing such service to be |
made if he prevails in such suit or action. |
(5) (a) The costs incurred by the Department of Insurance |
in conducting any hearing authorized by law shall be assessed |
against the parties to the hearing in such proportion as the |
Director of Insurance may determine upon consideration of all |
relevant circumstances including: (1) the nature of the |
hearing; (2) whether the hearing was instigated by, or for the |
benefit of a particular party or parties; (3) whether there is |
a successful party on the merits of the proceeding; and (4) the |
relative levels of participation by the parties. |
(b) For purposes of this subsection (5) costs incurred |
shall mean the hearing officer fees, court reporter fees, and |
travel expenses of Department of Insurance officers and |
|
employees; provided however, that costs incurred shall not |
include hearing officer fees or court reporter fees unless the |
Department has retained the services of independent |
contractors or outside experts to perform such functions. |
(c) The Director shall make the assessment of costs |
incurred as part of the final order or decision arising out of |
the proceeding; provided, however, that such order or decision |
shall include findings and conclusions in support of the |
assessment of costs. This subsection (5) shall not be |
construed as permitting the payment of travel expenses unless |
calculated in accordance with the applicable travel |
regulations of the Department of Central Management Services, |
as approved by the Governor's Travel Control Board. The |
Director as part of such order or decision shall require all |
assessments for hearing officer fees and court reporter fees, |
if any, to be paid directly to the hearing officer or court |
reporter by the party(s) assessed for such costs. The |
assessments for travel expenses of Department officers and |
employees shall be reimbursable to the Director of Insurance |
for deposit to the fund out of which those expenses had been |
paid. |
(d) The provisions of this subsection (5) shall apply in |
the case of any hearing conducted by the Director of Insurance |
not otherwise specifically provided for by law. |
(6) The Director shall charge and collect an annual |
financial regulation fee from every domestic company for |
|
examination and analysis of its financial condition and to |
fund the internal costs and expenses of the Interstate |
Insurance Receivership Commission as may be allocated to the |
State of Illinois and companies doing an insurance business in |
this State pursuant to Article X of the Interstate Insurance |
Receivership Compact. The fee shall be the greater fixed |
amount based upon the combination of nationwide direct premium |
income and nationwide reinsurance assumed premium income or |
upon admitted assets calculated under this subsection as |
follows: |
(a) Combination of nationwide direct premium income |
and nationwide reinsurance assumed premium. |
(i) $150, if the premium is less than $500,000 and |
there is no reinsurance assumed premium; |
(ii) $750, if the premium is $500,000 or more, but |
less than $5,000,000 and there is no reinsurance |
assumed premium; or if the premium is less than |
$5,000,000 and the reinsurance assumed premium is less |
than $10,000,000; |
(iii) $3,750, if the premium is less than |
$5,000,000 and the reinsurance assumed premium is |
$10,000,000 or more; |
(iv) $7,500, if the premium is $5,000,000 or more, |
but less than $10,000,000; |
(v) $18,000, if the premium is $10,000,000 or |
more, but less than $25,000,000; |
|
(vi) $22,500, if the premium is $25,000,000 or |
more, but less than $50,000,000; |
(vii) $30,000, if the premium is $50,000,000 or |
more, but less than $100,000,000; |
(viii) $37,500, if the premium is $100,000,000 or |
more. |
(b) Admitted assets. |
(i) $150, if admitted assets are less than |
$1,000,000; |
(ii) $750, if admitted assets are $1,000,000 or |
more, but less than $5,000,000; |
(iii) $3,750, if admitted assets are $5,000,000 or |
more, but less than $25,000,000; |
(iv) $7,500, if admitted assets are $25,000,000 or |
more, but less than $50,000,000; |
(v) $18,000, if admitted assets are $50,000,000 or |
more, but less than $100,000,000; |
(vi) $22,500, if admitted assets are $100,000,000 |
or more, but less than $500,000,000; |
(vii) $30,000, if admitted assets are $500,000,000 |
or more, but less than $1,000,000,000; |
(viii) $37,500, if admitted assets are |
$1,000,000,000 or more. |
(c) The sum of financial regulation fees charged to |
the domestic companies of the same affiliated group shall |
not exceed $250,000 in the aggregate in any single year |
|
and shall be billed by the Director to the member company |
designated by the group. |
(7) The Director shall charge and collect an annual |
financial regulation fee from every foreign or alien company, |
except fraternal benefit societies, for the examination and |
analysis of its financial condition and to fund the internal |
costs and expenses of the Interstate Insurance Receivership |
Commission as may be allocated to the State of Illinois and |
companies doing an insurance business in this State pursuant |
to Article X of the Interstate Insurance Receivership Compact. |
The fee shall be a fixed amount based upon Illinois direct |
premium income and nationwide reinsurance assumed premium |
income in accordance with the following schedule: |
(a) $150, if the premium is less than $500,000 and |
there is no reinsurance assumed premium; |
(b) $750, if the premium is $500,000 or more, but less |
than $5,000,000 and there is no reinsurance assumed |
premium; or if the premium is less than $5,000,000 and the |
reinsurance assumed premium is less than $10,000,000; |
(c) $3,750, if the premium is less than $5,000,000 and |
the reinsurance assumed premium is $10,000,000 or more; |
(d) $7,500, if the premium is $5,000,000 or more, but |
less than $10,000,000; |
(e) $18,000, if the premium is $10,000,000 or more, |
but less than $25,000,000; |
(f) $22,500, if the premium is $25,000,000 or more, |
|
but less than $50,000,000; |
(g) $30,000, if the premium is $50,000,000 or more, |
but less than $100,000,000; |
(h) $37,500, if the premium is $100,000,000 or more. |
The sum of financial regulation fees under this subsection |
(7) charged to the foreign or alien companies within the same |
affiliated group shall not exceed $250,000 in the aggregate in |
any single year and shall be billed by the Director to the |
member company designated by the group. |
(8) Beginning January 1, 1992, the financial regulation |
fees imposed under subsections (6) and (7) of this Section |
shall be paid by each company or domestic affiliated group |
annually. After January 1, 1994, the fee shall be billed by |
Department invoice based upon the company's premium income or |
admitted assets as shown in its annual statement for the |
preceding calendar year. The invoice is due upon receipt and |
must be paid no later than June 30 of each calendar year. All |
financial regulation fees collected by the Department shall be |
paid to the Insurance Financial Regulation Fund. The |
Department may not collect financial examiner per diem charges |
from companies subject to subsections (6) and (7) of this |
Section undergoing financial examination after June 30, 1992. |
(9) In addition to the financial regulation fee required |
by this Section, a company undergoing any financial |
examination authorized by law shall pay the following costs |
and expenses incurred by the Department: electronic data |
|
processing costs, the expenses authorized under Section 131.21 |
and subsection (d) of Section 132.4 of this Code, and lodging |
and travel expenses. |
Electronic data processing costs incurred by the |
Department in the performance of any examination shall be |
billed directly to the company undergoing examination for |
payment to the Technology Management Revolving Fund. Except |
for direct reimbursements authorized by the Director or direct |
payments made under Section 131.21 or subsection (d) of |
Section 132.4 of this Code, all financial regulation fees and |
all financial examination charges collected by the Department |
shall be paid to the Insurance Financial Regulation Fund. |
All lodging and travel expenses shall be in accordance |
with applicable travel regulations published by the Department |
of Central Management Services and approved by the Governor's |
Travel Control Board, except that out-of-state lodging and |
travel expenses related to examinations authorized under |
Sections 132.1 through 132.7 shall be in accordance with |
travel rates prescribed under paragraph 301-7.2 of the Federal |
Travel Regulations, 41 C.F.R. 301-7.2, for reimbursement of |
subsistence expenses incurred during official travel. All |
lodging and travel expenses may be reimbursed directly upon |
the authorization of the Director. |
In the case of an organization or person not subject to the |
financial regulation fee, the expenses incurred in any |
financial examination authorized by law shall be paid by the |
|
organization or person being examined. The charge shall be |
reasonably related to the cost of the examination including, |
but not limited to, compensation of examiners and other costs |
described in this subsection. |
(10) Any company, person, or entity failing to make any |
payment of $150 or more as required under this Section shall be |
subject to the penalty and interest provisions provided for in |
subsections (4) and (7) of Section 412. |
(11) Unless otherwise specified, all of the fees collected |
under this Section shall be paid into the Insurance Financial |
Regulation Fund. |
(12) For purposes of this Section: |
(a) "Domestic company" means a company as defined in |
Section 2 of this Code which is incorporated or organized |
under the laws of this State, and in addition includes a |
not-for-profit corporation authorized under the Dental |
Service Plan Act or the Voluntary Health Services Plans |
Act, a health maintenance organization, and a limited |
health service organization. |
(b) "Foreign company" means a company as defined in |
Section 2 of this Code which is incorporated or organized |
under the laws of any state of the United States other than |
this State and in addition includes a health maintenance |
organization and a limited health service organization |
which is incorporated or organized under the laws of any |
state of the United States other than this State. |
|
(c) "Alien company" means a company as defined in |
Section 2 of this Code which is incorporated or organized |
under the laws of any country other than the United |
States. |
(d) "Fraternal benefit society" means a corporation, |
society, order, lodge or voluntary association as defined |
in Section 282.1 of this Code. |
(e) "Mutual benefit association" means a company, |
association or corporation authorized by the Director to |
do business in this State under the provisions of Article |
XVIII of this Code. |
(f) "Burial society" means a person, firm, |
corporation, society or association of individuals |
authorized by the Director to do business in this State |
under the provisions of Article XIX of this Code. |
(g) "Farm mutual" means a district, county and |
township mutual insurance company authorized by the |
Director to do business in this State under the provisions |
of the Farm Mutual Insurance Company Act of 1986. |
(Source: P.A. 102-775, eff. 5-13-22; 103-75, eff. 1-1-25.) |
|
(215 ILCS 5/511.109) (from Ch. 73, par. 1065.58-109) |
(Section scheduled to be repealed on January 1, 2027) |
Sec. 511.109. Examination. |
(a) The Director or the Director's his designee may |
examine any applicant for or holder of an administrator's |
|
license in accordance with Sections 132 through 132.7. If the |
Director or the examiners find that the administrator has |
violated this Article or any other insurance-related laws, |
rules, or regulations under the Director's jurisdiction |
because of the manner in which the administrator has conducted |
business on behalf of an insurer or plan sponsor, then, unless |
the insurer or plan sponsor is included in the examination and |
has been afforded the same opportunity to request or |
participate in a hearing on the examination report, the |
examination report shall not allege a violation by the insurer |
or plan sponsor and the Director's order based on the report |
shall not impose any requirements, prohibitions, or penalties |
on the insurer or plan sponsor. Nothing in this Section shall |
prevent the Director from using any information obtained |
during the examination of an administrator to examine, |
investigate, or take other appropriate regulatory or legal |
action with respect to an insurer or plan sponsor . |
(b) Any administrator being examined shall provide to the |
Director or his designee convenient and free access, at all |
reasonable hours at their offices, to all books, records, |
documents and other papers relating to such administrator's |
business affairs. |
(c) The Director or his designee may administer oaths and |
thereafter examine any individual about the business of the |
administrator. |
(d) The examiners designated by the Director pursuant to |
|
this Section may make reports to the Director. Any report |
alleging substantive violations of this Article, any |
applicable provisions of the Illinois Insurance Code, or any |
applicable Part of Title 50 of the Illinois Administrative |
Code shall be in writing and be based upon facts obtained by |
the examiners. The report shall be verified by the examiners. |
(e) If a report is made, the Director shall either deliver |
a duplicate thereof to the administrator being examined or |
send such duplicate by certified or registered mail to the |
administrator's address specified in the records of the |
Department. The Director shall afford the administrator an |
opportunity to request a hearing to object to the report. The |
administrator may request a hearing within 30 days after |
receipt of the duplicate of the examination report by giving |
the Director written notice of such request together with |
written objections to the report. Any hearing shall be |
conducted in accordance with Sections 402 and 403 of this |
Code. The right to hearing is waived if the delivery of the |
report is refused or the report is otherwise undeliverable or |
the administrator does not timely request a hearing. After the |
hearing or upon expiration of the time period during which an |
administrator may request a hearing, if the examination |
reveals that the administrator is operating in violation of |
any applicable provision of the Illinois Insurance Code, any |
applicable Part of Title 50 of the Illinois Administrative |
Code or prior order, the Director, in the written order, may |
|
require the administrator to take any action the Director |
considers necessary or appropriate in accordance with the |
report or examination hearing. If the Director issues an |
order, it shall be issued within 90 days after the report is |
filed, or if there is a hearing, within 90 days after the |
conclusion of the hearing. The order is subject to review |
under the Administrative Review Law. |
(Source: P.A. 84-887 .) |
|
(215 ILCS 5/512-3) (from Ch. 73, par. 1065.59-3) |
Sec. 512-3. Definitions. For the purposes of this Article, |
unless the context otherwise requires, the terms defined in |
this Article have the meanings ascribed to them herein: |
"Health care payer" means an insurance company, health |
maintenance organization, limited health service organization, |
health services plan corporation, or dental service plan |
corporation authorized to do business in this State. |
(a) "Third party prescription program" or "program" means |
any system of providing for the reimbursement of |
pharmaceutical services and prescription drug products offered |
or operated in this State under a contractual arrangement or |
agreement between a provider of such services and another |
party who is not the consumer of those services and products. |
Such programs may include, but need not be limited to, |
employee benefit plans whereby a consumer receives |
prescription drugs or other pharmaceutical services and those |
|
services are paid for by an agent of the employer or others. |
(b) "Third party program administrator" or "administrator" |
means any person, partnership or corporation who issues or |
causes to be issued any payment or reimbursement to a provider |
for services rendered pursuant to a third party prescription |
program, but does not include the Director of Healthcare and |
Family Services or any agent authorized by the Director to |
reimburse a provider of services rendered pursuant to a |
program of which the Department of Healthcare and Family |
Services is the third party. |
(Source: P.A. 95-331, eff. 8-21-07.) |
|
(215 ILCS 5/512-5) (from Ch. 73, par. 1065.59-5) |
Sec. 512-5. Fiduciary and Bonding Requirements. A third |
party prescription program administrator shall (1) establish |
and maintain a fiduciary account, separate and apart from any |
and all other accounts, for the receipt and disbursement of |
funds for reimbursement of providers of services under the |
program, or (2) post, or cause to be posted, a bond of |
indemnity in an amount equal to not less than 10% of the total |
estimated annual reimbursements under the program. |
The establishment of such fiduciary accounts and bonds |
shall be consistent with applicable State law. If a bond of |
indemnity is posted, it shall be held by the Director of |
Insurance for the benefit and indemnification of the providers |
of services under the third party prescription program. |
|
An administrator who operates more than one third party |
prescription program may establish and maintain a separate |
fiduciary account or bond of indemnity for each such program, |
or may operate and maintain a consolidated fiduciary account |
or bond of indemnity for all such programs. |
The requirements of this Section do not apply to any third |
party prescription program administered by or on behalf of any |
health care payer insurance company, Health Care Service Plan |
Corporation or Pharmaceutical Service Plan Corporation |
authorized to do business in the State of Illinois . |
(Source: P.A. 82-1005.) |
|
(215 ILCS 5/512-11 new) |
Sec. 512-11. Examination. The Director or the Director's |
designee may examine any applicant for or holder of an |
administrator's registration in accordance with Sections 132 |
through 132.7 of this Code. If the Director or the examiners |
find that the administrator has violated this Article or any |
other insurance-related laws or regulations under the |
Director's jurisdiction because of the manner in which the |
administrator has conducted business on behalf of a separately |
incorporated health care payer, then, unless the health care |
payer is included in the examination and has been afforded the |
same opportunity to request or participate in a hearing on the |
examination report, the examination report shall not allege a |
violation by the health care payer and the Director's order |
|
based on the report shall not impose any requirements, |
prohibitions, or penalties on the health care payer. Nothing |
in this Section shall prevent the Director from using any |
information obtained during the examination of an |
administrator to examine, investigate, or take other |
appropriate regulatory or legal action with respect to a |
health care payer. |
|
(215 ILCS 5/513b3) |
Sec. 513b3. Examination. (a) The Director, or his or her |
designee, may examine a registered pharmacy benefit manager in |
accordance with Sections 132-132.7. If the Director or the |
examiners find that the pharmacy benefit manager has violated |
this Article or any other insurance-related laws, rules, or |
regulations under the Director's jurisdiction because of the |
manner in which the pharmacy benefit manager has conducted |
business on behalf of a health insurer or plan sponsor, then, |
unless the health insurer or plan sponsor is included in the |
examination and has been afforded the same opportunity to |
request or participate in a hearing on the examination report, |
the examination report shall not allege a violation by the |
health insurer or plan sponsor and the Director's order based |
on the report shall not impose any requirements, prohibitions, |
or penalties on the health insurer or plan sponsor. Nothing in |
this Section shall prevent the Director from using any |
information obtained during the examination of an |
|
administrator to examine, investigate, or take other |
appropriate regulatory or legal action with respect to a |
health insurer or plan sponsor . |
(b) Any pharmacy benefit manager being examined shall |
provide to the Director, or his or her designee, convenient |
and free access to all books, records, documents, and other |
papers relating to such pharmacy benefit manager's business |
affairs at all reasonable hours at its offices. |
(c) The Director, or his or her designee, may administer |
oaths and thereafter examine the pharmacy benefit manager's |
designee, representative, or any officer or senior manager as |
listed on the license or registration certificate about the |
business of the pharmacy benefit manager. |
(d) The examiners designated by the Director under this |
Section may make reports to the Director. Any report alleging |
substantive violations of this Article, any applicable |
provisions of this Code, or any applicable Part of Title 50 of |
the Illinois Administrative Code shall be in writing and be |
based upon facts obtained by the examiners. The report shall |
be verified by the examiners. |
(e) If a report is made, the Director shall either deliver |
a duplicate report to the pharmacy benefit manager being |
examined or send such duplicate by certified or registered |
mail to the pharmacy benefit manager's address specified in |
the records of the Department. The Director shall afford the |
pharmacy benefit manager an opportunity to request a hearing |
|
to object to the report. The pharmacy benefit manager may |
request a hearing within 30 days after receipt of the |
duplicate report by giving the Director written notice of such |
request together with written objections to the report. Any |
hearing shall be conducted in accordance with Sections 402 and |
403 of this Code. The right to a hearing is waived if the |
delivery of the report is refused or the report is otherwise |
undeliverable or the pharmacy benefit manager does not timely |
request a hearing. After the hearing or upon expiration of the |
time period during which a pharmacy benefit manager may |
request a hearing, if the examination reveals that the |
pharmacy benefit manager is operating in violation of any |
applicable provision of this Code, any applicable Part of |
Title 50 of the Illinois Administrative Code, a provision of |
this Article, or prior order, the Director, in the written |
order, may require the pharmacy benefit manager to take any |
action the Director considers necessary or appropriate in |
accordance with the report or examination hearing. If the |
Director issues an order, it shall be issued within 90 days |
after the report is filed, or if there is a hearing, within 90 |
days after the conclusion of the hearing. The order is subject |
to review under the Administrative Review Law. |
(Source: P.A. 101-452, eff. 1-1-20 .) |
Section 95. No acceleration or delay. Where this Act makes |
changes in a statute that is represented in this Act by text |