|
Public Act 098-0226
|
HB1552 Enrolled | LRB098 02751 RPM 39104 b |
|
|
AN ACT concerning insurance.
|
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 143, 356z.12, and 1202 as follows:
|
(215 ILCS 5/143) (from Ch. 73, par. 755)
|
Sec. 143. Policy forms.
|
(1) Life, accident and health. No company
transacting the |
kind or kinds of business enumerated in Classes 1 (a), 1
(b) |
and 2 (a) of Section 4 shall issue or deliver in this State a |
policy
or certificate of insurance or evidence of coverage, |
attach an
endorsement or rider thereto,
incorporate by |
reference bylaws or other matter therein or use an
application |
blank in this State until the form and content of such
policy, |
certificate, evidence of coverage, endorsement, rider, bylaw |
or
other matter
incorporated by reference or application blank |
has been filed electronically
with the Director, either through |
the System for Electronic Rate and Form Filing (SERFF) or as |
otherwise prescribed by the Director, and
approved by the |
Director. The Department shall mail a quarterly invoice to the |
company for the appropriate filing fees required under Section |
408. Any such endorsement or rider
that unilaterally reduces |
benefits and is to be attached to a
policy subsequent to the |
|
date the policy is
issued must be filed with, reviewed, and |
formally approved by the
Director prior to the date it is |
attached to a policy issued or
delivered in this State. It |
shall be the duty of the Director to
withhold approval of any |
such policy, certificate, endorsement, rider,
bylaw or other |
matter incorporated by reference or application blank
filed |
with him if it contains provisions which encourage
|
misrepresentation or are unjust, unfair, inequitable, |
ambiguous,
misleading, inconsistent, deceptive, contrary to |
law or to the public
policy of this State, or contains |
exceptions and conditions that
unreasonably or deceptively |
affect the risk purported to be assumed in
the general coverage |
of the policy. In all cases the Director shall
approve or |
disapprove any such form within 60 days after submission
unless |
the Director extends by not more than an additional 30 days the
|
period within which he shall approve or disapprove any such |
form by
giving written notice to the insurer of such extension |
before expiration
of the initial 60 days period. The Director |
shall withdraw his approval
of a policy, certificate, evidence |
of coverage, endorsement, rider,
bylaw, or other matter |
incorporated
by reference or application blank if he |
subsequently determines that such
policy, certificate, |
evidence of coverage, endorsement, rider, bylaw,
other matter, |
or application
blank is misrepresentative, unjust, unfair, |
inequitable, ambiguous, misleading,
inconsistent, deceptive, |
contrary to law or public policy of this State,
or contains |
|
exceptions or conditions which unreasonably or deceptively |
affect
the risk purported to be assumed in the general coverage |
of the policy or
evidence of coverage.
|
If a previously approved policy, certificate, evidence of
|
coverage, endorsement, rider, bylaw
or other matter |
incorporated by reference or application blank is withdrawn
for |
use, the Director shall serve upon the company an order of |
withdrawal
of use, either personally or by mail, and if by |
mail, such service shall
be completed if such notice be |
deposited in the post office, postage prepaid,
addressed to the |
company's last known address specified in the records
of the |
Department of Insurance. The order of withdrawal of use shall |
take
effect 30 days from the date of mailing but shall be |
stayed if within the
30-day period a written request for |
hearing is filed with the Director.
Such hearing shall be held |
at such time and place as designated in the order
given by the |
Director. The hearing may be held either in the City of |
Springfield,
the City of Chicago or in the county where the |
principal business address
of the company is located.
The |
action of the Director in
disapproving or withdrawing such form |
shall be subject to judicial review under
the
Administrative |
Review Law.
|
This subsection shall not apply to riders or endorsements |
issued or
made at the request of the individual policyholder |
relating to the
manner of distribution of benefits or to the |
reservation of rights and
benefits under his life insurance |
|
policy.
|
(2) Casualty, fire, and marine. The Director shall require |
the
filing of all policy forms issued or delivered by any |
company transacting
the kind or
kinds of business enumerated in |
Classes 2 (except Class 2 (a)) and 3 of
Section 4 in an |
electronic format either through the System for Electronic Rate |
and Form Filing (SERFF) or as otherwise prescribed and approved |
by the Director. In addition, he may require the filing of any
|
generally used riders, endorsements, certificates, application |
blanks, and
other matter
incorporated by reference in any such |
policy or contract of insurance. The Department shall mail a |
quarterly invoice to the company for the appropriate filing |
fees required under Section 408.
Companies that are members of |
an organization, bureau, or association may
have the same filed |
for them by the organization, bureau, or association. If
the |
Director shall find from an examination of any such policy |
form,
rider, endorsement, certificate, application blank, or |
other matter
incorporated by
reference in any such policy so |
filed that it (i) violates any provision of
this Code, (ii) |
contains inconsistent, ambiguous, or misleading clauses, or
|
(iii) contains exceptions and conditions that will |
unreasonably or deceptively
affect the risks that are purported |
to be assumed by the policy, he
shall order the company or |
companies issuing these forms to discontinue
their use. Nothing |
in this subsection shall require a company
transacting the kind |
or kinds of business enumerated in Classes 2
(except Class 2 |
|
(a)) and 3 of Section 4 to obtain approval of these forms
|
before they are issued nor in any way affect the legality of |
any
policy that has been issued and found to be in conflict |
with this
subsection, but such policies shall be subject to the |
provisions of
Section 442.
|
(3) This Section shall not apply (i) to surety contracts or |
fidelity
bonds, (ii) to policies issued to an industrial |
insured as defined in Section
121-2.08 except for workers' |
compensation policies, nor (iii) to riders
or
endorsements |
prepared to meet special, unusual,
peculiar, or extraordinary |
conditions applying to an individual risk.
|
(Source: P.A. 97-486, eff. 1-1-12.)
|
(215 ILCS 5/356z.12) |
Sec. 356z.12. Dependent coverage. |
(a) A group or individual policy of accident and health |
insurance or managed care plan that provides coverage for |
dependents and that is amended, delivered, issued, or renewed |
after the effective date of this amendatory Act of the 95th |
General Assembly shall not terminate coverage or deny the |
election of coverage for an unmarried dependent by reason of |
the dependent's age before the dependent's 26th birthday. |
(b) A policy or plan subject to this Section shall, upon |
amendment, delivery, issuance, or renewal, establish an |
initial enrollment period of not less than 90 days during which |
an insured may make a written election for coverage of an |
|
unmarried person as a dependent under this Section. After the |
initial enrollment period, enrollment by a dependent pursuant |
to this Section shall be consistent with the enrollment terms |
of the plan or policy. |
(c) A policy or plan subject to this Section shall allow |
for dependent coverage during the annual open enrollment date |
or the annual renewal date if the dependent, as of the date on |
which the insured elects dependent coverage under this |
subsection, has: |
(1) a period of continuous creditable coverage of 90 |
days or more; and |
(2) not been without creditable coverage for more than |
63 days. |
An insured may elect coverage for a dependent who does not meet |
the continuous creditable coverage requirements of this |
subsection (c) and that dependent shall not be denied coverage |
due to age. |
For purposes of this subsection (c), "creditable coverage" |
shall have the meaning provided under subsection (C)(1) of |
Section 20 of the Illinois Health Insurance Portability and |
Accountability Act. |
(d) Military personnel. A group or individual policy of |
accident and health insurance or managed care plan that |
provides coverage for dependents and that is amended, |
delivered, issued, or renewed after the effective date of this |
amendatory Act of the 95th General Assembly shall not terminate |
|
coverage or deny the election of coverage for an unmarried |
dependent by reason of the dependent's age before the |
dependent's 30th birthday if the dependent (i) is an Illinois |
resident, (ii) served as a member of the active or reserve |
components of any of the branches of the Armed Forces of the |
United States, and (iii) has received a release or discharge |
other than a dishonorable discharge. To be eligible for |
coverage under this subsection (d), the eligible dependent |
shall submit to the insurer a form approved by the Illinois |
Department of Veterans' Affairs stating the date on which the |
dependent was released from service. |
(e) Calculation of the cost of coverage provided to an |
unmarried dependent under this Section shall be identical. |
(f) Nothing in this Section shall prohibit an employer from |
requiring an employee to pay all or part of the cost of |
coverage provided under this Section. |
(g) No exclusions or limitations may be applied to coverage |
elected pursuant to this Section that do not apply to all |
dependents covered under the policy. |
(h) A policy or plan subject to this Section shall not |
condition eligibility for dependent coverage provided pursuant |
to this Section on enrollment in any educational institution. |
(i) Notice regarding coverage for a dependent as provided |
pursuant to this Section shall be provided to an insured by the |
insurer: |
(1) upon application or enrollment; |
|
(2) in the certificate of coverage or equivalent |
document prepared for an insured and delivered on or about |
the date on which the coverage commences; and |
(3) (blank) in a notice delivered to an insured on a |
semi-annual basis .
|
(Source: P.A. 95-958, eff. 6-1-09 .)
|
(215 ILCS 5/1202) (from Ch. 73, par. 1065.902)
|
Sec. 1202. Duties. The Director shall:
|
(a) determine the relationship of insurance premiums and |
related income
as compared to insurance costs and expenses and |
provide such information to
the General Assembly and the |
general public;
|
(b) study the insurance system in the State of Illinois, |
and recommend
to the General Assembly what it deems to be the |
most appropriate and
comprehensive cost containment system for |
the State;
|
(c) respond to the requests by agencies of government and |
the General
Assembly for special studies and analysis of data |
collected pursuant to
this Article. Such reports shall be made |
available in a form prescribed by
the Director. The Director |
may also determine a fee to be charged to the
requesting agency |
to cover the direct and indirect costs for producing such
a |
report, and shall permit affected insurers the right to review |
the
accuracy of the report before it is released. The fees |
shall
be deposited
into the Statistical Services Revolving Fund |
|
and credited to the account
of the Department of Insurance;
|
(d) make an interim report to the General Assembly no later |
than August
15, 1987, and a annual report to the General |
Assembly no later than July 1 April 15
every year thereafter |
which shall include the Director's findings and
|
recommendations regarding its duties as provided under |
subsections (a),
(b), and (c) of this Section.
|
(Source: P.A. 91-357, eff. 7-29-99.)
|