| |||||||
| |||||||
| |||||||
| 1 | AN ACT concerning regulation.
| ||||||
| 2 | Be it enacted by the People of the State of Illinois,
| ||||||
| 3 | represented in the General Assembly:
| ||||||
| 4 | Section 5. The Illinois Insurance Code is amended by | ||||||
| 5 | changing Section 511.101 as follows:
| ||||||
| 6 | (215 ILCS 5/511.101) (from Ch. 73, par. 1065.58-101)
| ||||||
| 7 | (Section scheduled to be repealed on January 1, 2027)
| ||||||
| 8 | Sec. 511.101. Definitions. For the purpose of this Article:
| ||||||
| 9 | (a) "Administrator" means any person who on behalf of a | ||||||
| 10 | plan sponsor or
insurer receives or collects charges, | ||||||
| 11 | contributions or premiums for, or
adjusts or settles claims on | ||||||
| 12 | residents of this State in connection with
any type of life or | ||||||
| 13 | accident or health benefit provided through or as an
| ||||||
| 14 | alternative to insurance within the scope of Class 1(a), 1(b) | ||||||
| 15 | or 2(a) of
Section 4 of this the Illinois Insurance Code, other | ||||||
| 16 | than any of the following:
| ||||||
| 17 | (1) A corporation, association, trust or partnership | ||||||
| 18 | which is administering
a plan (i) on behalf of the | ||||||
| 19 | employees of such corporation, association,
trust or | ||||||
| 20 | partnership or (ii) for the employees of one or more | ||||||
| 21 | subsidiaries
or affiliated corporations or affiliated | ||||||
| 22 | associations, trusts or partnerships;
| ||||||
| 23 | (2) A union administering a plan for its members;
| ||||||
| |||||||
| |||||||
| 1 | (3) A plan sponsor administering its own plan;
| ||||||
| 2 | (4) An insurer or dental service plan to the extent | ||||||
| 3 | regulated by this the Illinois Insurance Code;
| ||||||
| 4 | (5) A producer licensed in this State whose insurance | ||||||
| 5 | activities are limited
to the scope of such license;
| ||||||
| 6 | (6) A trust and its trustees and employees acting | ||||||
| 7 | pursuant to its trust
agreement established in conformity | ||||||
| 8 | with 29 U.S.C. 186;
| ||||||
| 9 | (7) A person who adjusts or settles claims in the | ||||||
| 10 | normal course of such
person's practice or employment as an | ||||||
| 11 | attorney-at-law, and who does not
collect contributions or | ||||||
| 12 | premiums in connection with life or accident or
health | ||||||
| 13 | coverage;
| ||||||
| 14 | (8) A person who administers only self-insured | ||||||
| 15 | workers' compensation plans,
or single employer self | ||||||
| 16 | insured life or accident or health benefit plans;
| ||||||
| 17 | (9) A credit card issuing company which advances for | ||||||
| 18 | and collects
premiums or charges from its credit card | ||||||
| 19 | holders who have authorized such
collection, if such | ||||||
| 20 | company does not adjust or settle claims;
| ||||||
| 21 | (10) A creditor on behalf of its debtors with respect | ||||||
| 22 | to insurance
covering a debt between the creditor and its | ||||||
| 23 | debtors.
| ||||||
| 24 | (b) "Covered Individual" means any individual eligible for | ||||||
| 25 | life or accident
or health benefits under a plan.
| ||||||
| 26 | (c) "Contributions" means any money charged a covered | ||||||
| |||||||
| |||||||
| 1 | individual, plan
sponsor or other entity to fund the | ||||||
| 2 | self-insured portion of any plan in
accordance with written | ||||||
| 3 | provisions of the plan or contracts of insurance.
Contributions | ||||||
| 4 | shall include administrative fees charged to a covered
| ||||||
| 5 | individual. Administrative fee means any compensation paid by a | ||||||
| 6 | covered
individual for services performed by the | ||||||
| 7 | administrator.
| ||||||
| 8 | (d) "Premiums" means any money charged a covered | ||||||
| 9 | individual, plan sponsor
or other entity to provide life or | ||||||
| 10 | accident or health insurance under a
plan. The term premium | ||||||
| 11 | shall include amounts paid by or charged to a covered
| ||||||
| 12 | individual plan sponsor or other entity for stop loss or excess | ||||||
| 13 | insurance.
| ||||||
| 14 | (e) "Charges" means any compensation paid by a plan sponsor | ||||||
| 15 | or insurer
for services performed by the administrator.
| ||||||
| 16 | (f) "Administrator Trust Fund", hereinafter referred to as | ||||||
| 17 | "ATF", means
a special fiduciary account established and | ||||||
| 18 | maintained by an administrator
pursuant to Section 511.112 in | ||||||
| 19 | which contributions and premiums are deposited.
| ||||||
| 20 | (g) "Claims Administration Services Account", hereinafter | ||||||
| 21 | referred to
as "CASA", means a special fiduciary account | ||||||
| 22 | established and maintained
by an administrator pursuant to | ||||||
| 23 | Section 511.112 of this Code from which
claims and claims | ||||||
| 24 | adjustment expenses are disbursed.
| ||||||
| 25 | (h) "Plan Sponsor" means any person other than an insurer, | ||||||
| 26 | who establishes
or maintains a plan covering residents of this | ||||||
| |||||||
| |||||||
| 1 | State, including but not
limited to plans established or | ||||||
| 2 | maintained by 2 or more employers or
jointly by one or more | ||||||
| 3 | employers and one or more employee organizations,
the | ||||||
| 4 | association, committee, joint board of trustees, or other | ||||||
| 5 | similar group
of representatives of the parties who establish | ||||||
| 6 | or maintain the plan.
| ||||||
| 7 | Provided, however, that "Plan Sponsor" shall not include:
| ||||||
| 8 | (1) The employer in the case of a plan established or | ||||||
| 9 | maintained by a
single employer; or
| ||||||
| 10 | (2) The employee organization in the case of a plan | ||||||
| 11 | established or
maintained by an employee organization.
| ||||||
| 12 | No plan sponsor covered in whole by provisions of the | ||||||
| 13 | Employee Retirement
Income Security Act of 1974 (ERISA) shall | ||||||
| 14 | be covered by any of the
provisions of this Act to the extent | ||||||
| 15 | that such provisions are inconsistent
with or in conflict with | ||||||
| 16 | any provisions of ERISA as now or hereafter amended.
| ||||||
| 17 | (i) "Financial Institution" means any federal or state | ||||||
| 18 | chartered bank
or savings and loan institution which is insured | ||||||
| 19 | by the Federal Deposit
Insurance Corporation (FDIC) or the | ||||||
| 20 | Federal Savings and Loan Insurance
Corporation (FSLIC).
| ||||||
| 21 | (j) "Plan" means any plan, fund or program established or | ||||||
| 22 | maintained by
a plan sponsor or insurer to the extent that such | ||||||
| 23 | plan, fund or program
was established or is maintained to | ||||||
| 24 | provide through insurance or alternatives
to insurance any type | ||||||
| 25 | of life or accident or health benefit within the scope
of Class | ||||||
| 26 | 1(a), 1(b) or 2(a) of Section 4 of the Illinois Insurance Code.
| ||||||
| |||||||
| |||||||
| 1 | (k) "Insurer" means any person who transacts insurance or | ||||||
| 2 | health care
service business authorized under the laws of this | ||||||
| 3 | State.
| ||||||
| 4 | (l) "Quasi-resident" means a nonresident licensee who | ||||||
| 5 | produces 50% or
more of his contributions and premium volume | ||||||
| 6 | during a calendar year from
residents of this State.
| ||||||
| 7 | (Source: P.A. 84-1431.)
| ||||||