Bill Text: IL SB3926 | 2021-2022 | 102nd General Assembly | Engrossed

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Bill Title: Amends the Illinois Insurance Code. Provides that any failure to make a disclosure or obtain a signed confirmation required under specified provisions of the Short-Term, Limited-Duration Health Insurance Coverage Act is an unfair method of competition and an unfair and deceptive act or practice in the business of insurance. Provides that the Director of Insurance shall have the power to examine and investigate into the affairs of every person subject to specified provisions of the Short-Term, Limited-Duration Health Insurance Coverage Act. Provides that the Director may place on probation, suspend, revoke, or refuse to issue or renew an insurance producer's license or may levy a civil penalty or take any combination of actions for any failure to make a disclosure or obtain a signed confirmation required or any unlawful practice described under specified provisions of the Short-Term, Limited-Duration Health Insurance Coverage Act. Amends the Short-Term, Limited-Duration Health Insurance Coverage Act. Sets forth provisions concerning the purpose and scope of the Act. Provides that the Act applies to health insurance issuers that offer short-term, limited-duration health insurance coverage to groups and individuals (rather than only individuals) in the State. Sets forth provisions concerning duration of coverage; cancellation; and disclosure, filing, and coverage requirements of short term, limited-duration health insurance coverage. Sets forth provisions concerning unfair or deceptive practices relating to the sale of supplemental or short-term, limited-duration health insurance coverage. Provides that the Department of Insurance may adopt any rules necessary to carry out the provisions of the Act. Defines terms. Makes other changes. Effective January 1, 2023.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Engrossed - Dead) 2022-04-22 - Added as Co-Sponsor Sen. Jacqueline Y. Collins [SB3926 Detail]

Download: Illinois-2021-SB3926-Engrossed.html

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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 121-2.05, 356z.18, 367.3, 367a, 368f, 424,
425, and 500-70 as follows:
(215 ILCS 5/121-2.05) (from Ch. 73, par. 733-2.05)
Sec. 121-2.05. Group insurance policies issued and
delivered in other State-Transactions in this State. With the
exception of insurance transactions authorized under Sections
230.2 or 367.3 of this Code and transactions subject to the
requirements of the Short-Term, Limited-Duration Health
Insurance Coverage Act, transactions in this State involving
group legal, group life and group accident and health or
blanket accident and health insurance or group annuities where
the master policy of such groups was lawfully issued and
delivered in, and under the laws of, a State in which the
insurer was authorized to do an insurance business, to a group
properly established pursuant to law or regulation, and where
the policyholder is domiciled or otherwise has a bona fide
situs.
(Source: P.A. 86-753.)

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(215 ILCS 5/356z.18)
Sec. 356z.18. Prosthetic and customized orthotic devices.
(a) For the purposes of this Section:
"Customized orthotic device" means a supportive device for
the body or a part of the body, the head, neck, or extremities,
and includes the replacement or repair of the device based on
the patient's physical condition as medically necessary,
excluding foot orthotics defined as an in-shoe device designed
to support the structural components of the foot during
weight-bearing activities.
"Licensed provider" means a prosthetist, orthotist, or
pedorthist licensed to practice in this State.
"Prosthetic device" means an artificial device to replace,
in whole or in part, an arm or leg and includes accessories
essential to the effective use of the device and the
replacement or repair of the device based on the patient's
physical condition as medically necessary.
(b) This amendatory Act of the 96th General Assembly shall
provide benefits to any person covered thereunder for expenses
incurred in obtaining a prosthetic or custom orthotic device
from any Illinois licensed prosthetist, licensed orthotist, or
licensed pedorthist as required under the Orthotics,
Prosthetics, and Pedorthics Practice Act.
(c) A group or individual major medical policy of accident
or health insurance or managed care plan or medical, health,
or hospital service corporation contract that provides

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coverage for prosthetic or custom orthotic care and is
amended, delivered, issued, or renewed 6 months after the
effective date of this amendatory Act of the 96th General
Assembly must provide coverage for prosthetic and orthotic
devices in accordance with this subsection (c). The coverage
required under this Section shall be subject to the other
general exclusions, limitations, and financial requirements of
the policy, including coordination of benefits, participating
provider requirements, utilization review of health care
services, including review of medical necessity, case
management, and experimental and investigational treatments,
and other managed care provisions under terms and conditions
that are no less favorable than the terms and conditions that
apply to substantially all medical and surgical benefits
provided under the plan or coverage.
(d) The policy or plan or contract may require prior
authorization for the prosthetic or orthotic devices in the
same manner that prior authorization is required for any other
covered benefit.
(e) Repairs and replacements of prosthetic and orthotic
devices are also covered, subject to the co-payments and
deductibles, unless necessitated by misuse or loss.
(f) A policy or plan or contract may require that, if
coverage is provided through a managed care plan, the benefits
mandated pursuant to this Section shall be covered benefits
only if the prosthetic or orthotic devices are provided by a

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licensed provider employed by a provider service who contracts
with or is designated by the carrier, to the extent that the
carrier provides in-network and out-of-network service, the
coverage for the prosthetic or orthotic device shall be
offered no less extensively.
(g) The policy or plan or contract shall also meet
adequacy requirements as established by the Health Care
Reimbursement Reform Act of 1985 of the Illinois Insurance
Code.
(h) This Section shall not apply to accident only,
specified disease, short-term travel hospital or medical,
hospital confinement indemnity, credit, dental, vision,
Medicare supplement, long-term care, basic hospital and
medical-surgical expense coverage, disability income insurance
coverage, coverage issued as a supplement to liability
insurance, workers' compensation insurance, or automobile
medical payment insurance.
(Source: P.A. 96-833, eff. 6-1-10.)
(215 ILCS 5/367.3) (from Ch. 73, par. 979.3)
Sec. 367.3. Group accident and health insurance;
discretionary groups.
(a) No group health insurance offered to a resident of
this State under a policy issued to a group, other than one
specifically described in Section 367(1), shall be delivered
or issued for delivery in this State unless the Director

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determines that:
(1) the issuance of the policy is not contrary to the
public interest;
(2) the issuance of the policy will result in
economies of acquisition and administration; and
(3) the benefits under the policy are reasonable in
relation to the premium charged.
(b) No such group health insurance may be offered in this
State under a policy issued in another state unless this State
or the state in which the group policy is issued has made a
determination that the requirements of subsection (a) have
been met.
Where insurance is to be offered in this State under a
policy described in this subsection, the insurer shall file
for informational review purposes:
(1) a copy of the group master contract;
(2) a copy of the statute authorizing the issuance of
the group policy in the state of situs, which statute has
the same or similar requirements as this State, or in the
absence of such statute, a certification by an officer of
the company that the policy meets the Illinois minimum
standards required for individual accident and health
policies under authority of Section 401 of this Code, as
now or hereafter amended, as promulgated by rule at 50
Illinois Administrative Code, Ch. I, Sec. 2007, et seq.,
as now or hereafter amended, or under the Short-Term,

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Limited-Duration Health Insurance Coverage Act and rules
thereunder, as applicable, or by a successor rule;
(3) evidence of approval by the state of situs of the
group master policy; and
(4) copies of all supportive material furnished to the
state of situs to satisfy the criteria for approval.
(c) The Director may, at any time after receipt of the
information required under subsection (b) and after finding
that the standards of subsection (a) have not been met, order
the insurer to cease the issuance or marketing of that
coverage in this State.
(d) Notwithstanding subsections (a) and (b), group Group
accident and health insurance subject to the provisions of
this Section is also subject to the provisions of Section 367i
of this Code or the Short-Term, Limited-Duration Health
Insurance Coverage Act, as applicable, and rules thereunder
that pertain to group accident and health insurance.
(Source: P.A. 90-655, eff. 7-30-98.)
(215 ILCS 5/367a) (from Ch. 73, par. 979a)
Sec. 367a. Blanket accident and health insurance.
(1) Blanket accident and health insurance is that form of
accident and health insurance covering special groups of
persons as enumerated in one of the following paragraphs (a)
to (g), inclusive:
(a) Under a policy or contract issued to any carrier for

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hire, which shall be deemed the policyholder, covering a group
defined as all persons who may become passengers on such
carrier.
(b) Under a policy or contract issued to an employer, who
shall be deemed the policyholder, covering all employees or
any group of employees defined by reference to exceptional
hazards incident to such employment.
(c) Under a policy or contract issued to a college,
school, or other institution of learning or to the head or
principal thereof, who or which shall be deemed the
policyholder, covering students or teachers. However, except
where inconsistent with 45 CFR 147.145, student health
insurance coverage other than excepted benefits or short-term,
limited-duration health insurance coverage that is provided
pursuant to a written agreement with an institution of higher
education for the benefit of its enrolled students and their
dependents shall remain subject to the standards and
requirements for individual health insurance coverage.
(d) Under a policy or contract issued in the name of any
volunteer fire department, first aid, or other such volunteer
group, which shall be deemed the policyholder, covering all of
the members of such department or group.
(e) Under a policy or contract issued to a creditor, who
shall be deemed the policyholder, to insure debtors of the
creditors; Provided, however, that in the case of a loan which
is subject to the Small Loans Act, no insurance premium or

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other cost shall be directly or indirectly charged or assessed
against, or collected or received from the borrower.
(f) Under a policy or contract issued to a sports team or
to a camp, which team or camp sponsor shall be deemed the
policyholder, covering members or campers.
(g) Under a policy or contract issued to any other
substantially similar group which, in the discretion of the
Director, may be subject to the issuance of a blanket accident
and health policy or contract.
(2) Any insurance company authorized to write accident and
health insurance in this state shall have the power to issue
blanket accident and health insurance. No such blanket policy
may be issued or delivered in this State unless a copy of the
form thereof shall have been filed in accordance with Section
355, and it contains in substance such of those provisions
contained in Sections 357.1 through 357.30 as may be
applicable to blanket accident and health insurance and the
following provisions:
(a) A provision that the policy and the application shall
constitute the entire contract between the parties, and that
all statements made by the policyholder shall, in absence of
fraud, be deemed representations and not warranties, and that
no such statements shall be used in defense to a claim under
the policy, unless it is contained in a written application.
(b) A provision that to the group or class thereof
originally insured shall be added from time to time all new

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persons or individuals eligible for coverage.
(3) An individual application shall not be required from a
person covered under a blanket accident or health policy or
contract, nor shall it be necessary for the insurer to furnish
each person a certificate.
(4) All benefits under any blanket accident and health
policy shall be payable to the person insured, or to his
designated beneficiary or beneficiaries, or to his or her
estate, except that if the person insured be a minor or person
under legal disability, such benefits may be made payable to
his or her parent, guardian, or other person actually
supporting him or her. Provided further, however, that the
policy may provide that all or any portion of any indemnities
provided by any such policy on account of hospital, nursing,
medical or surgical services may, at the insurer's option, be
paid directly to the hospital or person rendering such
services; but the policy may not require that the service be
rendered by a particular hospital or person. Payment so made
shall discharge the insurer's obligation with respect to the
amount of insurance so paid.
(5) Nothing contained in this section shall be deemed to
affect the legal liability of policyholders for the death of
or injury to, any such member of such group.
(Source: P.A. 83-1362.)
(215 ILCS 5/368f)

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Sec. 368f. Military service member insurance
reinstatement.
(a) No Illinois resident activated for military service
and no spouse or dependent of the resident who becomes
eligible for a federal government-sponsored health insurance
program, including the TriCare program providing coverage for
civilian dependents of military personnel, as a result of the
activation shall be denied reinstatement into the same
individual health insurance coverage with the health insurer
that the resident lapsed as a result of activation or becoming
covered by the federal government-sponsored health insurance
program. The resident shall have the right to reinstatement in
the same individual health insurance coverage without medical
underwriting, subject to payment of the current premium
charged to other persons of the same age and gender that are
covered under the same individual health coverage. Except in
the case of birth or adoption that occurs during the period of
activation, reinstatement must be into the same coverage type
as the resident held prior to lapsing the individual health
insurance coverage and at the same or, at the option of the
resident, higher deductible level. The reinstatement rights
provided under this subsection (a) are not available to a
resident or dependents if the activated person is discharged
from the military under other than honorable conditions.
(b) The health insurer with which the reinstatement is
being requested must receive a request for reinstatement no

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later than 63 days following the later of (i) deactivation or
(ii) loss of coverage under the federal government-sponsored
health insurance program. The health insurer may request proof
of loss of coverage and the timing of the loss of coverage of
the government-sponsored coverage in order to determine
eligibility for reinstatement into the individual coverage.
The effective date of the reinstatement of individual health
coverage shall be the first of the month following receipt of
the notice requesting reinstatement.
(c) All insurers must provide written notice to the
policyholder of individual health coverage of the rights
described in subsection (a) of this Section. In lieu of the
inclusion of the notice in the individual health insurance
policy, an insurance company may satisfy the notification
requirement by providing a single written notice:
(1) in conjunction with the enrollment process for a
policyholder initially enrolling in the individual
coverage on or after the effective date of this amendatory
Act of the 94th General Assembly; or
(2) by mailing written notice to policyholders whose
coverage was effective prior to the effective date of this
amendatory Act of the 94th General Assembly no later than
90 days following the effective date of this amendatory
Act of the 94th General Assembly.
(d) The provisions of subsection (a) of this Section do
not apply to any policy or certificate providing coverage for

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any specified disease, specified accident or accident-only
coverage, credit, dental, disability income, hospital
indemnity, long-term care, Medicare supplement, vision care,
or short-term travel nonrenewable health policy or other
limited-benefit supplemental insurance, or any coverage issued
as a supplement to any liability insurance, workers'
compensation or similar insurance, or any insurance under
which benefits are payable with or without regard to fault,
whether written on a group, blanket, or individual basis.
(e) Nothing in this Section shall require an insurer to
reinstate the resident if the insurer requires residency in an
enrollment area and those residency requirements are not met
after deactivation or loss of coverage under the
government-sponsored health insurance program.
(f) All terms, conditions, and limitations of the
individual coverage into which reinstatement is made apply
equally to all insureds enrolled in the coverage.
(g) The Secretary may adopt rules as may be necessary to
carry out the provisions of this Section.
(Source: P.A. 94-1037, eff. 7-20-06.)
(215 ILCS 5/424) (from Ch. 73, par. 1031)
Sec. 424. Unfair methods of competition and unfair or
deceptive acts or practices defined. The following are hereby
defined as unfair methods of competition and unfair and
deceptive acts or practices in the business of insurance:

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(1) The commission by any person of any one or more of
the acts defined or prohibited by Sections 134, 143.24c,
147, 148, 149, 151, 155.22, 155.22a, 155.42, 236, 237,
364, and 469 of this Code.
(2) Entering into any agreement to commit, or by any
concerted action committing, any act of boycott, coercion
or intimidation resulting in or tending to result in
unreasonable restraint of, or monopoly in, the business of
insurance.
(3) Making or permitting, in the case of insurance of
the types enumerated in Classes 1, 2, and 3 of Section 4,
any unfair discrimination between individuals or risks of
the same class or of essentially the same hazard and
expense element because of the race, color, religion, or
national origin of such insurance risks or applicants. The
application of this Article to the types of insurance
enumerated in Class 1 of Section 4 shall in no way limit,
reduce, or impair the protections and remedies already
provided for by Sections 236 and 364 of this Code or any
other provision of this Code.
(4) Engaging in any of the acts or practices defined
in or prohibited by Sections 154.5 through 154.8 of this
Code.
(5) Making or charging any rate for insurance against
losses arising from the use or ownership of a motor
vehicle which requires a higher premium of any person by

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reason of his physical disability, race, color, religion,
or national origin.
(6) Failing to meet any requirement of the Unclaimed
Life Insurance Benefits Act with such frequency as to
constitute a general business practice.
(7) Failing to make a disclosure or obtain a signed
confirmation required under Section 15 of the Short-Term,
Limited-Duration Health Insurance Coverage Act or any
unlawful practice described in Section 30 of the
Short-Term, Limited-Duration Health Insurance Coverage
Act.
(Source: P.A. 99-143, eff. 7-27-15; 99-893, eff. 1-1-17.)
(215 ILCS 5/425) (from Ch. 73, par. 1032)
Sec. 425. Power of Director.
The Director shall have power to examine and investigate
into the affairs of every person engaged in the business of
insurance in this State, or otherwise subject to the
provisions of Section 30 of the Short-Term, Limited-Duration
Health Insurance Coverage Act, and to examine and investigate
into the affairs of any person domiciled in or resident of this
State engaged in the business of insurance in any other State,
Territory, Province, Possession, Country or District in which
he is not licensed or otherwise authorized to transact
business in order to determine whether such person has been or
is engaged in any unfair method of competition or in any unfair

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or deceptive act or practice prohibited by Section 424.
(Source: Laws 1967, p. 990.)
(215 ILCS 5/500-70)
(Section scheduled to be repealed on January 1, 2027)
Sec. 500-70. License denial, nonrenewal, or revocation.
(a) The Director may place on probation, suspend, revoke,
or refuse to issue or renew an insurance producer's license or
may levy a civil penalty in accordance with this Section or
take any combination of actions, for any one or more of the
following causes:
(1) providing incorrect, misleading, incomplete, or
materially untrue information in the license application;
(2) violating any insurance laws, or violating any
rule, subpoena, or order of the Director or of another
state's insurance commissioner;
(3) obtaining or attempting to obtain a license
through misrepresentation or fraud;
(4) improperly withholding, misappropriating or
converting any moneys or properties received in the course
of doing insurance business;
(5) intentionally misrepresenting the terms of an
actual or proposed insurance contract or application for
insurance;
(6) having been convicted of a felony, unless the
individual demonstrates to the Director sufficient

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rehabilitation to warrant the public trust; consideration
of such conviction of an applicant shall be in accordance
with Section 500-76;
(7) having admitted or been found to have committed
any insurance unfair trade practice or fraud;
(8) using fraudulent, coercive, or dishonest
practices, or demonstrating incompetence,
untrustworthiness or financial irresponsibility in the
conduct of business in this State or elsewhere;
(9) having an insurance producer license, or its
equivalent, denied, suspended, or revoked in any other
state, province, district or territory;
(10) forging a name to an application for insurance or
to a document related to an insurance transaction;
(11) improperly using notes or any other reference
material to complete an examination for an insurance
license;
(12) knowingly accepting insurance business from an
individual who is not licensed;
(13) failing to comply with an administrative or court
order imposing a child support obligation;
(14) failing to pay state income tax or penalty or
interest or comply with any administrative or court order
directing payment of state income tax or failed to file a
return or to pay any final assessment of any tax due to the
Department of Revenue;

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(15) (blank); or
(16) failing to comply with any provision of the
Viatical Settlements Act of 2009; or .
(17) failing to make a disclosure or obtain a signed
confirmation required under Section 15 of the Short-Term,
Limited-Duration Health Insurance Coverage Act or any
unlawful practice described in Section 30 of the
Short-Term, Limited-Duration Health Insurance Coverage
Act.
(b) If the action by the Director is to nonrenew, suspend,
or revoke a license or to deny an application for a license,
the Director shall notify the applicant or licensee and
advise, in writing, the applicant or licensee of the reason
for the suspension, revocation, denial or nonrenewal of the
applicant's or licensee's license. The applicant or licensee
may make written demand upon the Director within 30 days after
the date of mailing for a hearing before the Director to
determine the reasonableness of the Director's action. The
hearing must be held within not fewer than 20 days nor more
than 30 days after the mailing of the notice of hearing and
shall be held pursuant to 50 Ill. Adm. Code 2402.
(c) The license of a business entity may be suspended,
revoked, or refused if the Director finds, after hearing, that
an individual licensee's violation was known or should have
been known by one or more of the partners, officers, or
managers acting on behalf of the partnership, corporation,

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limited liability company, or limited liability partnership
and the violation was neither reported to the Director nor
corrective action taken.
(d) In addition to or instead of any applicable denial,
suspension, or revocation of a license, a person may, after
hearing, be subject to a civil penalty of up to $10,000 for
each cause for denial, suspension, or revocation, however, the
civil penalty may total no more than $100,000.
(e) The Director has the authority to enforce the
provisions of and impose any penalty or remedy authorized by
this Article against any person who is under investigation for
or charged with a violation of this Code or rules even if the
person's license or registration has been surrendered or has
lapsed by operation of law.
(f) Upon the suspension, denial, or revocation of a
license, the licensee or other person having possession or
custody of the license shall promptly deliver it to the
Director in person or by mail. The Director shall publish all
suspensions, denials, or revocations after the suspensions,
denials, or revocations become final in a manner designed to
notify interested insurance companies and other persons.
(g) A person whose license is revoked or whose application
is denied pursuant to this Section is ineligible to apply for
any license for 3 years after the revocation or denial. A
person whose license as an insurance producer has been
revoked, suspended, or denied may not be employed, contracted,

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or engaged in any insurance related capacity during the time
the revocation, suspension, or denial is in effect.
(Source: P.A. 100-286, eff. 1-1-18; 100-872, eff. 8-14-18.)
Section 10. The Short-Term, Limited-Duration Health
Insurance Coverage Act is amended by changing Sections 5, 10,
15, and 20 and by adding Sections 2, 25, 30, and 35 as follows:
(215 ILCS 190/2 new)
Sec. 2. Purpose and scope. This Act is intended to
regulate the sale, solicitation, and marketing of short-term,
limited-duration health insurance coverage to insurance
consumers, and the referral of insurance consumers to
short-term, limited-duration health insurance coverage, and to
protect consumers from confusing or deceptive marketing
practices. This Act applies to health insurance issuers and
insurance producers. Additionally, except as provided therein,
Section 30 applies to any other person whose business
transactions include advertising, referring, or directing
prospective insurance purchasers or enrollees to health
insurance coverage even when such persons are not otherwise
required to obtain a license, certificate, or registration
from the Department.
(215 ILCS 190/5)
Sec. 5. Definitions. In this Act:

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"Department" means the Department of Insurance.
"Excepted benefits" has the meaning given to that term in
42 U.S.C. 300gg-91(c) and regulations thereunder.
"Health insurance coverage" has the meaning given to that
term in Section 5 of the Illinois Health Insurance Portability
and Accountability Act.
"Health insurance issuer" has the meaning given to that
term in Section 5 of the Illinois Health Insurance Portability
and Accountability Act.
"Health insurance issuer doing direct sales" means a
health insurance issuer that provides a means to accept a
completed application or enrollment form for a policy or
certificate of health insurance coverage directly from an
individual or group without any prior live interaction or
written correspondence between that individual or group and an
insurance producer. A "health insurance issuer doing direct
sales" includes a health insurance issuer that accepts an
application for health insurance coverage through its own
website. A "health insurance issuer doing direct sales" does
not include the enrollment of individuals under a group policy
by a non-producer representative of the group or the group's
own website.
"Fraud" means an intentional misrepresentation of a
material fact in connection with the coverage.
"Person" means any natural or legal person, organization,
body, association, corporation, company, partnership, society,

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order, aggregation of individuals, or other entity described
under any State or federal law.
"Short-term, limited-duration health insurance coverage"
means health insurance coverage, other than excepted benefits,
provided pursuant to a policy or certificate with an issuer,
regardless of the situs of the delivery of the policy, that has
an expiration date of is less than 365 days after the effective
date of the policy or certificate.
(Source: P.A. 100-1118, eff. 11-27-18.)
(215 ILCS 190/10)
Sec. 10. Application; scope; duration of coverage.
(a) This Act applies to health insurance issuers that
offer short-term, limited-duration health insurance coverage
to groups and individuals in this State and to short-term,
limited-duration health insurance coverage that is delivered
or issued for delivery in this State, including group coverage
issued outside of this State that covers individuals in this
State.
(b) A short-term, limited-duration health insurance
coverage policy or certificate may not be issued or delivered
to any natural or legal person residing in this State unless
the policy or certificate, when delivered or issued for
delivery in this State, complies with the provisions of this
Act.
(b-5) In addition to the entities recognized under Section

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230.1 or 367 of the Illinois Insurance Code or under the Health
Maintenance Organization Act as eligible for group coverage, a
group policy of short-term, limited-duration health insurance
coverage may be issued to an institution of higher education
for the benefit of its enrolled students and their dependents
for purposes of this Act.
(c) Any short-term, limited-duration health insurance
coverage policy or certificate that is delivered or issued for
delivery in this State must have an expiration date in the
policy that is less than the lesser of 181 days after the
effective date or any applicable time limitation provided in
federal law or regulation and shall not be renewable or
extendable within a period of 365 days after the individual's
coverage under the policy ends, either at the option of the
issuer or the individual. Renewal of a short-term,
limited-duration health insurance coverage policy or
certificate includes the issuance of a new or different
short-term, limited-duration health insurance policy or
certificate by an issuer to a policyholder within 60 days
after the expiration of a policy or certificate previously
issued by the issuer to the policyholder.
(d) An issuer may not rescind any Any short-term,
limited-duration health insurance coverage policy or
certificate that is delivered or issued for delivery in this
State may not be rescinded before the expiration date in the
policy, except as provided in Section 154 of the Illinois

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Insurance Code. An issuer may not cancel any such policy or
certificate except for nonpayment of premiums or for fraud in
the making of a claim or an application for the policy or
certificate. Notwithstanding Section 357.22 of the Illinois
Insurance Code, cancellations for nonpayment of premiums shall
not be valid except upon 10 days' notice but may be effectuated
retroactively back to the last date of coverage for which
premiums were paid in cases of nonpayment of premiums, fraud,
or as provided in subsection (e).
(e) Any short-term, limited-duration health insurance
coverage policy or certificate that is delivered or issued for
delivery in this State shall contain an option for an
individual to cancel coverage after any 30-day interval during
the term of the plan, counting such intervals from the
effective date of coverage.
(Source: P.A. 100-1118, eff. 11-27-18.)
(215 ILCS 190/15)
Sec. 15. Disclosure requirements.
(a) A health insurance issuer that offers short-term,
limited-duration health insurance coverage to be delivered or
issued for delivery in this State shall, in addition to all
other documents required, including, but not limited to, the
policy, the certificate, the membership booklet, the completed
and signed application or enrollment form, all signed
confirmations required by this Section, and a description of

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appeal and external review rights, deliver an outline of
coverage to an applicant for or an enrollee in short-term,
limited-duration health insurance coverage delivered or issued
for delivery in this State.
(b) Any short-term, limited-duration health insurance
coverage policy that is delivered or issued for delivery in
the State shall display prominently in the policy, any
application, sales, and marketing materials provided in
connection with enrollment in such coverage, and the outline
of coverage for such coverage, in at least 14-point, bold
type, the following: "NOTICE: THE SHORT-TERM, LIMITED-DURATION
INSURANCE BENEFITS UNDER THIS COVERAGE DO NOT MEET ALL FEDERAL
REQUIREMENTS TO QUALIFY AS "MINIMUM ESSENTIAL COVERAGE" FOR
HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. THIS PLAN OF
COVERAGE DOES NOT INCLUDE ALL ESSENTIAL HEALTH BENEFITS AS
REQUIRED BY THE AFFORDABLE CARE ACT. PREEXISTING CONDITIONS
ARE NOT COVERED UNDER THIS PLAN OF COVERAGE. BE SURE TO CHECK
YOUR POLICY CAREFULLY TO MAKE SURE YOU UNDERSTAND WHAT THE
POLICY DOES AND DOES NOT COVER. IF THIS COVERAGE EXPIRES OR YOU
LOSE ELIGIBILITY FOR THIS COVERAGE, YOU MIGHT HAVE TO WAIT
UNTIL THE NEXT OPEN ENROLLMENT PERIOD TO GET OTHER HEALTH
INSURANCE COVERAGE. YOU MAY BE ABLE TO GET LONGER TERM
INSURANCE THAT QUALIFIES AS "MINIMUM ESSENTIAL COVERAGE" FOR
HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT NOW AND HELP TO
PAY FOR IT AT WWW.HEALTHCARE.GOV.".
(c)(1) Before enrolling any individual or accepting any

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application for group or individual short-term,
limited-duration health insurance coverage to be delivered or
issued for delivery in this State, an insurance producer or a
health insurance issuer doing direct sales shall review with
the prospective purchaser or enrollee each essential health
benefit in the State of Illinois, identify whether the policy
or certificate covers that benefit, and obtain the prospective
purchaser or enrollee's signed confirmation of receipt of this
disclosure. The signed confirmation document must be in at
least 12-point type and must include the complete list of
essential health benefits and an indication for each benefit
as to whether the policy or certificate covers it to the extent
provided in the Illinois Essential Health Benefits Benchmark
Plan. An insurance producer or other representative of an
issuer or its administrator may not sign on the prospective
purchaser or enrollee's behalf.
(2) For coverage offered to an individual in this State
under a group policy by a representative of the group
policyholder or its administrator, if the issuer does not
receive the signed confirmation with the individual's
completed and signed application or enrollment form, the
issuer must provide this disclosure to the individual and
obtain the individual's signed confirmation before enrolling
the individual under the coverage.
(d)(1) Before enrolling any individual or accepting any
individual application for short-term, limited-duration health

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insurance coverage, an insurance producer or a health
insurance issuer doing direct sales must review the complete
list of qualifying events for special enrollment with the
prospective purchaser or enrollee, verify whether the
individual qualifies for special enrollment on the date the
short-term, limited-duration health insurance coverage is
offered, and obtain the prospective purchaser or enrollee's
signed confirmation as to whether the individual has
experienced a qualifying event within the time frames provided
under the Patient Protection and Affordable Care Act. The
signed confirmation must be in at least 12-point type and must
include the complete list of qualifying events, the relevant
time frames for each, and an indication for each qualifying
event as to whether it applies to the individual. An insurance
producer or other representative of the issuer or its
administrator may not sign the confirmation on the
individual's behalf.
(2) If the individual qualifies for special enrollment, or
during an open enrollment period described in 42 U.S.C.
300gg-1, the issuer or producer, before accepting the
application or enrollment, must inform the individual in
writing and via either face-to-face interaction or telephone
call or voicemail about the availability of qualified health
plans on the healthcare.gov website. If the issuer or producer
also offers policies in the individual market, the issuer or
producer may also inform the individual of the availability of

SB3926 Engrossed - 27 - LRB102 24061 BMS 34191 b
such plans.
(3) For coverage offered to an individual in this State
under a group policy by a representative of the group
policyholder or its administrator, if the issuer does not
receive the signed confirmation regarding qualifying events
with the individual's completed and signed application or
enrollment form, the issuer must provide this disclosure to
the individual and obtain the individual's signed confirmation
regarding qualifying events before enrolling the individual
under the coverage. If the individual indicates that a
qualifying event has occurred within the relevant time frame,
the issuer must comply with paragraph (2).
(e) A health insurance issuer shall provide a website
where prospective purchasers or enrollees can review the
complete policy or certificate and the outline of coverage
before submitting their application or enrollment form. The
availability of this website shall be disclosed on the
application or enrollment form and in any sales or marketing
materials for the coverage.
(f) The policy or certificate and any application or
enrollment form must contain a provision stating that, during
a period of 10 days from the date the policy or certificate is
delivered, the group or individual may submit a written
request for retroactive cancellation of coverage and that in
such event the issuer will refund any premium paid for the
policy or certificate, including any contract fees or other

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charges.
(g) In addition to the written disclosures, any insurance
producer (c) Any individual selling a short-term,
limited-duration health insurance coverage policy in this
State in face-to-face or telephonic sales interactions must
read out loud the disclosures disclosure in subsections
subsection (b), (c), (d), (e), and (f) to a prospective
purchaser or enrollee. An issuer entity selling a short-term,
limited-duration health insurance coverage policy or
certificate in Illinois must display the disclosures
disclosure in subsections subsection (b), (c), (d), (e), and
(f) on the webpage where a prospective purchaser or enrollee
would purchase or enroll in coverage. For sales conducted by
an insurance producer in face-to-face or telephonic
interactions, the application or enrollment form shall contain
an attestation to be initialed by the applicant that the
producer read each disclosure out loud, that the applicant
understood each disclosure, and that the applicant was given
opportunities to ask the producer questions about each
disclosure and to review the policy or certificate and the
outline of coverage.
(h) (d) Nothing in this Section precludes an issuer
insurer from providing disclosures in addition to those
required in subsections (b), and (c), (d), (e), and (f).
Nothing in this Section precludes an insurer from providing
disclosures intended to clarify those required in subsections

SB3926 Engrossed - 29 - LRB102 24061 BMS 34191 b
(b), and (c), (d), (e), and (f) if approved by the Department.
Nothing in this Section precludes an issuer from including the
written disclosures required in subsections (c) and (d) on the
application or enrollment form.
(i) No policy or certificate of short-term,
limited-duration health insurance coverage shall be delivered
or issued for delivery in this State unless the prospective
purchaser or enrollee reviews and signs the completed written
application or enrollment form. Any application or enrollment
form submitted by an insurance producer to a health insurance
issuer shall contain an attestation clause signed by the
producer stating that the producer received the signed form
from the applicant, that no alterations have been made to any
of the applicant's personal information appearing on the
signed form at the time the producer received it, and that the
applicant received and signed all disclosures described in
this Section.
(j) Nothing in this Act shall preclude a prospective
purchaser or enrollee from designating an authorized
representative to act on his or her behalf in relation to the
purchase or enrollment. However, no designation of an
insurance producer, a health insurance issuer, or an agent or
employee of either shall be valid with respect to the
disclosures, applications, enrollment forms, and signed
confirmations under this Section.
(Source: P.A. 100-1118, eff. 11-27-18.)

SB3926 Engrossed - 30 - LRB102 24061 BMS 34191 b
(215 ILCS 190/20)
Sec. 20. Filing and approval.
(a) Coverage subject to this Act may not be delivered or
issued for delivery in this State unless the health insurance
issuer has complied with the policy form and rate filing
requirements of Sections 143 and 355 of the Illinois Insurance
Code or Sections 4-12 and 4-13 of the Health Maintenance
Organization Act, as applicable, including rules thereunder
policy evidencing such coverage has been filed with and been
approved by the Department.
(b) A health insurance issuer that who intends to deliver
or issue for delivery a short-term, limited-duration health
insurance coverage policy or certificate in this State shall
file with the Department: (1) all paperwork required for
individual health insurance coverage pursuant to 50 Ill. Adm.
Code 916; and (2) all sales and marketing materials provided
in connection with enrollment in such coverage for
informational purposes.
(c) (Blank). The Department shall adopt any rules
necessary to carry out the provisions of this Act.
(Source: P.A. 100-1118, eff. 11-27-18.)
(215 ILCS 190/25 new)
Sec. 25. Coverage requirements; other laws.
(a) Except where inconsistent with this Act, a health

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insurance issuer that offers any policy or certificate of
short-term, limited-duration health insurance coverage shall
be subject to all Illinois insurance laws or rules not
specifically referenced in this Act that apply to major
medical accident and health insurance or health maintenance
organization health care plans, as applicable to the
certificate of authority under which the short-term,
limited-duration health insurance coverage is offered or
issued, and that do not:
(1) require the policy or certificate to cover
essential health benefits or other specified health care
services or to maintain parity between certain types of
benefits;
(2) prescribe standards for continuation coverage or
conversion privileges;
(3) prohibit or prescribe standards for allowable
cost-sharing amounts; or
(4) require an issuer to satisfy standards for the
adequacy and transparency of any provider network through
which the insured or enrollee is required or incentivized
to obtain covered health care services.
(b) Notwithstanding subsection (a), no State law or rule
shall apply to the extent that it would require a policy or
certificate of short-term, limited-duration health insurance
coverage to provide coverage for at least 3 calendar months or
to renew, extend, or reinstate coverage within 365 days of the

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date that coverage terminates.
(c) Nothing in this Act shall exempt a health maintenance
organization offering short-term, limited-duration health
insurance coverage from the requirements for coverage of basic
health care services or other requirements to maintain and
restrictions on a certificate of authority under Sections 2-1
through 2-3 of the Health Maintenance Organization Act.
(215 ILCS 190/30 new)
Sec. 30. Unfair or deceptive practices relating to the
sale of supplemental or short-term, limited-duration health
insurance coverage.
(a) It is an unlawful method, act, or practice within the
meaning of this Act for any person who solicits, negotiates,
sells, offers, offers to enroll, issues, or delivers
short-term, limited-duration health insurance coverage or
excepted benefits within this State, or advertisers for such
persons, or persons whose business transactions include
referring or directing prospective purchasers or enrollees of
health insurance coverage that reside or are domiciled in this
State to health insurance issuers or insurance producers
transacting business in this State, to do any of the
following:
(1) represent or warrant to any prospective purchaser
or enrollee, or use language or imagery in speech or
published content that is suggestive, that a policy or

SB3926 Engrossed - 33 - LRB102 24061 BMS 34191 b
certificate of excepted benefits or short-term,
limited-duration health insurance coverage, or any
combination of such policies or certificates, constitutes
minimum essential coverage;
(2) represent or warrant to any prospective purchaser
or enrollee, or use language or imagery in speech or
published content that is suggestive, that a policy or
certificate of excepted benefits or short-term,
limited-duration health insurance coverage, or any
combination of such policies or certificates, is similar
to, is almost as beneficial as, can be used for similar
purposes as, or may be better for the prospective
purchaser or enrollee than minimum essential coverage,
major medical coverage that complies with all Illinois
requirements, a health maintenance organization health
care plan that complies with all Illinois requirements, a
voluntary health services plan, comprehensive health
insurance coverage, a qualified health plan, or any other
description of coverage indicating such policies or
certificates. An application or enrollment form for
specified disease or accident-only excepted benefits that
allows an individual prospective purchaser or enrollee to
choose coverage for a majority of the diseases, health
conditions, or accidents typically covered under major
medical accident health insurance or a health maintenance
organization health care plan, or that covers a majority

SB3926 Engrossed - 34 - LRB102 24061 BMS 34191 b
of the health care services constituting preventive care
under 42 U.S.C. 300gg-13, shall be deemed an unlawful
practice within the meaning of this Act; or
(3) use any logo, brand, trademark, service mark,
mark, device, name, tagline, slogan, descriptor, or
website domain that is deceptively similar to those used
for Get Covered Illinois or the healthcare.gov website,
including those that do not expressly mention Illinois or
its political subdivisions. This paragraph expressly
includes circumstances that would not violate the
Counterfeit Trademark Act.
(b) This Section does not apply to Internet search
engines, Internet service providers, website domain
registrars, Internet network hardware providers, or other
natural or legal persons insofar as they do not propose,
approve, or submit the content published by an insurance
producer, health insurance issuer, or their advertisers, or
propose, approve, or submit the content published by persons
whose business transactions include referring prospective
purchasers or enrollees resident or domiciled in this State to
health insurance issuers or insurance producers transacting
business in this State.
(215 ILCS 190/35 new)
Sec. 35. Department administration and enforcement. The
Department may adopt any rules necessary to carry out the

SB3926 Engrossed - 35 - LRB102 24061 BMS 34191 b
provisions of this Act. The Department shall have all
enforcement powers granted to it by law with respect to
accident and health insurance and health maintenance
organization health care plans and all persons otherwise under
the Director's jurisdiction.
Section 99. Effective date. This Act takes effect January
1, 2023.