Illinois Administrative Code

Section 4530.70 Operational Requirements An independent review organization shall secure and maintain a current certificate of accreditation by the American Accreditation Healthcare Commission (URAC) under applicable standards for Independent Review Organizations except when the …

Section 4530.80 Examination a) The Director or his or her designee may examine any applicant for registration or any registrant upon receipt of information that the applicant or registrant may be in violation of this Part, or any applicable provision of the Code, when he or she r…

Section 4530.90 Random Selection of IROs by Director The assignment by the Director of an approved independent review organization to conduct an external review in accordance with the Act shall be done on a random basis among those independent review organizations approved by the…

Section 4530.APPENDIX C Independent Review Organizations – Application for Registration INDEPENDENT REVIEW ORGANIZATION Registration Form [Today's Date] 1. Name of Independent Review Organization DBA Type of Applicant (check one): Corporation Partnership Limited Liability Other (…

Section 4540.10 Purpose and Scope The purpose of this Part is to establish a uniform, expeditious, and required procedure for filing network descriptions with the Department before issuing, delivering, or renewing approved products as required under Section 10 of the Network Adeq…

Section 4540.20 Applicability This Part applies to any individual or group policy of accident and health insurance, health maintenance organization health care plan, or voluntary health services plan when the insurance or plan is a network plan issued, delivered, or renewed in Il…

Section 4540.30 Definitions Terms used in this Part have the meanings ascribed in Section 5 of the Act. In addition, the following definitions apply to this Part and the Act: "2023 Letter" means the "2023 Letter to Issuers in the Federally-facilitated Exchanges" published by the …

Section 4540.40 Filing Procedures At least annually, an insurer shall file with the Director the description required under Section 10 of the Act for each network plan before the network plan is issued, delivered, or renewed in this State. Each filing shall be submitted through S…

Section 4540.50 Material Changes to a Network a) Within 15 days after any material change in an approved network plan, an insurer must submit a material change filing. The insurer shall submit a revised version of the most recent network adequacy filing described in Section 4540.…

Section 4540.60 Provider Directory Audits a) By April 1 of each year, an insurer shall file with the Department a report applicable to all provider directories of all its network plans that describes the protocols the insurer uses to ensure that it complies with the requirements …

Section 4540.70 Notice of Nonrenewal or Termination Beginning May 1, 2023, before sending any notice of nonrenewal or termination required under Section 15 of the Act, an insurer shall file informationally with the Department through SERFF a sample copy of the notices to provider…

Section 4540.80 Confidentiality a) All records in the custody or possession of the Department are presumed to be open to public inspection or copying unless exempt from disclosure by Section 7 or 7.5 of the Freedom of Information Act [5 ILCS 140]. Except as otherwise provided in …

Section 8000.10 Introduction a) Section 143.29 of the Illinois Insurance Code provides for an appropriate reduction of the premium for automobile liability insurance of those insureds over the age of 55 who successfully complete a motor vehicle accident prevention course. The Sec…

Section 8000.100 Records of Certification of Course Completion a) A Provider is responsible for maintaining records on all individuals completing its motor vehicle accident prevention course for liability insurance premium reduction in a manner that will facilitate the ease of ve…

Section 8000.20 Course and Provider Approval A Provider that proposes to offer a motor vehicle accident prevention course to the public for liability insurance premium reduction must submit a completed application designating which modality they will use, in-person, virtual, eLea…

Section 8000.30 Delivery Agency Approval (Repealed) (Source: Repealed at 46 Ill. Reg. 6651, effective April 11, 2022)

Section 8000.40 In-Person and Virtual Course Instructor Approval All in-person and virtual instructors must be approved by the Program Administrator prior to conducting an approved course. a) To be approved, an instructor must: 1) have the Provider submit to the Program Administr…

Section 8000.50 Retroactive Approval (Repealed) (Source: Repealed at 46 Ill. Reg. 6651, effective April 11, 2022)

Section 8000.60 Denial and Withdrawal of Approval - Hearing a) Denial 1) The Program Administrator shall deny the approval of: A) a course and Provider if the Program Administrator determines that such course does not meet or exceed the standards of the National Safety Council's …

Section 8000.70 Course Administration An approved Provider must: a) Notify the Program Administrator, within 15 days from course completion, that a student has successfully completed the course on a form and in a manner prescribed by the Program Administrator, including the follo…

Section 8000.80 Delivery Agency Course Administration (Repealed) (Source: Repealed at 46 Ill. Reg. 6651, effective April 11, 2022)

Section 8000.90 Course Advertising a) The Secretary reserves the right to review and approve all advertising regarding an approved motor vehicle accident prevention course that is offered for liability premium reduction. b) Advertising by a Provider approved to administer or cond…

Section 8010.10 Definitions For purposes of this Part, the following definitions shall apply: "Act" – is Article VI of the Illinois Safety Responsibility Law of the Illinois Vehicle Code (Ill. Rev. Stat. 1988 Supp., ch. 95½, par. 7-601 et seq.) "Certificate of Insurance" – legal …

Section 8010.20 Insurance Card Requirements a) Pursuant to Section 7-602 of the Act, each insurance company which issues vehicle liability policies in Illinois shall issue an insurance card to the policy holder of the vehicle indicating the vehicle is insured. The insurance card …

Section 8010.30 Document Requirements for Other Evidence of Insurance a) If an insured owner has lost or has not yet received an insurance card from his/her insurance company, or is the resident of another state or jurisdiction other evidences of insurance may be carried in the v…

Section 8010.40 Mandatory Vehicle Insurance Verification Form a) As provided in Section 7-604 of the Act, the Secretary of State may randomly sample motor vehicles subject to Section 7-601 of the Act to determine whether the motor vehicles are insured. b) The Secretary shall send…

Section 8010.50 Insurance Company Verification a) The Department shall verify with the named insurance company the information provided on the Mandatory Vehicle Insurance Verification Form. The request for verification may be a computer list, computer tape, or other forms as pres…

Section 8010.60 Suspension Notices The suspension notice pursuant to Section 7-606 of the Act shall be mailed at least fourteen (14) days before the suspension is to begin. The suspension notice shall be sent to the vehicle owner's last known address.

Section 8010.70 Termination of a Suspension for a Violation of the Mandatory Insurance Law After the statutorily required period of suspension of the vehicle registration, the vehicle owner shall have the suspension cleared if the owner has paid the statutorily required reinstate…

Section 8010.80 Exemption For Certain Religious Organizations a) In order to qualify for the exemption from the Mandatory Insurance requirement as specified in Section 7-609 of the Act, the religious organization shall submit the following to the Secretary of State: 1) evidence t…

Section 9010.10 Time Limitations Every employer within the provisions of the Workers' Compensation Act [820 ILCS 305/6(b)] and the Workers' Occupational Diseases Act [820 ILCS 310/6] shall report all fatal accidental injuries to the Workers' Compensation Commission immediately; a…

Section 9015.10 Overview of Electronic Filing a) The Uniform Electronic Transactions Act [815 ILCS 333] (UETA) authorizes State agencies to send and receive electronic records and electronic signatures to and from other persons and otherwise create, use, store, and rely upon elec…

Section 9015.20 Format a) Documents must be submitted in the format prescribed by the Commission or in PDF format. All electronically filed documents shall include the case caption and nature of filing. Each document shall include the typed name, e-mail address, and telephone num…

Section 9015.30 Filing a) The e-filing provider is an agent of the Commission for purpose of e-filing and receipt of electronic documents. Upon submission of the e-filed document, the e-filing provider will e-mail the registered user a transaction confirmation that includes the t…

Section 9015.40 Signatures a) When a signature is required, or when certain consequences are provided if a document is not signed, an electronic signature will suffice. b) Any document electronically filed with a subscriber identifier is deemed to have been signed by the holder o…

Section 9015.50 Service and Proof of Service a) Electronic service is not capable of conferring jurisdiction. Documents requiring personal service to confer jurisdiction may not be served electronically. b) All other documents may be served upon the other party or the party's rep…

Section 9015.60 Document Privacy and Errors in Electronic Filings a) It is the responsibility of the filing party to insure that the documents filed electronically do not disclose private or confidential information. b) The Commission shall not be liable for malfunction or errors…

Section 9020.10 Docketing and Numbering of Cases a) All cases brought before the Illinois Workers' Compensation Commission (Commission) shall be docketed, time-stamped and given a letter, a number and the year of filing. All subsequent pleadings or correspondence should refer to …

Section 9020.100 Medical Examinations a) Notice of Medical Examination The petitioner need not present himself for any examination requested by the respondent unless the name and address of the examining physician and surgeon is furnished the petitioner in writing at the time the…

Section 9020.20 Application for Adjustment of Claim a) Applications for Adjustment of Claim (Application) with a certificate setting forth the date of service shall be filed in triplicate on an appropriate form provided by the Commission. The filing party shall serve one copy of …

Section 9020.30 Memorandum of Names and Addresses for Service of Notice and Attorneys' Appearance a) Each party, upon instituting or responding to any proceedings before the Commission, shall file and timely update with the Commission, his/her address or the names and addresses o…

Section 9020.40 Who May Appear-Unauthorized Practice a) Only attorneys licensed to practice in the State of Illinois may appear on behalf of parties to litigation before the Commission. This specifically includes presentation of Settlement Contracts and Lump Sum Petitions. Attorn…

Section 9020.50 Hearing: Place; Change of Venue a) Except to the extent modified by Section 9020.80 in reference to proceedings under Section 19(b-1) of the Workers' Compensation Act [820 ILCS 305/19(b-1)] (Act), the provisions of subsection (b) apply: b) Upon receipt of an Appli…

Section 9020.60 Continuances on Arbitration, Notices, Monthly Status Calls, Voluntary Dismissal a) Continuances on Arbitration; Notices Written notices will be sent to the parties for the initial status call setting on Arbitration only. Thereafter, cases will be continued for 3 m…

Section 9020.70 Motion Practice, General a) Form of Motions All motions, except motions made during an Arbitration or Review hearing, motions for a continuance of cases in the regular review call, and petitions filed under Section 19(h) and/or Section 8(a) of the Act must be acco…

Section 9020.80 Petitions for Immediate Hearing a) Petition for Immediate Hearing Under Section 19(b) 1) In a Petition alleging that the Petitioner is not receiving benefits under Section 8(a) or 8(b) of the Act to which the Petitioner is entitled, the Petitioner may file a Petit…

Section 9020.90 Petitions to Reinstate a) When a cause has been dismissed from the Arbitration call for want of prosecution, the parties shall have 60 days from receipt of the dismissal order to file a Petition to Reinstate the cause onto the Arbitration call. Notices of dismissa…

Section 9030.10 Arbitration Assignments a) In cases arising in Cook County, cases shall be assigned at the time of the First Notice of Hearing to Arbitrators on a random basis. b) In cases arising outside Cook County, cases shall be assigned to an Arbitrator, on a random basis, a…

Section 9030.100 Voluntary Arbitration under Section 19(p) of the Workers' Compensation Act and Section 19(m) of the Workers' Occupational Diseases Act a) Selection of Arbitrators to Hear Cases under Voluntary Arbitration 1) The Workers' Compensation Advisory Board shall compile …

Section 9030.20 Setting a Case for Trial a) A written request for a date certain for trial may be made by any party at the monthly status call on which the case appears. A request for a trial date in a case that does not appear on the monthly status call may only be made in accor…