Chapter 215 — INSURANCE

(215 ILCS 106/1) Sec. 1. Short title. This Act may be cited as the Children's Health Insurance Program Act. (Source: P.A. 90-736, eff. 8-12-98.)

(215 ILCS 106/10) Sec. 10. Definitions. As used in this Act: "Benchmarking" means health benefits coverage as defined in Section 2103 of the Social Security Act. "Child" means a person under the age of 19. "Department" means the Department of Healthcare and Family Services. "Medi…

(215 ILCS 106/15) Sec. 15. Operation of the Program. There is hereby created a Children's Health Insurance Program. The Program shall operate subject to appropriation and shall be administered by the Department of Healthcare and Family Services. The Department shall have the powe…

(215 ILCS 106/20) Sec. 20. Eligibility. (a) To be eligible for this Program, a person must be a person who has a child eligible under this Act and who is eligible under a waiver of federal requirements pursuant to an application made pursuant to subdivision (a)(1) of Section 40 o…

(215 ILCS 106/21) Sec. 21. Presumptive eligibility. Beginning on the effective date of this amendatory Act of the 96th General Assembly and except where federal law requires presumptive eligibility, no adult may be presumed eligible for health care coverage under the Program, and…

(215 ILCS 106/22) Sec. 22. Enrollment in program. The Department shall develop procedures to allow community providers, schools, youth service agencies, employers, labor unions, local chambers of commerce, and religious organizations to assist in enrolling children in the Program…

(215 ILCS 106/23) Sec. 23. Care coordination. (a) At least 50% of recipients eligible for comprehensive medical benefits in all medical assistance programs or other health benefit programs administered by the Department, including the Children's Health Insurance Program Act and t…

(215 ILCS 106/25) Sec. 25. Health benefits for children. (a) The Department shall, subject to appropriation, provide health benefits coverage to eligible children by: (1) Until December 31, 2013 and providing that no application for such coverage shall be accepted after September…

(215 ILCS 106/26) Sec. 26. Moratorium on eligibility expansions. Beginning on the effective date of this amendatory Act of the 96th General Assembly, there shall be a 2-year moratorium on the expansion of eligibility through increasing financial eligibility standards, or through …

(215 ILCS 106/30) Sec. 30. Cost sharing. (a) Children enrolled in a health benefits program pursuant to subdivision (a)(2) of Section 25 and persons enrolled in a health benefits waiver program pursuant to Section 40 shall be subject to the following cost sharing requirements: (1…

(215 ILCS 106/31) Sec. 31. Health care provider participation in State Employees Deferred Compensation Plan. Notwithstanding any other provision of law, a health care provider who participates under the Program may elect, in lieu of receiving direct payment for services provided …

(215 ILCS 106/35) Sec. 35. Funding. (a) This Program is not an entitlement and shall not be construed to create an entitlement. Eligibility for the Program is subject to appropriation of funds by the State and federal governments. (b) Any requirement imposed under this Act and an…

(215 ILCS 106/40) Sec. 40. Waivers. The Department shall request any necessary waivers of federal requirements in order to allow receipt of federal funding. (Source: P.A. 96-328, eff. 8-11-09; 97-689, eff. 6-14-12.)

(215 ILCS 106/45) Sec. 45. Study. (a) The Department shall conduct a study which includes, but is not limited to, the following: (1) Establishes estimates, broken down by regions of the State, of the number of children with health insurance coverage and without health insurance c…

(215 ILCS 106/5) Sec. 5. Legislative intent. The General Assembly finds that, for the economic and social benefit of all citizens of the State, it is important to enable low-income children of this State, to the extent funding permits, to access health benefits coverage, especial…

(215 ILCS 106/50) Sec. 50. Program evaluation. The Department shall conduct 2 evaluations of the effectiveness of the program implemented under this Act. The first evaluation shall be for the first 6 full months of implementation, and the evaluation shall be completed within 90 d…

(215 ILCS 106/55) Sec. 55. Contracts with non-governmental bodies. All contracts with non-governmental bodies that are determined by the Department to be necessary for the implementation of this Act are deemed to be purchase of care as defined in the Illinois Procurement Code. (S…

(215 ILCS 106/6) Sec. 6. Act inoperative. This Act is inoperative if (i) the Department of Healthcare and Family Services receives federal approval to make children younger than 19 who have countable income at or below 313% of the federal poverty level eligible for medical assist…

(215 ILCS 106/60) Sec. 60. Emergency rulemaking. Prior to June 30, 1999, the Department may adopt rules necessary to establish and implement this Act through the use of emergency rulemaking in accordance with Section 5-45 of the Illinois Administrative Procedure Act. For purposes…

(215 ILCS 106/65) Sec. 65. Dental home initiative. The Department, in cooperation with the dental community and other affected organizations such as Head Start, shall work to develop and promote the concept of a dental home for children covered under this Act. Included in this de…

(215 ILCS 106/7) Sec. 7. Eligibility verification. Notwithstanding any other provision of this Act, with respect to applications for benefits provided under the Program, eligibility shall be determined in a manner that ensures program integrity and that complies with federal law …

(215 ILCS 106/8) Sec. 8. COVID-19 public health emergency. Notwithstanding any other provision of this Act, the Department may take necessary actions to address the COVID-19 public health emergency to the extent such actions are required, approved, or authorized by the United Sta…

(215 ILCS 106/96) Sec. 96. Inseverability. The provisions of this Act are mutually dependent and inseverable. If any provision or its application to any person or circumstance is held invalid, then this entire Act is invalid. (Source: P.A. 90-736, eff. 8-12-98.)

(215 ILCS 106/97) Sec. 97. (Repealed). (Source: P.A. 92-597, eff. 6-28-02. Repealed by P.A. 93-63, eff. 6-30-03.)

(215 ILCS 106/98) Sec. 98. (Amendatory provisions; text omitted). (Source: P.A. 90-736, eff. 8-12-98; text omitted.)

(215 ILCS 106/99) Sec. 99. Effective Date. This Act takes effect upon becoming law. (Source: P.A. 90-736, eff. 8-12-98.)

(215 ILCS 107/1) Sec. 1. Short title. This Act may be cited as the Producer Controlled Insurer Act. (Source: P.A. 87-1090.)

(215 ILCS 107/10) Sec. 10. Applicability. This Act applies to licensed insurers domiciled in this State or domiciled in a state that is not an accredited state having in effect a substantially similar law. All provisions of Article VIII 1/2 of the Illinois Insurance Code, to the …

(215 ILCS 107/15) Sec. 15. Minimum standards. (a) Controlled insurers and controlling producers must comply with the provisions of this Section no later than 60 days after the effective date of this Act. (b) Except as provided in subsection (c), this Section shall apply if, in an…

(215 ILCS 107/20) Sec. 20. Disclosure. The producer shall deliver written notice to the prospective insured before the effective date of any policy disclosing the relationship between the producer and the controlled insurer; except that if the business is placed through a subprod…

(215 ILCS 107/25) Sec. 25. Penalties. (a) If the Director believes that the controlling producer or any other person has not materially complied with this Act or any regulation or order promulgated hereunder, after notice and opportunity to be heard, the Director may order the co…

(215 ILCS 107/30) Sec. 30. Administration of Act. The Department of Insurance shall administer this Act and may promulgate reasonable and necessary rules for that purpose. (Source: P.A. 87-1090.)

(215 ILCS 107/5) Sec. 5. Definitions. As used in this Act, the terms defined in the Sections that follow this Section and precede Section 6 have the meanings set forth in those Sections. (Source: P.A. 87-1090.)

(215 ILCS 107/5.05) Sec. 5.05. Accredited state. "Accredited state" means a state in which the insurance regulatory agency has qualified as meeting the minimum financial regulatory standards promulgated and established from time to time by the National Association of Insurance Co…

(215 ILCS 107/5.10) Sec. 5.10. Captive Insurer. "Captive insurer" is defined as in Section 123C-1 of the Illinois Insurance Code. (Source: P.A. 87-1090.)

(215 ILCS 107/5.15) Sec. 5.15. Control or controlled. "Control" or "controlled" has the meaning ascribed thereto in Article VIII 1/2 of the Illinois Insurance Code. (Source: P.A. 87-1090.)

(215 ILCS 107/5.20) Sec. 5.20. Controlled insurer. "Controlled insurer" means a licensed insurer that is controlled directly or indirectly by a producer. (Source: P.A. 87-1090.)

(215 ILCS 107/5.25) Sec. 5.25. Controlling producer. "Controlling producer" means a producer that directly or indirectly controls an insurer. (Source: P.A. 87-1090.)

(215 ILCS 107/5.30) Sec. 5.30. Licensed insurer or insurer. "Licensed insurer" or "insurer" means any person, firm, association, or corporation duly licensed to transact a property or casualty insurance business in this State except that, for the purposes of this Act, the followi…

(215 ILCS 107/5.35) Sec. 5.35. Producer. "Producer" means any person, firm, association, or corporation that for compensation, commission, or other thing of value acts or aids in any manner in soliciting, negotiating, or procuring the making of any insurance contract on behalf of…

(215 ILCS 107/5.40) Sec. 5.40. Director. "Director" means the Director of the Department of Insurance. (Source: P.A. 87-1090.)

(215 ILCS 107/99) Sec. 99. This Act takes effect upon becoming law. (Source: P.A. 87-1090.)

(215 ILCS 109/1) Sec. 1. Short title. This Act may be cited as the Dental Care Patient Protection Act. (Source: P.A. 91-355, eff. 1-1-00.)

(215 ILCS 109/10) Sec. 10. Definitions. As used in this Act: "Dental care services" means services permitted to be performed by a licensed dentist or any person working under the dentist's supervision as permitted by law. "Dentist" means a person licensed to practice dentistry in…

(215 ILCS 109/15) Sec. 15. Rules. The Department may promulgate such rules as it deems reasonably necessary to implement the terms of this Act. The Department shall establish an advisory committee made up of representatives from the dental profession to provide clinical advice an…

(215 ILCS 109/25) Sec. 25. Provision of information. (a) A managed care dental plan shall provide upon request to prospective enrollees a written summary description of all of the following terms of coverage: (1) Information about the dental plan, including how the plan operates …

(215 ILCS 109/35) Sec. 35. Credentialing; utilization review; provider input. (a) Participating dentists shall be given an opportunity to comment on the plan's policies affecting their services to include the plan's dental policy, including coverage of a new technology and proced…

(215 ILCS 109/40) Sec. 40. Coverage; prior authorization. A managed care dental plan shall: (1) cover palliative treatment for emergency dental services, as included in its certificate of coverage, without regard to whether the provider furnishing the services has a contractual o…

(215 ILCS 109/45) Sec. 45. Prior authorization; consent forms. A plan for which prior authorization is a condition to coverage of a service must clearly disclose this provision in the evidence of coverage. (Source: P.A. 91-355, eff. 1-1-00.)

(215 ILCS 109/5) Sec. 5. Purpose; dental care patient rights. (a) The purpose of this Act is to provide fairness and choice to dental patients and dentists under managed care dental benefit plans. (b) Dental care patients have the following rights: (1) A patient has the right to …