Chapter 215 — INSURANCE

(215 ILCS 180/75) Sec. 75. Disclosure requirements. (a) Each health carrier shall include a description of the external review procedures in, or attached to, the policy, certificate, membership booklet, and outline of coverage or other evidence of coverage it provides to covered …

(215 ILCS 180/80) Sec. 80. Administration and enforcement. (a) The Director of Insurance may adopt rules necessary to implement the Department's responsibilities under this Act. (b) The Director is authorized to make use of any of the powers established under the Illinois Insuran…

(215 ILCS 180/90) Sec. 90. (Amendatory provisions; text omitted). (Source: P.A. 96-857, eff. 7-1-10; text omitted.)

(215 ILCS 180/95) Sec. 95. (Amendatory provisions; text omitted). (Source: P.A. 96-857, eff. 7-1-10; text omitted.)

(215 ILCS 180/96) Sec. 96. No acceleration or delay. Where this Act makes changes in a statute that is represented in this Act by text that is not yet or no longer in effect (for example, a Section represented by multiple versions), the use of that text does not accelerate or del…

(215 ILCS 180/97) Sec. 97. Severability. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes. (Source: P.A. 96-857, eff. 7-1-10.)

(215 ILCS 180/99) Sec. 99. Effective date. This Act takes effect January 1, 2010, except that the changes to Section 155.36 of the Illinois Insurance Code and Sections 40 and 45 of the Managed Care Reform and Patient Rights Act and the Health Carrier External Review Act take effe…

(215 ILCS 185/1) Sec. 1. Short title. This Act may be cited as the Unclaimed Life Insurance Benefits Act. (Source: P.A. 99-893, eff. 1-1-17.)

(215 ILCS 185/10) Sec. 10. Definitions. As used in this Act: "Annuity contract" does not include an annuity contract used to fund an employment-based retirement plan or program where (1) the insurer does not perform the record keeping services or (2) the insurer is not committed …

(215 ILCS 185/15) Sec. 15. Insurer conduct. (a) An insurer shall initially perform a comparison of its insureds', annuitants', and retained asset account holders' in-force policies, annuity contracts, and retained asset accounts in force on or after January 1, 2017 by using the f…

(215 ILCS 185/20) Sec. 20. Revised Uniform Unclaimed Property Act. Nothing in this Act shall be construed to amend, modify, or supersede the Revised Uniform Unclaimed Property Act, including the authority of the State Treasurer to examine the records of any person if the State Tr…

(215 ILCS 185/25) Sec. 25. Lost policy finder. (a) The Department shall develop and implement a lost policy finder to assist requesters with locating unclaimed life insurance benefits. The lost policy finder shall be available online and via other means. The Department shall assi…

(215 ILCS 185/30) Sec. 30. Administrative rules. The Department shall adopt rules to administer and implement this Act, including defining "electronic searchable files" for the purposes of this Act. (Source: P.A. 99-893, eff. 1-1-17; 100-543, eff. 1-1-18.)

(215 ILCS 185/35) Sec. 35. Application. (a) Except as provided in subsections (b), (c), and (d), the provisions of this Act apply to policies, annuity contracts, and retained asset accounts in force at any time on or after January 1, 2012. (b) For an insurer that has entered into…

(215 ILCS 185/40) Sec. 40. (Amendatory provisions; text omitted). (Source: P.A. 99-893, eff. 1-1-17; text omitted.)

(215 ILCS 185/5) Sec. 5. Purpose. This Act shall require recognition of the Revised Uniform Unclaimed Property Act and require the complete and proper disclosure, transparency, and accountability relating to any method of payment for life insurance, annuity, or retained asset agr…

(215 ILCS 200/1) Sec. 1. Short title. This Act may be cited as the Prior Authorization Reform Act. (Source: P.A. 102-409, eff. 1-1-22.)

(215 ILCS 200/10) Sec. 10. Applicability; scope. This Act applies to health insurance coverage as defined in the Illinois Health Insurance Portability and Accountability Act, and policies issued or delivered in this State to the Department of Healthcare and Family Services and pr…

(215 ILCS 200/15) Sec. 15. Definitions. As used in this Act: "Adverse determination" has the meaning given to that term in Section 10 of the Health Carrier External Review Act. "Appeal" means a formal request, either orally or in writing, to reconsider an adverse determination. "…

(215 ILCS 200/20) Sec. 20. Disclosure and review of prior authorization requirements. (a) A health insurance issuer shall maintain a complete list of services for which prior authorization is required, including for all services where prior authorization is performed by an entity…

(215 ILCS 200/25) Sec. 25. Health insurance issuer's and its contracted utilization review organization's obligations with respect to prior authorizations in nonurgent circumstances. Notwithstanding any other provision of law, if a health insurance issuer requires prior authoriza…

(215 ILCS 200/30) Sec. 30. Health insurance issuer's and its contracted utilization review organization's obligations with respect to prior authorizations concerning urgent health care services. (a) Notwithstanding any other provision of law, a health insurance issuer or its cont…

(215 ILCS 200/35) Sec. 35. Personnel qualified to make adverse determinations of a prior authorization request. A health insurance issuer or its contracted utilization review organization must ensure that all adverse determinations are made by a physician when the request is by a…

(215 ILCS 200/40) Sec. 40. Requirements for adverse determination. If a health insurance issuer or its contracted utilization review organization makes an adverse determination, the health insurance issuer or its contracted utilization review organization shall include the follow…

(215 ILCS 200/45) Sec. 45. Requirements applicable to the personnel who can review appeals. A health insurance issuer or its contracted utilization review organization must ensure that all appeals are reviewed by a physician when the request is by a physician or a representative …

(215 ILCS 200/5) Sec. 5. Purpose. The General Assembly hereby finds and declares that: (1) the health care professional-patient relationship is paramount and should not be subject to third-party intrusion; (2) prior authorization programs shall be subject to member coverage agree…

(215 ILCS 200/50) Sec. 50. Review of prior authorization requirements. A health insurance issuer shall periodically review its prior authorization requirements and consider removal of prior authorization requirements: (1) where a medication or procedure prescribed is customary an…

(215 ILCS 200/55) Sec. 55. Denial or penalty. (a) The health insurance issuer or its contracted utilization review organization may not revoke or further limit, condition, or restrict a previously issued prior authorization approval while it remains valid under this Act. (b) Notw…

(215 ILCS 200/60) Sec. 60. Length of prior authorization approval. A prior authorization approval shall be valid for the lesser of 6 months after the date the health care professional or health care provider receives the prior authorization approval or the length of treatment as …

(215 ILCS 200/65) Sec. 65. Length of prior authorization approval for treatment for chronic or long-term conditions. If a health insurance issuer requires a prior authorization for a recurring health care service or maintenance medication for the treatment of a chronic or long-te…

(215 ILCS 200/70) Sec. 70. Continuity of care for enrollees. (a) On receipt of information documenting a prior authorization approval from the enrollee or from the enrollee's health care professional or health care provider, a health insurance issuer shall honor a prior authoriza…

(215 ILCS 200/75) Sec. 75. Health care services deemed authorized if a health insurance issuer or its contracted utilization review organization fails to comply with the requirements of this Act. A failure by a health insurance issuer or its contracted utilization review organiza…

(215 ILCS 200/77) Sec. 77. Prior authorization for drug therapies for hereditary bleeding disorders. Notwithstanding any other provision of law, a health insurance issuer or a contracted utilization review organization may not require a prior authorization for drug therapies appr…

(215 ILCS 200/80) Sec. 80. Severability. If any provision of this Act or its application to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this Act that can be given effect without the invalid provision or applicatio…

(215 ILCS 200/85) Sec. 85. Administration and enforcement. (a) The Department shall enforce the provisions of this Act pursuant to the enforcement powers granted to it by law. To enforce the provisions of this Act, the Director is hereby granted specific authority to issue a ceas…

(215 ILCS 200/900) Sec. 900. (Amendatory provisions; text omitted). (Source: P.A. 102-409, eff. 1-1-22; text omitted.)

(215 ILCS 200/905) Sec. 905. (Amendatory provisions; text omitted). (Source: P.A. 102-409, eff. 1-1-22; text omitted.)

(215 ILCS 200/910) Sec. 910. (Amendatory provisions; text omitted). (Source: P.A. 102-409, eff. 1-1-22; text omitted.)

(215 ILCS 200/999) Sec. 999. Effective date. This Act takes effect January 1, 2022. (Source: P.A. 102-409, eff. 1-1-22.)

(215 ILCS 205/1) Sec. 1. Short title. This Act may be cited as the Private Primary Residential Flood Insurance Act. (Source: P.A. 102-720, eff. 1-1-23.)

(215 ILCS 205/10) Sec. 10. Forms. The coverage for residential properties required to have flood insurance that are in a special flood hazard area designated by the Federal Emergency Management Agency shall meet the private flood insurance requirements specified in subsection (b)…

(215 ILCS 205/15) Sec. 15. Regulatory notice of intent. Authorized insurers must: (1) notify the Department of plans to sell primary residential flood insurance products in accordance with the State's rate filing laws at least 30 days before writing primary residential flood insu…

(215 ILCS 205/20) Sec. 20. Notice to consumers. (a) If a consumer currently has no coverage under the National Flood Insurance Program, the consumer applicant must be informed of the existence of the National Flood Insurance Program before being placed with private flood insuranc…

(215 ILCS 205/25) Sec. 25. Other provisions. (a) With respect to the regulation of private flood insurance coverage written in this State by authorized insurers, this Section supersedes any other provision of the Illinois Insurance Code in the event of a conflict. (b) An insurer …

(215 ILCS 205/3) Sec. 3. Purpose. To provide protection of lives and property from the peril of flood, this Act is designed to encourage a robust private primary residential flood insurance market to provide consumer choices and alternatives to the existing National Flood Insuran…

(215 ILCS 205/30) Sec. 30. Rules. The Department may adopt rules to implement this Act. (Source: P.A. 102-720, eff. 1-1-23.)

(215 ILCS 205/5) Sec. 5. Definitions. As used in this Act: "Authorized insurer" means an insurer that is authorized by the Department of Insurance to write insurance under a certificate of authority issued by the Department of Insurance to transact insurance in this State. "Depar…

(215 ILCS 210/1) Sec. 1. Short title. This Act may be cited as the Health Insurance Coverage Premium Misalignment Study Act. (Source: P.A. 102-900, eff. 1-1-23.)

(215 ILCS 210/10) Sec. 10. Findings. The General Assembly finds that: (1) Section 1402 of the Patient Protection and Affordable Care Act requires health insurance issuers to provide cost-sharing reductions to low-income marketplace consumers below the 250% federal poverty level w…

(215 ILCS 210/15) Sec. 15. Premium misalignment study. (a) The Department of Insurance shall oversee a study to explore rate setting approaches that may yield a misalignment of premiums across different tiers of coverage in Illinois' individual health insurance market. The study …