Chapter 215 — INSURANCE

(215 ILCS 5/339) (from Ch. 73, par. 951) Sec. 339. Present authorized burial societies may transact business. Every society organized prior to the effective date of this amendatory Act of 1959 and which society on that date was transacting business under a certificate of authorit…

(215 ILCS 5/34) (from Ch. 73, par. 646) (Section scheduled to be repealed on January 1, 2027) Sec. 34. Procedure when insufficient assets possessed by company. (1) Whenever the Director finds that the admitted assets of any company subject to the provisions of this Article are le…

(215 ILCS 5/34.1) (from Ch. 73, par. 646.1) (Section scheduled to be repealed on January 1, 2027) Sec. 34.1. Subordinated indebtedness. A company organized under this Article may borrow or assume a liability for the repayment of a sum of money under a written agreement. The loan …

(215 ILCS 5/340) (from Ch. 73, par. 952) Sec. 340. Article of Incorporation. The articles of incorporation of a burial society shall state: (a) The corporate name which shall not resemble the name of any existing society or corporation organized under the laws of this State or au…

(215 ILCS 5/341) (from Ch. 73, par. 953) Sec. 341. Deposit required. (1) A burial society shall maintain with the Director a deposit of cash or securities in an amount of at least $1,000. A society having a membership of more than 2,500 members and less than 5,000 members shall m…

(215 ILCS 5/342) (from Ch. 73, par. 954) Sec. 342. Officers bond. The officer or officers of the society entrusted with the custody of its funds shall give bond to the association in double the amount of the minimum deposit required by this article, but in no event less than Two …

(215 ILCS 5/343) (from Ch. 73, par. 955) Sec. 343. Certificate form. (1) Every burial society shall issue a certificate of membership to each member, agreeing to pay upon death a specified sum of money not to exceed $1,000, which specified amount shall not be diminished during th…

(215 ILCS 5/344) (from Ch. 73, par. 956) Sec. 344. Burial benefit payable in lawful money. No society operating under or by virtue of this article shall pay a burial benefit or award other than in lawful money of the United States and any provision in any contract to the contrary…

(215 ILCS 5/345) (from Ch. 73, par. 957) Sec. 345. Society and directors or officers may not advertise funeral supplies. No burial society nor any officer, director or agent of any burial society shall offer or make any oral or written agreement to furnish, or shall distribute or…

(215 ILCS 5/346) (from Ch. 73, par. 958) Sec. 346. Benefit account and expense account. (1) All burial societies shall charge a premium or levy an assessment to be paid by the members. Unless the society maintains reserves meeting the standards of Article XIV on its benefit certi…

(215 ILCS 5/347) (from Ch. 73, par. 959) Sec. 347. Failure to maintain deposit-Payment of claims. All claims filed with a society shall be approved or disapproved within sixty days after receipt of due proof of death and, if approved, shall be paid within thirty days after such a…

(215 ILCS 5/348) (from Ch. 73, par. 960) Sec. 348. Amendment of articles. The articles of incorporation of any society, subject to the provisions of this article, may be amended by proper resolutions adopted by the Board of Directors. (Source: Laws 1937, p. 696.)

(215 ILCS 5/349) (from Ch. 73, par. 961) Sec. 349. Penalties. Any society or any officer or agent of any society who violates any of the provisions of this article shall be guilty of a petty offense. (Source: P.A. 77-2699.)

(215 ILCS 5/35) (from Ch. 73, par. 647) (Section scheduled to be repealed on January 1, 2027) Sec. 35. Stock companies may become mutuals. (1) Any domestic stock company may become a mutual company by complying with the provisions of this Section. (2) The board of directors shall…

(215 ILCS 5/35.1) (from Ch. 73, par. 647.1) (Section scheduled to be repealed on January 1, 2027) Sec. 35.1. Par value of stock. No company organized after August 10, 1961 under this Article shall issue any shares of stock having a par value of less than $1.00 per share. No compa…

(215 ILCS 5/351) (from Ch. 73, par. 963) Sec. 351. Application of article and other code provisions. (1) This article shall not apply to fraternal or fraternal benefit societies, assessment life and accident associations existing or operating under or by virtue of any statute of …

(215 ILCS 5/351A-1) (from Ch. 73, par. 963A-1) Sec. 351A-1. Definitions. Unless the context requires otherwise, in this Article: (a) "Long-term care insurance" means any accident and health insurance policy or rider advertised, marketed, offered or designed to provide coverage fo…

(215 ILCS 5/351A-10) (from Ch. 73, par. 963A-10) Sec. 351A-10. Any policy or rider advertised, marketed or offered as long-term care or nursing home insurance shall comply with the provisions of this Article. (Source: P.A. 85-1440; 86-384.)

(215 ILCS 5/351A-11) (from Ch. 73, par. 963A-11) Sec. 351A-11. Rules and regulations. The Director may adopt rules and regulations establishing minimum standards for marketing practices and reporting practices, penalties for violating those standards, and loss ratio standards for…

(215 ILCS 5/351A-2) (from Ch. 73, par. 963A-2) Sec. 351A-2. Group policy issued in another state. No group long-term care insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in paragraph (4) of subsection…

(215 ILCS 5/351A-3) (from Ch. 73, par. 963A-3) Sec. 351A-3. Disclosures. The Director may adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewa…

(215 ILCS 5/351A-4) (from Ch. 73, par. 963A-4) Sec. 351A-4. Limitation. No long-term care insurance policy may: (1) Be cancelled, nonrenewed or otherwise terminated on grounds of the age or the deterioration of the mental or physical health of the insured individual or certificat…

(215 ILCS 5/351A-4.5) Sec. 351A-4.5. Long-term care; coverages. Nothing in this Code prohibits an insurance company from offering a long-term care insurance policy that provides for (1) reimbursement of paid premiums in the event of cancellation or (2) reduced benefits in the eve…

(215 ILCS 5/351A-5) (from Ch. 73, par. 963A-5) Sec. 351A-5. Preexisting condition. (a) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group as defined in paragraph (1) of subsection (e) of Section 351A-1 shall use a def…

(215 ILCS 5/351A-6) (from Ch. 73, par. 963A-6) Sec. 351A-6. Prior hospitalization; institutionalizations. (a) On and after the effective date of this amendatory Act of 1989, no long-term care insurance policy may be delivered or issued for delivery in this State if such policy: (…

(215 ILCS 5/351A-7) (from Ch. 73, par. 963A-7) Sec. 351A-7. Right to return. (a) An individual long-term care insurance policyholder shall have the right to return the policy within 30 days of its delivery and to have the premium refunded directly to him or her if, after examinat…

(215 ILCS 5/351A-8) (from Ch. 73, par. 963A-8) Sec. 351A-8. Outline of coverage. (a) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means which prominently direct the attention of the r…

(215 ILCS 5/351A-9) (from Ch. 73, par. 963A-9) Sec. 351A-9. Disclosure in certificate. A certificate issued pursuant to a group long-term care insurance policy, which policy is delivered or issued for delivery in this State, shall include each of the following: (1) A description …

(215 ILCS 5/351A-9.1) (from Ch. 73, par. 963A-9.1) Sec. 351A-9.1. Policy summary and benefit reports. (a) At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy which provides long-term care benefits within the policy or by rid…

(215 ILCS 5/351A-9.2) Sec. 351A-9.2. Delivery of policy. If an applicant for a long-term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than 30 days after the date of approval. (Sourc…

(215 ILCS 5/351A-9.3) Sec. 351A-9.3. Claim denial; explanation. If a claim under a long-term care insurance contract is denied, the issuer, within 60 days after receipt of a written request by a policyholder or certificate holder or a policyholder's or certificate holder's repres…

(215 ILCS 5/352) (from Ch. 73, par. 964) Sec. 352. Scope of Article. (a) Except as provided in subsections (b), (c), (d), (e), and (g), this Article shall apply to all companies transacting in this State the kinds of business enumerated in clause (b) of Class 1 and clause (a) of …

(215 ILCS 5/352a) (from Ch. 73, par. 964a) Sec. 352a. Mandated Coverages. No legislation enacted after the effective date of this Amendatory Act of 1990 which mandates or requires the offering of health care coverages or services shall apply to any insurer unless the legislation …

(215 ILCS 5/352b) Sec. 352b. Excepted benefits exempted. (a) Unless specified otherwise and when used in context of accident and health insurance policy benefits, coverage, terms, or conditions required to be provided under this Article, references to any policy of individual or …

(215 ILCS 5/352c) Sec. 352c. Short-term, limited-duration insurance prohibited. (a) In this Section: "Excepted benefits" has the meaning given to that term in 42 U.S.C. 300gg-91 and implementing regulations. "Excepted benefits" includes individual, group, or blanket coverage. "Sh…

(215 ILCS 5/353) (from Ch. 73, par. 965) Sec. 353. Non-cancellable accident and health insurance reserves. (1) The legal minimum standard for computing the active life reserve, including the unearned premium reserve, of non-cancellable accident and health policies issued on and a…

(215 ILCS 5/353a) (from Ch. 73, par. 965a) Sec. 353a. Accident and health reserves. The reserves for all accident and health policies issued after the operative date of this section shall be computed and maintained on a basis which shall place an actuarially sound value on the li…

(215 ILCS 5/354) (from Ch. 73, par. 966) Sec. 354. Accident and health loss reserves. The loss reserves of all accident and health policies other than non-cancellable accident and health policies shall be computed and maintained in accordance with the applicable provisions of Art…

(215 ILCS 5/355) Sec. 355. Accident and health policies; provisions. (a) As used in this Section: "Inadequate rate" means a rate: (1) that is insufficient to sustain projected losses and expenses to which the rate applies; and (2) the continued use of which endangers the solvency…

(215 ILCS 5/355.1) (from Ch. 73, par. 967.1) Sec. 355.1. No claim for benefits for loss of time from the insured person's occupation, under a group or individual accident and health insurance policy delivered in this State more than 120 days after the effective date of this Secti…

(215 ILCS 5/355.2) (from Ch. 73, par. 967.2) Sec. 355.2. Dental coverage reimbursement rates. (a) Every company that issues, delivers, amends, or renews any individual or group policy of accident and health insurance on or after the effective date of this amendatory Act of 1991 t…

(215 ILCS 5/355.3) Sec. 355.3. Noncovered dental services. (a) In this Section: "Covered services" means dental care services for which a reimbursement is available under an enrollee's plan contract, or for which a reimbursement would be available but for the application of contr…

(215 ILCS 5/355.4) Sec. 355.4. Provider notification of network plan changes. (a) As used in this Section: "Contracting entity" means any person or company that enters into direct contracts with providers for the delivery of dental services in the ordinary course of business, inc…

(215 ILCS 5/355.5) Sec. 355.5. Dental coverage reimbursement; prohibitions. No insurer, dental service plan corporation, professional service corporation, insurance network leasing company, or any company that amends, delivers, issues, or renews an individual or group policy of a…

(215 ILCS 5/355.6) Sec. 355.6. Health care provider reimbursement. (a) In this Section, "health care provider" has the meaning given to the term "provider" in Section 370g. (b) Any group or individual policy of accident and health insurance or managed care plan amended, delivered…

(215 ILCS 5/355.7) Sec. 355.7. Medical loss ratio report and premium rebate. (a) A health insurance issuer offering group or individual health insurance coverage, including a grandfathered health plan, shall, with respect to each plan year, submit to the Director a report concern…

(215 ILCS 5/355a) (from Ch. 73, par. 967a) Sec. 355a. Standardization of terms and coverage. (1) The purposes of this Section shall be (a) to provide reasonable standardization and simplification of terms and coverages of individual accident and health insurance policies to facil…

(215 ILCS 5/355b) Sec. 355b. Claim-related information; alternative means of communication. (a) For the purposes of this Section, "claim-related information" means all claim or billing information relating specifically to an insured, subscriber, or person covered by an individual…

(215 ILCS 5/355c) Sec. 355c. Availability of information on qualified health plans. (a) Without limiting the generality of paragraph (b) of subsection (5) of Section 355a, no qualified health plans shall be offered for sale directly to consumers through the health insurance marke…

(215 ILCS 5/355d) Sec. 355d. Denials of claims submitted after prior authorization. (a) In this Section: "Dental carrier" means an insurer, dental service corporation, insurance network leasing company, or any company that offers individual or group policies of accident and healt…