Public Act 098-0226
 
HB1552 EnrolledLRB098 02751 RPM 39104 b


  
    AN ACT concerning insurance.
  
 
    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 143, 356z.12, and 1202 as follows:
 



    (215 ILCS 5/143)  (from Ch. 73, par. 755)



    Sec. 143. Policy forms. 

    (1) Life, accident and health. No company
transacting the 
kind or kinds of business enumerated in Classes 1 (a), 1
(b) 
and 2 (a) of Section 4 shall issue or deliver in this State a 
policy
or certificate of insurance or evidence of coverage, 
attach an
endorsement or rider thereto,
incorporate by 
reference bylaws or other matter therein or use an
application 
blank in this State until the form and content of such
policy, 
certificate, evidence of coverage, endorsement, rider, bylaw 
or
other matter
incorporated by reference or application blank 
has been filed electronically
with the Director, either through 
the System for Electronic Rate and Form Filing (SERFF) or as 
otherwise prescribed by the Director, and
approved by the 
Director. The Department shall mail a quarterly invoice to the 
company for the appropriate filing fees required under Section 
408. Any such endorsement or rider
that unilaterally reduces 
benefits and is to be attached to a
policy subsequent to the 
date the policy is
issued must be filed with, reviewed, and 
formally approved by the
Director prior to the date it is 
attached to a policy issued or
delivered in this State.  It 
shall be the duty of the Director to
withhold approval of any 
such policy, certificate, endorsement, rider,
bylaw or other 
matter incorporated by reference or application blank
filed 
with him if it contains provisions which encourage

misrepresentation or are unjust, unfair, inequitable, 
ambiguous,
misleading, inconsistent, deceptive, contrary to 
law or to the public
policy of this State, or contains 
exceptions and conditions that
unreasonably or deceptively 
affect the risk purported to be assumed in
the general coverage 
of the policy.  In all cases the Director shall
approve or 
disapprove any such form within 60 days after submission
unless 
the Director extends by not more than an additional 30 days the

period within which he shall approve or disapprove any such 
form by
giving written notice to the insurer of such extension 
before expiration
of the initial 60 days period. The Director 
shall withdraw his approval
of a policy, certificate, evidence 
of coverage, endorsement, rider,
bylaw, or other matter 
incorporated
by reference or application blank if he 
subsequently determines that such
policy, certificate, 
evidence of coverage, endorsement, rider, bylaw,
other matter, 
or application
blank is misrepresentative, unjust, unfair, 
inequitable, ambiguous, misleading,
inconsistent, deceptive, 
contrary to law or public policy of this State,
or contains 
exceptions or conditions which unreasonably or deceptively 
affect
the risk purported to be assumed in the general coverage 
of the policy or
evidence of coverage.

    If a previously approved policy, certificate, evidence of

coverage, endorsement, rider, bylaw
or other matter 
incorporated by reference or application blank is withdrawn
for 
use, the Director shall serve upon the company an order of 
withdrawal
of use, either personally or by mail, and if by 
mail, such service shall
be completed if such notice be 
deposited in the post office, postage prepaid,
addressed to the 
company's last known address specified in the records
of the 
Department of Insurance.  The order of withdrawal of use shall 
take
effect 30 days from the date of mailing but shall be 
stayed if within the
30-day period a written request for 
hearing is filed with the Director.
Such hearing shall be held 
at such time and place as designated in the order
given by the 
Director.  The hearing may be held either in the City of 
Springfield,
the City of Chicago or in the county where the 
principal business address
of the company is located.
The 
action of the Director in
disapproving or withdrawing such form 
shall be subject to judicial review under
the
Administrative 
Review Law.

    This subsection shall not apply to riders or endorsements 
issued or
made at the request of the individual policyholder 
relating to the
manner of distribution of benefits or to the 
reservation of rights and
benefits under his life insurance 
policy.

    (2) Casualty, fire, and marine.  The Director shall require 
the
filing of all policy forms issued or delivered by any 
company transacting
the kind or
kinds of business enumerated in 
Classes 2 (except Class 2 (a)) and 3 of
Section 4 in an 
electronic format either through the System for Electronic Rate 
and Form Filing (SERFF) or as otherwise prescribed and approved 
by the Director. In addition, he may require the filing of any

generally used riders, endorsements, certificates, application 
blanks, and
other matter
incorporated by reference in any such 
policy or contract of insurance. The Department shall mail a 
quarterly invoice to the company for the appropriate filing 
fees required under Section 408.
Companies that are members of 
an organization, bureau, or association may
have the same filed 
for them by the organization, bureau, or association.  If
the 
Director shall find from an examination of any such policy 
form,
rider, endorsement, certificate, application blank, or 
other matter
incorporated by
reference in any such policy so 
filed that it (i) violates any provision of
this Code, (ii) 
contains inconsistent, ambiguous, or misleading clauses, or

(iii) contains exceptions and conditions that will 
unreasonably or deceptively
affect the risks that are purported 
to be assumed by the policy, he
shall order the company or 
companies issuing these forms to discontinue
their use.  Nothing 
in this subsection shall require a company
transacting the kind 
or kinds of business enumerated in Classes 2
(except Class 2 
(a)) and 3 of Section 4 to obtain approval of these forms

before they are issued nor in any way affect the legality of 
any
policy that has been issued and found to be in conflict 
with this
subsection, but such policies shall be subject to the 
provisions of
Section 442.

    (3) This Section shall not apply (i) to surety contracts or 
fidelity
bonds, (ii) to policies issued to an industrial 
insured as defined in Section
121-2.08 except for workers' 
compensation policies, nor (iii) to riders
or
endorsements 
prepared to meet special, unusual,
peculiar, or extraordinary 
conditions applying to an individual risk.

(Source: P.A. 97-486, eff. 1-1-12.)

 
    (215 ILCS 5/356z.12)
    Sec. 356z.12. Dependent coverage. 
    (a) A group or individual policy of accident and health 
insurance or managed care plan that provides coverage for 
dependents and that is amended, delivered, issued, or renewed 
after the effective date of this amendatory Act of the 95th 
General Assembly shall not terminate coverage or deny the 
election of coverage for an unmarried dependent by reason of 
the dependent's age before the dependent's 26th birthday.
    (b)  A policy or plan subject to this Section shall, upon 
amendment, delivery, issuance, or renewal, establish an 
initial enrollment period of not less than 90 days during which 
an insured may make a written election for coverage of an 
unmarried person as a dependent under this Section.  After the 
initial enrollment period, enrollment by a dependent pursuant 
to this Section shall be consistent with the enrollment terms 
of the plan or policy.
    (c)  A policy or plan subject to this Section shall allow 
for dependent coverage during the annual open enrollment date 
or the annual renewal date if the dependent, as of the date on 
which the insured elects dependent coverage under this 
subsection, has:
        (1) a period of continuous creditable coverage of 90 
    days or more; and
        (2) not been without creditable coverage for more than 
    63 days.
An insured may elect coverage for a dependent who does not meet 
the continuous creditable coverage requirements of this 
subsection (c) and that dependent shall not be denied coverage 
due to age. 
    For purposes of this subsection (c), "creditable coverage" 
shall have the meaning provided under subsection (C)(1) of 
Section 20 of the Illinois Health Insurance Portability and 
Accountability Act. 
    (d) Military personnel. A group or individual policy of 
accident and health insurance or managed care plan that 
provides coverage for dependents and that is amended, 
delivered, issued, or renewed after the effective date of this 
amendatory Act of the 95th General Assembly shall not terminate 
coverage or deny the election of coverage for an unmarried 
dependent by reason of the dependent's age before the 
dependent's 30th birthday if the dependent (i) is an Illinois 
resident, (ii) served as a member of the active or reserve 
components of any of the branches of the Armed Forces of the 
United States, and (iii) has received a release or discharge 
other than a dishonorable discharge. To be eligible for 
coverage under this subsection (d), the eligible dependent 
shall submit to the insurer a form approved by the Illinois 
Department of Veterans' Affairs stating the date on which the 
dependent was released from service.
    (e) Calculation of the cost of coverage provided to an 
unmarried dependent under this Section shall be identical.
    (f) Nothing in this Section shall prohibit an employer from 
requiring an employee to pay all or part of the cost of 
coverage provided under this Section.
    (g) No exclusions or limitations may be applied to coverage 
elected pursuant to this Section that do not apply to all 
dependents covered under the policy.
    (h) A policy or plan subject to this Section shall not 
condition eligibility for dependent coverage provided pursuant 
to this Section on enrollment in any educational institution.
    (i) Notice regarding coverage for a dependent as provided 
pursuant to this Section shall be provided to an insured by the 
insurer: 
        (1) upon application or enrollment;
        (2) in the certificate of coverage or equivalent 
    document prepared for an insured and delivered on or about 
    the date on which the coverage commences; and
        (3) (blank) in a notice delivered to an insured on a 
    semi-annual basis. 

(Source: P.A. 95-958, eff. 6-1-09.)
 



    (215 ILCS 5/1202)  (from Ch. 73, par. 1065.902)



    Sec. 1202. Duties. The Director shall:

    (a) determine the relationship of insurance premiums and 
related income
as compared to insurance costs and expenses and 
provide such information to
the General Assembly and the 
general public;

    (b) study the insurance system in the State of Illinois, 
and recommend
to the General Assembly what it deems to be the 
most appropriate and
comprehensive cost containment system for 
the State;

    (c) respond to the requests by agencies of government and 
the General
Assembly for special studies and analysis of data 
collected pursuant to
this Article. Such reports shall be made 
available in a form prescribed by
the Director. The Director 
may also determine a fee to be charged to the
requesting agency 
to cover the direct and indirect costs for producing such
a 
report, and shall permit affected insurers the right to review 
the
accuracy of the report before it is released. The fees 
shall
be deposited
into the Statistical Services Revolving Fund 
and credited to the account
of the Department of Insurance;

    (d) make an interim report to the General Assembly no later 
than August
15, 1987, and a annual report to the General 
Assembly no later than July 1 April 15
every year thereafter 
which shall include the Director's findings and

recommendations regarding its duties as provided under 
subsections (a),
(b), and (c) of this Section.

(Source: P.A. 91-357, eff. 7-29-99.)