|
Sec. 8.6. State Police Training and Academy Fund; Law |
Enforcement Training Fund. Before April 1 of each year, each |
insurer engaged in writing private passenger motor vehicle |
insurance coverage that is included in Class 2 and Class 3 of |
Section 4 of the Illinois Insurance Code, as a condition of its |
authority to transact business in this State, may collect and |
shall pay shall collect and remit to the Department of |
Insurance an amount equal to $4, or a lesser amount determined |
by the Illinois Law Enforcement Training Board by rule, |
multiplied by the insurer's total earned car years of private |
passenger motor vehicle insurance policies providing physical |
damage insurance coverage written in this State during the |
preceding calendar year. Of the amounts collected under this |
Section, the Department of Insurance shall deposit 10% into |
the State Police Training and Academy Fund and 90% into the Law |
Enforcement Training Fund.
|
(Source: P.A. 102-16, eff. 6-17-21.) |
Section 10. The Illinois Insurance Code is amended by |
changing Sections 35B-30, 143, 143a, 229.4a, 353a, 355a, 408, |
412, and 416 and by adding Section 355c as follows: |
(215 ILCS 5/35B-30) |
Sec. 35B-30. Certificate of division. |
(a) After a plan of division has been adopted and |
approved, an officer or duly authorized representative of the |
|
dividing company shall sign a certificate of division. |
(b) The certificate of division shall set forth: |
(1) the name of the dividing company; |
(2) a statement disclosing whether the dividing |
company will survive the division; |
(3) the name of each new company that will be created |
by the division; |
(4) the kinds of insurance business enumerated in |
Section 4 that the new company will be authorized to |
conduct; |
(5) the date that the division is to be effective, |
which shall not be more than 90 days after the dividing |
company has filed the certificate of division with the |
recorder, with a concurrent copy to the Director; |
(6) a statement that the division was approved by the |
Director in accordance with Section 35B-25; |
(7) (6) a statement that the dividing company |
provided, no later than 10 business days after the |
dividing company filed the plan of division with the |
Director, reasonable notice to each reinsurer that is |
party to a reinsurance contract that is applicable to the |
policies included in the plan of division; |
(8) (7) if the dividing company will survive the |
division, an amendment to its articles of incorporation or |
bylaws approved as part of the plan of division; |
(9) (8) for each new company created by the division, |
|
its articles of incorporation and bylaws, provided that |
the articles of incorporation and bylaws need not state |
the name or address of an incorporator; and |
(10) (9) a reasonable description of the capital, |
surplus, other assets and liabilities, including policy |
liabilities, of the dividing company that are to be |
allocated to each resulting company. |
(c) The articles of incorporation and bylaws of each new |
company must satisfy the requirements of the laws of this |
State, provided that the documents need not be signed or |
include a provision that need not be included in a restatement |
of the document. |
(d) A certificate of division is effective when filed with |
the recorder, with a concurrent copy to the Director, as |
provided in this Section or on another date specified in the |
plan of division, whichever is later, provided that a |
certificate of division shall become effective not more than |
90 days after it is filed with the recorder. A division is |
effective when the relevant certificate of division is |
effective.
|
(Source: P.A. 100-1118, eff. 11-27-18.)
|
(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. 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 disapprove or withdraw
|
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 |
deficiencies, 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 , withdraw, 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 the he shall approve or disapprove any such form |
shall be approved, withdrawn, or disapproved 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 it is subsequently |
determined 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.
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; 98-226, eff. 1-1-14.)
|
|
(215 ILCS 5/143a) (from Ch. 73, par. 755a)
|
Sec. 143a. Uninsured and hit and run motor vehicle |
coverage.
|
(1) No policy insuring against
loss resulting from |
liability imposed by law for bodily injury or death
suffered |
by any person arising out of the ownership, maintenance or use
|
of a motor vehicle that is designed for use on public highways |
and that
is either required to be registered in this State or |
is principally garaged
in this State shall be renewed, |
delivered, or issued for delivery
in this State unless |
coverage is provided therein or
supplemental thereto, in |
limits for bodily injury or death set forth in
Section 7-203 of |
the Illinois Vehicle Code for the
protection of persons |
insured thereunder who are legally entitled to
recover damages |
from owners or operators of uninsured motor vehicles and
|
hit-and-run motor vehicles because of bodily injury, sickness |
or
disease, including death, resulting therefrom. Uninsured |
motor vehicle
coverage does not apply to bodily injury, |
sickness, disease, or death resulting
therefrom, of an insured |
while occupying a motor vehicle owned by, or furnished
or |
available for the regular use of the insured, a resident |
spouse or resident
relative, if that motor vehicle is not |
described in the policy under which a
claim is made or is not a |
newly acquired or replacement motor vehicle covered
under the |
terms of the policy. The limits for any coverage for any |
|
vehicle
under the policy may not be aggregated with the limits |
for any similar
coverage, whether provided by the same insurer |
or another insurer, applying to
other motor vehicles, for |
purposes of determining the total limit of insurance
coverage |
available for bodily injury or death suffered by a person in |
any one
accident. No
policy shall be renewed, delivered, or |
issued for delivery in this
State unless it is provided |
therein that any dispute
with respect to the coverage and the |
amount of damages shall be submitted
for arbitration to the
|
American Arbitration Association and be subject to its rules |
for the conduct
of arbitration hearings
as to all matters |
except medical opinions. As to medical opinions, if the
amount |
of damages being sought is equal to or less than the amount |
provided for
in Section 7-203 of the Illinois Vehicle Code, |
then the current American
Arbitration Association Rules shall |
apply. If the amount being sought in an
American Arbitration |
Association case exceeds that amount as set forth in
Section |
7-203 of the Illinois Vehicle Code, then the Rules of Evidence |
that
apply in the circuit court for placing medical opinions |
into evidence shall
govern. Alternatively, disputes with |
respect to damages and the coverage shall
be
determined in the
|
following
manner: Upon the insured requesting arbitration, |
each party to the
dispute shall select an arbitrator and the 2 |
arbitrators so named
shall select a third arbitrator. If such |
arbitrators are not selected
within 45 days from such request, |
either party may request that the
arbitration be submitted to |
|
the American Arbitration Association.
Any decision made by the |
arbitrators shall be binding for the amount of
damages not |
exceeding $75,000 for bodily injury to or
death of any one |
person, $150,000 for bodily injury to or death of 2 or more
|
persons in any one motor vehicle accident,
or the |
corresponding policy limits for bodily injury or death, |
whichever is
less.
All 3-person arbitration cases proceeding |
in accordance with any uninsured
motorist
coverage conducted |
in this State in
which the claimant is only seeking monetary |
damages up to the limits
set forth in Section 7-203 of the |
Illinois Vehicle Code
shall be subject to the following rules:
|
(A) If at least 60 days' written
notice of the |
intention to offer the following documents in evidence is |
given
to every other party, accompanied by a copy of the |
document, a party may offer
in evidence, without |
foundation or other proof:
|
(1) bills, records, and reports of hospitals, |
doctors, dentists,
registered nurses, licensed |
practical nurses, physical therapists, and other
|
healthcare providers;
|
(2) bills for drugs, medical appliances, and |
prostheses;
|
(3) property repair bills or estimates, when |
identified and itemized
setting forth the charges for |
labor and material used or proposed for use in
the |
repair of the property;
|
|
(4) a report of the rate of earnings and time lost |
from work or lost
compensation prepared by an |
employer;
|
(5) the written opinion of an opinion witness, the |
deposition of a
witness, and the statement of a |
witness that the witness would be allowed to
express |
if testifying in person, if the opinion or statement |
is made by
affidavit or by
certification as provided |
in Section 1-109 of the Code of Civil Procedure;
|
(6) any other document not specifically covered by |
any of the foregoing
provisions that is otherwise |
admissible under the rules of evidence.
|
Any party receiving a notice under this paragraph (A) |
may apply to the
arbitrator or panel of arbitrators, as |
the case may be, for the issuance of a
subpoena directed to |
the author or maker or custodian of the document that is
|
the subject of the notice, requiring the person subpoenaed |
to produce copies of
any additional documents as may be |
related to the subject matter of the
document that is the |
subject of the notice. Any such subpoena shall be issued
|
in substantially similar form and served by notice as |
provided by Illinois
Supreme Court Rule 204(a)(4). Any |
such subpoena shall be returnable not
less than 5 days |
before the arbitration hearing.
|
(B) Notwithstanding the provisions of Supreme Court |
Rule 213(g), a party
who proposes to use a written opinion |
|
of an expert or opinion witness or the
testimony of
an |
expert or opinion witness at the hearing may do so |
provided a written notice
of that
intention is given to |
every other party not less than 60 days prior to the date
|
of hearing, accompanied by a statement containing the |
identity of the
witness, his or her qualifications, the |
subject matter, the basis of the
witness's conclusions,
|
and his or her opinion.
|
(C) Any other party may subpoena the author or maker |
of a document
admissible under this subsection, at that |
party's expense, and examine the
author
or maker as if |
under cross-examination. The provisions of Section 2-1101 |
of
the
Code of Civil Procedure shall be applicable to |
arbitration hearings, and it
shall be the duty of a party |
requesting the subpoena to modify the form to show
that |
the appearance is set before an arbitration panel and to |
give the time and
place set for the hearing.
|
(D) The provisions of Section 2-1102 of the Code of |
Civil Procedure shall
be
applicable to arbitration |
hearings under this subsection.
|
(2) No policy insuring
against loss resulting from |
liability imposed by law for property damage
arising out of |
the ownership, maintenance, or use of a motor vehicle shall
be |
renewed, delivered, or issued for delivery in this State with |
respect
to any private passenger or recreational motor vehicle |
that is
designed for use on public highways and that is either |
|
required to be
registered in this State or is principally |
garaged in this State and
is not covered by collision |
insurance under the provisions of such
policy , unless coverage |
is made available in the amount of the actual
cash value of the |
motor vehicle described in the policy or the corresponding |
policy limit for uninsured motor vehicle property damage |
coverage, $15,000
whichever is less, subject to a maximum $250 |
deductible, for the protection of
persons insured thereunder |
who are legally entitled to recover damages from
owners or |
operators of uninsured motor vehicles and hit-and-run motor
|
vehicles because of property damage to the motor vehicle |
described in the
policy.
|
There shall be no liability imposed under the uninsured |
motorist
property damage coverage required by this subsection |
if the owner or
operator of the at-fault uninsured motor |
vehicle or hit-and-run motor
vehicle cannot be identified. |
This subsection shall not apply to any
policy which does not |
provide primary motor vehicle liability insurance for
|
liabilities arising from the maintenance, operation, or use of |
a
specifically insured motor vehicle.
|
Each insurance company providing motor vehicle property |
damage liability
insurance shall advise applicants of the |
availability of uninsured motor
vehicle property damage |
coverage, the premium therefor, and provide a brief
|
description of the coverage. That information
need be given |
only once and shall not be required in any subsequent renewal,
|
|
reinstatement or reissuance, substitute, amended, replacement |
or
supplementary policy. No written rejection shall be |
required, and
the absence of a premium payment for uninsured |
motor vehicle property damage
shall constitute conclusive |
proof that the applicant or policyholder has
elected not to |
accept uninsured motorist property damage coverage.
|
An insurance company issuing uninsured motor vehicle
|
property damage coverage may provide that:
|
(i) Property damage losses recoverable thereunder |
shall be limited to
damages caused by the actual physical |
contact of an uninsured motor vehicle
with the insured |
motor vehicle.
|
(ii) There shall be no coverage for loss of use of the |
insured motor
vehicle and no coverage for loss or damage |
to personal property located in
the insured motor vehicle.
|
(iii) Any claim submitted shall include the name and |
address of the
owner of the at-fault uninsured motor |
vehicle, or a registration number and
description of the |
vehicle, or any other available information to
establish |
that there is no applicable motor vehicle property damage |
liability
insurance.
|
Any dispute with respect to the coverage and the amount of
|
damages shall be submitted for
arbitration to the American |
Arbitration Association and be subject to its
rules for the |
conduct of arbitration hearings or for determination in
the |
following manner: Upon the insured requesting arbitration, |
|
each party
to the dispute shall select an arbitrator and the 2 |
arbitrators so named
shall select a third arbitrator. If such |
arbitrators are not selected
within 45 days from such request, |
either party may request that the
arbitration be submitted to |
the American Arbitration Association.
Any arbitration |
proceeding under this subsection seeking recovery for
property |
damages shall be
subject to the following rules:
|
(A) If at least 60 days' written
notice of the |
intention to offer the following documents in evidence is |
given
to every other party, accompanied by a copy of the |
document, a party may offer
in evidence, without |
foundation or other proof:
|
(1) property repair bills or estimates, when |
identified and itemized
setting forth the charges for |
labor and material used or proposed for use in
the |
repair of the property;
|
(2) the written opinion of an opinion witness, the |
deposition of a
witness, and the statement of a |
witness that the witness would be allowed to
express |
if testifying in person, if the opinion or statement |
is made by
affidavit or by
certification as provided |
in Section 1-109 of the Code of Civil Procedure;
|
(3) any other document not specifically covered by |
any of the foregoing
provisions that is otherwise |
admissible under the rules of evidence.
|
Any party receiving a notice under this paragraph (A) |
|
may apply to the
arbitrator or panel of arbitrators, as |
the case may be, for the issuance of a
subpoena directed to |
the author or maker or custodian of the document that is
|
the subject of the notice, requiring the person subpoenaed |
to produce copies of
any additional documents as may be |
related to the subject matter of the
document that is the |
subject of the notice. Any such subpoena shall be issued
|
in substantially similar form and served by notice as |
provided by Illinois
Supreme Court Rule 204(a)(4). Any |
such subpoena shall be returnable not
less than 5 days |
before the arbitration hearing.
|
(B) Notwithstanding the provisions of Supreme Court |
Rule 213(g), a party
who proposes to use a written opinion |
of an expert or opinion witness or the
testimony of
an |
expert or opinion witness at the hearing may do so |
provided a written notice
of that
intention is given to |
every other party not less than 60 days prior to the date
|
of hearing, accompanied by a statement containing the |
identity of the
witness, his or her qualifications, the |
subject matter, the basis of the
witness's conclusions,
|
and his or her opinion.
|
(C) Any other party may subpoena the author or maker |
of a document
admissible under this subsection, at that |
party's expense, and examine the
author
or maker as if |
under cross-examination. The provisions of Section 2-1101 |
of
the
Code of Civil Procedure shall be applicable to |
|
arbitration hearings, and it
shall be the duty of a party |
requesting the subpoena to modify the form to show
that |
the appearance is set before an arbitration panel and to |
give the time and
place set for the hearing.
|
(D) The provisions of Section 2-1102 of the Code of |
Civil Procedure shall
be
applicable to arbitration |
hearings under this subsection.
|
(3) For the purpose of the coverage, the term "uninsured |
motor
vehicle" includes, subject to the terms and conditions |
of the coverage,
a motor vehicle where on, before or after the |
accident date the
liability insurer thereof is unable to make |
payment with respect to the
legal liability of its insured |
within the limits specified in the policy
because of the entry |
by a court of competent jurisdiction of an order of
|
rehabilitation or liquidation by reason of insolvency on or |
after the
accident date. An insurer's extension of coverage, |
as provided in this
subsection, shall be applicable to all |
accidents occurring after July
1, 1967 during a policy period |
in which its insured's uninsured motor
vehicle coverage is in |
effect. Nothing in this Section may be construed
to prevent |
any insurer from extending coverage under terms and
conditions |
more favorable to its insureds than is required by this |
Section.
|
(4) In the event of payment to any person under the |
coverage
required by this Section and subject to the terms and |
conditions of the
coverage, the insurer making the payment |
|
shall, to the extent thereof,
be entitled to the proceeds of |
any settlement or judgment resulting from
the exercise of any |
rights of recovery of the person against any person
or |
organization legally responsible for the property damage, |
bodily
injury or death for which the payment is made, |
including the proceeds
recoverable from the assets of the |
insolvent insurer. With respect to
payments made by reason of |
the coverage described in subsection (3), the
insurer making |
such payment shall not be entitled to any right of recovery
|
against the tortfeasor in excess of the proceeds recovered |
from the assets
of the insolvent insurer of the tortfeasor.
|
(5) This amendatory Act of 1967 (Laws of Illinois 1967, |
page 875) shall not be construed to terminate
or reduce any |
insurance coverage or any right of any party under this
Code in |
effect before July 1, 1967. Public Act 86-1155 shall not
be |
construed to terminate or reduce any insurance coverage or any |
right of
any party under this Code in effect before its |
effective date.
|
(6) Failure of the motorist from whom the claimant is |
legally
entitled to recover damages to file the appropriate |
forms with the
Safety Responsibility Section of the Department |
of Transportation within
120 days of the accident date shall |
create a rebuttable presumption that
the motorist was |
uninsured at the time of the injurious occurrence.
|
(7) An insurance carrier may upon good cause require the
|
insured to commence a legal action against the owner or |
|
operator of an
uninsured motor vehicle before good faith |
negotiation with the carrier. If
the action is commenced at |
the request of the insurance carrier, the
carrier shall pay to |
the insured, before the action is commenced, all court
costs, |
jury fees and sheriff's fees arising from the action.
|
The changes made by Public Act 90-451 apply to all |
policies of
insurance amended, delivered, issued, or renewed |
on and after January 1, 1998 (the effective
date of Public Act |
90-451).
|
(8) The changes made by Public Act 98-927 apply to all |
policies of
insurance amended, delivered, issued, or renewed |
on and after January 1, 2015 (the effective
date of Public Act |
98-927). |
(Source: P.A. 98-242, eff. 1-1-14; 98-927, eff. 1-1-15; |
99-642, eff. 7-28-16.)
|
(215 ILCS 5/229.4a)
|
Sec. 229.4a. Standard Non-forfeiture Law for Individual |
Deferred
Annuities. |
(1)
Title.
This Section shall be known as the Standard |
Nonforfeiture Law for Individual Deferred Annuities. |
(2) Applicability.
This Section shall not apply to any |
reinsurance, group annuity purchased under a retirement plan |
or plan of deferred compensation established or maintained by |
an employer (including a partnership or sole proprietorship) |
or by an employee organization, or by both, other than a plan |
|
providing individual retirement accounts or individual |
retirement annuities under Section 408 of the Internal Revenue |
Code, as now or hereafter amended, premium deposit fund, |
variable annuity, investment annuity, immediate annuity, any |
deferred annuity contract after annuity payments have |
commenced, or reversionary annuity, nor to any contract which |
shall be delivered outside this State through an agent or |
other representative of the company issuing the contract. |
(3) Nonforfeiture Requirements. |
(A) In the case of contracts issued on or after the |
operative date of this Section
as defined in subsection |
(13), no contract of annuity, except as stated in |
subsection (2), shall be delivered or issued for delivery |
in this State unless it contains in substance the |
following provisions, or corresponding provisions which in |
the opinion of the Director of Insurance are at least as |
favorable to the contract holder, upon cessation of |
payment of considerations under the contract: |
(i) That upon cessation of payment of |
considerations under a contract, or upon the written |
request of the contract owner, the company shall grant |
a paid-up annuity benefit on a plan stipulated in the |
contract of such value as is specified in subsections |
(5), (6), (7), (8) and (10); |
(ii)
If a contract provides for a lump sum |
settlement at maturity, or at any other time, that |
|
upon surrender of the contract at or prior to the |
commencement of any annuity payments, the company |
shall pay in lieu of a paid-up annuity benefit a cash |
surrender benefit of such amount as is
specified in |
subsections (5), (6), (8) and (10). The company may |
reserve the right to
defer the payment of the cash |
surrender benefit for a period not to exceed 6 months |
after demand therefor with surrender of the contract |
after making written request and receiving written |
approval of the Director. The request shall address |
the necessity and equitability to all policyholders of |
the deferral; |
(iii) A statement of the mortality table, if any, |
and interest rates used calculating any minimum |
paid-up annuity, cash surrender, or death benefits |
that are guaranteed under the contract, together with |
sufficient information to determine the amounts of the |
benefits; and |
(iv)
A statement that any paid-up annuity, cash |
surrender or death benefits that may be available |
under the contract are not less than the minimum |
benefits required by any statute of the state in which |
the contract is delivered and an explanation of the |
manner in which the benefits are altered by the |
existence of any additional amounts credited by the |
company to the contract, any indebtedness to the |
|
company on the contract or any prior withdrawals from |
or partial surrenders of the contract. |
(B) Notwithstanding the requirements of this Section, |
a deferred annuity contract may provide that if no |
considerations have been received under a contract for a |
period of 2 full years and the portion of the paid-up |
annuity benefit at maturity on the plan stipulated in the |
contract arising from prior considerations paid would be |
less than $20 monthly, the company may at its option |
terminate the contract by payment in cash of the then |
present value of the portion of the paid-up annuity |
benefit, calculated on the basis on the mortality table, |
if any, and interest rate specified in the contract for |
determining the paid-up annuity benefit, and by this |
payment shall be relieved of any further obligation under |
the contract. |
(4) Minimum values. The minimum values as specified in |
subsections (5), (6), (7), (8) and (10) of any paid-up |
annuity, cash surrender or death benefits available under an |
annuity contract shall be based upon minimum nonforfeiture |
amounts as defined in this subsection.
|
(A)(i) The minimum nonforfeiture amount at any time at |
or prior to the commencement of any annuity payments shall |
be equal to an accumulation up to such time at rates of |
interest as indicated in subdivision (4)(B) of the net |
considerations (as hereinafter defined) paid prior to such |
|
time, decreased by the sum of paragraphs (a) through (d) |
below: |
(a) Any prior withdrawals from or partial |
surrenders of the contract accumulated at rates of |
interest as indicated in subdivision (4)(B);
|
(b) An annual contract charge of $50, accumulated |
at rates of interest as indicated in subdivision |
(4)(B);
|
(c) Any premium tax paid by the company for the |
contract, accumulated at rates of interest as |
indicated in subdivision (4)(B); and
|
(d) The amount of any indebtedness to the company |
on the contract, including
interest due and accrued. |
(ii) The net considerations for a given contract year |
used to define the minimum nonforfeiture amount shall be |
an amount
equal to 87.5% of the gross considerations,
|
credited to the contract during that contract year. |
(B) The interest rate used in determining minimum |
nonforfeiture amounts shall be an
annual rate of interest |
determined as the lesser of 3% per annum
and the |
following, which shall be specified in the contract if the |
interest rate will be reset: |
(i) The five-year Constant Maturity Treasury Rate |
reported by the Federal Reserve as of a date, or |
average over a period, rounded to the nearest 1/20th |
of one percent, specified in the contract no longer |
|
than 15 months prior to the contract issue date or |
redetermination date under subdivision (4)(B)(iv); |
(ii) Reduced by 125 basis points; |
(iii) Where the resulting interest rate is not |
less than 0.15% 1% ; and |
(iv) The interest rate shall apply for an initial |
period and may be redetermined for additional periods. |
The redetermination date, basis and period, if any, |
shall be stated in the contract. The basis is the date |
or average over a specified period that produces the |
value of the 5-year Constant Maturity Treasury Rate to |
be used at each redetermination date. |
(C) During the period or term that a contract provides |
substantive participation in an equity indexed benefit, it |
may increase the reduction described in subdivision |
(4)(B)(ii)
above by up to an additional 100 basis points |
to reflect the value of the equity
index benefit. The |
present value at the contract issue date, and at each
|
redetermination date thereafter, of the additional |
reduction shall not exceed market value of the benefit. |
The Director may require a demonstration that the present |
value of the additional reduction does not exceed the |
market value of the benefit. Lacking such a demonstration |
that is acceptable to the Director, the Director may |
disallow or limit the additional reduction. |
(D) The Director may adopt rules to implement the |
|
provisions of subdivision (4)(C) and to provide for |
further adjustments to the calculation of minimum |
nonforfeiture amounts for contracts that provide |
substantive participation in an equity index benefit and |
for other contracts that the Director determines |
adjustments are justified. |
(5) Computation of Present Value.
Any paid-up annuity |
benefit available under a contract shall be such that its |
present value on the date annuity payments are to commence is |
at least equal to the minimum nonforfeiture amount on that |
date. Present value shall be computed using the mortality |
table, if any, and the interest rates specified in the |
contract for determining the minimum paid-up annuity benefits |
guaranteed in the contract. |
(6) Calculation of Cash Surrender Value.
For contracts |
that provide cash surrender benefits, the cash surrender |
benefits available prior to maturity shall not be less than |
the present value as of the date of surrender of that portion |
of the maturity value of the paid-up annuity benefit that |
would be provided under the contract at maturity arising from |
considerations paid prior to the time of cash surrender |
reduced by the amount appropriate to reflect any prior |
withdrawals from or partial surrenders of the contract, such |
present value being calculated on the basis of an interest |
rate not more than 1% higher than the interest rate specified |
in the contract for accumulating the net considerations to |
|
determine maturity value, decreased by the amount of any |
indebtedness to the company on the contract, including |
interest due and accrued, and increased by any existing |
additional amounts credited by the company to the contract. In |
no event shall any cash surrender benefit be less than the |
minimum nonforfeiture amount at that time. The death benefit |
under such contracts shall be at least equal to the cash |
surrender benefit. |
(7) Calculation of Paid-up Annuity Benefits.
For contracts |
that do not provide cash surrender benefits, the present value |
of any paid-up annuity benefit available as a nonforfeiture |
option at any time prior to maturity shall not be less than the |
present value of that portion of the maturity value of the |
paid-up annuity benefit provided under the contract arising |
from considerations paid prior to the time the contract is
|
surrendered in exchange for, or changed to, a deferred paid-up |
annuity, such present value being calculated for the period |
prior to the maturity date on the basis of the interest rate |
specified in the contract for accumulating the net |
considerations to determine maturity value, and increased by |
any additional amounts credited by the company to the |
contract. For contracts that do not provide any death benefits |
prior to the commencement of any annuity payments, present |
values shall be calculated on the basis of such interest rate |
and the mortality table specified in the contract for |
determining the maturity value of the paid-up annuity benefit. |
|
However, in no event shall the present value of a paid-up |
annuity benefit be less than the minimum nonforfeiture amount |
at that time. |
(8) Maturity Date.
For the purpose of determining the |
benefits calculated under subsections (6) and (7), in the case |
of annuity contracts under which an election may be made to |
have annuity payments commence at optional maturity dates, the |
maturity date shall be deemed to be the latest date for which |
election shall be permitted by the contract, but shall not be |
deemed to be later than the anniversary of the contract next |
following the annuitant's seventieth birthday or the tenth |
anniversary of the contract, whichever is later. |
(9) Disclosure of Limited Death Benefits.
A contract that |
does not provide cash surrender benefits or does not provide |
death benefits at least equal to the minimum nonforfeiture |
amount prior to the commencement of any annuity payments shall |
include a statement in a prominent place in the contract that |
such benefits are not
provided. |
(10) Inclusion of Lapse of Time Considerations.
Any |
paid-up annuity, cash surrender or death benefits available at |
any time, other than on the contract anniversary under any |
contract with fixed scheduled considerations, shall be |
calculated with allowance for the lapse of time and the |
payment of any scheduled considerations beyond the beginning |
of the contract year in which cessation of payment of |
considerations under the contract occurs. |
|
(11) Proration of Values; Additional Benefits.
For a |
contract which provides, within the same contract by rider or |
supplemental contract provision, both annuity benefits and |
life insurance benefits that are in excess of the greater of |
cash surrender benefits or a return of the gross |
considerations with interest, the minimum nonforfeiture |
benefits shall be equal to the sum of the minimum |
nonforfeiture benefits for the annuity portion and the minimum |
nonforfeiture benefits, if any, for the life insurance portion |
computed as if each portion were a separate contract. |
Notwithstanding the provisions of subsections (5), (6), (7), |
(8) and (10), additional benefits payable in the event of |
total and permanent disability, as reversionary annuity or |
deferred reversionary annuity benefits, or as other policy |
benefits additional to life insurance, endowment and annuity |
benefits, and considerations for all such additional benefits, |
shall be disregarded in ascertaining the minimum nonforfeiture |
amounts,
paid-up annuity, cash surrender and death benefits |
that may be required under this Section. The inclusion of such |
benefits shall not be required in any paid-up benefits, unless |
the additional benefits separately would require minimum |
nonforfeiture amounts, paid-up annuity, cash surrender and |
death benefits. |
(12) Rules. The Director may adopt rules to implement the |
provisions of this Section. |
(13) Effective Date. After the effective date of this |
|
amendatory Act of the 93rd General Assembly, a company may |
elect to apply its provisions to annuity
contracts on a |
contract form-by-contract form basis before July 1, 2006. In |
all other instances, this Section shall become operative with |
respect to annuity contracts issued by the company on or after |
July 1, 2006.
|
(14) (Blank).
|
(Source: P.A. 93-873, eff. 8-6-04; 94-1076, eff. 12-29-06 .)
|
(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 liabilities under such
policies. To provide a |
basis for the determination of such actuarially
sound value, |
the Director from time to time shall adopt rules requiring the
|
use of appropriate tables of morbidity, mortality, interest |
rates and
valuation methods for such reserves for policies |
issued before January 1, 2017. For policies issued on or after |
January 1, 2017, Section 223 shall govern the basis for |
determining such actuarially sound value . In no event shall |
such reserves be
less than the pro rata gross unearned premium |
reserve for such policies.
|
The company shall give the notice required in section 234 |
on all
non-cancellable accident and health policies.
|
|
After this section becomes effective, any company may file |
with the
Director written notice of its election to comply |
with the provisions of
this section after a specified date |
before January 1, 1967. After the
filing of such notice, then |
upon such specified date (which shall be the
operative date of |
this section for such company), this section shall become
|
operative with respect to the accident and health policies |
thereafter
issued by such company. If a company makes no such |
election, the operative
date of this section for such company |
shall be January 1, 1967.
|
After this section becomes effective, any company may file |
with the
Director written notice of its election to establish |
and maintain reserves
upon its accident and health policies |
issued prior to the operative date of
this section in |
accordance with the standards for reserves established by
this |
section, and thereafter the reserve standards prescribed |
pursuant to
this section shall be effective with respect to |
said accident and health
policies issued prior to the |
operative date of this section.
|
(Source: Laws 1965, p. 740.)
|
(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 facilitate public
understanding and comparisons; (b) to |
eliminate provisions contained in
individual accident and |
health insurance policies which may be
misleading or |
unreasonably confusing in connection either with the
purchase |
of such coverages or with the settlement of claims; and (c) to
|
provide for reasonable disclosure in the sale of accident and |
health
coverages.
|
(2) Definitions applicable to this Section are as follows:
|
(a) "Policy" means all or any part of the forms |
constituting the
contract between the insurer and the |
insured, including the policy,
certificate, subscriber |
contract, riders, endorsements, and the
application if |
attached, which are subject to filing with and approval
by |
the Director.
|
(b) "Service corporations" means
voluntary health and |
dental
corporations organized and operating respectively |
under
the Voluntary Health Services Plans Act and
the |
Dental Service Plan Act.
|
(c) "Accident and health insurance" means insurance |
written under
Article XX of this Code, other than credit |
accident and health
insurance, and coverages provided in |
subscriber contracts issued by
service corporations. For |
purposes of this Section such service
corporations shall |
be deemed to be insurers engaged in the business of
|
insurance.
|
(3) The Director shall issue such rules as he shall deem |
|
necessary
or desirable to establish specific standards, |
including standards of
full and fair disclosure that set forth |
the form and content and
required disclosure for sale, of |
individual policies of accident and
health insurance, which |
rules and regulations shall be in addition to
and in |
accordance with the applicable laws of this State, and which |
may
cover but shall not be limited to: (a) terms of |
renewability; (b)
initial and subsequent conditions of |
eligibility; (c) non-duplication of
coverage provisions; (d) |
coverage of dependents; (e) pre-existing
conditions; (f) |
termination of insurance; (g) probationary periods; (h)
|
limitation, exceptions, and reductions; (i) elimination |
periods; (j)
requirements regarding replacements; (k) |
recurrent conditions; and (l)
the definition of terms, |
including, but not limited to, the following:
hospital, |
accident, sickness, injury, physician, accidental means, total
|
disability, partial disability, nervous disorder, guaranteed |
renewable,
and non-cancellable.
|
The Director may issue rules that specify prohibited |
policy
provisions not otherwise specifically authorized by |
statute which in the
opinion of the Director are unjust, |
unfair or unfairly discriminatory to
the policyholder, any |
person insured under the policy, or beneficiary.
|
(4) The Director shall issue such rules as he shall deem |
necessary
or desirable to establish minimum standards for |
benefits under each
category of coverage in individual |
|
accident and health policies, other
than conversion policies |
issued pursuant to a contractual conversion
privilege under a |
group policy, including but not limited to the
following |
categories: (a) basic hospital expense coverage; (b) basic
|
medical-surgical expense coverage; (c) hospital confinement |
indemnity
coverage; (d) major medical expense coverage; (e) |
disability income
protection coverage; (f) accident only |
coverage; and (g) specified
disease or specified accident |
coverage.
|
Nothing in this subsection (4) shall preclude the issuance |
of any
policy which combines two or more of the categories of |
coverage
enumerated in subparagraphs (a) through (f) of this |
subsection.
|
No policy shall be delivered or issued for delivery in |
this State
which does not meet the prescribed minimum |
standards for the categories
of coverage listed in this |
subsection unless the Director finds that
such policy is |
necessary to meet specific needs of individuals or groups
and |
such individuals or groups will be adequately informed that |
such
policy does not meet the prescribed minimum standards, |
and such policy
meets the requirement that the benefits |
provided therein are reasonable
in relation to the premium |
charged. The standards and criteria to be
used by the Director |
in approving such policies shall be included in the
rules |
required under this Section with as much specificity as
|
practicable.
|
|
The Director shall prescribe by rule the method of |
identification of
policies based upon coverages provided.
|
(5) (a) In order to provide for full and fair disclosure in |
the
sale of individual accident and health insurance policies, |
no such
policy shall be delivered or issued for delivery in |
this State unless
the outline of coverage described in |
paragraph (b) of this subsection
either accompanies the |
policy, or is delivered to the applicant at the
time the |
application is made, and an acknowledgment signed by the
|
insured, of receipt of delivery of such outline, is provided |
to the
insurer. In the event the policy is issued on a basis |
other than that
applied for, the outline of coverage properly |
describing the policy must
accompany the policy when it is |
delivered and such outline shall clearly
state that the policy |
differs, and to what extent, from that for which
application |
was originally made. All policies, except single premium
|
nonrenewal policies, shall have a notice prominently printed |
on the
first page of the policy or attached thereto stating in |
substance, that
the policyholder shall have the right to |
return the policy within 10 days of its delivery and to have |
the premium refunded if after
examination of the policy the |
policyholder is not satisfied for any
reason.
|
(b) The Director shall issue such rules as he shall deem |
necessary
or desirable to prescribe the format and content of |
the outline of
coverage required by paragraph (a) of this |
subsection. "Format" means
style, arrangement, and overall |
|
appearance, including such items as the
size, color, and |
prominence of type and the arrangement of text and
captions. |
"Content" shall include without limitation thereto,
statements |
relating to the particular policy as to the applicable
|
category of coverage prescribed under subsection (4); |
principal benefits;
exceptions, reductions and limitations; |
and renewal provisions,
including any reservation by the |
insurer of a right to change premiums.
Such outline of |
coverage shall clearly state that it constitutes a
summary of |
the policy issued or applied for and that the policy should
be |
consulted to determine governing contractual provisions.
|
(c) (Blank). Without limiting the generality of paragraph |
(b) of this subsection (5), no qualified health plans shall be |
offered for sale directly to consumers through the health |
insurance marketplace operating in the State in accordance |
with Sections 1311 and
1321 of the federal Patient Protection |
and Affordable Care Act of 2010 (Public Law 111-148), as |
amended by the federal Health Care and Education |
Reconciliation Act of 2010 (Public Law 111-152), and any |
amendments thereto, or regulations or guidance issued |
thereunder (collectively, "the Federal Act"), unless the |
following information is made available to the consumer at the |
time he or she is comparing policies and their premiums: |
(i) With respect to prescription drug benefits, the |
most recently published formulary where a consumer can |
view in one location covered prescription drugs; |
|
information on tiering and the cost-sharing structure for |
each tier; and information about how a consumer can obtain |
specific copayment amounts or coinsurance percentages for |
a specific qualified health plan before enrolling in that |
plan. This information shall clearly identify the |
qualified health plan to which it applies. |
(ii) The most recently published provider directory |
where a consumer can view the provider network that |
applies to each qualified health plan and information |
about each provider, including location, contact |
information, specialty, medical group, if any, any |
institutional affiliation, and whether the provider is |
accepting new patients at each of the specific locations |
listing the provider. Dental providers shall notify |
qualified health plans electronically or in writing of any |
changes to their information as listed in the provider |
directory. Qualified health plans shall update their |
directories in a manner consistent with the information |
provided by the provider or dental management service |
organization within 10 business days after being notified |
of the change by the provider. Nothing in this paragraph |
(ii) shall void any contractual relationship between the |
provider and the plan. The information shall clearly |
identify the qualified health plan to which it applies. |
(d) (Blank). Each company that offers qualified health |
plans for sale directly to consumers through the health |
|
insurance marketplace operating in the State shall make the |
information in paragraph (c) of this subsection (5), for each |
qualified health plan that it offers, available and accessible |
to the general public on the company's Internet website and |
through other means for individuals without access to the |
Internet. |
(e) (Blank). The Department shall ensure that |
State-operated Internet websites, in addition to the Internet |
website for the health insurance marketplace established in |
this State in accordance with the Federal Act, prominently |
provide links to Internet-based materials and tools to help |
consumers be informed purchasers of health insurance. |
(f) (Blank). Nothing in this Section shall be interpreted |
or implemented in a manner not consistent with the Federal |
Act. This Section shall apply to all qualified health plans |
offered for sale directly to consumers through the health |
insurance marketplace operating in this State for any coverage |
year beginning on or after January 1, 2015. |
(6) Prior to the issuance of rules pursuant to this |
Section, the
Director shall afford the public, including the |
companies affected
thereby, reasonable opportunity for |
comment. Such rulemaking is subject
to the provisions of the |
Illinois Administrative Procedure Act.
|
(7) When a rule has been adopted, pursuant to this |
Section, all
policies of insurance or subscriber contracts |
which are not in
compliance with such rule shall, when so |
|
provided in such rule, be
deemed to be disapproved as of a date |
specified in such rule not less
than 120 days following its |
effective date, without any further or
additional notice other |
than the adoption of the rule.
|
(8) When a rule adopted pursuant to this Section so |
provides, a
policy of insurance or subscriber contract which |
does not comply with
the rule shall, not less than 120 days |
from the effective date of such
rule, be construed, and the |
insurer or service corporation shall be
liable, as if the |
policy or contract did comply with the rule.
|
(9) Violation of any rule adopted pursuant to this Section |
shall be
a violation of the insurance law for purposes of |
Sections 370 and 446 of this
Code.
|
(Source: P.A. 99-329, eff. 1-1-16; 100-201, eff. 8-18-17.)
|
(215 ILCS 5/355c new) |
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 marketplace operating in this State in |
accordance with Sections 1311 and 1321 of the federal Patient |
Protection and Affordable Care Act of 2010 (Public Law |
111-148), as amended by the federal Health Care and Education |
Reconciliation Act of 2010 (Public Law 111-152), and any |
|
amendments thereto, or regulations or guidance issued |
thereunder (collectively, "the Federal Act"), unless the |
following information is made available to the consumer at the |
time he or she is comparing policies and their premiums: |
(1) With respect to prescription drug benefits, the |
most recently published formulary where a consumer can |
view in one location covered prescription drugs; |
information on tiering and the cost-sharing structure for |
each tier; and information about how a consumer can obtain |
specific copayment amounts or coinsurance percentages for |
a specific qualified health plan before enrolling in that |
plan. This information shall clearly identify the |
qualified health plan to which it applies. |
(2) The most recently published provider directory |
where a consumer can view the provider network that |
applies to each qualified health plan and information |
about each provider, including location, contact |
information, specialty, medical group, if any, any |
institutional affiliation, and whether the provider is |
accepting new patients at each of the specific locations |
listing the provider. Dental providers shall notify |
qualified health plans electronically or in writing of any |
changes to their information as listed in the provider |
directory. Qualified health plans shall update their |
directories in a manner consistent with the information |
provided by the provider or dental management service |
|
organization within 10 business days after being notified |
of the change by the provider. Nothing in this paragraph |
(2) shall void any contractual relationship between the |
provider and the plan. The information shall clearly |
identify the qualified health plan to which it applies. |
(b) Each company that offers qualified health plans for |
sale directly to consumers through the health insurance |
marketplace operating in this State shall make the information |
in subsection (a), for each qualified health plan that it |
offers, available and accessible to the general public on the |
company's website and through other means for individuals |
without access to the Internet. |
(c) The Department shall ensure that State-operated |
websites, in addition to the website for the health insurance |
marketplace established in this State in accordance with the |
Federal Act, prominently provide links to Internet-based |
materials and tools to help consumers be informed purchasers |
of health insurance. |
(d) Nothing in this Section shall be interpreted or |
implemented in a manner not consistent with the Federal Act. |
This Section shall apply to all qualified health plans offered |
for sale directly to consumers through the health insurance |
marketplace operating in this State for any coverage year |
beginning on or after January 1, 2015.
|
(215 ILCS 5/408) (from Ch. 73, par. 1020)
|
|
Sec. 408. Fees and charges.
|
(1) The Director shall charge, collect and
give proper |
acquittances for the payment of the following fees and |
charges:
|
(a) For filing all documents submitted for the |
incorporation or
organization or certification of a |
domestic company, except for a fraternal
benefit society, |
$2,000.
|
(b) For filing all documents submitted for the |
incorporation or
organization of a fraternal benefit |
society, $500.
|
(c) For filing amendments to articles of incorporation |
and amendments to
declaration of organization, except for |
a fraternal benefit society, a
mutual benefit association, |
a burial society or a farm mutual, $200.
|
(d) For filing amendments to articles of incorporation |
of a fraternal
benefit society, a mutual benefit |
association or a burial society, $100.
|
(e) For filing amendments to articles of incorporation |
of a farm mutual,
$50.
|
(f) For filing bylaws or amendments thereto, $50.
|
(g) For filing agreement of merger or consolidation:
|
(i) for a domestic company, except
for a fraternal |
benefit society, a
mutual benefit association, a |
burial society,
or a farm mutual, $2,000.
|
(ii) for a foreign or
alien company, except for a |
|
fraternal
benefit society, $600.
|
(iii) for a fraternal benefit society,
a mutual |
benefit association, a burial society,
or a farm |
mutual, $200.
|
(h) For filing agreements of reinsurance by a domestic |
company, $200.
|
(i) For filing all documents submitted by a foreign or |
alien
company to be admitted to transact business or |
accredited as a
reinsurer in this State, except for a
|
fraternal benefit society, $5,000.
|
(j) For filing all documents submitted by a foreign or |
alien
fraternal benefit society to be admitted to transact |
business
in this State, $500.
|
(k) For filing declaration of withdrawal of a foreign |
or
alien company, $50.
|
(l) For filing annual statement by a domestic company, |
except a fraternal benefit
society, a mutual benefit |
association, a burial society, or
a farm mutual, $200.
|
(m) For filing annual statement by a domestic |
fraternal benefit
society, $100.
|
(n) For filing annual statement by a farm mutual, a |
mutual benefit
association, or a burial society, $50.
|
(o) For issuing a certificate of authority or
renewal |
thereof except to a foreign fraternal benefit society, |
$400.
|
(p) For issuing a certificate of authority or renewal |
|
thereof to a foreign
fraternal benefit society, $200.
|
(q) For issuing an amended certificate of authority, |
$50.
|
(r) For each certified copy of certificate of |
authority, $20.
|
(s) For each certificate of deposit, or valuation, or |
compliance
or surety certificate, $20.
|
(t) For copies of papers or records per page, $1.
|
(u) For each certification to copies
of papers or |
records, $10.
|
(v) For multiple copies of documents or certificates |
listed in
subparagraphs (r), (s), and (u) of paragraph (1) |
of this Section, $10 for
the first copy of a certificate of |
any type and $5 for each additional copy
of the same |
certificate requested at the same time, unless, pursuant |
to
paragraph (2) of this Section, the Director finds these |
additional fees
excessive.
|
(w) For issuing a permit to sell shares or increase |
paid-up
capital:
|
(i) in connection with a public stock offering, |
$300;
|
(ii) in any other case, $100.
|
(x) For issuing any other certificate required or |
permissible
under the law, $50.
|
(y) For filing a plan of exchange of the stock of a |
domestic
stock insurance company, a plan of |
|
demutualization of a domestic
mutual company, or a plan of |
reorganization under Article XII, $2,000.
|
(z) For filing a statement of acquisition of a
|
domestic company as defined in Section 131.4 of this Code, |
$2,000.
|
(aa) For filing an agreement to purchase the business |
of an
organization authorized under the Dental Service |
Plan Act
or the Voluntary Health Services Plans Act or
of a |
health maintenance
organization or a limited health |
service organization, $2,000.
|
(bb) For filing a statement of acquisition of a |
foreign or alien
insurance company as defined in Section |
131.12a of this Code, $1,000.
|
(cc) For filing a registration statement as required |
in Sections 131.13
and 131.14, the notification as |
required by Sections 131.16,
131.20a, or 141.4, or an
|
agreement or transaction required by Sections 124.2(2), |
141, 141a, or
141.1, $200.
|
(dd) For filing an application for licensing of:
|
(i) a religious or charitable risk pooling trust |
or a workers'
compensation pool, $1,000;
|
(ii) a workers' compensation service company, |
$500;
|
(iii) a self-insured automobile fleet, $200; or
|
(iv) a renewal of or amendment of any license |
issued pursuant to (i),
(ii), or (iii) above, $100.
|
|
(ee) For filing articles of incorporation for a |
syndicate to engage in
the business of insurance through |
the Illinois Insurance Exchange, $2,000.
|
(ff) For filing amended articles of incorporation for |
a syndicate engaged
in the business of insurance through |
the Illinois Insurance Exchange, $100.
|
(gg) For filing articles of incorporation for a |
limited syndicate to
join with other subscribers or |
limited syndicates to do business through
the Illinois |
Insurance Exchange, $1,000.
|
(hh) For filing amended articles of incorporation for |
a limited
syndicate to do business through the Illinois |
Insurance Exchange, $100.
|
(ii) For a permit to solicit subscriptions to a |
syndicate
or limited syndicate, $100.
|
(jj) For the filing of each form as required in |
Section 143 of this
Code, $50 per form. Informational and |
advertising filings shall be $25 per filing. The fee for |
advisory and rating
organizations shall be $200 per form.
|
(i) For the purposes of the form filing fee, |
filings made on insert page
basis will be considered |
one form at the time of its original submission.
|
Changes made to a form subsequent to its approval |
shall be considered a
new filing.
|
(ii) Only one fee shall be charged for a form, |
regardless of the number
of other forms or policies |
|
with which it will be used.
|
(iii) Fees charged for a policy filed as it will be |
issued regardless of the number of forms comprising |
that policy shall not exceed $1,500. For advisory or |
rating organizations, fees charged for a policy filed |
as it will be issued regardless of the number of forms |
comprising that policy shall not exceed $2,500.
|
(iv) The Director may by rule exempt forms from |
such fees.
|
(kk) For filing an application for licensing of a |
reinsurance
intermediary, $500.
|
(ll) For filing an application for renewal of a |
license of a reinsurance
intermediary, $200.
|
(mm) For filing a plan of division of a domestic stock |
company under Article IIB, $10,000. |
(nn) For filing all documents submitted by a foreign |
or alien company to be a certified reinsurer in this |
State, except for a fraternal benefit society, $1,000. |
(oo) For filing a renewal by a foreign or alien
|
company to be a certified reinsurer in this State, except
|
for a fraternal benefit society, $400. |
(pp) For filing all documents submitted by a reinsurer |
domiciled in a reciprocal jurisdiction, $1,000. |
(qq) For filing a renewal by a reinsurer domiciled in |
a reciprocal jurisdiction, $400. |
(rr) For registering a captive management company or |
|
renewal thereof, $50. |
(2) When printed copies or numerous copies of the same |
paper or records
are furnished or certified, the Director may |
reduce such fees for copies
if he finds them excessive. He may, |
when he considers it in the public
interest, furnish without |
charge to state insurance departments and persons
other than |
companies, copies or certified copies of reports of |
examinations
and of other papers and records.
|
(3) The expenses incurred in any performance
examination |
authorized by law shall be paid by the company or person being
|
examined. The charge shall be reasonably related to the cost |
of the
examination including but not limited to compensation |
of examiners,
electronic data processing costs, supervision |
and preparation of an
examination report and lodging and |
travel expenses.
All lodging and travel expenses shall be in |
accord
with the applicable travel regulations as published by |
the Department of
Central Management Services and approved by |
the Governor's Travel Control
Board, except that out-of-state |
lodging and travel expenses related to
examinations authorized |
under Section 132 shall be in accordance with
travel rates |
prescribed under paragraph 301-7.2 of the Federal Travel
|
Regulations, 41 C.F.R. 301-7.2, for reimbursement of |
subsistence expenses
incurred during official travel. All |
lodging and travel expenses may be reimbursed directly upon |
authorization of the
Director. With the exception of the
|
direct reimbursements authorized by the
Director, all |
|
performance examination charges collected by the
Department |
shall be paid
to the Insurance Producer Administration Fund,
|
however, the electronic data processing costs
incurred by the |
Department in the performance of any examination shall be
|
billed directly to the company being examined for payment to |
the Technology Management
Revolving Fund.
|
(4) At the time of any service of process on the Director
|
as attorney for such service, the Director shall charge and |
collect the
sum of $40 $20 , which may be recovered as taxable |
costs by
the party to the suit or action causing such service |
to be made if he prevails
in such suit or action.
|
(5) (a) The costs incurred by the Department of Insurance
|
in conducting any hearing authorized by law shall be assessed |
against the
parties to the hearing in such proportion as the |
Director of Insurance may
determine upon consideration of all |
relevant circumstances including: (1)
the nature of the |
hearing; (2) whether the hearing was instigated by, or
for the |
benefit of a particular party or parties; (3) whether there is |
a
successful party on the merits of the proceeding; and (4) the |
relative levels
of participation by the parties.
|
(b) For purposes of this subsection (5) costs incurred |
shall
mean the hearing officer fees, court reporter fees, and |
travel expenses
of Department of Insurance officers and |
employees; provided however, that
costs incurred shall not |
include hearing officer fees or court reporter
fees unless the |
Department has retained the services of independent
|
|
contractors or outside experts to perform such functions.
|
(c) The Director shall make the assessment of costs |
incurred as part of
the final order or decision arising out of |
the proceeding; provided, however,
that such order or decision |
shall include findings and conclusions in support
of the |
assessment of costs. This subsection (5) shall not be |
construed as
permitting the payment of travel expenses unless |
calculated in accordance
with the applicable travel |
regulations of the Department
of Central Management Services, |
as approved by the Governor's Travel Control
Board. The |
Director as part of such order or decision shall require all
|
assessments for hearing officer fees and court reporter fees, |
if any, to
be paid directly to the hearing officer or court |
reporter by the party(s)
assessed for such costs. The |
assessments for travel expenses of Department
officers and |
employees shall be reimbursable to the
Director of Insurance |
for
deposit to the fund out of which those expenses had been |
paid.
|
(d) The provisions of this subsection (5) shall apply in |
the case of any
hearing conducted by the Director of Insurance |
not otherwise specifically
provided for by law.
|
(6) The Director shall charge and collect an annual |
financial
regulation fee from every domestic company for |
examination and analysis of
its financial condition and to |
fund the internal costs and expenses of the
Interstate |
Insurance Receivership Commission as may be allocated to the |
|
State
of Illinois and companies doing an insurance business in |
this State pursuant to
Article X of the Interstate Insurance |
Receivership Compact. The fee shall be
the greater fixed |
amount based upon
the combination of nationwide direct premium |
income and
nationwide reinsurance
assumed premium
income or |
upon admitted assets calculated under this subsection as |
follows:
|
(a) Combination of nationwide direct premium income |
and
nationwide reinsurance assumed premium.
|
(i) $150, if the premium is less than $500,000 and |
there is
no
reinsurance assumed premium;
|
(ii) $750, if the premium is $500,000 or more, but |
less
than $5,000,000
and there is no reinsurance |
assumed premium; or if the premium is less than
|
$5,000,000 and the reinsurance assumed premium is less |
than $10,000,000;
|
(iii) $3,750, if the premium is less than |
$5,000,000 and
the reinsurance
assumed premium is |
$10,000,000 or more;
|
(iv) $7,500, if the premium is $5,000,000 or more, |
but
less than
$10,000,000;
|
(v) $18,000, if the premium is $10,000,000 or |
more, but
less than $25,000,000;
|
(vi) $22,500, if the premium is $25,000,000 or |
more, but
less
than $50,000,000;
|
(vii) $30,000, if the premium is $50,000,000 or |
|
more,
but less than $100,000,000;
|
(viii) $37,500, if the premium is $100,000,000 or |
more.
|
(b) Admitted assets.
|
(i) $150, if admitted assets are less than |
$1,000,000;
|
(ii) $750, if admitted assets are $1,000,000 or |
more, but
less than
$5,000,000;
|
(iii) $3,750, if admitted assets are $5,000,000 or |
more,
but less than
$25,000,000;
|
(iv) $7,500, if admitted assets are $25,000,000 or |
more,
but less than
$50,000,000;
|
(v) $18,000, if admitted assets are $50,000,000 or |
more,
but less than
$100,000,000;
|
(vi) $22,500, if admitted assets are $100,000,000 |
or
more, but less
than $500,000,000;
|
(vii) $30,000, if admitted assets are $500,000,000 |
or
more, but less
than $1,000,000,000;
|
(viii) $37,500, if admitted assets are |
$1,000,000,000
or more.
|
(c) The sum of financial regulation fees charged to |
the domestic
companies of the same affiliated group shall |
not exceed $250,000
in the aggregate in any single year |
and shall be billed by the Director to
the member company |
designated by the
group.
|
(7) The Director shall charge and collect an annual |
|
financial regulation
fee from every foreign or alien company, |
except fraternal benefit
societies, for the
examination and |
analysis of its financial condition and to fund the internal
|
costs and expenses of the Interstate Insurance Receivership |
Commission as may
be allocated to the State of Illinois and |
companies doing an insurance business
in this State pursuant |
to Article X of the Interstate Insurance Receivership
Compact.
|
The fee shall be a fixed amount based upon Illinois direct |
premium income
and nationwide reinsurance assumed premium |
income in accordance with the
following schedule:
|
(a) $150, if the premium is less than $500,000 and |
there is
no
reinsurance assumed premium;
|
(b) $750, if the premium is $500,000 or more, but less |
than
$5,000,000
and there is no reinsurance assumed |
premium;
or if the premium is less than $5,000,000 and the |
reinsurance assumed
premium is less than $10,000,000;
|
(c) $3,750, if the premium is less than $5,000,000 and |
the
reinsurance
assumed premium is $10,000,000 or more;
|
(d) $7,500, if the premium is $5,000,000 or more, but |
less
than
$10,000,000;
|
(e) $18,000, if the premium is $10,000,000 or more, |
but
less than
$25,000,000;
|
(f) $22,500, if the premium is $25,000,000 or more, |
but
less than
$50,000,000;
|
(g) $30,000, if the premium is $50,000,000 or more, |
but
less than
$100,000,000;
|
|
(h) $37,500, if the premium is $100,000,000 or more.
|
The sum of financial regulation fees under this subsection |
(7)
charged to the foreign or alien companies within the same |
affiliated group
shall not exceed $250,000 in the aggregate in |
any single year
and shall be
billed by the Director to the |
member company designated by the group.
|
(8) Beginning January 1, 1992, the financial regulation |
fees imposed
under subsections (6) and (7)
of this Section |
shall be paid by each company or domestic affiliated group
|
annually. After January
1, 1994, the fee shall be billed by |
Department invoice
based upon the company's
premium income or |
admitted assets as shown in its annual statement for the
|
preceding calendar year. The invoice is due upon
receipt and |
must be paid no later than June 30 of each calendar year. All
|
financial
regulation fees collected by the Department shall be |
paid to the Insurance
Financial Regulation Fund. The |
Department may not collect financial
examiner per diem charges |
from companies subject to subsections (6) and (7)
of this |
Section undergoing financial examination
after June 30, 1992.
|
(9) In addition to the financial regulation fee required |
by this
Section, a company undergoing any financial |
examination authorized by law
shall pay the following costs |
and expenses incurred by the Department:
electronic data |
processing costs, the expenses authorized under Section 131.21
|
and
subsection (d) of Section 132.4 of this Code, and lodging |
and travel expenses.
|
|
Electronic data processing costs incurred by the |
Department in the
performance of any examination shall be |
billed directly to the company
undergoing examination for |
payment to the Technology Management Revolving
Fund. Except |
for direct reimbursements authorized by the Director or
direct |
payments made under Section 131.21 or subsection (d) of |
Section
132.4 of this Code, all financial regulation fees and |
all financial
examination charges collected by the Department |
shall be paid to the
Insurance Financial Regulation Fund.
|
All lodging and travel expenses shall be in accordance |
with applicable
travel regulations published by the Department |
of Central Management
Services and approved by the Governor's |
Travel Control Board, except that
out-of-state lodging and |
travel expenses related to examinations authorized
under |
Sections 132.1 through 132.7 shall be in accordance
with |
travel rates prescribed
under paragraph 301-7.2 of the Federal |
Travel Regulations, 41 C.F.R. 301-7.2,
for reimbursement of |
subsistence expenses incurred during official travel.
All |
lodging and travel expenses may be
reimbursed directly upon |
the authorization of the Director.
|
In the case of an organization or person not subject to the |
financial
regulation fee, the expenses incurred in any |
financial examination authorized
by law shall be paid by the |
organization or person being examined. The charge
shall be |
reasonably related to the cost of the examination including, |
but not
limited to, compensation of examiners and other costs |
|
described in this
subsection.
|
(10) Any company, person, or entity failing to make any |
payment of $150
or more as required under this Section shall be |
subject to the penalty and
interest provisions provided for in |
subsections (4) and (7)
of Section 412.
|
(11) Unless otherwise specified, all of the fees collected |
under this
Section shall be paid into the Insurance Financial |
Regulation Fund.
|
(12) For purposes of this Section:
|
(a) "Domestic company" means a company as defined in |
Section 2 of this
Code which is incorporated or organized |
under the laws of this State, and in
addition includes a |
not-for-profit corporation authorized under the Dental
|
Service Plan Act or the Voluntary Health
Services Plans |
Act, a health maintenance organization, and a
limited
|
health service organization.
|
(b) "Foreign company" means a company as defined in |
Section 2 of this
Code which is incorporated or organized |
under the laws of any state of the
United States other than |
this State and in addition includes a health
maintenance |
organization and a limited health service organization |
which is
incorporated or organized under the laws
of any |
state of the United States other than this State.
|
(c) "Alien company" means a company as defined in |
Section 2 of this Code
which is incorporated or organized |
under the laws of any country other than
the United |
|
States.
|
(d) "Fraternal benefit society" means a corporation, |
society, order,
lodge or voluntary association as defined |
in Section 282.1 of this
Code.
|
(e) "Mutual benefit association" means a company, |
association or
corporation authorized by the Director to |
do business in this State under
the provisions of Article |
XVIII of this Code.
|
(f) "Burial society" means a person, firm, |
corporation, society or
association of individuals |
authorized by the Director to do business in
this State |
under the provisions of Article XIX of this Code.
|
(g) "Farm mutual" means a district, county and |
township mutual insurance
company authorized by the |
Director to do business in this State under the
provisions |
of the Farm Mutual Insurance Company Act of 1986.
|
(Source: P.A. 100-23, eff. 7-6-17.)
|
(215 ILCS 5/412) (from Ch. 73, par. 1024)
|
Sec. 412. Refunds; penalties; collection.
|
(1)(a) Whenever it appears to
the satisfaction of the |
Director that because of some mistake of fact,
error in |
calculation, or erroneous interpretation of a statute of this
|
or any other state, any authorized company, surplus line |
producer, or industrial insured has paid to him, pursuant to
|
any provision of law, taxes, fees, or other charges
in excess |
|
of the
amount legally chargeable against it, during the 6 year |
period
immediately preceding the discovery of such |
overpayment, he shall have
power to refund to such company, |
surplus line producer, or industrial insured the amount of the |
excess or excesses by
applying the amount or amounts thereof |
toward
the payment of taxes, fees, or other charges already |
due, or which may
thereafter become due from that company |
until such excess or excesses have been
fully
refunded, or |
upon a written request from the authorized company, surplus |
line producer, or industrial insured, the
Director shall |
provide a cash refund within
120 days after receipt of the |
written request if all necessary information has
been filed |
with the Department in order for it to perform an audit of the
|
tax report for the transaction or period or annual return for |
the year in which the overpayment occurred or within 120 days
|
after the date the Department receives all the necessary |
information to perform
such audit. The Director shall not |
provide a cash refund if there are
insufficient funds in the |
Insurance Premium Tax Refund Fund to provide a cash
refund, if |
the amount of the overpayment is less than $100, or if the |
amount of
the overpayment can be fully offset against the |
taxpayer's estimated liability
for the year following the year |
of the cash refund request. Any cash refund
shall be paid from |
the Insurance Premium Tax Refund Fund, a special fund hereby
|
created in the
State treasury.
|
(b) As determined by the Director pursuant to paragraph |
|
(a) of this subsection Beginning January 1, 2000 and |
thereafter , the Department shall deposit an amount of cash |
refunds approved by the Director for payment as a result of |
overpayment of tax liability
a percentage of the amounts |
collected under Sections 121-2.08, 409, 444, and 444.1 , and |
445 of
this
Code into the Insurance Premium Tax Refund Fund. |
The percentage deposited into
the Insurance Premium Tax Refund |
Fund shall be the annual percentage. The
annual
percentage |
shall be calculated as a fraction, the numerator of which |
shall be
the amount of cash refunds approved by the Director |
for payment and paid during
the preceding calendar year as a |
result of overpayment of tax liability under
Sections |
121-2.08, 409, 444, 444.1, and 445 of this Code and the |
denominator of which shall
be the amounts collected pursuant |
to Sections 121-2.08, 409, 444, 444.1, and 445 of this Code
|
during the preceding calendar year. However, if there were no |
cash refunds
paid in a preceding calendar year, the Department |
shall deposit 5% of the
amount collected in that preceding |
calendar year pursuant to Sections 121-2.08, 409, 444,
444.1, |
and 445 of this Code into the Insurance Premium Tax Refund Fund |
instead of an
amount calculated by using the annual |
percentage.
|
(c) Beginning July 1, 1999, moneys in the Insurance |
Premium Tax Refund
Fund
shall be expended exclusively for the |
purpose of paying cash refunds resulting
from overpayment of |
tax liability under Sections 121-2.08, 409, 444, 444.1, and |
|
445 of this
Code
as
determined by the Director pursuant to |
subsection 1(a) of this Section. Cash
refunds made in |
accordance with this Section may be made from the Insurance
|
Premium Tax Refund Fund only to the extent that amounts have |
been deposited and
retained in the Insurance Premium Tax |
Refund Fund.
|
(d) This Section shall constitute an irrevocable and |
continuing
appropriation from the Insurance Premium Tax Refund |
Fund for the purpose of
paying cash refunds pursuant to the |
provisions of this Section.
|
(2)(a) When any insurance company fails to
file any tax |
return required under Sections 408.1, 409, 444, and 444.1 of
|
this Code or Section 12 of the Fire Investigation Act on the |
date
prescribed, including any extensions, there shall be |
added as a penalty
$400 or 10% of the amount of such tax, |
whichever is
greater, for each month
or part of a month of |
failure to file, the entire penalty not to exceed
$2,000 or 50% |
of the tax due, whichever is greater.
|
(b) When any industrial insured or surplus line producer |
fails to file any tax return or report required under Sections |
121-2.08 and 445 of this Code or Section 12 of the Fire |
Investigation Act on the date prescribed, including any |
extensions, there shall be added: |
(i) as a late fee, if the return or report is received |
at least one day but not more than 7 days after the |
prescribed due date, $400 or 10% of the tax due, whichever |
|
is greater, the entire fee not to exceed $1,000; |
(ii) as a late fee, if the return or report is received |
at least 8 days but not more than 14 days after the |
prescribed due date, $400 or 10% of the tax due, whichever |
is greater, the entire fee not to exceed $1,500; |
(iii) as a late fee, if the return or report is |
received at least 15 days but not more than 21 days after |
the prescribed due date, $400 or 10% of the tax due, |
whichever is greater, the entire fee not to exceed $2,000; |
or |
(iv) as a penalty, if the return or report is received |
more than 21 days after the prescribed due date, $400 or |
10% of the tax due, whichever is greater, for each month or |
part of a month of failure to file, the entire penalty not |
to exceed $2,000 or 50% of the tax due, whichever is |
greater. |
A tax return or report shall be deemed received as of the |
date mailed as evidenced by a postmark, proof of mailing on a |
recognized United States Postal Service form or a form |
acceptable to the United States Postal Service or other |
commercial mail delivery service, or other evidence acceptable |
to the Director.
|
(3)(a) When any insurance company
fails to pay the full |
amount due under the provisions of this Section,
Sections |
408.1, 409, 444, or 444.1 of this Code, or Section 12 of the
|
Fire Investigation Act, there shall be added to the amount due |
|
as a penalty
an amount equal to 10% of the deficiency.
|
(a-5) When any industrial insured or surplus line producer |
fails to pay the full amount due under the provisions of this |
Section, Sections 121-2.08 or 445 of this Code, or Section 12 |
of the Fire Investigation Act on the date prescribed, there |
shall be added: |
(i) as a late fee, if the payment is received at least |
one day but not more than 7 days after the prescribed due |
date, 10% of the tax due, the entire fee not to exceed |
$1,000; |
(ii) as a late fee, if the payment is received at least |
8 days but not more than 14 days after the prescribed due |
date, 10% of the tax due, the entire fee not to exceed |
$1,500; |
(iii) as a late fee, if the payment is received at |
least 15 days but not more than 21 days after the |
prescribed due date, 10% of the tax due, the entire fee not |
to exceed $2,000; or |
(iv) as a penalty, if the return or report is received |
more than 21 days after the prescribed due date, 10% of the |
tax due. |
A tax payment shall be deemed received as of the date |
mailed as evidenced by a postmark, proof of mailing on a |
recognized United States Postal Service form or a form |
acceptable to the United States Postal Service or other |
commercial mail delivery service, or other evidence acceptable |
|
to the Director.
|
(b) If such failure to pay is determined by the Director to |
be wilful,
after a hearing under Sections 402 and 403, there |
shall be added to the tax
as a penalty an amount equal to the |
greater of 50% of the
deficiency or 10%
of the amount due and |
unpaid for each month or part of a month that the
deficiency |
remains unpaid commencing with the date that the amount |
becomes
due. Such amount shall be in lieu of any determined |
under paragraph (a) or (a-5).
|
(4) Any insurance company, industrial insured, or surplus |
line producer that
fails to pay the full amount due under this |
Section or Sections 121-2.08, 408.1, 409,
444, 444.1, or 445 |
of this Code, or Section 12 of the Fire Investigation
Act is |
liable, in addition to the tax and any late fees and penalties, |
for interest
on such deficiency at the rate of 12% per annum, |
or at such higher adjusted
rates as are or may be established |
under subsection (b) of Section 6621
of the Internal Revenue |
Code, from the date that payment of any such tax
was due, |
determined without regard to any extensions, to the date of |
payment
of such amount.
|
(5) The Director, through the Attorney
General, may |
institute an action in the name of the People of the State
of |
Illinois, in any court of competent jurisdiction, for the |
recovery of
the amount of such taxes, fees, and penalties due, |
and prosecute the same to
final judgment, and take such steps |
as are necessary to collect the same.
|
|
(6) In the event that the certificate of authority of a |
foreign or
alien company is revoked for any cause or the |
company withdraws from
this State prior to the renewal date of |
the certificate of authority as
provided in Section 114, the |
company may recover the amount of any such
tax paid in advance. |
Except as provided in this subsection, no
revocation or |
withdrawal excuses payment of or constitutes grounds for
the |
recovery of any taxes or penalties imposed by this Code.
|
(7) When an insurance company or domestic affiliated group |
fails to pay
the full amount of any fee of $200 or more due |
under
Section 408 of this Code, there shall be added to the |
amount due as
a penalty the greater of $100 or an amount equal |
to 10%
of the deficiency for
each month or part of
a month that |
the deficiency remains unpaid.
|
(8) The Department shall have a lien for the taxes, fees, |
charges, fines, penalties, interest, other charges, or any |
portion thereof, imposed or assessed pursuant to this Code, |
upon all the real and personal property of any company or |
person to whom the assessment or final order has been issued or |
whenever a tax return is filed without payment of the tax or |
penalty shown therein to be due, including all such property |
of the company or person acquired after receipt of the |
assessment, issuance of the order, or filing of the return. |
The company or person is liable for the filing fee incurred by |
the Department for filing the lien and the filing fee incurred |
by the Department to file the release of that lien. The filing |
|
fees shall be paid to the Department in addition to payment of |
the tax, fee, charge, fine, penalty, interest, other charges, |
or any portion thereof, included in the amount of the lien. |
However, where the lien arises because of the issuance of a |
final order of the Director or tax assessment by the |
Department, the lien shall not attach and the notice referred |
to in this Section shall not be filed until all administrative |
proceedings or proceedings in court for review of the final |
order or assessment have terminated or the time for the taking |
thereof has expired without such proceedings being instituted. |
Upon the granting of Department review after a lien has |
attached, the lien shall remain in full force except to the |
extent to which the final assessment may be reduced by a |
revised final assessment following the rehearing or review. |
The lien created by the issuance of a final assessment shall |
terminate, unless a notice of lien is filed, within 3 years |
after the date all proceedings in court for the review of the |
final assessment have terminated or the time for the taking |
thereof has expired without such proceedings being instituted, |
or (in the case of a revised final assessment issued pursuant |
to a rehearing or review by the Department) within 3 years |
after the date all proceedings in court for the review of such |
revised final assessment have terminated or the time for the |
taking thereof has expired without such proceedings being |
instituted. Where the lien results from the filing of a tax |
return without payment of the tax or penalty shown therein to |
|
be due, the lien shall terminate, unless a notice of lien is |
filed, within 3 years after the date when the return is filed |
with the Department. |
The time limitation period on the Department's right to |
file a notice of lien shall not run during any period of time |
in which the order of any court has the effect of enjoining or |
restraining the Department from filing such notice of lien. If |
the Department finds that a company or person is about to |
depart from the State, to conceal himself or his property, or |
to do any other act tending to prejudice or to render wholly or |
partly ineffectual proceedings to collect the amount due and |
owing to the Department unless such proceedings are brought |
without delay, or if the Department finds that the collection |
of the amount due from any company or person will be |
jeopardized by delay, the Department shall give the company or |
person notice of such findings and shall make demand for |
immediate return and payment of the amount, whereupon the |
amount shall become immediately due and payable. If the |
company or person, within 5 days after the notice (or within |
such extension of time as the Department may grant), does not |
comply with the notice or show to the Department that the |
findings in the notice are erroneous, the Department may file |
a notice of jeopardy assessment lien in the office of the |
recorder of the county in which any property of the company or |
person may be located and shall notify the company or person of |
the filing. The jeopardy assessment lien shall have the same |
|
scope and effect as the statutory lien provided for in this |
Section. If the company or person believes that the company or |
person does not owe some or all of the tax for which the |
jeopardy assessment lien against the company or person has |
been filed, or that no jeopardy to the revenue in fact exists, |
the company or person may protest within 20 days after being |
notified by the Department of the filing of the jeopardy |
assessment lien and request a hearing, whereupon the |
Department shall hold a hearing in conformity with the |
provisions of this Code and, pursuant thereto, shall notify |
the company or person of its findings as to whether or not the |
jeopardy assessment lien will be released. If not, and if the |
company or person is aggrieved by this decision, the company |
or person may file an action for judicial review of the final |
determination of the Department in accordance with the |
Administrative Review Law. If, pursuant to such hearing (or |
after an independent determination of the facts by the |
Department without a hearing), the Department determines that |
some or all of the amount due covered by the jeopardy |
assessment lien is not owed by the company or person, or that |
no jeopardy to the revenue exists, or if on judicial review the |
final judgment of the court is that the company or person does |
not owe some or all of the amount due covered by the jeopardy |
assessment lien against them, or that no jeopardy to the |
revenue exists, the Department shall release its jeopardy |
assessment lien to the extent of such finding of nonliability |
|
for the amount, or to the extent of such finding of no jeopardy |
to the revenue. The Department shall also release its jeopardy |
assessment lien against the company or person whenever the |
amount due and owing covered by the lien, plus any interest |
which may be due, are paid and the company or person has paid |
the Department in cash or by guaranteed remittance an amount |
representing the filing fee for the lien and the filing fee for |
the release of that lien. The Department shall file that |
release of lien with the recorder of the county where that lien |
was filed. |
Nothing in this Section shall be construed to give the |
Department a preference over the rights of any bona fide |
purchaser, holder of a security interest, mechanics |
lienholder, mortgagee, or judgment lien creditor arising prior |
to the filing of a regular notice of lien or a notice of |
jeopardy assessment lien in the office of the recorder in the |
county in which the property subject to the lien is located. |
For purposes of this Section, "bona fide" shall not include |
any mortgage of real or personal property or any other credit |
transaction that results in the mortgagee or the holder of the |
security acting as trustee for unsecured creditors of the |
company or person mentioned in the notice of lien who executed |
such chattel or real property mortgage or the document |
evidencing such credit transaction. The lien shall be inferior |
to the lien of general taxes, special assessments, and special |
taxes levied by any political subdivision of this State. In |
|
case title to land to be affected by the notice of lien or |
notice of jeopardy assessment lien is registered under the |
provisions of the Registered Titles (Torrens) Act, such notice |
shall be filed in the office of the Registrar of Titles of the |
county within which the property subject to the lien is |
situated and shall be entered upon the register of titles as a |
memorial or charge upon each folium of the register of titles |
affected by such notice, and the Department shall not have a |
preference over the rights of any bona fide purchaser, |
mortgagee, judgment creditor, or other lienholder arising |
prior to the registration of such notice. The regular lien or |
jeopardy assessment lien shall not be effective against any |
purchaser with respect to any item in a retailer's stock in |
trade purchased from the retailer in the usual course of the |
retailer's business. |
(Source: P.A. 98-158, eff. 8-2-13; 98-978, eff. 1-1-15 .)
|
(215 ILCS 5/416)
|
Sec. 416. Illinois Workers' Compensation
Commission |
Operations Fund Surcharge.
|
(a) As of July 30, 2004 (the effective date of Public Act |
93-840), every company licensed or
authorized by the Illinois |
Department of Insurance and insuring employers'
liabilities |
arising under the Workers' Compensation Act or the Workers'
|
Occupational Diseases Act shall remit to the Director a |
surcharge based upon
the annual direct written premium, as |
|
reported under Section 136 of this Act,
of the company in the |
manner provided in this
Section. Such
proceeds shall
be |
deposited into the Illinois Workers' Compensation
Commission |
Operations Fund as
established in
the Workers' Compensation |
Act. If a company
survives or
was formed by a merger, |
consolidation, reorganization, or reincorporation, the
direct
|
written premiums of all companies party to the merger, |
consolidation,
reorganization, or
reincorporation shall, for |
purposes of determining the amount of the fee
imposed by this
|
Section, be regarded as those of the surviving or new company.
|
(b)(1) Except as provided in subsection (b)(2) of this |
Section, beginning on
July 30, 2004 (the effective date of |
Public Act 93-840) and on July 1 of each year thereafter,
the
|
Director shall
charge an annual Illinois Workers' Compensation |
Commission Operations Fund Surcharge from every
company |
subject to subsection (a) of this Section equal to 1.01% of its |
direct
written
premium for insuring employers' liabilities |
arising under the Workers'
Compensation Act or Workers' |
Occupational Diseases Act as reported in each
company's
annual
|
statement filed for the previous year as required by Section |
136. The
Illinois Workers' Compensation Commission Operations |
Fund Surcharge shall be collected by companies
subject to |
subsection (a) of this Section as a separately stated |
surcharge on
insured employers at the rate of 1.01% of direct |
written premium. The
Illinois Workers' Compensation Commission |
Operations Fund Surcharge shall not be collected by companies
|
|
subject to subsection (a) of this Section from any employer |
that self-insures its liabilities arising under the Workers' |
Compensation Act or Workers' Occupational Diseases Act, |
provided that the employer has paid the Illinois Workers' |
Compensation Commission Operations Fund Fee pursuant to |
Section 4d of the Workers' Compensation Act. All sums
|
collected by
the Department of Insurance under the provisions |
of this Section shall be paid
promptly
after the receipt of the |
same, accompanied by a detailed statement thereof,
into the
|
Illinois Workers' Compensation Commission Operations Fund in |
the State treasury.
|
(b)(2) The surcharge due pursuant to Public Act 93-840 |
shall be collected instead of the surcharge due on July 1, 2004 |
under Public Act 93-32. Payment of the surcharge due under |
Public Act 93-840 shall discharge the employer's obligations |
due on July 1, 2004.
|
(c) In addition to the authority specifically granted |
under Article XXV of
this
Code, the Director shall have such |
authority to adopt rules or establish forms
as may be
|
reasonably necessary for purposes of enforcing this Section. |
The Director shall
also have
authority to defer, waive, or |
abate the surcharge or any penalties imposed by
this
Section |
if in
the Director's opinion the company's solvency and |
ability to meet its insured
obligations
would be immediately |
threatened by payment of the surcharge due.
|
(d) When a company fails to pay the full amount of any |
|
annual
Illinois Workers' Compensation
Commission Operations |
Fund Surcharge of $100 or more due under this Section,
there
|
shall be
added to the amount due as a penalty the greater of |
$1,000 or an amount equal
to 10% 5% of
the deficiency for each |
month or part of a month that the deficiency remains
unpaid.
|
(e) The Department of Insurance may enforce the collection |
of any delinquent
payment, penalty, or portion thereof by |
legal action or in any other manner by
which the
collection of |
debts due the State of Illinois may be enforced under the laws |
of
this State.
|
(f) Whenever it appears to the satisfaction of the |
Director that a company
has
paid
pursuant to this Act an |
Illinois Workers' Compensation Commission Operations Fund |
Surcharge in
an amount
in excess of the amount legally |
collectable from the company, the Director
shall issue a
|
credit memorandum for an amount equal to the amount of such |
overpayment. A
credit
memorandum may be applied for the 2-year |
period from the date of issuance,
against the
payment of any |
amount due during that period under the surcharge imposed by
|
this
Section or,
subject to reasonable rule of the Department |
of Insurance including requirement
of
notification, may be |
assigned to any other company subject to regulation under
this |
Act.
Any application of credit memoranda after the period |
provided for in this
Section is void.
|
(g) Annually, the Governor may direct a transfer of up to |
2% of all moneys
collected under this Section to the Insurance |
|
Financial Regulation Fund.
|
(Source: P.A. 95-331, eff. 8-21-07.)
|
(215 ILCS 5/356z.27 rep.) |
Section 15. The Illinois Insurance Code is amended by |
repealing Section 356z.27. |
Section 20. The Illinois Health Insurance Portability and |
Accountability Act is amended by changing Section 20 as |
follows:
|
(215 ILCS 97/20)
|
Sec. 20.
Increased portability through prohibition of |
limitation on preexisting
condition exclusions.
|
(A) No health insurance coverage issued, amended, |
delivered, or renewed on or after the effective date of this |
amendatory Act of the 102nd General Assembly may impose any |
preexisting condition exclusion with respect to the plan or |
coverage. This provision does not apply to the provision of |
excepted benefits as described in paragraph (2) of subsection |
(C). Limitation of preexisting condition exclusion period;
|
crediting for periods of previous coverage. Subject
to |
subsection (D), a group health plan, and a health
insurance |
issuer offering group health insurance
coverage, may, with |
respect to a participant or
beneficiary, impose a preexisting |
condition exclusion
only if:
|
|
(1) the exclusion relates to a condition (whether
|
physical or mental), regardless of the cause of
the |
condition, for which medical advice,
diagnosis, care, or |
treatment was recommended or
received
within the 6-month |
period ending on the enrollment
date;
|
(2) the exclusion extends for a period of not more
|
than 12 months (or 18 months in the case of a late
|
enrollee) after the enrollment date; and
|
(3) the period of any such preexisting condition
|
exclusion is reduced by the aggregate of the periods
of |
creditable coverage (if any, as defined in
subsection |
(C)(1)) applicable to the participant or
beneficiary as of |
the enrollment date.
|
(B) (Blank). Preexisting condition exclusion. A group
|
health plan, and health insurance issuer offering
group health |
insurance coverage, may not impose
any preexisting condition |
exclusion relating to
pregnancy as a preexisting condition.
|
Genetic information shall not be treated as a condition
|
described in subsection (A)(1) in the absence of a
diagnosis |
of the condition related to such
information.
|
(C) Rules relating to crediting previous coverage.
|
(1) Creditable coverage defined. For purposes of this
|
Act, the term "creditable coverage" means, with
respect to |
an individual, coverage of the individual
under any of the |
following:
|
(a) A group health plan.
|
|
(b) Health insurance coverage.
|
(c) Part A or part B of title XVIII of the Social |
Security
Act.
|
(d) Title XIX of the Social Security Act, other |
than coverage
consisting solely of benefits under |
Section 1928.
|
(e) Chapter 55 of title 10, United States Code.
|
(f) A medical care program of the Indian Health |
Service or of
a tribal organization.
|
(g) A State health benefits risk pool.
|
(h) A health plan offered under chapter 89 of |
title 5, United
States Code.
|
(i) A public health plan (as defined in |
regulations).
|
(j) A health benefit plan under Section 5(e) of |
the Peace
Corps Act (22 U.S.C. 2504(e)).
|
(k) Title XXI of the federal Social Security Act, |
State Children's
Health Insurance Program.
|
Such term does not include coverage consisting solely |
of
coverage of excepted benefits.
|
(2) Excepted benefits. For purposes of this Act, the |
term "excepted
benefits" means benefits under one or more |
of the following:
|
(a) Benefits not subject to requirements:
|
(i) Coverage only for accident, or disability |
income
insurance, or any combination thereof.
|
|
(ii) Coverage issued as a supplement to |
liability insurance.
|
(iii) Liability insurance, including general |
liability
insurance and automobile liability |
insurance.
|
(iv) Workers' compensation or similar |
insurance.
|
(v) Automobile medical payment insurance.
|
(vi) Credit-only insurance.
|
(vii) Coverage for on-site medical clinics.
|
(viii) Other similar insurance coverage, |
specified
in regulations, under which benefits for |
medical
care are secondary or incidental to other |
insurance
benefits.
|
(b) Benefits not subject to requirements if |
offered separately:
|
(i) Limited scope dental or vision benefits.
|
(ii) Benefits for long-term care, nursing home |
care, home
health care, community-based care, or |
any combination
thereof.
|
(iii) Such other similar, limited benefits as |
are
specified in rules.
|
(c) Benefits not subject to requirements if |
offered, as
independent, noncoordinated benefits:
|
(i) Coverage only for a specified disease or
|
illness.
|
|
(ii) Hospital indemnity or other fixed |
indemnity
insurance.
|
(d) Benefits not subject to requirements if |
offered as
separate insurance policy. Medicare |
supplemental health
insurance (as defined under |
Section 1882(g)(1) of the
Social Security Act), |
coverage supplemental to the
coverage provided under |
chapter 55 of title 10, United
States Code, and |
similar supplemental coverage provided to
coverage |
under a group health plan.
|
(3) Not counting periods before significant breaks in |
coverage.
|
(a) In general. A period of creditable coverage |
shall not
be counted, with respect to enrollment of an
|
individual under a group health plan, if, after such
|
period and before the enrollment date, there was a |
63-day period during all of
which the individual was |
not
covered under any creditable coverage.
|
(b) Waiting period not treated as a break in
|
coverage. For purposes of subparagraph (a) and
|
subsection (D)(3), any period that an individual is in
|
a waiting period for any coverage under a group health
|
plan (or for group health insurance coverage) or is in
|
an affiliation period (as defined in subsection
|
(G)(2)) shall not be taken into account in determining
|
the continuous period under subparagraph (a).
|
|
(4) (Blank). Method of crediting coverage.
|
(a) Standard method. Except as otherwise provided |
under
subparagraph (b), for purposes of applying |
subsection
(A)(3), a group health plan, and a health |
insurance
issuer offering group health insurance |
coverage, shall
count a period of creditable coverage |
without regard
to the specific benefits covered during |
the period.
|
(b) Election of alternative method. A group health |
plan,
or a health insurance issuer offering group |
health
insurance, may elect to apply subsection (A)(3) |
based
on coverage of benefits within each of several |
classes
or categories of benefits specified in |
regulations
rather than as provided under subparagraph |
(a). Such
election shall be made on a uniform basis for |
all
participants and beneficiaries. Under such |
election a
group health plan or issuer shall count a |
period of
creditable coverage with respect to any |
class or
category of benefits if any level of benefits |
is
covered within such class or category.
|
(c) Plan notice. In the case of an election with |
respect
to a group health plan under subparagraph (b) |
(whether
or not health insurance coverage is provided |
in
connection with such plan), the plan shall:
|
(i) prominently state in any disclosure |
statements
concerning the plan, and state to each |
|
enrollee at
the time of enrollment under the plan, |
that the
plan has made such election; and
|
(ii) include in such statements a description |
of
the effect of this election.
|
(d) Issuer notice. In the case of an election
|
under subparagraph (b) with respect to health
|
insurance coverage offered by an issuer in the small
|
or large group market, the issuer:
|
(i) shall prominently state in any disclosure
|
statements concerning the coverage, and to each
|
employer at the time of the offer or sale of the
|
coverage, that the issuer has made such election;
|
and
|
(ii) shall include in such statements a
|
description of the effect of such election.
|
(5) Establishment of period. Periods of creditable |
coverage
with respect to an individual shall be |
established through
presentation or certifications |
described in subsection (E)
or in such other manner as may |
be specified in
regulations.
|
(D) (Blank). Exceptions:
|
(1) Exclusion not applicable to certain newborns.
|
Subject to paragraph (3), a group health plan, and
a |
health insurance issuer offering group health
insurance |
coverage, may not impose any preexisting
condition |
exclusion in the case of an
individual who, as of the last |
|
day of the 30-day
period beginning with the date of birth, |
is
covered under creditable coverage.
|
(2) Exclusion not applicable to certain adopted
|
children. Subject to paragraph (3), a group
health plan, |
and a health insurance issuer
offering group health |
insurance coverage, may not
impose any preexisting |
condition exclusion in the
case of a child who is adopted |
or placed for
adoption before attaining 18 years of age |
and who,
as of the last day of the 30-day period beginning
|
on the date of the adoption or placement for
adoption, is |
covered under creditable coverage.
|
The previous sentence
shall not apply to coverage |
before the date of
such adoption or placement for |
adoption.
|
(3) Loss if break in coverage. Paragraphs (1) and
(2) |
shall no longer apply to an individual
after the end of the |
first 63-day period
during all of which the individual was |
not
covered under any creditable coverage.
|
(E) Certifications and disclosure of coverage.
|
(1) Requirement for Certification of Period of |
Creditable
Coverage.
|
(a) A group health plan, and a
health insurance |
issuer offering group health
insurance coverage, shall |
provide the certification described in subparagraph
|
(b):
|
(i) at the time an individual ceases to be |
|
covered
under the plan or otherwise becomes |
covered
under a COBRA continuation provision;
|
(ii) in the case of an individual becoming |
covered
under such a provision, at the time the
|
individual ceases to be covered under such
|
provision; and
|
(iii) on the request on behalf of an |
individual
made not later than 24 months after the |
date
of cessation of the coverage described in
|
clause (i) or (ii), whichever is later.
|
The certification under clause (i) may be provided, to
|
the extent practicable, at a time consistent with
|
notices required under any applicable COBRA
|
continuation provision.
|
(b) The certification described in
this |
subparagraph is a written certification of:
|
(i) the period of creditable coverage of the
|
individual under such plan and the coverage (if
|
any) under such COBRA continuation provision; and
|
(ii) the waiting period (if any) (and
|
affiliation period, if applicable) imposed with
|
respect to the individual for any coverage under
|
such plan.
|
(c) To the extent that medical care
under a group |
health plan consists of group health
insurance |
coverage, the plan is deemed to have
satisfied the |
|
certification requirement under this
paragraph if the |
health insurance issuer offering the
coverage provides |
for such certification in accordance
with this |
paragraph.
|
(2) (Blank). Disclosure of information on previous |
benefits. In the
case of an election described in |
subsection (C)(4)(b) by a
group health plan or health |
insurance issuer, if the plan
or issuer enrolls an |
individual for coverage under the
plan and the individual |
provides a certification of
coverage of the individual |
under paragraph (1):
|
(a) upon request of such plan or issuer, the |
entity which
issued the certification provided by the |
individual
shall promptly disclose to such requesting |
plan or
issuer information on coverage of classes and
|
categories of health benefits available under such
|
entity's plan or coverage; and
|
(b) such entity may charge the requesting plan or |
issuer
for the reasonable cost of disclosing such
|
information.
|
(3) Rules. The Department shall establish rules to
|
prevent an entity's failure to provide information under
|
paragraph (1) or (2) with respect to previous coverage of
|
an individual from adversely affecting any subsequent
|
coverage of the individual under another group health plan
|
or health insurance coverage.
|
|
(4) Treatment of certain plans as group health plan |
for
notice provision. A program under which creditable
|
coverage described in subparagraph (c), (d), (e), or
(f) |
of Section 20(C)(1) is provided shall be treated
as a |
group health plan for purposes of this Section.
|
(F) Special enrollment periods.
|
(1) Individuals losing other coverage. A group health
|
plan, and a health insurance issuer offering group
health |
insurance coverage in connection with a group health
plan, |
shall permit an employee who is eligible, but not
|
enrolled, for coverage under the terms of the plan (or a
|
dependent of such an employee if the dependent is |
eligible,
but not enrolled, for coverage under such terms) |
to enroll for
coverage under the terms of the plan if each |
of the following
conditions is met:
|
(a) The employee or dependent was covered under a
|
group health plan or had health insurance coverage
at |
the time coverage was previously offered to the
|
employee or dependent.
|
(b) The employee stated in writing at such time
|
that coverage under a group health plan or health
|
insurance coverage was the reason for declining
|
enrollment, but only if the plan sponsor or issuer
(if |
applicable) required such a statement at such
time and |
provided the employee with notice of such
requirement |
(and the consequences of such
requirement) at such |
|
time.
|
(c) The employee's or dependent's coverage
|
described in subparagraph (a):
|
(i) was under a COBRA continuation provision |
and the
coverage under such provision was |
exhausted; or
|
(ii) was not under such a provision and either |
the
coverage was terminated as a result of loss of
|
eligibility for the coverage (including as a
|
result of legal separation, divorce, death,
|
termination of employment, or reduction in the
|
number of hours of
employment) or employer |
contributions towards such
coverage were |
terminated.
|
(d) Under the terms of the plan, the employee
|
requests such enrollment not later than 30 days after
|
the date of exhaustion of coverage described in
|
subparagraph (c)(i) or termination of coverage or
|
employer contributions described in subparagraph
|
(c)(ii).
|
(2) For dependent beneficiaries.
|
(a) In general. If:
|
(i) a group health plan makes coverage
|
available with respect to a dependent of an
|
individual,
|
(ii) the individual is a participant under the |
|
plan (or
has met any waiting period applicable to |
becoming a
participant under the plan and is |
eligible to be
enrolled under the plan but for a |
failure to enroll
during a previous enrollment |
period), and
|
(iii) a person becomes such a dependent of the |
individual
through marriage, birth, or adoption or |
placement
for adoption,
|
then the group health plan shall provide
for a |
dependent special enrollment period described
in |
subparagraph (b) during which the person (or, if
not |
otherwise enrolled, the individual) may be
enrolled |
under the plan as a dependent of the
individual, and in |
the case of the birth or
adoption of a child, the |
spouse of the individual
may be enrolled as a |
dependent of the individual if
such spouse is |
otherwise eligible for coverage.
|
(b) Dependent special enrollment period. A
|
dependent special enrollment period under this
|
subparagraph shall be a period of not less than 30 days
|
and shall begin on the later of:
|
(i) the date dependent coverage is made
|
available; or
|
(ii) the date of the marriage, birth, or |
adoption or
placement for adoption (as the case |
may be)
described in subparagraph (a)(iii).
|
|
(c) No waiting period. If an individual seeks to |
enroll
a dependent during the first 30 days of such a
|
dependent special enrollment period, the coverage of
|
the dependent shall become effective:
|
(i) in the case of marriage, not later than |
the
first day of the first month beginning after |
the
date the completed request for enrollment is
|
received;
|
(ii) in the case of a dependent's birth, as of |
the
date of such birth; or
|
(iii) in the case of a dependent's adoption or
|
placement for adoption, the date of such
adoption |
or placement for adoption.
|
(G) Use of affiliation period by HMOs as alternative to |
preexisting
condition exclusion.
|
(1) In general. A health maintenance organization
|
which offers health insurance coverage in connection
with |
a group health plan and which does not impose any
|
pre-existing condition exclusion allowed under
subsection |
(A) with respect to any particular coverage
option may |
impose an affiliation period for such
coverage option, but |
only if:
|
(a) such period is applied uniformly without |
regard to
any health status-related factors; and
|
(b) such period does not exceed 2 months (or 3 |
months in
the case of a late enrollee).
|
|
(2) Affiliation period.
|
(a) Defined. For purposes of this Act, the term
|
"affiliation period" means a period which, under the
|
terms of the health insurance coverage offered by the
|
health maintenance organization, must expire before |
the
health insurance coverage becomes
effective. The |
organization is not required to
provide health care |
services or benefits during such
period and no premium |
shall be charged to the
participant or beneficiary for |
any coverage during
the period.
|
(b) Beginning. Such period shall begin on the
|
enrollment date.
|
(c) Runs concurrently with waiting periods. An
|
affiliation period under a plan shall run concurrently |
with any waiting period
under the plan.
|
(3) Alternative methods. A health maintenance |
organization
described in paragraph (1) may use |
alternative methods,
from those described in such |
paragraph, to address
adverse selection as approved by the |
Department.
|
(Source: P.A. 90-30, eff. 7-1-97; 90-736, eff. 8-12-98.)
|
Section 25. The Health Maintenance Organization Act is |
amended by changing Section 5-3 as follows:
|
(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
|
|
Sec. 5-3. Insurance Code provisions.
|
(a) Health Maintenance Organizations
shall be subject to |
the provisions of Sections 133, 134, 136, 137, 139, 140, |
141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, |
154, 154.5, 154.6,
154.7, 154.8, 155.04, 155.22a, 355.2, |
355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x, |
356y,
356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, |
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, |
356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, |
356z.30, 356z.30a, 356z.32, 356z.33, 356z.35, 356z.36, |
356z.40, 356z.41, 356z.43, 356z.46, 356z.47, 356z.48, 356z.50, |
356z.51, 364, 364.01, 364.3, 367.2, 367.2-5, 367i, 368a, 368b, |
368c, 368d, 368e, 370c,
370c.1, 401, 401.1, 402, 403, 403A,
|
408, 408.2, 409, 412, 444,
and
444.1,
paragraph (c) of |
subsection (2) of Section 367, and Articles IIA, VIII 1/2,
|
XII,
XII 1/2, XIII, XIII 1/2, XXV, XXVI, and XXXIIB of the |
Illinois Insurance Code.
|
(b) For purposes of the Illinois Insurance Code, except |
for Sections 444
and 444.1 and Articles XIII and XIII 1/2, |
Health Maintenance Organizations in
the following categories |
are deemed to be "domestic companies":
|
(1) a corporation authorized under the
Dental Service |
Plan Act or the Voluntary Health Services Plans Act;
|
(2) a corporation organized under the laws of this |
State; or
|
(3) a corporation organized under the laws of another |
|
state, 30% or more
of the enrollees of which are residents |
of this State, except a
corporation subject to |
substantially the same requirements in its state of
|
organization as is a "domestic company" under Article VIII |
1/2 of the
Illinois Insurance Code.
|
(c) In considering the merger, consolidation, or other |
acquisition of
control of a Health Maintenance Organization |
pursuant to Article VIII 1/2
of the Illinois Insurance Code,
|
(1) the Director shall give primary consideration to |
the continuation of
benefits to enrollees and the |
financial conditions of the acquired Health
Maintenance |
Organization after the merger, consolidation, or other
|
acquisition of control takes effect;
|
(2)(i) the criteria specified in subsection (1)(b) of |
Section 131.8 of
the Illinois Insurance Code shall not |
apply and (ii) the Director, in making
his determination |
with respect to the merger, consolidation, or other
|
acquisition of control, need not take into account the |
effect on
competition of the merger, consolidation, or |
other acquisition of control;
|
(3) the Director shall have the power to require the |
following
information:
|
(A) certification by an independent actuary of the |
adequacy
of the reserves of the Health Maintenance |
Organization sought to be acquired;
|
(B) pro forma financial statements reflecting the |
|
combined balance
sheets of the acquiring company and |
the Health Maintenance Organization sought
to be |
acquired as of the end of the preceding year and as of |
a date 90 days
prior to the acquisition, as well as pro |
forma financial statements
reflecting projected |
combined operation for a period of 2 years;
|
(C) a pro forma business plan detailing an |
acquiring party's plans with
respect to the operation |
of the Health Maintenance Organization sought to
be |
acquired for a period of not less than 3 years; and
|
(D) such other information as the Director shall |
require.
|
(d) The provisions of Article VIII 1/2 of the Illinois |
Insurance Code
and this Section 5-3 shall apply to the sale by |
any health maintenance
organization of greater than 10% of its
|
enrollee population (including without limitation the health |
maintenance
organization's right, title, and interest in and |
to its health care
certificates).
|
(e) In considering any management contract or service |
agreement subject
to Section 141.1 of the Illinois Insurance |
Code, the Director (i) shall, in
addition to the criteria |
specified in Section 141.2 of the Illinois
Insurance Code, |
take into account the effect of the management contract or
|
service agreement on the continuation of benefits to enrollees |
and the
financial condition of the health maintenance |
organization to be managed or
serviced, and (ii) need not take |
|
into account the effect of the management
contract or service |
agreement on competition.
|
(f) Except for small employer groups as defined in the |
Small Employer
Rating, Renewability and Portability Health |
Insurance Act and except for
medicare supplement policies as |
defined in Section 363 of the Illinois
Insurance Code, a |
Health Maintenance Organization may by contract agree with a
|
group or other enrollment unit to effect refunds or charge |
additional premiums
under the following terms and conditions:
|
(i) the amount of, and other terms and conditions with |
respect to, the
refund or additional premium are set forth |
in the group or enrollment unit
contract agreed in advance |
of the period for which a refund is to be paid or
|
additional premium is to be charged (which period shall |
not be less than one
year); and
|
(ii) the amount of the refund or additional premium |
shall not exceed 20%
of the Health Maintenance |
Organization's profitable or unprofitable experience
with |
respect to the group or other enrollment unit for the |
period (and, for
purposes of a refund or additional |
premium, the profitable or unprofitable
experience shall |
be calculated taking into account a pro rata share of the
|
Health Maintenance Organization's administrative and |
marketing expenses, but
shall not include any refund to be |
made or additional premium to be paid
pursuant to this |
subsection (f)). The Health Maintenance Organization and |
|
the
group or enrollment unit may agree that the profitable |
or unprofitable
experience may be calculated taking into |
account the refund period and the
immediately preceding 2 |
plan years.
|
The Health Maintenance Organization shall include a |
statement in the
evidence of coverage issued to each enrollee |
describing the possibility of a
refund or additional premium, |
and upon request of any group or enrollment unit,
provide to |
the group or enrollment unit a description of the method used |
to
calculate (1) the Health Maintenance Organization's |
profitable experience with
respect to the group or enrollment |
unit and the resulting refund to the group
or enrollment unit |
or (2) the Health Maintenance Organization's unprofitable
|
experience with respect to the group or enrollment unit and |
the resulting
additional premium to be paid by the group or |
enrollment unit.
|
In no event shall the Illinois Health Maintenance |
Organization
Guaranty Association be liable to pay any |
contractual obligation of an
insolvent organization to pay any |
refund authorized under this Section.
|
(g) Rulemaking authority to implement Public Act 95-1045, |
if any, is conditioned on the rules being adopted in |
accordance with all provisions of the Illinois Administrative |
Procedure Act and all rules and procedures of the Joint |
Committee on Administrative Rules; any purported rule not so |
adopted, for whatever reason, is unauthorized. |
|
(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; |
101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff. |
1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, |
eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21; |
102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. |
1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, |
eff. 10-8-21; revised 10-27-21.) |
Section 30. The Limited Health Service Organization Act is |
amended by changing Section 4003 as follows:
|
(215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
|
Sec. 4003. Illinois Insurance Code provisions. Limited |
health service
organizations shall be subject to the |
provisions of Sections 133, 134, 136, 137, 139,
140, 141.1, |
141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, |
154.5,
154.6, 154.7, 154.8, 155.04, 155.37, 355.2, 355.3, |
355b, 356q, 356v, 356z.10, 356z.21, 356z.22, 356z.25, 356z.26, |
356z.29, 356z.30a, 356z.32, 356z.33, 356z.41, 356z.46, |
356z.47, 356z.51, 364.3, 356z.43, 368a, 401, 401.1,
402,
403, |
403A, 408,
408.2, 409, 412, 444, and 444.1 and Articles IIA, |
VIII 1/2, XII, XII 1/2,
XIII,
XIII 1/2, XXV, and XXVI of the |
Illinois Insurance Code. For purposes of the
Illinois |
Insurance Code, except for Sections 444 and 444.1 and Articles |
XIII
and XIII 1/2, limited health service organizations in the |
following categories
are deemed to be domestic companies:
|
|
(1) a corporation under the laws of this State; or
|
(2) a corporation organized under the laws of another |
state, 30% or more
of the enrollees of which are residents |
of this State, except a corporation
subject to |
substantially the same requirements in its state of |
organization as
is a domestic company under Article VIII |
1/2 of the Illinois Insurance Code.
|
(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20; |
101-393, eff. 1-1-20; 101-625, eff. 1-1-21; 102-30, eff. |
1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, |
eff. 1-1-22; revised 10-27-21.)
|
Section 35. The Voluntary Health Services Plans Act is |
amended by changing Section 10 as follows:
|
(215 ILCS 165/10) (from Ch. 32, par. 604)
|
Sec. 10. Application of Insurance Code provisions. Health |
services
plan corporations and all persons interested therein |
or dealing therewith
shall be subject to the provisions of |
Articles IIA and XII 1/2 and Sections
3.1, 133, 136, 139, 140, |
143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b, |
356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v,
356w, |
356x, 356y, 356z.1, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, |
356z.8, 356z.9,
356z.10, 356z.11, 356z.12, 356z.13, 356z.14, |
356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, |
356z.29, 356z.30, 356z.30a, 356z.32, 356z.33, 356z.40, |
|
356z.41, 356z.46, 356z.47, 356z.51, 356z.43, 364.01, 364.3, |
367.2, 368a, 401, 401.1,
402,
403, 403A, 408,
408.2, and 412, |
and paragraphs (7) and (15) of Section 367 of the Illinois
|
Insurance Code.
|
Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19; |
101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff. |
1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, |
eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; |
revised 10-27-21.) |
Section 40. The Workers' Compensation Act is amended by
|
changing Section 19 as follows:
|
(820 ILCS 305/19) (from Ch. 48, par. 138.19)
|
Sec. 19. Any disputed questions of law or fact shall be |
determined
as herein provided.
|
(a) It shall be the duty of the Commission upon |
notification that
the parties have failed to reach an |
agreement, to designate an Arbitrator.
|
1. Whenever any claimant misconceives his remedy and |
|
files an
application for adjustment of claim under this |
Act and it is
subsequently discovered, at any time before |
final disposition of such
cause, that the claim for |
disability or death which was the basis for
such |
application should properly have been made under the |
Workers'
Occupational Diseases Act, then the provisions of |
Section 19, paragraph
(a-1) of the Workers' Occupational |
Diseases Act having reference to such
application shall |
apply.
|
2. Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under the |
Workers' Occupational
Diseases Act and it is subsequently |
discovered, at any time before final
disposition of such |
cause that the claim for injury or death which was
the |
basis for such application should properly have been made |
under this
Act, then the application so filed under the |
Workers' Occupational
Diseases Act may be amended in form, |
substance or both to assert claim
for such disability or |
death under this Act and it shall be deemed to
have been so |
filed as amended on the date of the original filing
|
thereof, and such compensation may be awarded as is |
warranted by the
whole evidence pursuant to this Act. When |
such amendment is submitted,
further or additional |
evidence may be heard by the Arbitrator or
Commission when |
deemed necessary. Nothing in this Section contained
shall |
be construed to be or permit a waiver of any provisions of |
|
this
Act with reference to notice but notice if given |
shall be deemed to be a
notice under the provisions of this |
Act if given within the time
required herein.
|
(b) The Arbitrator shall make such inquiries and |
investigations as he or
they shall deem necessary and may |
examine and inspect all books, papers,
records, places, or |
premises relating to the questions in dispute and hear
such |
proper evidence as the parties may submit.
|
The hearings before the Arbitrator shall be held in the |
vicinity where
the injury occurred after 10 days' notice of |
the time and place of such
hearing shall have been given to |
each of the parties or their attorneys
of record.
|
The Arbitrator may find that the disabling condition is |
temporary and has
not yet reached a permanent condition and |
may order the payment of
compensation up to the date of the |
hearing, which award shall be reviewable
and enforceable in |
the same manner as other awards, and in no instance be a
bar to |
a further hearing and determination of a further amount of |
temporary
total compensation or of compensation for permanent |
disability, but shall
be conclusive as to all other questions |
except the nature and extent of said
disability.
|
The decision of the Arbitrator shall be filed with the |
Commission which
Commission shall immediately send to each |
party or his attorney a copy of
such decision, together with a |
notification of the time when it was filed.
As of the effective |
date of this amendatory Act of the 94th General Assembly, all |
|
decisions of the Arbitrator shall set forth
in writing |
findings of fact and conclusions of law, separately stated, if |
requested by either party.
Unless a petition for review is |
filed by either party within 30 days after
the receipt by such |
party of the copy of the decision and notification of
time when |
filed, and unless such party petitioning for a review shall
|
within 35 days after the receipt by him of the copy of the |
decision, file
with the Commission either an agreed statement |
of the facts appearing upon
the hearing before the Arbitrator, |
or if such
party shall so elect a correct transcript of |
evidence of the proceedings
at such hearings, then the |
decision shall become the decision of the
Commission and in |
the absence of fraud shall be conclusive.
The Petition for |
Review shall contain a statement of the petitioning party's
|
specific exceptions to the decision of the arbitrator. The |
jurisdiction
of the Commission to review the decision of the |
arbitrator shall not be
limited to the exceptions stated in |
the Petition for Review.
The Commission, or any member |
thereof, may grant further time not exceeding
30 days, in |
which to file such agreed statement or transcript of
evidence. |
Such agreed statement of facts or correct transcript of
|
evidence, as the case may be, shall be authenticated by the |
signatures
of the parties or their attorneys, and in the event |
they do not agree as
to the correctness of the transcript of |
evidence it shall be authenticated
by the signature of the |
Arbitrator designated by the Commission.
|
|
Whether the employee is working or not, if the employee is |
not receiving or has not received medical, surgical, or |
hospital services or other services or compensation as |
provided in paragraph (a) of Section 8, or compensation as |
provided in paragraph (b) of Section 8, the employee may at any |
time petition for an expedited hearing by an Arbitrator on the |
issue of whether or not he or she is entitled to receive |
payment of the services or compensation. Provided the employer |
continues to pay compensation pursuant to paragraph (b) of |
Section 8, the employer may at any time petition for an |
expedited hearing on the issue of whether or not the employee |
is entitled to receive medical, surgical, or hospital services |
or other services or compensation as provided in paragraph (a) |
of Section 8, or compensation as provided in paragraph (b) of |
Section 8. When an employer has petitioned for an expedited |
hearing, the employer shall continue to pay compensation as |
provided in paragraph (b) of Section 8 unless the arbitrator |
renders a decision that the employee is not entitled to the |
benefits that are the subject of the expedited hearing or |
unless the employee's treating physician has released the |
employee to return to work at his or her regular job with the |
employer or the employee actually returns to work at any other |
job. If the arbitrator renders a decision that the employee is |
not entitled to the benefits that are the subject of the |
expedited hearing, a petition for review filed by the employee |
shall receive the same priority as if the employee had filed a |
|
petition for an expedited hearing by an Arbitrator. Neither |
party shall be entitled to an expedited hearing when the |
employee has returned to work and the sole issue in dispute |
amounts to less than 12 weeks of unpaid compensation pursuant |
to paragraph (b) of Section 8. |
Expedited hearings shall have priority over all other |
petitions and shall be heard by the Arbitrator and Commission |
with all convenient speed. Any party requesting an expedited |
hearing shall give notice of a request for an expedited |
hearing under this paragraph. A copy of the Application for |
Adjustment of Claim shall be attached to the notice. The |
Commission shall adopt rules and procedures under which the |
final decision of the Commission under this paragraph is filed |
not later than 180 days from the date that the Petition for |
Review is filed with the Commission. |
Where 2 or more insurance carriers, private self-insureds, |
or a group workers' compensation pool under Article V 3/4 of |
the Illinois Insurance Code dispute coverage for the same |
injury, any such insurance carrier, private self-insured, or |
group workers' compensation pool may request an expedited |
hearing pursuant to this paragraph to determine the issue of |
coverage, provided coverage is the only issue in dispute and |
all other issues are stipulated and agreed to and further |
provided that all compensation benefits including medical |
benefits pursuant to Section 8(a) continue to be paid to or on |
behalf of petitioner. Any insurance carrier, private |
|
self-insured, or group workers' compensation pool that is |
determined to be liable for coverage for the injury in issue |
shall reimburse any insurance carrier, private self-insured, |
or group workers' compensation pool that has paid benefits to |
or on behalf of petitioner for the injury.
|
(b-1) If the employee is not receiving medical, surgical |
or hospital
services as provided in paragraph (a) of Section 8 |
or compensation as
provided in paragraph (b) of Section 8, the |
employee, in accordance with
Commission Rules, may file a |
petition for an emergency hearing by an
Arbitrator on the |
issue of whether or not he is entitled to receive payment
of |
such compensation or services as provided therein. Such |
petition shall
have priority over all other petitions and |
shall be heard by the Arbitrator
and Commission with all |
convenient speed.
|
Such petition shall contain the following information and |
shall be served
on the employer at least 15 days before it is |
filed:
|
(i) the date and approximate time of accident;
|
(ii) the approximate location of the accident;
|
(iii) a description of the accident;
|
(iv) the nature of the injury incurred by the |
employee;
|
(v) the identity of the person, if known, to whom the |
accident was
reported and the date on which it was |
reported;
|
|
(vi) the name and title of the person, if known, |
representing the
employer with whom the employee conferred |
in any effort to obtain
compensation pursuant to paragraph |
(b) of Section 8 of this Act or medical,
surgical or |
hospital services pursuant to paragraph (a) of Section 8 |
of
this Act and the date of such conference;
|
(vii) a statement that the employer has refused to pay |
compensation
pursuant to paragraph (b) of Section 8 of |
this Act or for medical, surgical
or hospital services |
pursuant to paragraph (a) of Section 8 of this Act;
|
(viii) the name and address, if known, of each witness |
to the accident
and of each other person upon whom the |
employee will rely to support his
allegations;
|
(ix) the dates of treatment related to the accident by |
medical
practitioners, and the names and addresses of such |
practitioners, including
the dates of treatment related to |
the accident at any hospitals and the
names and addresses |
of such hospitals, and a signed authorization
permitting |
the employer to examine all medical records of all |
practitioners
and hospitals named pursuant to this |
paragraph;
|
(x) a copy of a signed report by a medical |
practitioner, relating to the
employee's current inability |
to return to work because of the injuries
incurred as a |
result of the accident or such other documents or |
affidavits
which show that the employee is entitled to |
|
receive compensation pursuant
to paragraph (b) of Section |
8 of this Act or medical, surgical or hospital
services |
pursuant to paragraph (a) of Section 8 of this Act. Such |
reports,
documents or affidavits shall state, if possible, |
the history of the
accident given by the employee, and |
describe the injury and medical
diagnosis, the medical |
services for such injury which the employee has
received |
and is receiving, the physical activities which the |
employee
cannot currently perform as a result of any |
impairment or disability due to
such injury, and the |
prognosis for recovery;
|
(xi) complete copies of any reports, records, |
documents and affidavits
in the possession of the employee |
on which the employee will rely to
support his |
allegations, provided that the employer shall pay the
|
reasonable cost of reproduction thereof;
|
(xii) a list of any reports, records, documents and |
affidavits which
the employee has demanded by subpoena and |
on which he intends to
rely to support his allegations;
|
(xiii) a certification signed by the employee or his |
representative that
the employer has received the petition |
with the required information 15
days before filing.
|
Fifteen days after receipt by the employer of the petition |
with the
required information the employee may file said |
petition and required
information and shall serve notice of |
the filing upon the employer. The
employer may file a motion |
|
addressed to the sufficiency of the petition.
If an objection |
has been filed to the sufficiency of the petition, the
|
arbitrator shall rule on the objection within 2 working days. |
If such an
objection is filed, the time for filing the final |
decision of the
Commission as provided in this paragraph shall |
be tolled until the
arbitrator has determined that the |
petition is sufficient.
|
The employer shall, within 15 days after receipt of the |
notice that such
petition is filed, file with the Commission |
and serve on the employee or
his representative a written |
response to each claim set forth in the
petition, including |
the legal and factual basis for each disputed
allegation and |
the following information: (i) complete copies of any
reports, |
records, documents and affidavits in the possession of the
|
employer on which the employer intends to rely in support of |
his response,
(ii) a list of any reports, records, documents |
and affidavits which the
employer has demanded by subpoena and |
on which the employer intends to rely
in support of his |
response, (iii) the name and address of each witness on
whom |
the employer will rely to support his response, and (iv) the |
names and
addresses of any medical practitioners selected by |
the employer pursuant to
Section 12 of this Act and the time |
and place of any examination scheduled
to be made pursuant to |
such Section.
|
Any employer who does not timely file and serve a written |
response
without good cause may not introduce any evidence to |
|
dispute any claim of
the employee but may cross examine the |
employee or any witness brought by
the employee and otherwise |
be heard.
|
No document or other evidence not previously identified by |
either party
with the petition or written response, or by any |
other means before the
hearing, may be introduced into |
evidence without good cause.
If, at the hearing, material |
information is discovered which was
not previously disclosed, |
the Arbitrator may extend the time for closing
proof on the |
motion of a party for a reasonable period of time which may
be |
more than 30 days. No evidence may be introduced pursuant
to |
this paragraph as to permanent disability. No award may be |
entered for
permanent disability pursuant to this paragraph. |
Either party may introduce
into evidence the testimony taken |
by deposition of any medical practitioner.
|
The Commission shall adopt rules, regulations and |
procedures whereby the
final decision of the Commission is |
filed not later than 90 days from the
date the petition for |
review is filed but in no event later than 180 days from
the |
date the petition for an emergency hearing is filed with the |
Illinois Workers' Compensation
Commission.
|
All service required pursuant to this paragraph (b-1) must |
be by personal
service or by certified mail and with evidence |
of receipt. In addition for
the purposes of this paragraph, |
all service on the employer must be at the
premises where the |
accident occurred if the premises are owned or operated
by the |
|
employer. Otherwise service must be at the employee's |
principal
place of employment by the employer. If service on |
the employer is not
possible at either of the above, then |
service shall be at the employer's
principal place of |
business. After initial service in each case, service
shall be |
made on the employer's attorney or designated representative.
|
(c)(1) At a reasonable time in advance of and in |
connection with the
hearing under Section 19(e) or 19(h), the |
Commission may on its own motion
order an impartial physical |
or mental examination of a petitioner whose
mental or physical |
condition is in issue, when in the Commission's
discretion it |
appears that such an examination will materially aid in the
|
just determination of the case. The examination shall be made |
by a member
or members of a panel of physicians chosen for |
their special qualifications
by the Illinois State Medical |
Society. The Commission shall establish
procedures by which a |
physician shall be selected from such list.
|
(2) Should the Commission at any time during the hearing |
find that
compelling considerations make it advisable to have |
an examination and
report at that time, the commission may in |
its discretion so order.
|
(3) A copy of the report of examination shall be given to |
the Commission
and to the attorneys for the parties.
|
(4) Either party or the Commission may call the examining |
physician or
physicians to testify. Any physician so called |
shall be subject to
cross-examination.
|
|
(5) The examination shall be made, and the physician or |
physicians, if
called, shall testify, without cost to the |
parties. The Commission shall
determine the compensation and |
the pay of the physician or physicians. The
compensation for |
this service shall not exceed the usual and customary amount
|
for such service.
|
(6) The fees and payment thereof of all attorneys and |
physicians for
services authorized by the Commission under |
this Act shall, upon request
of either the employer or the |
employee or the beneficiary affected, be
subject to the review |
and decision of the Commission.
|
(d) If any employee shall persist in insanitary or |
injurious
practices which tend to either imperil or retard his |
recovery or shall
refuse to submit to such medical, surgical, |
or hospital treatment as is
reasonably essential to promote |
his recovery, the Commission may, in its
discretion, reduce or |
suspend the compensation of any such injured
employee. |
However, when an employer and employee so agree in writing,
|
the foregoing provision shall not be construed to authorize |
the
reduction or suspension of compensation of an employee who |
is relying in
good faith, on treatment by prayer or spiritual |
means alone, in
accordance with the tenets and practice of a |
recognized church or
religious denomination, by a duly |
accredited practitioner thereof.
|
(e) This paragraph shall apply to all hearings before the |
Commission.
Such hearings may be held in its office or |
|
elsewhere as the Commission
may deem advisable. The taking of |
testimony on such hearings may be had
before any member of the |
Commission. If a petition for review and agreed
statement of |
facts or transcript of evidence is filed, as provided herein,
|
the Commission shall promptly review the decision of the |
Arbitrator and all
questions of law or fact which appear from |
the statement of facts or
transcript of evidence.
|
In all cases in which the hearing before the arbitrator is |
held after
December 18, 1989, no additional evidence shall be |
introduced by the
parties before the Commission on review of |
the decision of the Arbitrator.
In reviewing decisions of an |
arbitrator the Commission shall award such
temporary |
compensation, permanent compensation and other payments as are
|
due under this Act. The Commission shall file in its office its |
decision
thereon, and shall immediately send to each party or |
his attorney a copy of
such decision and a notification of the |
time when it was filed. Decisions
shall be filed within 60 days |
after the Statement of Exceptions and
Supporting Brief and |
Response thereto are required to be filed or oral
argument |
whichever is later.
|
In the event either party requests oral argument, such |
argument shall be
had before a panel of 3 members of the |
Commission (or before all available
members pursuant to the |
determination of 7 members of the Commission that
such |
argument be held before all available members of the |
Commission)
pursuant to the rules and regulations of the |
|
Commission. A panel of 3
members, which shall be comprised of |
not more than one representative
citizen of the employing |
class and not more than one representative from a labor |
organization recognized under the National Labor Relations Act |
or an attorney who has represented labor organizations or has |
represented employees in workers' compensation cases, shall |
hear the argument; provided that if all the
issues in dispute |
are solely the nature and extent of the permanent partial
|
disability, if any, a majority of the panel may deny the |
request for such
argument and such argument shall not be held; |
and provided further that 7
members of the Commission may |
determine that the argument be held before
all available |
members of the Commission. A decision of the Commission
shall |
be approved by a majority of Commissioners present at such |
hearing if
any; provided, if no such hearing is held, a |
decision of the Commission
shall be approved by a majority of a |
panel of 3 members of the Commission
as described in this |
Section. The Commission shall give 10 days' notice to
the |
parties or their attorneys of the time and place of such taking |
of
testimony and of such argument.
|
In any case the Commission in its decision may find |
specially
upon any question or questions of law or fact which |
shall be submitted
in writing by either party whether ultimate |
or otherwise;
provided that on issues other than nature and |
extent of the disability,
if any, the Commission in its |
decision shall find specially upon any
question or questions |
|
of law or fact, whether ultimate or otherwise,
which are |
submitted in writing by either party; provided further that
|
not more than 5 such questions may be submitted by either |
party. Any
party may, within 20 days after receipt of notice of |
the Commission's
decision, or within such further time, not |
exceeding 30 days, as the
Commission may grant, file with the |
Commission either an agreed
statement of the facts appearing |
upon the hearing, or, if such party
shall so elect, a correct |
transcript of evidence of the additional
proceedings presented |
before the Commission, in which report the party
may embody a |
correct statement of such other proceedings in the case as
|
such party may desire to have reviewed, such statement of |
facts or
transcript of evidence to be authenticated by the |
signature of the
parties or their attorneys, and in the event |
that they do not agree,
then the authentication of such |
transcript of evidence shall be by the
signature of any member |
of the Commission.
|
If a reporter does not for any reason furnish a transcript |
of the
proceedings before the Arbitrator in any case for use on |
a hearing for
review before the Commission, within the |
limitations of time as fixed in
this Section, the Commission |
may, in its discretion, order a trial de
novo before the |
Commission in such case upon application of either
party. The |
applications for adjustment of claim and other documents in
|
the nature of pleadings filed by either party, together with |
the
decisions of the Arbitrator and of the Commission and the |
|
statement of
facts or transcript of evidence hereinbefore |
provided for in paragraphs
(b) and (c) shall be the record of |
the proceedings of the Commission,
and shall be subject to |
review as hereinafter provided.
|
At the request of either party or on its own motion, the |
Commission shall
set forth in writing the reasons for the |
decision, including findings of
fact and conclusions of law |
separately stated. The Commission shall by rule
adopt a format |
for written decisions for the Commission and arbitrators.
The |
written decisions shall be concise and shall succinctly state |
the facts
and reasons for the decision. The Commission may |
adopt in whole or in part,
the decision of the arbitrator as |
the decision of the Commission. When the
Commission does so |
adopt the decision of the arbitrator, it shall do so by
order. |
Whenever the Commission adopts part of the arbitrator's |
decision,
but not all, it shall include in the order the |
reasons for not adopting all
of the arbitrator's decision. |
When a majority of a panel, after
deliberation, has arrived at |
its decision, the decision shall be filed as
provided in this |
Section without unnecessary delay, and without regard to
the |
fact that a member of the panel has expressed an intention to |
dissent.
Any member of the panel may file a dissent. Any |
dissent shall be filed no
later than 10 days after the decision |
of the majority has been filed.
|
Decisions rendered by the Commission and dissents, if any, |
shall be
published together by the Commission. The conclusions |
|
of law set out in
such decisions shall be regarded as |
precedents by arbitrators for the purpose
of achieving a more |
uniform administration of this Act.
|
(f) The decision of the Commission acting within its |
powers,
according to the provisions of paragraph (e) of this |
Section shall, in
the absence of fraud, be conclusive unless |
reviewed as in this paragraph
hereinafter provided. However, |
the Arbitrator or the Commission may on
his or its own motion, |
or on the motion of either party, correct any
clerical error or |
errors in computation within 15 days after the date of
receipt |
of any award by such Arbitrator or any decision on review of |
the
Commission and shall have the power to recall the original |
award on
arbitration or decision on review, and issue in lieu |
thereof such
corrected award or decision. Where such |
correction is made the time for
review herein specified shall |
begin to run from the date of
the receipt of the corrected |
award or decision.
|
(1) Except in cases of claims against the State of |
Illinois other than those claims under Section 18.1, in
|
which case the decision of the Commission shall not be |
subject to
judicial review, the Circuit Court of the |
county where any of the
parties defendant may be found, or |
if none of the parties defendant can
be found in this State |
then the Circuit Court of the county where the
accident |
occurred, shall by summons to the Commission have
power to |
review all questions of law and fact presented by such |
|
record.
|
A proceeding for review shall be commenced within 20 |
days of
the receipt of notice of the decision of the |
Commission. The summons shall
be issued by the clerk of |
such court upon written request returnable on a
designated |
return day, not less than 10 or more than 60 days from the |
date
of issuance thereof, and the written request shall |
contain the last known
address of other parties in |
interest and their attorneys of record who are
to be |
served by summons. Service upon any member of the |
Commission or the
Secretary or the Assistant Secretary |
thereof shall be service upon the
Commission, and service |
upon other parties in interest and their attorneys
of |
record shall be by summons, and such service shall be made |
upon the
Commission and other parties in interest by |
mailing notices of the
commencement of the proceedings and |
the return day of the summons to the
office of the |
Commission and to the last known place of residence of |
other
parties in interest or their attorney or attorneys |
of record. The clerk of
the court issuing the summons |
shall on the day of issue mail notice of the
commencement |
of the proceedings which shall be done by mailing a copy of
|
the summons to the office of the Commission, and a copy of |
the summons to
the other parties in interest or their |
attorney or attorneys of record and
the clerk of the court |
shall make certificate that he has so sent said
notices in |
|
pursuance of this Section, which shall be evidence of |
service on
the Commission and other parties in interest.
|
The Commission shall not be required to certify the |
record of their
proceedings to the Circuit Court, unless |
the party commencing the
proceedings for review in the |
Circuit Court as above provided, shall file with the |
Commission notice of intent to file for review in Circuit |
Court. It shall be the duty
of the Commission upon such |
filing of notice of intent to file for review in the |
Circuit Court to prepare a true and correct
copy of such |
testimony and a true and correct copy of all other matters
|
contained in such record and certified to by the Secretary |
or Assistant
Secretary thereof. The changes made to this |
subdivision (f)(1) by this amendatory Act of the 98th |
General Assembly apply to any Commission decision entered |
after the effective date of this amendatory Act of the |
98th General Assembly.
|
No request for a summons
may be filed and no summons |
shall issue unless the party seeking to review
the |
decision of the Commission shall exhibit to the clerk of |
the Circuit
Court proof of filing with the Commission of |
the notice of the intent to file for review in the Circuit |
Court or an affidavit
of the attorney setting forth that |
notice of intent to file for review in the Circuit Court |
has been given in writing to the Secretary or Assistant |
Secretary of the Commission.
|
|
(2) No such summons shall issue unless the one against |
whom the
Commission shall have rendered an award for the |
payment of money shall upon
the filing of his written |
request for such summons file with the clerk of
the court a |
bond conditioned that if he shall not successfully
|
prosecute the review, he will pay the award and the costs |
of the
proceedings in the courts. The amount of the bond |
shall be fixed by any
member of the Commission and the |
surety or sureties of the bond shall be
approved by the |
clerk of the court. The acceptance of the bond by the
clerk |
of the court shall constitute evidence of his approval of |
the bond.
|
The following Every county, city, town, township, |
incorporated village, school
district, body politic or |
municipal corporation against whom the
Commission shall |
have rendered an award for the payment of money shall
not |
be required to file a bond to secure the payment of the |
award and
the costs of the proceedings in the court to |
authorize the court to
issue such summons : .
|
(1) the State Treasurer, for a fund administered |
by the State Treasurer ex officio against whom the |
Commission shall have rendered an award for the |
payment of money; and |
(2) a county, city, town, township, incorporated |
village, school district, body politic, or municipal |
corporation against whom the Commission shall have |
|
rendered an award for the payment of money. |
The court may confirm or set aside the decision of the |
Commission. If
the decision is set aside and the facts |
found in the proceedings before
the Commission are |
sufficient, the court may enter such decision as is
|
justified by law, or may remand the cause to the |
Commission for further
proceedings and may state the |
questions requiring further hearing, and
give such other |
instructions as may be proper. Appeals shall be taken
to |
the Appellate Court in accordance
with Supreme Court Rules |
22(g) and 303. Appeals
shall be taken from the Appellate
|
Court to the Supreme Court in accordance with Supreme |
Court Rule 315.
|
It shall be the duty of the clerk of any court |
rendering a decision
affecting or affirming an award of |
the Commission to promptly furnish
the Commission with a |
copy of such decision, without charge.
|
The decision of a majority of the members of the panel |
of the Commission,
shall be considered the decision of the |
Commission.
|
(g) Except in the case of a claim against the State of |
Illinois,
either party may present a certified copy of the |
award of the
Arbitrator, or a certified copy of the decision of |
the Commission when
the same has become final, when no |
proceedings for review are pending,
providing for the payment |
of compensation according to this Act, to the
Circuit Court of |
|
the county in which such accident occurred or either of
the |
parties are residents, whereupon the court shall enter a |
judgment
in accordance therewith. In a case where the employer |
refuses to pay
compensation according to such final award or |
such final decision upon
which such judgment is entered the |
court shall in entering judgment
thereon, tax as costs against |
him the reasonable costs and attorney fees
in the arbitration |
proceedings and in the court entering the judgment
for the |
person in whose favor the judgment is entered, which judgment
|
and costs taxed as therein provided shall, until and unless |
set aside,
have the same effect as though duly entered in an |
action duly tried and
determined by the court, and shall with |
like effect, be entered and
docketed. The Circuit Court shall |
have power at any time upon
application to make any such |
judgment conform to any modification
required by any |
subsequent decision of the Supreme Court upon appeal, or
as |
the result of any subsequent proceedings for review, as |
provided in
this Act.
|
Judgment shall not be entered until 15 days' notice of the |
time and
place of the application for the entry of judgment |
shall be served upon
the employer by filing such notice with |
the Commission, which Commission
shall, in case it has on file |
the address of the employer or the name
and address of its |
agent upon whom notices may be served, immediately
send a copy |
of the notice to the employer or such designated agent.
|
(h) An agreement or award under this Act providing for |
|
compensation
in installments, may at any time within 18 months |
after such agreement
or award be reviewed by the Commission at |
the request of either the
employer or the employee, on the |
ground that the disability of the
employee has subsequently |
recurred, increased, diminished or ended.
|
However, as to accidents occurring subsequent to July 1, |
1955, which
are covered by any agreement or award under this |
Act providing for
compensation in installments made as a |
result of such accident, such
agreement or award may at any |
time within 30 months, or 60 months in the case of an award |
under Section 8(d)1, after such agreement
or award be reviewed |
by the Commission at the request of either the
employer or the |
employee on the ground that the disability of the
employee has |
subsequently recurred, increased, diminished or ended.
|
On such review, compensation payments may be |
re-established,
increased, diminished or ended. The Commission |
shall give 15 days'
notice to the parties of the hearing for |
review. Any employee, upon any
petition for such review being |
filed by the employer, shall be entitled
to one day's notice |
for each 100 miles necessary to be traveled by him in
attending |
the hearing of the Commission upon the petition, and 3 days in
|
addition thereto. Such employee shall, at the discretion of |
the
Commission, also be entitled to 5 cents per mile |
necessarily traveled by
him within the State of Illinois in |
attending such hearing, not to
exceed a distance of 300 miles, |
to be taxed by the Commission as costs
and deposited with the |
|
petition of the employer.
|
When compensation which is payable in accordance with an |
award or
settlement contract approved by the Commission, is |
ordered paid in a
lump sum by the Commission, no review shall |
be had as in this paragraph
mentioned.
|
(i) Each party, upon taking any proceedings or steps |
whatsoever
before any Arbitrator, Commission or court, shall |
file with the Commission
his address, or the name and address |
of any agent upon whom all notices to
be given to such party |
shall be served, either personally or by registered
mail, |
addressed to such party or agent at the last address so filed |
with
the Commission. In the event such party has not filed his |
address, or the
name and address of an agent as above provided, |
service of any notice may
be had by filing such notice with the |
Commission.
|
(j) Whenever in any proceeding testimony has been taken or |
a final
decision has been rendered and after the taking of such |
testimony or
after such decision has become final, the injured |
employee dies, then in
any subsequent proceedings brought by |
the personal representative or
beneficiaries of the deceased |
employee, such testimony in the former
proceeding may be |
introduced with the same force and effect as though
the |
witness having so testified were present in person in such
|
subsequent proceedings and such final decision, if any, shall |
be taken
as final adjudication of any of the issues which are |
the same in both
proceedings.
|
|
(k) In case where there has been any unreasonable or |
vexatious delay
of payment or intentional underpayment of |
compensation, or proceedings
have been instituted or carried |
on by the one liable to pay the
compensation, which do not |
present a real controversy, but are merely
frivolous or for |
delay, then the Commission may award compensation
additional |
to that otherwise payable under this Act equal to 50% of the
|
amount payable at the time of such award. Failure to pay |
compensation
in accordance with the provisions of Section 8, |
paragraph (b) of this
Act, shall be considered unreasonable |
delay.
|
When determining whether this subsection (k) shall apply, |
the
Commission shall consider whether an Arbitrator has |
determined
that the claim is not compensable or whether the |
employer has
made payments under Section 8(j). |
(l) If the employee has made written demand for payment of
|
benefits under Section 8(a) or Section 8(b), the employer |
shall
have 14 days after receipt of the demand to set forth in
|
writing the reason for the delay. In the case of demand for
|
payment of medical benefits under Section 8(a), the time for
|
the employer to respond shall not commence until the |
expiration
of the allotted 30 days specified under Section |
8.2(d). In case
the employer or his or her insurance carrier |
shall without good and
just cause fail, neglect, refuse, or |
unreasonably delay the
payment of benefits under Section 8(a) |
or Section 8(b), the
Arbitrator or the Commission shall allow |
|
to the employee
additional compensation in the sum of $30 per |
day for each day
that the benefits under Section 8(a) or |
Section 8(b) have been
so withheld or refused, not to exceed |
$10,000.
A delay in payment of 14 days or more
shall create a |
rebuttable presumption of unreasonable delay.
|
(m) If the commission finds that an accidental injury was |
directly
and proximately caused by the employer's wilful |
violation of a health
and safety standard under the Health and |
Safety Act or the Occupational Safety and Health Act in force |
at the time of the
accident, the arbitrator or the Commission |
shall allow to the injured
employee or his dependents, as the |
case may be, additional compensation
equal to 25% of the |
amount which otherwise would be payable under the
provisions |
of this Act exclusive of this paragraph. The additional
|
compensation herein provided shall be allowed by an |
appropriate increase
in the applicable weekly compensation |
rate.
|
(n) After June 30, 1984, decisions of the Illinois |
Workers' Compensation Commission
reviewing an award of an |
arbitrator of the Commission shall draw interest
at a rate |
equal to the yield on indebtedness issued by the United States
|
Government with a 26-week maturity next previously auctioned |
on the day on
which the decision is filed. Said rate of |
interest shall be set forth in
the Arbitrator's Decision. |
Interest shall be drawn from the date of the
arbitrator's |
award on all accrued compensation due the employee through the
|
|
day prior to the date of payments. However, when an employee |
appeals an
award of an Arbitrator or the Commission, and the |
appeal results in no
change or a decrease in the award, |
interest shall not further accrue from
the date of such |
appeal.
|
The employer or his insurance carrier may tender the |
payments due under
the award to stop the further accrual of |
interest on such award
notwithstanding the prosecution by |
either party of review, certiorari,
appeal to the Supreme |
Court or other steps to reverse, vacate or modify
the award.
|
(o) By the 15th day of each month each insurer providing |
coverage for
losses under this Act shall notify each insured |
employer of any compensable
claim incurred during the |
preceding month and the amounts paid or reserved
on the claim |
including a summary of the claim and a brief statement of the
|
reasons for compensability. A cumulative report of all claims |
incurred
during a calendar year or continued from the previous |
year shall be
furnished to the insured employer by the insurer |
within 30 days after the
end of that calendar year.
|
The insured employer may challenge, in proceeding before |
the Commission,
payments made by the insurer without |
arbitration and payments
made after a case is determined to be |
noncompensable. If the Commission
finds that the case was not |
compensable, the insurer shall purge its records
as to that |
employer of any loss or expense associated with the claim, |
reimburse
the employer for attorneys' fees arising from the |
|
challenge and for any
payment required of the employer to the |
Rate Adjustment Fund or the
Second Injury Fund, and may not |
reflect the loss or expense for rate making
purposes. The |
employee shall not be required to refund the challenged
|
payment. The decision of the Commission may be reviewed in the |
same manner
as in arbitrated cases. No challenge may be |
initiated under this paragraph
more than 3 years after the |
payment is made. An employer may waive the
right of challenge |
under this paragraph on a case by case basis.
|
(p) After filing an application for adjustment of claim |
but prior to
the hearing on arbitration the parties may |
voluntarily agree to submit such
application for adjustment of |
claim for decision by an arbitrator under
this subsection (p) |
where such application for adjustment of claim raises
only a |
dispute over temporary total disability, permanent partial
|
disability or medical expenses. Such agreement shall be in |
writing in such
form as provided by the Commission. |
Applications for adjustment of claim
submitted for decision by |
an arbitrator under this subsection (p) shall
proceed |
according to rule as established by the Commission. The |
Commission
shall promulgate rules including, but not limited |
to, rules to ensure that
the parties are adequately informed |
of their rights under this subsection
(p) and of the voluntary |
nature of proceedings under this subsection (p).
The findings |
of fact made by an arbitrator acting within his or her powers
|
under this subsection (p) in the absence of fraud shall be |
|
conclusive.
However, the arbitrator may on his own motion, or |
the motion of either
party, correct any clerical errors or |
errors in computation within 15 days
after the date of receipt |
of such award of the arbitrator
and shall have the power to |
recall the original award on arbitration, and
issue in lieu |
thereof such corrected award.
The decision of the arbitrator |
under this subsection (p) shall be
considered the decision of |
the Commission and proceedings for review of
questions of law |
arising from the decision may be commenced by either party
|
pursuant to subsection (f) of Section 19. The Advisory Board |
established
under Section 13.1 shall compile a list of |
certified Commission
arbitrators, each of whom shall be |
approved by at least 7 members of the
Advisory Board. The |
chairman shall select 5 persons from such list to
serve as |
arbitrators under this subsection (p). By agreement, the |
parties
shall select one arbitrator from among the 5 persons |
selected by the
chairman except that if the parties do not |
agree on an arbitrator from
among the 5 persons, the parties |
may, by agreement, select an arbitrator of
the American |
Arbitration Association, whose fee shall be paid by the State
|
in accordance with rules promulgated by the Commission. |
Arbitration under
this subsection (p) shall be voluntary.
|
(Source: P.A. 101-384, eff. 1-1-20 .)
|
Section 45. The Workers' Occupational Diseases Act is |
amended by changing Section 19 as follows:
|
|
(820 ILCS 310/19) (from Ch. 48, par. 172.54)
|
Sec. 19. Any disputed questions of law or fact shall be |
determined as
herein provided.
|
(a) It shall be the duty of the Commission upon |
notification that
the parties have failed to reach an |
agreement to designate an
Arbitrator.
|
(1) The application for adjustment of claim filed with |
the
Commission shall state:
|
A. The approximate date of the last day of the last |
exposure and the
approximate date of the disablement.
|
B. The general nature and character of the illness |
or disease
claimed.
|
C. The name and address of the employer by whom |
employed on the last
day of the last exposure and if |
employed by any other employer after
such last |
exposure and before disablement the name and address |
of such
other employer or employers.
|
D. In case of death, the date and place of death.
|
(2) Amendments to applications for adjustment of claim |
which relate
to the same disablement or disablement |
resulting in death originally
claimed upon may be allowed |
by the Commissioner or an Arbitrator
thereof, in their |
discretion, and in the exercise of such discretion,
they |
may in proper cases order a trial de novo; such amendment |
shall
relate back to the date of the filing of the original |
|
application so
amended.
|
(3) Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under this |
Act and it is
subsequently discovered, at any time before |
final disposition of such
cause, that the claim for |
disability or death which was the basis for
such |
application should properly have been made under the |
Workers'
Compensation Act, then the provisions of Section |
19 paragraph (a-1) of
the Workers' Compensation Act having |
reference to such application shall
apply.
|
Whenever any claimant misconceives his remedy and |
files an
application for adjustment of claim under the |
Workers' Compensation Act
and it is subsequently |
discovered, at any time before final disposition
of such |
cause that the claim for injury or death which was the |
basis for
such application should properly have been made |
under this Act, then the
application so filed under the |
Workers' Compensation Act may be amended
in form, |
substance or both to assert claim for such disability or |
death
under this Act and it shall be deemed to have been so |
filed as amended
on the date of the original filing |
thereof, and such compensation may be
awarded as is |
warranted by the whole evidence pursuant to the provisions
|
of this Act. When such amendment is submitted, further or |
additional
evidence may be heard by the Arbitrator or |
Commission when deemed
necessary; provided, that nothing |
|
in this Section contained shall be
construed to be or |
permit a waiver of any provisions of this Act with
|
reference to notice, but notice if given shall be deemed |
to be a notice
under the provisions of this Act if given |
within the time required
herein.
|
(b) The Arbitrator shall make such inquiries and |
investigations as he
shall deem necessary and may examine and |
inspect all books, papers,
records, places, or premises |
relating to the questions in dispute and hear
such proper |
evidence as the parties may submit.
|
The hearings before the Arbitrator shall be held in the |
vicinity where
the last exposure occurred, after 10 days' |
notice of the time and place of
such hearing shall have been |
given to each of the parties or their attorneys of record.
|
The Arbitrator may find that the disabling condition is |
temporary and has
not yet reached a permanent condition and |
may order the payment of
compensation up to the date of the |
hearing, which award shall be reviewable
and enforceable in |
the same manner as other awards, and in no instance be a
bar to |
a further hearing and determination of a further amount of |
temporary
total compensation or of compensation for permanent |
disability, but shall
be conclusive as to all other questions |
except the nature and extent of such
disability.
|
The decision of the Arbitrator shall be filed with the |
Commission which
Commission shall immediately send to each |
party or his attorney a copy of
such decision, together with a |
|
notification of the time when it was filed.
As of the effective |
date of this amendatory Act of the 94th General Assembly, all |
decisions of the Arbitrator shall set forth
in writing |
findings of fact and conclusions of law, separately stated, if |
requested by either party.
Unless a petition for review is |
filed by either party within 30 days after
the receipt by such |
party of the copy of the decision and notification of
time when |
filed, and unless such party petitioning for a review shall
|
within 35 days after the receipt by him of the copy of the |
decision, file
with the Commission either an agreed statement |
of the facts appearing upon
the hearing before the Arbitrator, |
or if such party shall so elect a
correct transcript of |
evidence of the proceedings at such hearings, then
the |
decision shall become the decision of the Commission and in |
the absence
of fraud shall be conclusive. The Petition for |
Review shall contain a
statement of the petitioning party's |
specific exceptions to the decision of
the arbitrator. The |
jurisdiction of the Commission to review the decision
of the |
arbitrator shall not be limited to the exceptions stated in |
the
Petition for Review. The Commission, or any member |
thereof, may grant
further time not exceeding 30 days, in |
which to file such agreed statement
or transcript of evidence. |
Such agreed statement of facts or correct
transcript of |
evidence, as the case may be, shall be authenticated by the
|
signatures of the parties or their attorneys, and in the event |
they do not
agree as to the correctness of the transcript of |
|
evidence it shall be
authenticated by the signature of the |
Arbitrator designated by the Commission.
|
Whether the employee is working or not, if the employee is |
not receiving or has not received medical, surgical, or |
hospital services or other services or compensation as |
provided in paragraph (a) of Section 8 of the Workers' |
Compensation
Act, or compensation as provided in paragraph (b) |
of Section 8 of the Workers' Compensation
Act, the employee |
may at any time petition for an expedited hearing by an |
Arbitrator on the issue of whether or not he or she is entitled |
to receive payment of the services or compensation. Provided |
the employer continues to pay compensation pursuant to |
paragraph (b) of Section 8 of the Workers' Compensation
Act, |
the employer may at any time petition for an expedited hearing |
on the issue of whether or not the employee is entitled to |
receive medical, surgical, or hospital services or other |
services or compensation as provided in paragraph (a) of |
Section 8 of the Workers' Compensation
Act, or compensation as |
provided in paragraph (b) of Section 8 of the Workers' |
Compensation
Act. When an employer has petitioned for an |
expedited hearing, the employer shall continue to pay |
compensation as provided in paragraph (b) of Section 8 of the |
Workers' Compensation
Act unless the arbitrator renders a |
decision that the employee is not entitled to the benefits |
that are the subject of the expedited hearing or unless the |
employee's treating physician has released the employee to |
|
return to work at his or her regular job with the employer or |
the employee actually returns to work at any other job. If the |
arbitrator renders a decision that the employee is not |
entitled to the benefits that are the subject of the expedited |
hearing, a petition for review filed by the employee shall |
receive the same priority as if the employee had filed a |
petition for an expedited hearing by an arbitrator. Neither |
party shall be entitled to an expedited hearing when the |
employee has returned to work and the sole issue in dispute |
amounts to less than 12 weeks of unpaid compensation pursuant |
to paragraph (b) of Section 8 of the Workers' Compensation
|
Act. |
Expedited hearings shall have priority over all other |
petitions and shall be heard by the Arbitrator and Commission |
with all convenient speed. Any party requesting an expedited |
hearing shall give notice of a request for an expedited |
hearing under this paragraph. A copy of the Application for |
Adjustment of Claim shall be attached to the notice. The |
Commission shall adopt rules and procedures under which the |
final decision of the Commission under this paragraph is filed |
not later than 180 days from the date that the Petition for |
Review is filed with the Commission. |
Where 2 or more insurance carriers, private self-insureds, |
or a group workers' compensation pool under Article V 3/4 of |
the Illinois Insurance Code dispute coverage for the same |
disease, any such insurance carrier, private self-insured, or |
|
group workers' compensation pool may request an expedited |
hearing pursuant to this paragraph to determine the issue of |
coverage, provided coverage is the only issue in dispute and |
all other issues are stipulated and agreed to and further |
provided that all compensation benefits including medical |
benefits pursuant to Section 8(a) of the Workers' Compensation
|
Act continue to be paid to or on behalf of petitioner. Any |
insurance carrier, private self-insured, or group workers' |
compensation pool that is determined to be liable for coverage |
for the disease in issue shall reimburse any insurance |
carrier, private self-insured, or group workers' compensation |
pool that has paid benefits to or on behalf of petitioner for |
the disease.
|
(b-1) If the employee is not receiving, pursuant to |
Section 7, medical,
surgical or hospital services of the type |
provided for in paragraph (a) of
Section 8 of the Workers' |
Compensation Act or compensation of the type
provided for in |
paragraph (b) of Section 8 of the Workers' Compensation
Act, |
the employee, in accordance with Commission Rules, may file a |
petition
for an emergency hearing by an Arbitrator on the |
issue of whether or not he
is entitled to receive payment of |
such compensation or services as provided
therein. Such |
petition shall have priority over all other petitions and
|
shall be heard by the Arbitrator and Commission with all |
convenient speed.
|
Such petition shall contain the following information and |
|
shall be served
on the employer at least 15 days before it is |
filed:
|
(i) the date and approximate time of the last |
exposure;
|
(ii) the approximate location of the last exposure;
|
(iii) a description of the last exposure;
|
(iv) the nature of the disability incurred by the |
employee;
|
(v) the identity of the person, if known, to whom the |
disability was
reported and the date on which it was |
reported;
|
(vi) the name and title of the person, if known, |
representing the
employer with whom the employee conferred |
in any effort to obtain pursuant
to Section 7 compensation |
of the type provided for in paragraph (b) of
Section 8 of |
the Workers' Compensation Act or medical, surgical or |
hospital
services of the type provided for in paragraph |
(a) of Section 8 of the
Workers' Compensation Act and the |
date of such conference;
|
(vii) a statement that the employer has refused to pay |
compensation
pursuant to Section 7 of the type provided |
for in paragraph (b) of Section
8 of the Workers' |
Compensation Act or for medical, surgical
or hospital |
services pursuant to Section 7 of the type provided for in
|
paragraph (a) of Section 8 of the Workers' Compensation |
Act;
|
|
(viii) the name and address, if known, of each witness |
to the last
exposure and of each other person upon whom the |
employee will rely to
support his allegations;
|
(ix) the dates of treatment related to the disability |
by medical
practitioners, and the names and addresses of |
such practitioners, including
the dates of treatment |
related to the disability at any hospitals and the
names |
and addresses of such hospitals, and a signed |
authorization
permitting the employer to examine all |
medical records of all practitioners
and hospitals named |
pursuant to this paragraph;
|
(x) a copy of a signed report by a medical |
practitioner, relating to the
employee's current inability |
to return to work because of the disability
incurred as a |
result of the exposure or such other documents or |
affidavits
which show that the employee is entitled to |
receive pursuant to Section 7
compensation of the type |
provided for in paragraph (b) of Section 8 of the
Workers' |
Compensation Act or medical, surgical or hospital services |
of the
type provided for in paragraph (a) of Section 8 of |
the Workers'
Compensation Act. Such reports, documents or |
affidavits shall state, if
possible, the history of the |
exposure given by the employee, and describe
the |
disability and medical diagnosis, the medical services for |
such
disability which the employee has received and is |
receiving, the physical
activities which the employee |
|
cannot currently perform as a result of such
disability, |
and the prognosis for recovery;
|
(xi) complete copies of any reports, records, |
documents and affidavits
in the possession of the employee |
on which the employee will rely to
support his |
allegations, provided that the employer shall pay the
|
reasonable cost of reproduction thereof;
|
(xii) a list of any reports, records, documents and |
affidavits which
the employee has demanded by subpoena and |
on which he intends to
rely to support his allegations;
|
(xiii) a certification signed by the employee or his |
representative that
the employer has received the petition |
with the required information 15
days before filing.
|
Fifteen days after receipt by the employer of the petition |
with the
required information the employee may file said |
petition and required
information and shall serve notice of |
the filing upon the employer. The
employer may file a motion |
addressed to the sufficiency of the petition.
If an objection |
has been filed to the sufficiency of the petition, the
|
arbitrator shall rule on the objection within 2 working days. |
If such an
objection is filed, the time for filing the final |
decision of the Commission
as provided in this paragraph shall |
be tolled until the arbitrator has
determined that the |
petition is sufficient.
|
The employer shall, within 15 days after receipt of the |
notice that such
petition is filed, file with the Commission |
|
and serve on the employee or
his representative a written |
response to each claim set
forth in the petition, including |
the legal and factual basis for each
disputed allegation and |
the following information: (i)
complete copies of any reports, |
records, documents and affidavits
in the possession of the |
employer on which the employer intends to rely in
support of |
his response, (ii) a list of any reports, records, documents |
and
affidavits which the employer has demanded by subpoena and |
on which the
employer intends to rely in support of his |
response, (iii) the name and address
of each witness on whom |
the employer will rely to support his response,
and (iv) the |
names and addresses of any medical practitioners
selected by |
the employer pursuant to Section 12 of this Act and the time
|
and place of any examination scheduled to be made pursuant to |
such Section.
|
Any employer who does not timely file and serve a written |
response
without good cause may not introduce any evidence to |
dispute any claim of
the employee but may cross examine the |
employee or any witness brought by
the employee and otherwise |
be heard.
|
No document or other evidence not previously identified by |
either party
with the petition or written response, or by any |
other means before the
hearing, may be introduced into |
evidence without good cause. If, at the
hearing, material |
information is discovered which was not previously
disclosed, |
the Arbitrator may extend the time for closing proof on the
|
|
motion of a party for a reasonable period of time which may be |
more than 30
days. No evidence may be introduced pursuant to |
this paragraph as to
permanent disability. No award may be |
entered for permanent disability
pursuant to this paragraph. |
Either party may introduce into evidence the
testimony taken |
by deposition of any medical practitioner.
|
The Commission shall adopt rules, regulations and |
procedures whereby
the final decision of the Commission is |
filed not later than 90 days from
the date the petition for |
review is filed but in no event later than 180
days from the |
date the petition for an emergency hearing is filed with the
|
Illinois Workers' Compensation Commission.
|
All service required pursuant to this paragraph (b-1) must |
be by personal
service or by certified mail and with evidence |
of receipt. In addition,
for the purposes of this paragraph, |
all service on the employer must be at
the premises where the |
accident occurred if the premises are owned or
operated by the |
employer. Otherwise service must be at the employee's
|
principal place of employment by the employer. If service on |
the employer
is not possible at either of the above, then |
service shall be at the
employer's principal place of |
business. After initial service in each case,
service shall be |
made on the employer's attorney or designated representative.
|
(c)(1) At a reasonable time in advance of and in |
connection with the
hearing under Section 19(e) or 19(h), the |
Commission may on its own motion
order an impartial physical |
|
or mental examination of a petitioner whose
mental or physical |
condition is in issue, when in the Commission's
discretion it |
appears that such an examination will materially aid in the
|
just determination of the case. The examination shall be made |
by a member
or members of a panel of physicians chosen for |
their special qualifications
by the Illinois State Medical |
Society. The Commission shall establish
procedures by which a |
physician shall be selected from such list.
|
(2) Should the Commission at any time during the hearing |
find that
compelling considerations make it advisable to have |
an examination and
report at that time, the Commission may in |
its discretion so order.
|
(3) A copy of the report of examination shall be given to |
the Commission
and to the attorneys for the parties.
|
(4) Either party or the Commission may call the examining |
physician
or physicians to testify. Any physician so called |
shall be subject to
cross-examination.
|
(5) The examination shall be made, and the physician or |
physicians,
if called, shall testify, without cost to the |
parties. The Commission shall
determine the compensation and |
the pay of the physician or physicians. The
compensation for |
this service shall not exceed the usual and customary amount
|
for such service.
|
The fees and payment thereof of all attorneys and |
physicians for
services authorized by the Commission under |
this Act shall, upon request
of either the employer or the |
|
employee or the beneficiary affected, be
subject to the review |
and decision of the Commission.
|
(d) If any employee shall persist in insanitary or |
injurious
practices which tend to either imperil or retard his |
recovery or shall
refuse to submit to such medical, surgical, |
or hospital treatment as is
reasonably essential to promote |
his recovery, the Commission may, in its
discretion, reduce or |
suspend the compensation of any such employee;
provided, that |
when an employer and employee so agree in writing, the
|
foregoing provision shall not be construed to authorize the |
reduction or
suspension of compensation of an employee who is |
relying in good faith,
on treatment by prayer or spiritual |
means alone, in accordance with the
tenets and practice of a |
recognized church or religious denomination, by
a duly |
accredited practitioner thereof.
|
(e) This paragraph shall apply to all hearings before the |
Commission.
Such hearings may be held in its office or |
elsewhere as the Commission may
deem advisable. The taking of |
testimony on such hearings may be had before
any member of the |
Commission. If a petition for review and agreed statement
of |
facts or transcript of evidence is filed, as provided herein, |
the
Commission shall promptly review the decision of the |
Arbitrator and all
questions of law or fact which appear from |
the statement of facts or
transcripts of evidence. In all |
cases in which the hearing before the
arbitrator is held after |
the effective date of this amendatory Act of 1989,
no |
|
additional evidence shall be introduced by the parties before |
the
Commission on review of the decision of the Arbitrator. |
The Commission
shall file in its office its decision thereon, |
and shall immediately send
to each party or his attorney a copy |
of such decision and a notification of
the time when it was |
filed. Decisions shall be filed within 60 days after
the |
Statement of Exceptions and Supporting Brief and Response |
thereto are
required to be filed or oral argument whichever is |
later.
|
In the event either party requests oral argument, such |
argument shall be
had before a panel of 3 members of the |
Commission (or before all available
members pursuant to the |
determination of 7 members of the Commission that
such |
argument be held before all available members of the |
Commission)
pursuant to the rules and regulations of the |
Commission. A panel of 3
members, which shall be comprised of |
not more than one representative
citizen of the employing |
class and not more than one representative from a labor |
organization recognized under the National Labor Relations Act |
or an attorney who has represented labor organizations or has |
represented employees in workers' compensation cases, shall |
hear the argument; provided that if all the
issues in dispute |
are solely the nature and extent of the permanent partial
|
disability, if any, a majority of the panel may deny the |
request for such
argument and such argument shall not be held; |
and provided further that 7
members of the Commission may |
|
determine that the argument be held before
all available |
members of the Commission. A decision of the Commission shall
|
be approved by a majority of Commissioners present at such |
hearing if any;
provided, if no such hearing is held, a |
decision of the Commission shall be
approved by a majority of a |
panel of 3 members of the Commission as
described in this |
Section. The Commission shall give 10 days' notice to the
|
parties or their attorneys of the time and place of such taking |
of
testimony and of such argument.
|
In any case the Commission in its decision may in its |
discretion find
specially upon any question or questions of |
law or facts which shall be
submitted in writing by either |
party whether ultimate or otherwise;
provided that on issues |
other than nature and extent of the disablement,
if any, the |
Commission in its decision shall find specially upon any
|
question or questions of law or fact, whether ultimate or |
otherwise,
which are submitted in writing by either party; |
provided further that
not more than 5 such questions may be |
submitted by either party. Any
party may, within 20 days after |
receipt of notice of the Commission's
decision, or within such |
further time, not exceeding 30 days, as the
Commission may |
grant, file with the Commission either an agreed
statement of |
the facts appearing upon the hearing, or, if such party
shall |
so elect, a correct transcript of evidence of the additional
|
proceedings presented before the Commission in which report |
the party
may embody a correct statement of such other |
|
proceedings in the case as
such party may desire to have |
reviewed, such statement of facts or
transcript of evidence to |
be authenticated by the signature of the
parties or their |
attorneys, and in the event that they do not agree,
then the |
authentication of such transcript of evidence shall be by the
|
signature of any member of the Commission.
|
If a reporter does not for any reason furnish a transcript |
of the
proceedings before the Arbitrator in any case for use on |
a hearing for
review before the Commission, within the |
limitations of time as fixed in
this Section, the Commission |
may, in its discretion, order a trial de
novo before the |
Commission in such case upon application of either
party. The |
applications for adjustment of claim and other documents in
|
the nature of pleadings filed by either party, together with |
the
decisions of the Arbitrator and of the Commission and the |
statement of
facts or transcript of evidence hereinbefore |
provided for in paragraphs
(b) and (c) shall be the record of |
the proceedings of the Commission,
and shall be subject to |
review as hereinafter provided.
|
At the request of either party or on its own motion, the |
Commission shall
set forth in writing the reasons for the |
decision, including findings of
fact and conclusions of law, |
separately stated. The Commission shall by
rule adopt a format |
for written decisions for the Commission and
arbitrators. The |
written decisions shall be concise and shall succinctly
state |
the facts and reasons for the decision. The Commission may |
|
adopt in
whole or in part, the decision of the arbitrator as |
the decision of the
Commission. When the Commission does so |
adopt the decision of the
arbitrator, it shall do so by order. |
Whenever the Commission adopts part of
the arbitrator's |
decision, but not all, it shall include in the order the
|
reasons for not adopting all of the arbitrator's decision. |
When a majority
of a panel, after deliberation, has arrived at |
its decision, the decision
shall be filed as provided in this |
Section without unnecessary delay, and
without regard to the |
fact that a member of the panel has expressed an
intention to |
dissent. Any member of the panel may file a dissent. Any
|
dissent shall be filed no later than 10 days after the decision |
of the
majority has been filed.
|
Decisions rendered by the Commission after the effective |
date of this
amendatory Act of 1980 and dissents, if any, shall |
be published
together by the Commission. The conclusions
of |
law set out in such decisions shall be regarded as precedents
|
by arbitrators, for the purpose of achieving
a more uniform |
administration of this Act.
|
(f) The decision of the Commission acting within its |
powers,
according to the provisions of paragraph (e) of this |
Section shall, in
the absence of fraud, be conclusive unless |
reviewed as in this paragraph
hereinafter provided. However, |
the Arbitrator or the Commission may on
his or its own motion, |
or on the motion of either party, correct any
clerical error or |
errors in computation within 15 days after the date of
receipt |
|
of any award by such Arbitrator or any decision on review of |
the
Commission, and shall have the power to recall the |
original award on
arbitration or decision on review, and issue |
in lieu thereof such
corrected award or decision. Where such |
correction is made the time for
review herein specified shall |
begin to run from the date of
the receipt of the corrected |
award or decision.
|
(1) Except in cases of claims against the State of |
Illinois, in
which case the decision of the Commission |
shall not be subject to
judicial review, the Circuit Court |
of the county where any of the
parties defendant may be |
found, or if none of the parties defendant be
found in this |
State then the Circuit Court of the county where any of
the |
exposure occurred, shall by summons to the Commission
have |
power to review all questions of law and fact presented by |
such
record.
|
A proceeding for review shall be commenced within 20 |
days of the
receipt of notice of the decision of the |
Commission. The summons shall be
issued by the clerk of |
such court upon written request returnable on a
designated |
return day, not less than 10 or more than 60 days from the |
date
of issuance thereof, and the written request shall |
contain the last known
address of other parties in |
interest and their attorneys of record who are
to be |
served by summons. Service upon any member of the |
Commission or the
Secretary or the Assistant Secretary |
|
thereof shall be service upon the
Commission, and service |
upon other parties in interest and their attorneys
of |
record shall be by summons, and such service shall be made |
upon the
Commission and other parties in interest by |
mailing notices of the
commencement of the proceedings and |
the return day of the summons to the
office of the |
Commission and to the last known place of residence of
|
other parties in interest or their attorney or attorneys |
of record. The
clerk of the court issuing the summons |
shall on the day of issue mail notice
of the commencement |
of the proceedings which shall be done by mailing a
copy of |
the summons to the office of the Commission, and a copy of |
the
summons to the other parties in interest or their |
attorney or
attorneys of record and the clerk of the court |
shall make certificate
that he has so sent such notices in |
pursuance of this Section, which
shall be evidence of |
service on the Commission and other parties in
interest.
|
The Commission shall not be required to certify the |
record of their
proceedings in the Circuit Court unless |
the party commencing the
proceedings for review in the |
Circuit Court as above provided, shall file with the |
Commission notice of intent to file for review in Circuit |
Court. It shall be
the duty of the Commission upon such |
filing of notice of intent to file for review in Circuit |
Court to prepare a true and correct
copy of such testimony |
and a true and correct copy of all
other matters contained |
|
in such record and certified to by the Secretary
or |
Assistant Secretary thereof. The changes made to this |
subdivision (f)(1) by this amendatory Act of the 98th |
General Assembly apply to any Commission decision entered |
after the effective date of this amendatory Act of the |
98th General Assembly.
|
No request
for a summons may be filed and no summons |
shall
issue unless the party seeking to review the |
decision of the Commission
shall exhibit to the clerk of |
the Circuit Court proof of
filing with the Commission of |
the notice of the intent to file for review in the Circuit |
Court or an affidavit of the attorney setting
forth that |
notice of intent to file for review in Circuit Court has |
been given in writing to the Secretary
or Assistant |
Secretary of the Commission.
|
(2) No such summons shall issue unless the one against
|
whom the Commission shall have rendered an award for the |
payment of money
shall upon the filing of his written |
request for such summons file with the
clerk of the court a |
bond conditioned that if he shall not successfully
|
prosecute the review, he will pay the award and the costs |
of the
proceedings in the court. The amount of the bond |
shall be fixed by any
member of the Commission and the |
surety or sureties of the bond shall be
approved by the |
clerk of the court. The acceptance of the bond by the
clerk |
of the court shall constitute evidence of his approval of |
|
the
bond.
|
The following Every county, city, town, township, |
incorporated village, school
district, body politic or |
municipal corporation having a population of
500,000 or |
more against whom the Commission shall have rendered an |
award
for the payment of money shall not be required to |
file a bond to secure
the payment of the award and the |
costs of the proceedings in the court
to authorize the |
court to issue such summons : .
|
(1) the State Treasurer, for a fund administered |
by the State Treasurer ex officio against whom the |
Commission shall have rendered an award for the |
payment of money; and |
(2) a county, city, town, township, incorporated |
village, school district, body politic, or municipal |
corporation having a population of 500,000 or more |
against whom the Commission shall have rendered an |
award for the payment of money. |
The court may confirm or set aside the decision of the |
Commission. If
the decision is set aside and the facts |
found in the proceedings before
the Commission are |
sufficient, the court may enter such decision as is
|
justified by law, or may remand the cause to the |
Commission for further
proceedings and may state the |
questions requiring further hearing, and
give such other |
instructions as may be proper. Appeals shall be taken
to |
|
the Appellate Court in accordance
with Supreme Court Rules |
22(g) and 303. Appeals shall be taken from the
Appellate |
Court to the Supreme Court
in accordance with Supreme |
Court Rule 315.
|
It shall be the duty of the clerk of any court |
rendering a decision
affecting or affirming an award of |
the Commission to promptly furnish
the Commission with a |
copy of such decision, without charge.
|
The decision of a majority of the members of the panel |
of the Commission,
shall be considered the decision of the |
Commission.
|
(g) Except in the case of a claim against the State of |
Illinois,
either party may present a certified copy of the |
award of the
Arbitrator, or a certified copy of the decision of |
the Commission when
the same has become final, when no |
proceedings for review are pending,
providing for the payment |
of compensation according to this Act, to the
Circuit Court of |
the county in which such exposure occurred or either of
the |
parties are residents, whereupon the court shall enter a |
judgment
in accordance therewith. In case where the employer |
refuses to pay
compensation according to such final award or |
such final decision upon
which such judgment is entered, the |
court shall in entering judgment
thereon, tax as costs against |
him the reasonable costs and attorney fees
in the arbitration |
proceedings and in the court entering the judgment
for the |
person in whose favor the judgment is entered, which judgment
|
|
and costs taxed as herein provided shall, until and unless set |
aside,
have the same effect as though duly entered in an action |
duly tried and
determined by the court, and shall with like |
effect, be entered and
docketed. The Circuit Court shall have |
power at any time upon
application to make any such judgment |
conform to any modification
required by any subsequent |
decision of the Supreme Court upon appeal, or
as the result of |
any subsequent proceedings for review, as provided in
this |
Act.
|
Judgment shall not be entered until 15 days' notice of the |
time and
place of the application for the entry of judgment |
shall be served upon
the employer by filing such notice with |
the Commission, which Commission
shall, in case it has on file |
the address of the employer or the name
and address of its |
agent upon whom notices may be served, immediately
send a copy |
of the notice to the employer or such designated agent.
|
(h) An agreement or award under this Act providing for |
compensation
in installments, may at any time within 18 months |
after such agreement
or award be reviewed by the Commission at |
the request of either the
employer or the employee on the |
ground that the disability of the
employee has subsequently |
recurred, increased, diminished or ended.
|
However, as to disablements occurring subsequently to July |
1, 1955,
which are covered by any agreement or award under this |
Act providing for
compensation in installments made as a |
result of such disablement, such
agreement or award may at any |
|
time within 30 months after such agreement
or award be |
reviewed by the Commission at the request of either the
|
employer or the employee on the ground that the disability of |
the
employee has subsequently recurred, increased, diminished |
or ended.
|
On such review compensation payments may be |
re-established,
increased, diminished or ended. The Commission |
shall give 15 days'
notice to the parties of the hearing for |
review. Any employee, upon any
petition for such review being |
filed by the employer, shall be entitled
to one day's notice |
for each 100 miles necessary to be traveled by him in
attending |
the hearing of the Commission upon the petition, and 3 days in
|
addition thereto. Such employee shall, at the discretion of |
the
Commission, also be entitled to 5 cents per mile |
necessarily traveled by
him within the State of Illinois in |
attending such hearing, not to
exceed a distance of 300 miles, |
to be taxed by the Commission as costs
and deposited with the |
petition of the employer.
|
When compensation which is payable in accordance with an |
award or
settlement contract approved by the Commission, is |
ordered paid in a
lump sum by the Commission, no review shall |
be had as in this paragraph
mentioned.
|
(i) Each party, upon taking any proceedings or steps |
whatsoever
before any Arbitrator, Commission or court,
shall |
file with the Commission his address, or the name and address |
of
any agent upon whom all notices to be given to such party |
|
shall be
served, either personally or by registered mail, |
addressed to such party
or agent at the last address so filed |
with the Commission. In the event
such party has not filed his |
address, or the name and address of an
agent as above provided, |
service of any notice may be had by filing such
notice with the |
Commission.
|
(j) Whenever in any proceeding testimony has been taken or |
a final
decision has been rendered, and after the taking of |
such testimony or
after such decision has become final, the |
employee dies, then in any
subsequent proceeding brought by |
the personal representative or
beneficiaries of the deceased |
employee, such testimony in the former
proceeding may be |
introduced with the same force and effect as though
the |
witness having so testified were present in person in such
|
subsequent proceedings and such final decision, if any, shall |
be taken
as final adjudication of any of the issues which are |
the same in both
proceedings.
|
(k) In any case where there has been any unreasonable or |
vexatious
delay of payment or intentional underpayment of |
compensation, or
proceedings have been instituted or carried |
on by one liable to pay the
compensation, which do not present |
a real controversy, but are merely
frivolous or for delay, |
then the Commission may award compensation
additional to that |
otherwise payable under this Act equal to 50% of the
amount |
payable at the time of such award. Failure to pay compensation |
in
accordance with the provisions of Section 8, paragraph (b) |
|
of this Act,
shall be considered unreasonable delay.
|
When determining whether this subsection (k) shall apply, |
the
Commission shall consider whether an arbitrator has |
determined
that the claim is not compensable or whether the |
employer has
made payments under Section 8(j) of the Workers' |
Compensation Act. |
(k-1) If the employee has made written demand for payment |
of
benefits under Section 8(a) or Section 8(b) of the Workers' |
Compensation Act, the employer shall
have 14 days after |
receipt of the demand to set forth in
writing the reason for |
the delay. In the case of demand for
payment of medical |
benefits under Section 8(a) of the Workers' Compensation Act, |
the time for
the employer to respond shall not commence until |
the expiration
of the allotted 60 days specified under Section |
8.2(d) of the Workers' Compensation Act. In case
the employer |
or his or her insurance carrier shall without good and
just |
cause fail, neglect, refuse, or unreasonably delay the
payment |
of benefits under Section 8(a) or Section 8(b) of the Workers' |
Compensation Act, the
Arbitrator or the Commission shall allow |
to the employee
additional compensation in the sum of $30 per |
day for each day
that the benefits under Section 8(a) or |
Section 8(b) of the Workers' Compensation Act have been
so |
withheld or refused, not to exceed $10,000.
A delay in payment |
of 14 days or more
shall create a rebuttable presumption of |
unreasonable delay.
|
(l) By the 15th day of each month each insurer providing |
|
coverage for
losses under this Act shall notify each insured |
employer of any compensable
claim incurred during the |
preceding month and the amounts paid or reserved
on the claim |
including a summary of the claim and a brief statement of the
|
reasons for compensability. A cumulative report of all claims |
incurred
during a calendar year or continued
from the previous |
year shall be furnished to the insured employer by the
insurer |
within 30 days after the end of that calendar year.
|
The insured employer may challenge, in proceeding before |
the Commission,
payments made by the insurer without |
arbitration and payments made after
a case is determined to be |
noncompensable. If the Commission finds that
the case was not |
compensable, the insurer shall purge its records as to
that |
employer of any loss or expense associated with the claim, |
reimburse
the employer for attorneys fee arising from the |
challenge and for any payment
required of the employer to the |
Rate Adjustment Fund or the Second Injury
Fund, and may not |
effect the loss or expense for rate making purposes. The
|
employee shall not be required to refund the challenged |
payment. The
decision of the Commission may be reviewed in the |
same
manner as in arbitrated cases. No challenge may be |
initiated under this
paragraph more than 3 years after the |
payment is made. An employer may
waive the right of challenge |
under this paragraph on a case by case basis.
|
(m) After filing an application for adjustment of claim |
but prior to
the hearing on arbitration the parties may |
|
voluntarily agree to submit such
application for adjustment of |
claim for decision by an arbitrator under
this subsection (m) |
where such application for adjustment
of claim raises only a |
dispute over temporary total disability, permanent
partial |
disability or medical expenses. Such agreement shall be in |
writing
in such form as provided by the Commission. |
Applications for adjustment of
claim submitted for decision by |
an arbitrator under
this subsection (m) shall proceed |
according
to rule as established by the Commission. The |
Commission shall promulgate
rules including, but not limited |
to, rules to ensure that the parties are
adequately informed |
of their rights under this subsection (m) and of the
voluntary |
nature of proceedings under this subsection
(m). The findings |
of fact made by an arbitrator acting within his or her
powers |
under this subsection (m) in the absence of fraud shall be
|
conclusive. However, the arbitrator may on his own motion, or |
the motion
of either party, correct any clerical errors or |
errors in computation
within 15 days after the date of receipt |
of such award of the arbitrator
and shall have the power to |
recall the original award on arbitration, and
issue in lieu |
thereof such corrected award.
The decision of the arbitrator |
under this subsection (m) shall be
considered the decision of |
the Commission and proceedings for review of
questions of law |
arising from the decision may be commenced by either party
|
pursuant to subsection (f) of Section 19. The Advisory Board |
established
under Section 13.1 of the Workers' Compensation |
|
Act shall compile a list of
certified Commission arbitrators, |
each of whom shall be approved by at least
7 members of the |
Advisory Board. The chairman shall select 5 persons
from such |
list to serve as arbitrators under this subsection (m). By
|
agreement, the parties shall select one arbitrator from among |
the 5 persons
selected by the chairman except, that if the |
parties do not agree on an
arbitrator from among the 5 persons, |
the parties may, by agreement,
select an arbitrator of the |
American Arbitration Association, whose fee
shall be paid by |
the State in accordance with rules promulgated by the
|
Commission. Arbitration under this subsection (m) shall be |
voluntary.
|
(Source: P.A. 101-384, eff. 1-1-20 .)
|
Section 50. The Unemployment Insurance Act is amended by
|
changing Section 1900 as follows:
|
(820 ILCS 405/1900) (from Ch. 48, par. 640)
|
Sec. 1900. Disclosure of information.
|
A. Except as provided in this Section, information |
obtained from any
individual or employing unit during the |
administration of this Act shall:
|
1. be confidential,
|
2. not be published or open to public inspection,
|
3. not be used in any court in any pending action or |
proceeding,
|
|
4. not be admissible in evidence in any action or |
proceeding other than
one arising out of this Act.
|
B. No finding, determination, decision, ruling , or order |
(including
any finding of fact, statement or conclusion made |
therein) issued pursuant
to this Act shall be admissible or |
used in evidence in any action other than
one arising out of |
this Act, nor shall it be binding or conclusive except
as |
provided in this Act, nor shall it constitute res judicata, |
regardless
of whether the actions were between the same or |
related parties or involved
the same facts.
|
C. Any officer or employee of this State, any officer or |
employee of any
entity authorized to obtain information |
pursuant to this Section, and any
agent of this State or of |
such entity
who, except with authority of
the Director under |
this Section or as authorized pursuant to subsection P-1, |
shall disclose information shall be guilty
of a Class B |
misdemeanor and shall be disqualified from holding any
|
appointment or employment by the State.
|
D. An individual or his duly authorized agent may be |
supplied with
information from records only to the extent |
necessary for the proper
presentation of his claim for |
benefits or with his existing or prospective
rights to |
benefits. Discretion to disclose this information belongs
|
solely to the Director and is not subject to a release or |
waiver by the
individual.
Notwithstanding any other provision |
to the contrary, an individual or his or
her duly authorized |
|
agent may be supplied with a statement of the amount of
|
benefits paid to the individual during the 18 months preceding |
the date of his
or her request.
|
E. An employing unit may be furnished with information, |
only if deemed by
the Director as necessary to enable it to |
fully discharge its obligations or
safeguard its rights under |
the Act. Discretion to disclose this information
belongs |
solely to the Director and is not subject to a release or |
waiver by the
employing unit.
|
F. The Director may furnish any information that he may |
deem proper to
any public officer or public agency of this or |
any other State or of the
federal government dealing with:
|
1. the administration of relief,
|
2. public assistance,
|
3. unemployment compensation,
|
4. a system of public employment offices,
|
5. wages and hours of employment, or
|
6. a public works program.
|
The Director may make available to the Illinois Workers' |
Compensation Commission or the Department of Insurance
|
information regarding employers for the purpose of verifying |
the insurance
coverage required under the Workers' |
Compensation Act and Workers'
Occupational Diseases Act.
|
G. The Director may disclose information submitted by the |
State or any
of its political subdivisions, municipal |
corporations, instrumentalities,
or school or community |
|
college districts, except for information which
specifically |
identifies an individual claimant.
|
H. The Director shall disclose only that information |
required to be
disclosed under Section 303 of the Social |
Security Act, as amended, including:
|
1. any information required to be given the United |
States Department of
Labor under Section 303(a)(6); and
|
2. the making available upon request to any agency of |
the United States
charged with the administration of |
public works or assistance through
public employment, the |
name, address, ordinary occupation , and employment
status |
of each recipient of unemployment compensation, and a |
statement of
such recipient's right to further |
compensation under such law as required
by Section |
303(a)(7); and
|
3. records to make available to the Railroad |
Retirement Board as
required by Section 303(c)(1); and
|
4. information that will assure reasonable cooperation |
with every agency
of the United States charged with the |
administration of any unemployment
compensation law as |
required by Section 303(c)(2); and
|
5. information upon request and on a reimbursable |
basis to the United
States Department of Agriculture and |
to any State food stamp agency
concerning any information |
required to be furnished by Section 303(d); and
|
6. any wage information upon request and on a |
|
reimbursable basis
to any State or local child support |
enforcement agency required by
Section 303(e); and
|
7. any information required under the income |
eligibility and
verification system as required by Section |
303(f); and
|
8. information that might be useful in locating an |
absent parent or that
parent's employer, establishing |
paternity or establishing, modifying, or
enforcing child |
support orders
for the purpose of a child support |
enforcement program
under Title IV of the Social Security |
Act upon the request of
and on a reimbursable basis to
the |
public
agency administering the Federal Parent Locator |
Service as required by
Section 303(h); and
|
9. information, upon request, to representatives of |
any federal, State ,
or local governmental public housing |
agency with respect to individuals who
have signed the |
appropriate consent form approved by the Secretary of |
Housing
and Urban Development and who are applying for or |
participating in any housing
assistance program |
administered by the United States Department of Housing |
and
Urban Development as required by Section 303(i).
|
I. The Director, upon the request of a public agency of |
Illinois, of the
federal government , or of any other state |
charged with the investigation or
enforcement of Section 10-5 |
of the Criminal Code of 2012 (or a similar
federal law or |
similar law of another State), may furnish the public agency
|
|
information regarding the individual specified in the request |
as to:
|
1. the current or most recent home address of the |
individual, and
|
2. the names and addresses of the individual's |
employers.
|
J. Nothing in this Section shall be deemed to interfere |
with the
disclosure of certain records as provided for in |
Section 1706 or with the
right to make available to the |
Internal Revenue Service of the United
States Department of |
the Treasury, or the Department of Revenue of the
State of |
Illinois, information obtained under this Act. With respect to |
each benefit claim that appears to have been filed other than |
by the individual in whose name the claim was filed or by the |
individual's authorized agent and with respect to which |
benefits were paid during the prior calendar year, the |
Director shall annually report to the Department of Revenue |
information that is in the Director's possession and may |
assist in avoiding negative income tax consequences for the |
individual in whose name the claim was filed.
|
K. The Department shall make available to the Illinois |
Student Assistance
Commission, upon request, information in |
the possession of the Department that
may be necessary or |
useful to the
Commission in the collection of defaulted or |
delinquent student loans which
the Commission administers.
|
L. The Department shall make available to the State |
|
Employees'
Retirement System, the State Universities |
Retirement System, the
Teachers' Retirement System of the |
State of Illinois, and the Department of Central Management |
Services, Risk Management Division, upon request,
information |
in the possession of the Department that may be necessary or |
useful
to the System or the Risk Management Division for the |
purpose of determining whether any recipient of a
disability |
benefit from the System or a workers' compensation benefit |
from the Risk Management Division is gainfully employed.
|
M. This Section shall be applicable to the information |
obtained in the
administration of the State employment |
service, except that the Director
may publish or release |
general labor market information and may furnish
information |
that he may deem proper to an individual, public officer , or
|
public agency of this or any other State or the federal |
government (in
addition to those public officers or public |
agencies specified in this
Section) as he prescribes by Rule.
|
N. The Director may require such safeguards as he deems |
proper to insure
that information disclosed pursuant to this |
Section is used only for the
purposes set forth in this |
Section.
|
O. Nothing in this Section prohibits communication with an |
individual or entity through unencrypted e-mail or other |
unencrypted electronic means as long as the communication does |
not contain the individual's or entity's name in combination |
with any one or more of the individual's or entity's entire or |
|
partial social security number; driver's license or State |
identification number; credit or debit card number; or any |
required security code, access code, or password that would |
permit access to further information pertaining to the |
individual or entity.
|
P. (Blank). |
P-1. With the express written consent of a claimant or
|
employing unit and an agreement not to publicly disclose, the |
Director shall provide requested information related to a |
claim
to an elected official performing constituent services |
or his or her agent.
|
Q. The Director shall make available to an elected federal
|
official the name and address of an individual or entity that |
is located within
the jurisdiction from which the official was |
elected and that, for the most
recently completed calendar |
year, has reported to the Department as paying
wages to |
workers, where the information will be used in connection with |
the
official duties of the official and the official requests |
the information in
writing, specifying the purposes for which |
it will be used.
For purposes of this subsection, the use of |
information in connection with the
official duties of an |
official does not include use of the information in
connection |
with the solicitation of contributions or expenditures, in |
money or
in kind, to or on behalf of a candidate for public or |
political office or a
political party or with respect to a |
public question, as defined in Section 1-3
of the Election |
|
Code, or in connection with any commercial solicitation. Any
|
elected federal official who, in submitting a request for |
information
covered by this subsection, knowingly makes a |
false statement or fails to
disclose a material fact, with the |
intent to obtain the information for a
purpose not authorized |
by this subsection, shall be guilty of a Class B
misdemeanor.
|
R. The Director may provide to any State or local child |
support
agency, upon request and on a reimbursable basis, |
information that might be
useful in locating an absent parent |
or that parent's employer, establishing
paternity, or |
establishing, modifying, or enforcing child support orders.
|
S. The Department shall make available to a State's |
Attorney of this
State or a State's Attorney's investigator,
|
upon request, the current address or, if the current address |
is
unavailable, current employer information, if available, of |
a victim of
a felony or a
witness to a felony or a person |
against whom an arrest warrant is
outstanding.
|
T. The Director shall make available to the Illinois State |
Police, a county sheriff's office, or a municipal police |
department, upon request, any information concerning the |
current address and place of employment or former places of |
employment of a person who is required to register as a sex |
offender under the Sex Offender Registration Act that may be |
useful in enforcing the registration provisions of that Act. |
U. The Director shall make information available to the |
Department of Healthcare and Family Services and the |
|
Department of Human Services for the purpose of determining |
eligibility for public benefit programs authorized under the |
Illinois Public Aid Code and related statutes administered by |
those departments, for verifying sources and amounts of |
income, and for other purposes directly connected with the |
administration of those programs. |
V. The Director shall make information available to the |
State Board of Elections as may be required by an agreement the |
State Board of Elections has entered into with a multi-state |
voter registration list maintenance system. |
W. The Director shall make information available to the |
State Treasurer's office and the Department of Revenue for the |
purpose of facilitating compliance with the Illinois Secure |
Choice Savings Program Act, including employer contact |
information for employers with 25 or more employees and any |
other information the Director deems appropriate that is |
directly related to the administration of this program. |
X. The Director shall make information available, upon |
request, to the Illinois Student Assistance Commission for the |
purpose of determining eligibility for the adult vocational |
community college scholarship program under Section 65.105 of |
the Higher Education Student Assistance Act. |
Y. Except as required under State or federal law, or |
unless otherwise provided for in this Section, the Department |
shall not disclose an individual's entire social security |
number in any correspondence physically mailed to an |