215 ILCS 109/60

(215 ILCS 109/60)

Sec. 60.

Record of complaints.

(a) The Department shall maintain records concerning the complaints
filed against the plan with the Department.  The Department shall
make a summary of all data collected available upon request and publish
the summary on the World Wide Web.

(b) The Department shall maintain records on the number of complaints
filed against each plan.

(c) The Department shall maintain records classifying each complaint by
whether the complaint was filed by:

(1) a consumer or enrollee;

(2) a provider; or

(3) any other individual.

(d) (Blank).

(e) The Department shall maintain records classifying each complaint
according to the nature of the complaint as it pertains to a specific
function of the plan. The complaints shall be classified under the following
categories:

(1) denial of care or treatment;

(2) denial of a diagnostic procedure;

(3) denial of a referral request;

(4) sufficient choice and accessibility of dentists;

(5) underwriting;

(6) marketing and sales;

(7) claims and utilization review;

(8) member services;

(9) provider relations; and

(10) miscellaneous.

(f) The Department shall maintain records classifying the disposition of
each complaint. The disposition of the complaint shall be classified in one
of the following categories:

(1) complaint referred to the plan and no further