95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB1443


 
Introduced 2/21/2007, by Rep. Frank J. Mautino
 
SYNOPSIS AS INTRODUCED:
 		














215 ILCS 5/352
  from Ch. 73, par. 964







    Amends the Illinois Insurance Code.  Makes a technical change in a Section concerning the scope of the Article.
















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A BILL FOR









 











HB1443

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    AN ACT concerning insurance.

 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:


 
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    Section 5. The Illinois Insurance Code is amended  by 
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changing Section 352 as follows:
 



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    (215 ILCS 5/352)  (from Ch. 73, par. 964)



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    Sec. 352. Scope of Article. 

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    (a) Except as provided in subsections (b), (c), (d), and 
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(e),
this
this Article shall
apply to all companies transacting 
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in this State the kinds of business
enumerated in clause (b) of 
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Class 1 and clause (a) of Class 2 of section 4.
Nothing in this 
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Article shall apply to, or in any way affect policies or

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contracts described in clause (a) of Class 1 of Section 4; 
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however, this
Article shall apply to policies and contracts 
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which contain benefits
providing reimbursement for the 
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expenses of long term health care which are
certified or 
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ordered by a physician including but not limited to

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professional nursing care, custodial nursing care, and 
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non-nursing
custodial care provided in a nursing home or at a 
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residence of the insured.

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    (b) This Article does not apply to policies of accident and 
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health
insurance issued in compliance with Article XIXB of this 
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Code.

 


 






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    (c) A policy issued and delivered in this State
that 
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provides coverage under that policy for
certificate holders who 
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are neither residents of nor employed in this State
does not 
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need to provide to those nonresident
certificate holders  who  
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are not employed in this State the coverages or
services 
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mandated by this Article.

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    (d) Stop-loss insurance is exempt from all Sections
of this 
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Article, except this Section and Sections 353a, 354, 357.30, 
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and
370.  For purposes of this exemption, stop-loss insurance is 
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further defined as
follows:


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        (1) The policy must be issued to and insure an 
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    employer, trustee, or other
sponsor of the plan, or the 
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    plan itself, but not employees, members, or
participants.


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        (2) Payments by the insurer must be made to the 
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    employer, trustee, or
other sponsors of the plan, or the 
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    plan itself, but not to the employees,
members, 
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    participants, or health care providers.

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    (e) A policy issued or delivered in this State to the 
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Department of Healthcare and Family Services (formerly

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Illinois Department
of Public Aid) and providing coverage, 
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under clause (b) of Class 1 or clause (a)
of Class 2 as 
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described in Section 4, to persons who are enrolled under 
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Article V of the Illinois
Public Aid Code or under the 
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Children's Health Insurance Program Act is
exempt from all 
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restrictions, limitations,
standards, rules, or regulations 
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respecting benefits imposed by or under
authority of this Code, 
 


 






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except those specified by subsection (1) of Section
143.  
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Nothing in this subsection, however, affects the total medical 
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services
available to persons eligible for medical assistance 
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under the Illinois Public
Aid Code.

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(Source: P.A. 92-370, eff. 8-15-01; revised 12-15-05.)