Full Text of SB0874 95th General Assembly
SB0874sam001 95TH GENERAL ASSEMBLY
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Sen. Jacqueline Y. Collins
Filed: 5/21/2008
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| AMENDMENT TO SENATE BILL 874
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| AMENDMENT NO. ______. Amend Senate Bill 874 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The State Employees Group Insurance Act of 1971 | 5 |
| is amended by changing Section 6.11 as follows:
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| (5 ILCS 375/6.11)
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| Sec. 6.11. Required health benefits; Illinois Insurance | 8 |
| Code
requirements. The program of health
benefits shall provide | 9 |
| the post-mastectomy care benefits required to be covered
by a | 10 |
| policy of accident and health insurance under Section 356t of | 11 |
| the Illinois
Insurance Code. The program of health benefits | 12 |
| shall provide the coverage
required under Sections 356f.1, | 13 |
| 356g.5,
356u, 356w, 356x, 356z.2, 356z.4, 356z.6, and 356z.9, | 14 |
| and 356z.10
356z.9 of the
Illinois Insurance Code.
The program | 15 |
| of health benefits must comply with Section 155.37 of the
| 16 |
| Illinois Insurance Code.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 2 |
| 95-520, eff. 8-28-07; revised 12-4-07.)
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| Section 10. The Counties Code is amended by changing | 4 |
| Section 5-1069.3 as follows: | 5 |
| (55 ILCS 5/5-1069.3)
| 6 |
| Sec. 5-1069.3. Required health benefits. If a county, | 7 |
| including a home
rule
county, is a self-insurer for purposes of | 8 |
| providing health insurance coverage
for its employees, the | 9 |
| coverage shall include coverage for the post-mastectomy
care | 10 |
| benefits required to be covered by a policy of accident and | 11 |
| health
insurance under Section 356t and the coverage required | 12 |
| under Sections 356f.1, 356g.5, 356u,
356w, 356x, 356z.6, and | 13 |
| 356z.9, and 356z.10
356z.9 of
the Illinois Insurance Code. The | 14 |
| requirement that health benefits be covered
as provided in this | 15 |
| Section is an
exclusive power and function of the State and is | 16 |
| a denial and limitation under
Article VII, Section 6, | 17 |
| subsection (h) of the Illinois Constitution. A home
rule county | 18 |
| to which this Section applies must comply with every provision | 19 |
| of
this Section.
| 20 |
| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 21 |
| 95-520, eff. 8-28-07; revised 12-4-07.)
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| Section 15. The Illinois Municipal Code is amended by | 23 |
| changing Section 10-4-2.3 as follows: |
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| (65 ILCS 5/10-4-2.3)
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| Sec. 10-4-2.3. Required health benefits. If a | 3 |
| municipality, including a
home rule municipality, is a | 4 |
| self-insurer for purposes of providing health
insurance | 5 |
| coverage for its employees, the coverage shall include coverage | 6 |
| for
the post-mastectomy care benefits required to be covered by | 7 |
| a policy of
accident and health insurance under Section 356t | 8 |
| and the coverage required
under Sections 356f.1, 356g.5, 356u, | 9 |
| 356w, 356x, 356z.6, and 356z.9, and 356z.10
356z.9 of the | 10 |
| Illinois
Insurance
Code. The requirement that health
benefits | 11 |
| be covered as provided in this is an exclusive power and | 12 |
| function of
the State and is a denial and limitation under | 13 |
| Article VII, Section 6,
subsection (h) of the Illinois | 14 |
| Constitution. A home rule municipality to which
this Section | 15 |
| applies must comply with every provision of this Section.
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| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 17 |
| 95-520, eff. 8-28-07; revised 12-4-07.)
| 18 |
| Section 20. The School Code is amended by changing Section | 19 |
| 10-22.3f as follows: | 20 |
| (105 ILCS 5/10-22.3f)
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| Sec. 10-22.3f. Required health benefits. Insurance | 22 |
| protection and
benefits
for employees shall provide the | 23 |
| post-mastectomy care benefits required to be
covered by a |
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| policy of accident and health insurance under Section 356t and | 2 |
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coverage required under Sections 356f.1, 356g.5, 356u, | 3 |
| 356w, 356x,
356z.6, and 356z.9 of
the
Illinois Insurance Code.
| 4 |
| (Source: P.A. 95-189, eff. 8-16-07; 95-422, eff. 8-24-07; | 5 |
| revised 12-4-07.)
| 6 |
| Section 25. The Illinois Insurance Code is amended by | 7 |
| adding Section 356f.1 as follows: | 8 |
| (215 ILCS 5/356f.1 new) | 9 |
| Sec. 356f.1. Health care services appeals,
complaints, and
| 10 |
| external independent reviews. | 11 |
| (a) A policy of accident or health insurance or managed | 12 |
| care plan shall establish and maintain an appeals procedure as
| 13 |
| outlined in this Section. Compliance with this Section's | 14 |
| appeals procedures shall
satisfy a policy or plan's obligation | 15 |
| to provide appeal procedures under any
other State law or | 16 |
| rules. | 17 |
| (b) When an appeal concerns a decision or action by a | 18 |
| policy of accident or health insurance or managed care plan,
| 19 |
| its
employees, or its subcontractors that relates to (i) health | 20 |
| care services,
including, but not limited to, procedures or
| 21 |
| treatments
for an enrollee with an ongoing course of treatment | 22 |
| ordered
by a health care provider,
the denial of which could | 23 |
| significantly
increase the risk to an
enrollee's health,
or | 24 |
| (ii) a treatment referral, service,
procedure, or other health |
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| care service,
the denial of which could significantly
increase | 2 |
| the risk to an
enrollee's health,
the policy or plan must allow | 3 |
| for the filing of an appeal
either orally or in writing. Upon | 4 |
| submission of the appeal, a policy or plan
must notify the | 5 |
| party filing the appeal, as soon as possible, but in no event
| 6 |
| more than 24 hours after the submission of the appeal, of all | 7 |
| information
that the plan requires to evaluate the appeal.
The | 8 |
| policy or plan shall render a decision on the appeal within
24 | 9 |
| hours after receipt of the required information. The policy or | 10 |
| plan shall
notify the party filing the
appeal and the enrollee, | 11 |
| enrollee's primary care physician, and any health care
provider | 12 |
| who recommended the health care service involved in the appeal | 13 |
| of its
decision orally
followed-up by a written notice of the | 14 |
| determination. | 15 |
| (c) For all appeals related to health care services | 16 |
| including, but not
limited to, procedures or treatments for an | 17 |
| enrollee and not covered by
subsection (b) above, the policy or | 18 |
| plan shall establish a procedure for the filing of such | 19 |
| appeals. Upon
submission of an appeal under this subsection, a | 20 |
| policy or plan must notify
the party filing an appeal, within 3 | 21 |
| business days, of all information that the
policy or plan | 22 |
| requires to evaluate the appeal.
The policy or plan shall | 23 |
| render a decision on the appeal within 15 business
days after | 24 |
| receipt of the required information. The policy or plan shall
| 25 |
| notify the party filing the appeal,
the enrollee, the | 26 |
| enrollee's primary care physician, and any health care
provider
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| who recommended the health care service involved in the appeal | 2 |
| orally of its
decision followed-up by a written notice of the | 3 |
| determination. | 4 |
| (d) An appeal under subsection (b) or (c) may be filed by | 5 |
| the
enrollee, the enrollee's designee or guardian, the | 6 |
| enrollee's primary care
physician, or the enrollee's health | 7 |
| care provider. A policy or plan shall
designate a clinical peer | 8 |
| to review
appeals, because these appeals pertain to medical or | 9 |
| clinical matters
and such an appeal must be reviewed by an | 10 |
| appropriate
health care professional. No one reviewing an | 11 |
| appeal may have had any
involvement
in the initial | 12 |
| determination that is the subject of the appeal. The written
| 13 |
| notice of determination required under subsections (b) and (c) | 14 |
| shall
include (i) clear and detailed reasons for the | 15 |
| determination, (ii)
the medical or
clinical criteria for the | 16 |
| determination, which shall be based upon sound
clinical | 17 |
| evidence and reviewed on a periodic basis, and (iii) in the | 18 |
| case of an
adverse determination, the
procedures for requesting | 19 |
| an external independent review under subsection (f). | 20 |
| (e) If an appeal filed under subsection (b) or (c) is | 21 |
| denied for a reason
including, but not limited to, the
service, | 22 |
| procedure, or treatment is not viewed as medically necessary,
| 23 |
| denial of specific tests or procedures, denial of referral
to | 24 |
| specialist physicians or denial of hospitalization requests or | 25 |
| length of
stay requests, any involved party may request an | 26 |
| external independent review
under subsection (f) of the adverse |
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| determination. | 2 |
| (f) The party seeking an external independent review shall | 3 |
| so notify the
policy or plan.
The policy or plan shall seek to | 4 |
| resolve all
external independent
reviews in the most | 5 |
| expeditious manner and shall make a determination and
provide | 6 |
| notice of the determination no more
than 24 hours after the | 7 |
| receipt of all necessary information when a delay would
| 8 |
| significantly increase
the risk to an enrollee's health or when | 9 |
| extended health care services for an
enrollee undergoing a
| 10 |
| course of treatment prescribed by a health care provider are at | 11 |
| issue. | 12 |
| (1) Within 30 days after the enrollee receives written | 13 |
| notice of an
adverse
determination,
if the enrollee decides | 14 |
| to initiate an external independent review, the
enrollee | 15 |
| shall send to the policy or plan a written request for an | 16 |
| external independent review, including any
information or
| 17 |
| documentation to support the enrollee's request for the | 18 |
| covered service or
claim for a covered
service. | 19 |
| (2) Within 30 days after the policy or plan receives a | 20 |
| request for an
external
independent review from an enrollee | 21 |
| or, within 24 hours after the receipt of a request if a | 22 |
| delay would significantly increase the risk to the | 23 |
| enrollee's health, the policy or plan shall: | 24 |
| (a) provide a mechanism for joint selection of an | 25 |
| external independent
reviewer by the enrollee, the | 26 |
| enrollee's physician or other health care
provider,
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| and the policy or plan; and | 2 |
| (b) forward to the independent reviewer all | 3 |
| medical records and
supporting
documentation | 4 |
| pertaining to the case, a summary description of the | 5 |
| applicable
issues including a
statement of the | 6 |
| decision made by, the criteria used, and the
medical | 7 |
| and clinical reasons
for that decision. | 8 |
| (3) Within 5 days after receipt of all necessary | 9 |
| information or within 24 hours when a delay would
| 10 |
| significantly increase
the risk to an enrollee's health, | 11 |
| the
independent
reviewer
shall evaluate and analyze the | 12 |
| case and render a decision that is based on
whether or not | 13 |
| the health
care service or claim for the health care | 14 |
| service is medically appropriate. The
decision by the
| 15 |
| independent reviewer is final. If the external independent | 16 |
| reviewer determines
the health care
service to be medically
| 17 |
| appropriate, the policy or plan shall pay for the health | 18 |
| care service. | 19 |
| (4) The policy or plan shall be solely responsible for | 20 |
| paying the fees
of the external
independent reviewer who is | 21 |
| selected to perform the review. | 22 |
| (5) An external independent reviewer who acts in good | 23 |
| faith shall have
immunity
from any civil or criminal | 24 |
| liability or professional discipline as a result of
acts or | 25 |
| omissions with
respect to any external independent review, | 26 |
| unless the acts or omissions
constitute wilful and wanton
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| misconduct. For purposes of any proceeding, the good faith | 2 |
| of the person
participating shall be
presumed. | 3 |
| (6) Future contractual or employment action by the | 4 |
| policy or plan
regarding the
patient's physician or other | 5 |
| health care provider shall not be based solely on
the | 6 |
| physician's or other
health care provider's participation | 7 |
| in this procedure. | 8 |
| (7) For the purposes of this Section, an external | 9 |
| independent reviewer
shall: | 10 |
| (a) be a clinical peer; | 11 |
| (b) have no direct financial interest in | 12 |
| connection with the case; and | 13 |
| (c) have not been informed of the specific identity | 14 |
| of the enrollee. | 15 |
| (g) Nothing in this Section shall be construed to require a | 16 |
| policy or
plan to pay for a health care service not covered | 17 |
| under the enrollee's
certificate of coverage or policy.
| 18 |
| Section 30. The Health Maintenance Organization Act is | 19 |
| amended by changing Section 5-3 as follows:
| 20 |
| (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
| 21 |
| Sec. 5-3. Insurance Code provisions.
| 22 |
| (a) Health Maintenance Organizations
shall be subject to | 23 |
| the provisions of Sections 133, 134, 137, 140, 141.1,
141.2, | 24 |
| 141.3, 143, 143c, 147, 148, 149, 151,
152, 153, 154, 154.5, |
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| 154.6,
154.7, 154.8, 155.04, 355.2, 356f.1, 356m, 356v, 356w, | 2 |
| 356x, 356y,
356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9, | 3 |
| 356z.10
356z.9 , 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, | 4 |
| 368d, 368e, 370c,
401, 401.1, 402, 403, 403A,
408, 408.2, 409, | 5 |
| 412, 444,
and
444.1,
paragraph (c) of subsection (2) of Section | 6 |
| 367, and Articles IIA, VIII 1/2,
XII,
XII 1/2, XIII, XIII 1/2, | 7 |
| XXV, and XXVI of the Illinois Insurance Code.
| 8 |
| (b) For purposes of the Illinois Insurance Code, except for | 9 |
| Sections 444
and 444.1 and Articles XIII and XIII 1/2, Health | 10 |
| Maintenance Organizations in
the following categories are | 11 |
| deemed to be "domestic companies":
| 12 |
| (1) a corporation authorized under the
Dental Service | 13 |
| Plan Act or the Voluntary Health Services Plans Act;
| 14 |
| (2) a corporation organized under the laws of this | 15 |
| State; or
| 16 |
| (3) a corporation organized under the laws of another | 17 |
| state, 30% or more
of the enrollees of which are residents | 18 |
| of this State, except a
corporation subject to | 19 |
| substantially the same requirements in its state of
| 20 |
| organization as is a "domestic company" under Article VIII | 21 |
| 1/2 of the
Illinois Insurance Code.
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| (c) In considering the merger, consolidation, or other | 23 |
| acquisition of
control of a Health Maintenance Organization | 24 |
| pursuant to Article VIII 1/2
of the Illinois Insurance Code,
| 25 |
| (1) the Director shall give primary consideration to | 26 |
| the continuation of
benefits to enrollees and the financial |
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| conditions of the acquired Health
Maintenance Organization | 2 |
| after the merger, consolidation, or other
acquisition of | 3 |
| control takes effect;
| 4 |
| (2)(i) the criteria specified in subsection (1)(b) of | 5 |
| Section 131.8 of
the Illinois Insurance Code shall not | 6 |
| apply and (ii) the Director, in making
his determination | 7 |
| with respect to the merger, consolidation, or other
| 8 |
| acquisition of control, need not take into account the | 9 |
| effect on
competition of the merger, consolidation, or | 10 |
| other acquisition of control;
| 11 |
| (3) the Director shall have the power to require the | 12 |
| following
information:
| 13 |
| (A) certification by an independent actuary of the | 14 |
| adequacy
of the reserves of the Health Maintenance | 15 |
| Organization sought to be acquired;
| 16 |
| (B) pro forma financial statements reflecting the | 17 |
| combined balance
sheets of the acquiring company and | 18 |
| the Health Maintenance Organization sought
to be | 19 |
| acquired as of the end of the preceding year and as of | 20 |
| a date 90 days
prior to the acquisition, as well as pro | 21 |
| forma financial statements
reflecting projected | 22 |
| combined operation for a period of 2 years;
| 23 |
| (C) a pro forma business plan detailing an | 24 |
| acquiring party's plans with
respect to the operation | 25 |
| of the Health Maintenance Organization sought to
be | 26 |
| acquired for a period of not less than 3 years; and
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| (D) such other information as the Director shall | 2 |
| require.
| 3 |
| (d) The provisions of Article VIII 1/2 of the Illinois | 4 |
| Insurance Code
and this Section 5-3 shall apply to the sale by | 5 |
| any health maintenance
organization of greater than 10% of its
| 6 |
| enrollee population (including without limitation the health | 7 |
| maintenance
organization's right, title, and interest in and to | 8 |
| its health care
certificates).
| 9 |
| (e) In considering any management contract or service | 10 |
| agreement subject
to Section 141.1 of the Illinois Insurance | 11 |
| Code, the Director (i) shall, in
addition to the criteria | 12 |
| specified in Section 141.2 of the Illinois
Insurance Code, take | 13 |
| into account the effect of the management contract or
service | 14 |
| agreement on the continuation of benefits to enrollees and the
| 15 |
| financial condition of the health maintenance organization to | 16 |
| be managed or
serviced, and (ii) need not take into account the | 17 |
| effect of the management
contract or service agreement on | 18 |
| competition.
| 19 |
| (f) Except for small employer groups as defined in the | 20 |
| Small Employer
Rating, Renewability and Portability Health | 21 |
| Insurance Act and except for
medicare supplement policies as | 22 |
| defined in Section 363 of the Illinois
Insurance Code, a Health | 23 |
| Maintenance Organization may by contract agree with a
group or | 24 |
| other enrollment unit to effect refunds or charge additional | 25 |
| premiums
under the following terms and conditions:
| 26 |
| (i) the amount of, and other terms and conditions with |
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| respect to, the
refund or additional premium are set forth | 2 |
| in the group or enrollment unit
contract agreed in advance | 3 |
| of the period for which a refund is to be paid or
| 4 |
| additional premium is to be charged (which period shall not | 5 |
| be less than one
year); and
| 6 |
| (ii) the amount of the refund or additional premium | 7 |
| shall not exceed 20%
of the Health Maintenance | 8 |
| Organization's profitable or unprofitable experience
with | 9 |
| respect to the group or other enrollment unit for the | 10 |
| period (and, for
purposes of a refund or additional | 11 |
| premium, the profitable or unprofitable
experience shall | 12 |
| be calculated taking into account a pro rata share of the
| 13 |
| Health Maintenance Organization's administrative and | 14 |
| marketing expenses, but
shall not include any refund to be | 15 |
| made or additional premium to be paid
pursuant to this | 16 |
| subsection (f)). The Health Maintenance Organization and | 17 |
| the
group or enrollment unit may agree that the profitable | 18 |
| or unprofitable
experience may be calculated taking into | 19 |
| account the refund period and the
immediately preceding 2 | 20 |
| plan years.
| 21 |
| The Health Maintenance Organization shall include a | 22 |
| statement in the
evidence of coverage issued to each enrollee | 23 |
| describing the possibility of a
refund or additional premium, | 24 |
| and upon request of any group or enrollment unit,
provide to | 25 |
| the group or enrollment unit a description of the method used | 26 |
| to
calculate (1) the Health Maintenance Organization's |
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| profitable experience with
respect to the group or enrollment | 2 |
| unit and the resulting refund to the group
or enrollment unit | 3 |
| or (2) the Health Maintenance Organization's unprofitable
| 4 |
| experience with respect to the group or enrollment unit and the | 5 |
| resulting
additional premium to be paid by the group or | 6 |
| enrollment unit.
| 7 |
| In no event shall the Illinois Health Maintenance | 8 |
| Organization
Guaranty Association be liable to pay any | 9 |
| contractual obligation of an
insolvent organization to pay any | 10 |
| refund authorized under this Section.
| 11 |
| (Source: P.A. 94-906, eff. 1-1-07; 94-1076, eff. 12-29-06; | 12 |
| 95-422, eff. 8-24-07; 95-520, eff. 8-28-07; revised 12-4-07.)
| 13 |
| Section 35. The Limited Health Service Organization Act is | 14 |
| amended by changing Section 4003 as follows:
| 15 |
| (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
| 16 |
| Sec. 4003. Illinois Insurance Code provisions. Limited | 17 |
| health service
organizations shall be subject to the provisions | 18 |
| of Sections 133, 134, 137,
140, 141.1, 141.2, 141.3, 143, 143c, | 19 |
| 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, 154.7, 154.8, | 20 |
| 155.04, 155.37, 355.2, 356f.1, 356v, 356z.10
356z.9 , 368a, 401, | 21 |
| 401.1,
402,
403, 403A, 408,
408.2, 409, 412, 444, and 444.1 and | 22 |
| Articles IIA, VIII 1/2, XII, XII 1/2,
XIII,
XIII 1/2, XXV, and | 23 |
| XXVI of the Illinois Insurance Code. For purposes of the
| 24 |
| Illinois Insurance Code, except for Sections 444 and 444.1 and |
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| Articles XIII
and XIII 1/2, limited health service | 2 |
| organizations in the following categories
are deemed to be | 3 |
| domestic companies:
| 4 |
| (1) a corporation under the laws of this State; or
| 5 |
| (2) a corporation organized under the laws of another | 6 |
| state, 30% of more
of the enrollees of which are residents | 7 |
| of this State, except a corporation
subject to | 8 |
| substantially the same requirements in its state of | 9 |
| organization as
is a domestic company under Article VIII | 10 |
| 1/2 of the Illinois Insurance Code.
| 11 |
| (Source: P.A. 95-520, eff. 8-28-07; revised 12-5-07.)
| 12 |
| Section 40. The Voluntary Health Services Plans Act is | 13 |
| amended by changing Section 10 as follows:
| 14 |
| (215 ILCS 165/10) (from Ch. 32, par. 604)
| 15 |
| Sec. 10. Application of Insurance Code provisions. Health | 16 |
| services
plan corporations and all persons interested therein | 17 |
| or dealing therewith
shall be subject to the provisions of | 18 |
| Articles IIA and XII 1/2 and Sections
3.1, 133, 140, 143, 143c, | 19 |
| 149, 155.37, 354, 355.2, 356f.1, 356g.5, 356r, 356t, 356u, | 20 |
| 356v,
356w, 356x, 356y, 356z.1, 356z.2, 356z.4, 356z.5, 356z.6, | 21 |
| 356z.8, 356z.9,
356z.10
356z.9 , 364.01, 367.2, 368a, 401, | 22 |
| 401.1,
402,
403, 403A, 408,
408.2, and 412, and paragraphs (7) | 23 |
| and (15) of Section 367 of the Illinois
Insurance Code.
| 24 |
| (Source: P.A. 94-1076, eff. 12-29-06; 95-189, eff. 8-16-07; |
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| 95-331, eff. 8-21-07; 95-422, eff. 8-24-07; 95-520, eff. | 2 |
| 8-28-07; revised 12-5-07.)".
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