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90_HB2783
215 ILCS 125/4-14 from Ch. 111 1/2, par. 1409.7
Amends the Health Maintenance Organization Act. Makes a
technical change in a Section concerning evidence of
coverage.
LRB9010120JSgc
LRB9010120JSgc
1 AN ACT to amend the Health Maintenance Organization Act
2 by changing Section 4-14.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Health Maintenance Organization Act is
6 amended by changing Section 4-14 as follows:
7 (215 ILCS 125/4-14) (from Ch. 111 1/2, par. 1409.7)
8 Sec. 4-14. Evidence of Coverage.
9 (a) Every subscriber shall be issued an evidence of
10 coverage, that which shall contain a clear and complete
11 statement of:
12 (1) The health services to which each enrollee is
13 entitled;
14 (2) Eligibility requirements indicating the conditions
15 which must be met to enroll in a Health Care Plan;
16 (3) Any limitation of the services, kinds of services or
17 benefits to be provided, and exclusions, including any
18 co-payment, or other charges;
19 (4) The terms or conditions upon which coverage may be
20 cancelled or otherwise terminated;
21 (5) Where and in what manner information is available as
22 to where and how services may be obtained; and
23 (6) The method for resolving complaints.
24 (b) Any amendment to the evidence of coverage may be
25 provided to the subscriber in a separate document.
26 (Source: P.A. 86-620.)