Illinois Compiled Statutes 215 ILCS 105 — Comprehensive Health Insurance Plan Act.

Short title

Short title. This Act shall be known and may be cited as the Comprehensive Health Insurance Plan Act. (Source: P.A. 84-1478.)

The General Assembly hereby makes the following findings and declarations: (a) The Comprehensive Health Insurance Plan is established as a State program that is intended to provide an alternate market for health insurance for certain uninsurable Illinois residents, and further is intended to provide an acceptable alter…

Definitions

Definitions. As used in this Act, unless the context otherwise requires: "Plan administrator" means the insurer or third party administrator designated under Section 5 of this Act. "Benefits plan" means the coverage to be offered by the Plan to eligible persons and federally eligible individuals pursuant to this Act. "…

Operation of the Plan

Operation of the Plan. a. There is hereby created an Illinois Comprehensive Health Insurance Plan. b. The Plan shall operate subject to the supervision and control of the Board. The Board is created as a political subdivision and body politic and corporate and, as such, is not a State agency. The Board shall consist of…

Powers and authority of the board

Powers and authority of the board. The board shall have the general powers and authority granted under the laws of this State to insurance companies licensed to transact health and accident insurance and in addition thereto, the specific authority to: a. Enter into contracts as are necessary or proper to carry out the…

Plan administrator

Plan administrator. a. The Board shall select a Plan administrator through a competitive bidding process to administer the Plan. The Board shall evaluate bids submitted under this Section based on criteria established by the Board which shall include: (1) The Plan administrator's proven ability to handle other large gr…

Contents of Plan

Contents of Plan. The Plan shall include, but is not limited to, the following: a. Schedules of premiums and benefits, limitations, exclusions, deductibles, coinsurance payments, and other policy terms and conditions established in accordance with appropriate actuarial principles and all the requirements of this Act. b…

Eligibility

Eligibility. a. Except as provided in subsection (e) of this Section or in Section 15 of this Act, any person who is either a citizen of the United States or an individual lawfully admitted for permanent residence and who has been for a period of at least 180 days and continues to be a resident of this State shall be e…

Premiums

Premiums. (a) The Board shall establish premium rates for coverage as provided in subsection (d) of this Section. (b) Separate schedules of premium rates based on sex, age, geographical location, and benefit plan shall apply for individual risks. (c) The Board may provide for separate premium rates for optional family…

Minimum benefits

Minimum benefits. a. Availability. The Plan shall offer in a periodically renewable policy major medical expense coverage to every eligible person who is not eligible for Medicare. Major medical expense coverage offered by the Plan shall pay an eligible person's covered expenses, subject to limit on the deductible and…

Managed Care Reform and Patient Rights Act

Managed Care Reform and Patient Rights Act. The Plan is subject to the provisions of the Managed Care Reform and Patient Rights Act. (Source: P.A. 91-617, eff. 1-1-00.)

Drug formulary; notice

Drug formulary; notice. The Plan must comply with Section 155.37 of the Illinois Insurance Code. (Source: P.A. 92-440, eff. 8-17-01.)

Taxation

Taxation. The Plan and the Board established pursuant to this Act shall be exempt from payment of all fees and all taxes levied by the State or any of its subdivisions. (Source: P.A. 85-702.)

Collective action

Collective action. Participation in the operation of the Plan, the establishment of rates, forms or procedures, or any other joint or collective action required by this Act shall not be the basis of any legal action, criminal or civil liability or penalty against the Plan, the Plan administrator, the Board or any of it…

Plan notice

Plan notice. On and after the date the Illinois Comprehensive Health Insurance Plan becomes operational as provided in this Act, every insurer licensed to issue, and which issues for delivery, policies of accident and health insurance in this State shall include a notice of the existence of the Illinois Comprehensive H…

Deficit or surplus

Deficit or surplus. a. If premiums or other receipts by the Board exceed the amount required for the operation of the Plan, including actual losses and administrative expenses of the Plan, the Board shall direct that the excess be held at interest, in a bank designated by the Board, or used to offset future losses or t…

Civil actions; availability of remedies; costs; attorney fees

Civil actions; availability of remedies; costs; attorney fees. (1) No civil action against the Plan or Board shall be allowed unless the party commencing the action has first filed a grievance and received a final decision thereon in accordance with the procedures established under paragraph (6) of subsection d of Sect…

Confidentiality

Confidentiality. (a) All steps necessary under State and Federal law to protect confidentiality of applicants and covered persons shall be undertaken by the Board to prevent the identification of individual records of persons covered under the Plan, rejected by the Plan, or who become ineligible for further participati…

(This Section was renumbered as Section 15 in P

(This Section was renumbered as Section 15 in P.A. 97-333.) Sec. 14.05. (Renumbered). (Source: P.A. 95-331, eff. 8-21-07. Renumbered by P.A. 97-333, eff. 8-12-11.)

Alternative portable coverage for federally eligible individuals

Alternative portable coverage for federally eligible individuals. (a) Notwithstanding the requirements of subsection a of Section 7 and except as otherwise provided in this Section, any federally eligible individual for whom a Plan application, and such enclosures and supporting documentation as the Board may require,…

Cessation of operations

Cessation of operations. (a) Except as otherwise provided in this Section, the insurance operations of the Plan authorized by this Act shall cease on December 31, 2021. (b) Coverage under the Plan does not apply to services provided on or after January 1, 2022. (c) The Plan shall cease providing coverage for participan…

Transfer of the Illinois Comprehensive Health Insurance Plan

Transfer of the Illinois Comprehensive Health Insurance Plan. (a) Upon entry of an Order of Rehabilitation or Liquidation against the Plan all powers, duties, rights, and responsibilities of the Plan and the Board shall be transferred to and vested in the Director, as rehabilitator or liquidator, who is authorized to w…

This Act takes effect July 1, 1987

This Act takes effect July 1, 1987.(Source: P.A. 97-333, eff. 8-12-11.)