215 ILCS 125/2-2
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 125/ - Health Maintenance Organization Act.|Article II - Certificate Of Authority, General Corporate And Financial Requirements

 (from Ch. 111 1/2, par. 1404)Sec. 2-2. Determination by Director.(a) Upon receipt of an application for issuance of a certificate of  authority, the Director shall transmit copies of such application and  accompanying documents to the Director of the Illinois Department of Public  Health. The Director of the Department of Public Health shall then  determine whether the applicant for certificate of authority, with respect  to health care services to be furnished: (1) has demonstrated the  willingness and potential ability to assure that such health care service  will be provided in a manner to insure both availability and accessibility  of adequate personnel and facilities and in a manner enhancing  availability, accessibility, and continuity of service; and (2) has  arrangements, established in accordance with regulations promulgated by the  Department of Public Health for an ongoing quality of health care assurance  program concerning health care processes and outcomes. Upon investigation,  the Director of the Department of Public Health shall certify to the  Director whether the proposed Health Maintenance Organization meets the  requirements of this subsection (a). If the Director of the Department of  Public Health certifies that the Health Maintenance Organization does not  meet such requirements, he shall specify in what respect it is deficient.(b) Issuance of a certificate of authority shall be granted if the  following conditions are met:(1) the requirements of subsection (c) of Section 2-1     have been fulfilled;(2) the persons responsible for the conduct of the     affairs of the applicant are competent, trustworthy, and possess good reputations, and have had appropriate experience, training or education;(3) the Director of the Department of Public Health     certifies that the Health Maintenance Organization's proposed plan of operation meets the requirements of this Act;(4) the Health Care Plan furnishes basic health care     services on a prepaid basis, through insurance or otherwise, except to the extent of reasonable requirements for co-payments or deductibles as authorized by this Act;(5) the Health Maintenance Organization is     financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees; in making this determination, the Director shall consider:(A) the financial soundness of the applicant's         arrangements for health services and the minimum standard rates, co-payments and other patient charges used in connection therewith;(B) the adequacy of working capital, other         sources of funding, and provisions for contingencies; and(C) that no certificate of authority shall be         issued if the initial minimum net worth of the applicant is less than $2,000,000. The initial net worth shall be provided in cash and securities in combination and form acceptable to the Director;(6) the agreements with providers for the provision     of health services contain the provisions required by Section 2-8 of this Act; and(7) any deficiencies identified by the Director have     been corrected. (Source: P.A. 100-63, eff. 8-11-17.)