reglab/housing_qa huggingface dataset:
215 ILCS 5/361a
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 973a)Sec. 361a.         Age  limit.If any such policy contains a provision establishing, as an age limit or  otherwise, a date after which the coverage provided by the policy will not  be effective, and if such date falls within a period for which premium is  accepted by the insurer or if the insurer accepts a premium after such  date, the coverage provided by the policy will continue in force subject to  any right of cancellation until the end of the period for which premium has  been accepted. In the event the age of the insured has been misstated and  if, according to the correct age of the insured, the coverage provided by  the policy would not have become effective, or would have ceased prior to  the acceptance of such premium or premiums, then the liability of the  insurer shall be limited to the refund, upon request, of all premiums paid  for the period not covered by the policy.    (Source: Laws 1951, p. 611.)
215 ILCS 5/362a
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 974a)Sec. 362a. Non-application to certain policies. The provisions of sections 356a to 359a, both inclusive, shall not  apply to or affect (1) any policy of workers' compensation insurance or  any policy of liability insurance with or without supplementary expense  coverage therein; or (2) any policy or contract of reinsurance; or (3)  any group policy of insurance (unless otherwise specifically provided);  or (4) life insurance, endowment or annuity contracts, or contracts  supplemental thereto which contain only such provisions relating to  accident and sickness insurance as (a) provide additional benefits in  case of death or dismemberment or loss of sight by accident, or as (b)  operate to safeguard such contracts against lapse, or to give a special  surrender value or special benefit or an annuity in the event that the  insured or annuitant shall become a person with a total and permanent disability, as  defined by the contract or supplemental contract.  (Source: P.A. 99-143, eff. 7-27-15.)
215 ILCS 5/364
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 976)Sec. 364. Discrimination prohibited. Discrimination between  individuals of the same class of risk in the issuance of its policies  or in the amount of premiums or rates charged  for any insurance covered by this article, or in the benefits  payable thereon, or in any of the terms or conditions of such policy, or  in any other manner whatsoever is prohibited. Nothing in this provision  shall prohibit an insurer from providing incentives for insureds to utilize  the services of a particular hospital or person. It is hereby expressly  provided that whenever the terms "physician" or "doctor" appear or are  used in any way in any policy of accident or health insurance issued in  this state, said terms shall include within their meaning persons  licensed to practice dentistry under the Illinois Dental Practice Act with  regard to benefits payable for services performed by a person so  licensed, which such services are within the coverage provided by the  particular policy or contract of insurance and are within the  professional services authorized to be performed by such person under  and in accordance with the said Act.No company, in any policy of accident or health insurance issued in this  State, shall make or permit any distinction or discrimination against  individuals solely because of the individuals' disabilities in the amount of  payment of premiums or rates charged for policies of insurance, in the  amount of any dividends or other benefits payable thereon, or in any other  terms and conditions of the contract it makes, except where the distinction  or discrimination is based on sound actuarial principles or is related to  actual or reasonably anticipated experience.No company shall refuse to insure, or refuse to continue to insure,  or limit the amount or extent or kind of coverage available to an  individual, or charge an individual a different rate for the same coverage  solely because of blindness or partial blindness.  With respect to all  other conditions, including the underlying cause of the blindness or  partial blindness, persons who are blind or partially blind shall be  subject to the same standards of sound actuarial principles or actual or  reasonably anticipated experience as are sighted persons. Refusal to  insure includes denial by an insurer of disability insurance coverage on  the grounds that the policy defines "disability" as being presumed in the  event that the insured loses his or her eyesight.  (Source: P.A. 99-143, eff. 7-27-15.)
215 ILCS 5/364.1
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 976.1)Sec. 364.1.         Every policy of accident and health insurance  delivered or issued for delivery to any person in this State after the  effective date of this amendatory Act of 1979 which provides coverage  for services coming within the practice of  optometry as defined in the Illinois Optometric Practice Act of  1987, as now or hereafter amended shall, upon  issuance or delivery, be accompanied by a written notice to the  policyholder that such policyholder may elect for optometric services  received to be reimbursed to either a physician licensed to practice  medicine in all its branches or to an optometrist licensed in this State.    (Source: P.A. 85-1209.)
215 ILCS 5/364.2
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 364.2. Purchase of ophthalmic goods or services. An insurer may not require a provider, as a condition of participation by the provider, to purchase ophthalmic goods or services, including but not limited to eyeglass frames, in a quantity or dollar amount in excess of the quantity or dollar amount an enrollee purchases under the terms of the policy.  (Source: P.A. 93-1077, eff. 1-18-05.)
215 ILCS 5/364.3
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 364.3. Insurer uniform electronic prior authorization form; prescription benefits.(a) As used in this Section, "prescribing provider" includes a provider authorized to write a prescription, as described in subsection (e) of Section 3 of the Pharmacy Practice Act, to treat a medical condition of an insured.(b) Notwithstanding any other provision of law to the contrary, on and after July 1, 2021, an insurer that provides prescription drug benefits shall utilize and accept the uniform electronic prior authorization form developed pursuant to subsection (c) when requiring prior authorization for prescription drug benefits.(c) On or before July 1, 2020, the Department shall develop a uniform electronic prior authorization form that shall be used by commercial insurers.  Notwithstanding any other provision of law to the contrary, on and after July 1, 2021, every prescribing provider must use the uniform electronic prior authorization form to request prior authorization for coverage of prescription drug benefits and every insurer shall accept the uniform electronic prior authorization form as sufficient to request prior authorization for prescription drug benefits.(d)  The Department  shall develop the uniform electronic prior authorization form with input from interested parties, including, but not limited to, the following individuals appointed by the Director: 2 psychiatrists recommended by a State organization that represents psychiatrists, 2 pharmacists recommended by a State organization that represents pharmacists, 2 physicians recommended by a State organization that represents physicians, 2 family physicians recommended by a State organization that represents family physicians, 2 pediatricians recommended by a State organization that represents pediatricians, and 2 representatives of the association that represents commercial insurers, from at least one public meeting.(e)  The Department, in development of the uniform electronic prior authorization form, shall take into consideration the following:(1) existing prior authorization forms established by     the federal Centers for Medicare and Medicaid Services and the Department; and(2) national standards pertaining to electronic prior     authorization.(f) If, upon receipt of a completed and accurate electronic prior authorization request from a prescribing provider pursuant to the submission of a uniform electronic prior authorization form, an insurer fails to use or accept the uniform electronic prior authorization form or fails to respond within 24 hours (if the patient has urgent medication needs) or within 72 hours (if the patient has regular medication needs), then the prior authorization request shall be deemed to have been granted.   (Source: P.A. 101-463, eff. 1-1-20.)
215 ILCS 5/367.3
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979.3)Sec. 367.3.     Group accident and health insurance; discretionary groups.(a) No group health insurance offered to a resident of this State under  a policy issued to a group, other than one specifically described in  Section 367(1), shall be delivered or issued for delivery in this State  unless the Director determines that:(1) the issuance of the policy is not contrary to the     public interest;(2) the issuance of the policy will result in     economies of acquisition and administration; and(3) the benefits under the policy are reasonable in     relation to the premium charged.(b) No such group health insurance may be offered in this State under a  policy issued in another state unless this State or the state in which the  group policy is issued has made a determination that the requirements of  subsection (a) have been met.Where insurance is to be offered in this State under a policy described  in this subsection, the insurer shall file for informational review purposes:(1) a copy of the group master contract;(2) a copy of the statute authorizing the issuance of     the group policy in the state of situs, which statute has the same or similar requirements as this State, or in the absence of such statute, a certification by an officer of the company that the policy meets the Illinois minimum standards required for individual accident and health policies under authority of Section 401 of this Code, as now or hereafter amended, as promulgated by rule at 50 Illinois Administrative Code, Ch. I, Sec. 2007, et seq., as now or hereafter amended, or by a successor rule;(3) evidence of approval by the state of situs of the     group master policy; and(4) copies of all supportive material furnished to     the state of situs to satisfy the criteria for approval.(c) The Director may, at any time after receipt of the information  required under subsection (b) and after finding that the standards of  subsection (a) have not been met, order the insurer to cease the issuance  or marketing of that coverage in this State.(d) Group accident and health insurance subject to the provisions of  this Section is also subject to the provisions of Section 367i of this Code.    (Source: P.A. 90-655, eff. 7-30-98.)
215 ILCS 5/367b
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979b)Sec. 367b. (a) This Section applies to the hospital and medical expense  provisions of a group accident or health insurance policy.(b) If a policy  provides that coverage of a dependent of an employee or other member of the  covered group terminates upon attainment of the limiting age for dependent  persons specified in the policy, the  attainment of such limiting age does not operate to terminate the hospital  and medical coverage of a person who, because of a disabling   condition that occurred before attainment of the limiting age, is incapable of  self-sustaining employment and is dependent on his or her parents or other  care providers for lifetime care and supervision.(c) For purposes of subsection (b), "dependent on other care providers" is  defined as requiring a Community Integrated Living Arrangement, group home,  supervised apartment, or other residential services licensed or certified by  the Department of Human Services (as successor to the Department of Mental  Health and Developmental Disabilities), the Department  of Public Health, or the Department of Healthcare and Family Services (formerly Department of Public Aid).(d) The insurer may inquire of the person insured 2 months prior to  attainment by a dependent of the limiting age set forth in the policy, or  at any reasonable time thereafter, whether such dependent is in fact a  person who has a disability and is dependent and, in the absence of proof submitted within  31 days of such inquiry that such dependent is a person who has a disability and is dependent may terminate coverage of such person at or after attainment of the  limiting age. In the absence of such inquiry, coverage of any person who has a disability and is dependent shall continue through the term of such policy or any  extension or renewal.(e) This amendatory Act of 1969 is applicable to policies issued or  renewed  more than 60 days after the effective date of this amendatory Act of 1969.  (Source: P.A. 99-143, eff. 7-27-15.)
215 ILCS 5/367c
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979c)Sec. 367c.No claim shall be denied, under any group accident and health policy  delivered or renewed in this State after the effective date of this  Amendatory Act, for treatment or services for mental illness rendered in a  hospital solely because such hospital lacks surgical facilities.    (Source: P.A. 78-708.)
215 ILCS 5/367d
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979d)Sec. 367d.         No claim shall be denied, under any group accident and health  policy delivered or renewed in this State after the effective date of this  amendatory Act, for treatment or services for rehabilitation following either a  physical or mental illness, rendered in a hospital solely because such hospital  lacks surgical facilities.    (Source: P.A. 79-303.)
215 ILCS 5/367d.1
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979d.1)Sec. 367d.1.   After the effective date of this amendatory Act of 1992,  no group policy of accident and health insurance that provides coverage for  the treatment of alcoholism or other drug abuse or dependency on both an  inpatient and outpatient basis may be issued, delivered or amended in this  State if it excludes from coverage services provided by persons or entities  licensed by the Department of Human Services to provide  substance use disorder treatment, provided however that (a)  the charges are otherwise eligible for reimbursement under the policy and  (b) the services provided are medically necessary and within the scope of  the licensure of the provider.  This Section shall not apply to  arrangements, agreements or policies authorized under the Health Care  Reimbursement Reform Act of 1985; the Limited  Health Service Organization Act; or the  Health Maintenance Organization Act.  (Source: P.A. 100-759, eff. 1-1-19.)
215 ILCS 5/367i
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 979i)Sec. 367i. Discontinuance and replacement of coverage. Group health  insurance policies issued, amended, delivered or renewed on and after the  effective date of this amendatory Act of 1989, shall provide a reasonable  extension of benefits in the event of total disability on the date the  policy is discontinued for any reason.Any applicable extension of benefits or accrued liability shall be  described in the policy and group certificate.  Benefits payable during any  extension of benefits may be subject to the policy's regular benefit limits.Any insurer discontinuing a group health insurance policy shall provide  to the policyholder for delivery to covered employees or members a notice  as to the date such discontinuation is to be effective and urging them to  refer to their group certificates to determine what contract rights, if  any, are available to them.In the event a discontinued policy is replaced by another group policy,  the prior insurer or plan shall be liable only to the extent of its accrued  liabilities and extension of benefits.  Persons eligible for coverage  under the succeeding insurer's plan shall include all  employees and dependents covered under the prior insurer's plan, including  individuals with disabilities covered under the prior plan but absent from work on the  effective date and thereafter.  The prior insurer shall provide extension of  benefits for an insured's disabling condition when no coverage is available  under the succeeding insurer's plan whether due to the absence of coverage in  the contract or lack of required creditable coverage for a preexisting  condition.The Director shall promulgate reasonable rules as necessary to carry  out this Section.  (Source: P.A. 99-143, eff. 7-27-15.)
215 ILCS 5/367k
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 367k. Intoxication and narcotics; exclusion of coverage prohibited.(a) A  group or individual major medical policy of accident or health insurance or managed care plan amended, delivered, issued, or renewed after January 1, 2008 shall not, solely on the basis of the insured being intoxicated or under the influence of a narcotic, exclude coverage for any emergency or other medical, hospital, or surgical expenses incurred by an insured as a result of and related to an injury acquired while the insured is intoxicated or under the influence of any narcotic, regardless of whether the intoxicant or narcotic is administered on the advice of a health care practitioner.(b) Coverage required under this Section may be subject to deductibles, copayments, coinsurance, or annual or maximum payment limits that are consistent with deductibles, copayments, coinsurance, or annual or maximum payment limits applicable to other similar coverage under the plan.  (Source: P.A. 95-230, eff. 1-1-08.)
215 ILCS 5/367m
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 367m. Early intervention services. A policy of accident and health insurance that provides coverage for early intervention services must conform to the following criteria:(1) The use of private health insurance to pay for     early intervention services under Part C of the federal Individuals with Disabilities Education Act may not count towards or result in a loss of benefits due to annual or lifetime insurance caps for an infant or toddler with a disability, the infant's or toddler's parent, or the infant's or toddler's family members who are covered under that health insurance policy.(2) The use of private health insurance to pay for     early intervention services under Part C of the federal Individuals with Disabilities Education Act may not negatively affect the availability of health insurance to an infant or toddler with a disability, the infant's or toddler's parent, or the infant's or toddler's family members who are covered under that health insurance policy, and health insurance coverage may not be discontinued for these individuals due to the use of the health insurance to pay for services under Part C of the federal Individuals with Disabilities Education Act.(3) The use of private health insurance to pay for     early intervention services under Part C of the federal Individuals with Disabilities Education Act may not be the basis for increasing the health insurance premiums of an infant or toddler with a disability, the infant's or toddler's parent, or the infant's or toddler's family members covered under that health insurance policy.For the purposes of this Section, "early intervention services" has the same meaning as in the Early Intervention Services System Act.   (Source: P.A. 98-41, eff. 6-28-13.)
215 ILCS 5/368
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 980)Sec. 368.         Industrial  accident and health insurance.(1) Industrial accident and health insurance is hereby declared to be  that form of accident and health insurance in which the premium is payable  weekly.(2) Any insurance company authorized to write accident and health  insurance in this State shall have power to issue industrial accident and  health policies. No policy of industrial accident and health insurance may  be issued or delivered in this State unless it has printed thereon the  words "Industrial Policy," a copy of the form thereof shall have been filed  with the department and approved by it in accordance with section 355.    (Source: Laws 1951, p. 611.)
215 ILCS 5/368c
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 368c.     Remittance advice and procedures.(a) A remittance advice shall be furnished to a health care professional or  health  care provider that identifies the disposition of each claim.  The remittance  advice shall identify the services billed; the patient responsibility, if any;  the actual payment, if any, for the services billed; and the reason for any  reduction to the amount for  which the claim was submitted.  For any reductions to the amount for which the  claim was submitted, the remittance shall identify any withholds and the reason  for any denial or reduction.A remittance advice for capitation or prospective payment arrangements shall  be  furnished to a health care professional or health care provider pursuant to a  contract with  an insurer, health maintenance organization,  independent practice association,  or  physician hospital organization in accordance with the terms of the contract.(b) When health care services are provided by a non-participating  health care  professional or health care provider, an insurer, health maintenance  organization,  independent practice association, or physician hospital organization may pay  for covered  services either to a patient directly or to the non-participating health care  professional or  health care provider.(c) When a person presents a  benefits information card,  a health care professional or health care provider shall make a good faith  effort  to inform the  person if the  health care professional or health care provider has a participation contract  with the  insurer,  health maintenance organization, or other  entity identified on the card.    (Source: P.A. 93-261, eff. 1-1-04.)