reglab/housing_qa huggingface dataset:
215 ILCS 5/352
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 964)Sec. 352. Scope of Article.(a) Except as provided in subsections (b), (c), (d), and (e),  this Article shall  apply to all companies transacting in this State the kinds of business  enumerated in clause (b) of Class 1 and clause (a) of Class 2 of Section 4.  Nothing in this Article shall apply to, or in any way affect policies or  contracts described in clause (a) of Class 1 of Section 4; however, this  Article shall apply to policies and contracts which contain benefits  providing reimbursement for the expenses of long term health care which are  certified or ordered by a physician including but not limited to  professional nursing care, custodial nursing care, and non-nursing  custodial care provided in a nursing home or at a residence of the insured.(b) (Blank).(c) A policy issued and delivered in this State  that provides coverage under that policy for  certificate holders who are neither residents of nor employed in this State  does not need to provide to those nonresident  certificate holders  who  are not employed in this State the coverages or  services mandated by this Article.(d) Stop-loss insurance is exempt from all Sections  of this Article, except this Section and Sections 353a, 354, 357.30, and  370.  For purposes of this exemption, stop-loss insurance is further defined as  follows:(1) The policy must be issued to and insure an     employer, trustee, or other sponsor of the plan, or the plan itself, but not employees, members, or participants.(2) Payments by the insurer must be made to the     employer, trustee, or other sponsors of the plan, or the plan itself, but not to the employees, members, participants, or health care providers.(e) A policy issued or delivered in this State to the Department of Healthcare and Family Services (formerly  Illinois Department  of Public Aid) and providing coverage, under clause (b) of Class 1 or clause (a)  of Class 2 as described in Section 4, to persons who are enrolled under Article V of the Illinois  Public Aid Code or under the Children's Health Insurance Program Act is  exempt from all restrictions, limitations,  standards, rules, or regulations respecting benefits imposed by or under  authority of this Code, except those specified by subsection (1) of Section  143, Section 370c, and Section 370c.1.  Nothing in this subsection, however, affects the total medical services  available to persons eligible for medical assistance under the Illinois Public  Aid Code.(f) An in-office membership care agreement provided under the In-Office Membership Care Act is not insurance for the purposes of this Code. (Source: P.A. 101-190, eff. 8-2-19.)
215 ILCS 5/352a
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 964a)Sec. 352a.     Mandated Coverages.     No legislation enacted after the  effective date of this Amendatory Act of 1990 which mandates or requires  the offering of health care coverages or services shall apply to any  insurer unless the legislation applies equally to employee welfare benefit  plans described in 29 U.S.C. 1001 et seq.    (Source: P.A. 86-1365.)
215 ILCS 5/352b
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 352b. Policy of individual or group accident and health insurance. Unless specified otherwise and when used in context of accident and health insurance policy benefits, coverage, terms, or conditions required to be provided under this Article, "policy of individual or group accident and health insurance", as used in this Article, does not include any coverage or policy that provides an excepted benefit, as that term is defined in Section 2791(c) of the federal Public Health Service Act (42 U.S.C. 300gg-91). Nothing in this amendatory Act of the 101st General Assembly applies to a policy of liability, workers' compensation, automobile medical payment, or limited scope dental or vision benefits insurance issued under this Code.  (Source: P.A. 101-456, eff. 8-23-19.)
215 ILCS 5/353
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 965)Sec. 353.     Non-cancellable accident and health insurance reserves.(1) The legal minimum standard for computing the active life reserve,  including the unearned premium reserve, of non-cancellable accident and  health policies issued on and after January 1 of the year following that  during which this Code becomes effective shall be based on Class III  Disability Experience with interest at not to exceed three and one-half per  centum per annum on the full preliminary term basis; and the minimum  standard for computing the active life reserve of such policies issued  prior to January 1 of the year following that during which this Code  becomes effective shall be such as to place an adequate value, as  determined by sound insurance practices, on the liabilities thereunder.(2) For policies with a waiting period of less than three (3) months, or  providing benefits at ages beyond the limits of Class III Disability  Experience, such tables shall be extended to cover the provisions of such  policies on such basis as may be approved by the Director.(3) The reserve for losses under non-cancellable accident and health  policies issued on and after January 1 of the year following that during  which this Code becomes effective shall be based on Class III Disability  Experience, except that for claims of less than twenty-seven months  duration the reserve may be taken as equivalent to the prospective claim  payments for three and one-half times the elapsed period of disability,  provided, that in no case shall the reserve be less than the equivalent of  seven weeks' claim payments; and the minimum standard for computing the  reserve for losses under such policies issued prior to January 1 of the  year following that during which the Code becomes effective shall be such  as to place an adequate value, as determined by sound insurance practices,  on such losses.(4) The Director shall modify the application of the tables and  requirements prescribed in this section to policies or to claims arising  under policies in accordance with the waiting period contained in such  policies and in accordance with any limitation as to the time for which  indemnity is payable. The company shall give the notice required in section  234 on all non-cancellable accident and health policies.This section shall apply only to accident and health policies issued  prior to the operative date under section 353a as defined therein.    (Source: Laws 1965, p. 740.)
215 ILCS 5/353a
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 965a)Sec. 353a.         Accident  and health reserves.The reserves for all accident and health policies issued after the  operative date of this section shall be computed and maintained on a basis  which shall place an actuarially sound value on the liabilities under such  policies. To provide a basis for the determination of such actuarially  sound value, the Director from time to time shall adopt rules requiring the  use of appropriate tables of morbidity, mortality, interest rates and  valuation methods for such reserves. In no event shall such reserves be  less than the pro rata gross unearned premium reserve for such policies.The company shall give the notice required in section 234 on all  non-cancellable accident and health policies.After this section becomes effective, any company may file with the  Director written notice of its election to comply with the provisions of  this section after a specified date before January 1, 1967. After the  filing of such notice, then upon such specified date (which shall be the  operative date of this section for such company), this section shall become  operative with respect to the accident and health policies thereafter  issued by such company. If a company makes no such election, the operative  date of this section for such company shall be January 1, 1967.After this section becomes effective, any company may file with the  Director written notice of its election to establish and maintain reserves  upon its accident and health policies issued prior to the operative date of  this section in accordance with the standards for reserves established by  this section, and thereafter the reserve standards prescribed pursuant to  this section shall be effective with respect to said accident and health  policies issued prior to the operative date of this section.    (Source: Laws 1965, p. 740.)
215 ILCS 5/354
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 966)Sec. 354.         Accident  and health loss reserves.The loss reserves of all accident and health policies other than  non-cancellable accident and health policies shall be computed and  maintained in accordance with the applicable provisions of Article XXII.  The unearned premium reserve of all accident and health policies other than  non-cancellable accident and health policies shall be computed and  maintained on the monthly pro rata basis.This Section shall apply only to accident and health policies issued  prior to the operative date under section 353a as defined therein.    (Source: P.A. 83-584.)
215 ILCS 5/355
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 967)Sec. 355.         Accident  and health policies-Provisions.)  No policy of insurance against loss or damage from the sickness, or from  the bodily injury or death of the insured by accident shall be issued or  delivered to any person in this State until a copy of the form thereof and  of the classification of risks and the premium rates pertaining thereto  have been filed with the Director; nor shall it be so issued or delivered  until the Director shall have approved such policy pursuant to the provisions  of Section 143.  If the Director  disapproves the policy form he shall make a written decision stating the  respects in which such form does not comply with the requirements of law  and shall deliver a copy thereof to the company and it shall be unlawful  thereafter for any such company to issue any policy in such form.    (Source: P.A. 79-777.)
215 ILCS 5/355.1
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 967.1)Sec. 355.1.         No claim for benefits for loss of time from the insured person's  occupation, under a group or individual accident and health insurance  policy delivered in this State more than 120 days after the effective date  of this Section, shall be reduced by reason of any cost-of-living increase,  designated as such under the Federal Social Security Act, if such  cost-of-living increase occurs while the policy's benefits are payable for  that claim.    (Source: P.A. 78-603.)
215 ILCS 5/355.2
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 967.2)Sec. 355.2.     Dental coverage reimbursement rates.(a) Every company that issues, delivers, amends, or renews any  individual or group policy of accident and health insurance on or after the  effective date of this amendatory Act of 1991 that provides  dental insurance and bases payment for those benefits upon a  usual and customary fee charged by licensed dentists  must disclose all of the following:(1) The frequency of the determination of the usual     and customary fee.(2) A general description of the methodology used to     determine usual and customary fees.(3) The percentile that determines the maximum     benefit that the company will pay for any dental procedure, if the usual and customary fee is determined by taking a sample of fees submitted on actual claims from licensed dentists and then determining the benefit by selecting a percentile of those fees.(b) The disclosure must be provided upon request to all group and  individual policy holders and group certificate holders.  All proposals for  dental insurance must notify the prospective policy holder that information  regarding usual and customary fee determinations is available from the  insurer.  All employee benefit descriptions or supplemental documents must  notify the employee that information regarding reimbursement rates is  available from the employer.    (Source: P.A. 87-587.)
215 ILCS 5/355.3
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 355.3. Noncovered dental services.(a) In this Section:"Covered services" means dental care services for which a reimbursement is available under an    enrollee's plan contract, or for which a reimbursement would be available but for the application of    contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or    lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation."Dental insurance" means any policy of insurance that is issued by a company that provides coverage for dental services not covered by a medical plan.(b) No company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of this amendatory Act of the 97th General Assembly that provides dental insurance shall issue a service provider contract that requires a dentist to provide services to the insurer's policyholders at a fee set by the insurer unless the services are covered services under the applicable policyholder agreement.  (Source: P.A. 97-805, eff. 1-1-13.)
215 ILCS 5/355.4
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 355.4. Provider notification of network plan changes. Any contract entered into or renewed on or after the effective date of this amendatory Act of the 99th General Assembly that allows the rights and obligations of the contract to be assigned or leased to another insurer shall provide for notice of that assignment or lease within 30 days after the assignment or lease to the contracting dentist.  (Source: P.A. 99-568, eff. 7-15-16.)
215 ILCS 5/355b
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 355b. Claim-related information; alternative means of communication.(a) For the purposes of this Section, "claim-related information" means all claim or billing information relating specifically to an insured, subscriber, or person covered by an individual or group policy of accident and health insurance issued, delivered, amended, or renewed by a company doing business in this State.(b) A company that issues, delivers, amends, or renews an individual or group policy of accident and health insurance on or after the effective date of this amendatory Act of the 98th General Assembly shall accommodate a reasonable request by a person covered by a policy issued by the company to receive communications of claim-related information from the company by alternative means or at alternative locations if the person clearly states that disclosure of all or part of the information could endanger the person.(c) If a child is covered by a policy issued by a company, then the child's parent or guardian may make a request to the company pursuant to subsection (b) of this Section.(d) A company may require (1) a person making a request pursuant to subsection (b) of this Section to do so in writing, (2) the request to contain a statement that disclosure of all or part of the claim-related information to which the request pertains could endanger the person or child, and (3) the specification of an alternative address, telephone number, or other method of contact.(e) Except with the express consent of the person making a request pursuant to subsection (b) of this Section, a company may not disclose to the policyholder (1) the address, telephone number, or any other personally identifying information of the person who made the request or child for whose benefit a request was made, (2) the nature of the health care services provided, or (3) the name or address of the provider of the health care services.(f) A company that makes reasonable and good faith efforts to comply with this Section shall not be subject to civil or criminal liability on the grounds of noncompliance with this Section.(g) The Director shall adopt rules to guide companies in guarding against the disclosure of the information protected pursuant to this Section.(h) Nothing in this Section shall prevent, hinder, or otherwise affect the entry of an appropriate order made in the best interests of a child by a court of competent jurisdiction adjudicating disputed issues of child welfare or custody.  (Source: P.A. 98-189, eff. 1-1-14.)
215 ILCS 5/356a
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 968a)Sec. 356a.         Form of  policy.(1) No policy of accident and health insurance shall be delivered or  issued for delivery to any person in this state unless:(a) the entire money and other considerations therefor are expressed  therein; and(b) the time at which the insurance takes effect and terminates is  expressed therein; and(c) it purports to insure only one person, except that a policy may  insure, originally or by subsequent amendment, upon the application of an  adult member of a family who shall be deemed the policyholder, any two or  more eligible members of that family, including husband, wife, dependent  children or any children under a specified age which shall not exceed 19  years and any other person dependent upon the policyholder; and(d) the style, arrangement and over-all appearance of the policy give no  undue prominence to any portion of the text, and unless every printed  portion of the text of the policy and of any endorsements or attached  papers is plainly printed in light-faced type of a style in general use,  the size of which shall be uniform and not less than ten-point with a  lower-case unspaced alphabet length not less than one hundred and  twenty-point (the "text" shall include all printed matter except the name  and address of the insurer, name or title of the policy, the brief  description if any, and captions and subcaptions); and(e) the exceptions and reductions of indemnity are set forth in the  policy and, except those which are set forth in Sections 357.1 through  357.30 of this act, are printed, at the insurer's option, either included  with the benefit provision to which they apply, or under an appropriate  caption such as "EXCEPTIONS", or "EXCEPTIONS AND REDUCTIONS", provided that  if an exception or reduction specifically applies only to a particular  benefit of the policy, a statement of such exception or reduction shall be  included with the benefit provision to which it applies; and(f) each such form, including riders and endorsements, shall be  identified by a form number in the lower left-hand corner of the first page  thereof; and(g) it contains no provision purporting to make any portion of the  charter, rules, constitution, or by-laws of the insurer a part of the  policy unless such portion is set forth in full in the policy, except in  the case of the incorporation of, or reference to, a statement of rates or  classification of risks, or short-rate table filed with the Director.(2) If any policy is issued by an insurer domiciled in this state for  delivery to a person residing in another state, and if the official having  responsibility for the administration of the insurance laws of such other  state shall have advised the Director that any such policy is not subject  to approval or disapproval by such official, the Director may by ruling  require that such policy meet the standards set forth in subsection (1) of  this section and in Sections 357.1 through 357.30.    (Source: P.A. 76-860.)
215 ILCS 5/356b
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 968b)Sec. 356b. (a) This Section applies to the hospital and medical expense  provisions of an accident or health insurance policy.(b) If a policy provides that coverage of a dependent person 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 policyholder 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 60 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  thereof.(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.)