reglab/housing_qa huggingface dataset:
215 ILCS 5/368e
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 368e.     Administration and enforcement.(a) Other than the duties specifically created in Sections 368b, 368c, and  368d,  nothing in those Sections is intended to preclude, prevent, or require the  adoption,  modification, or termination of any utilization management, quality management,  or  claims processing methodologies or other provisions of a contract applicable to  services provided under a  contract  between an insurer, health maintenance organization,  independent practice  association, or  physician hospital organization and a health care professional or health care  provider.(b) Nothing in Sections 368b, 368c, and 368d precludes, prevents, or  requires  the  adoption, modification, or termination of any health plan term, benefit,  coverage or  eligibility provision, or payment methodology.(c) The provisions of Sections 368b, 368c, and 368d are deemed incorporated  into health care professional and health care provider service contracts  entered into on or before the  effective date of  this amendatory Act of the 93rd General Assembly and do not require an insurer,  health  maintenance organization, independent practice  association, or physician  hospital  organization to renew or renegotiate the contracts with a health care  professional or health  care provider.(d) The Department shall enforce the provisions of this Section and  Sections 368b, 368c, and 368d pursuant to the enforcement powers granted to it  by law.(e) The Department is hereby granted specific authority to issue a cease and  desist order against, fine, or otherwise penalize independent practice  associations and  physician-hospital organizations for violations.(f) The Department shall adopt reasonable rules to enforce compliance with  this Section and Sections 368b, 368c, and 368d.    (Source: P.A. 93-261, eff. 1-1-04.)
215 ILCS 5/368g
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 368g. Time-based billing.(a) As used in this Section, "CPT code" means the medical billing code set contained in the most recent version of the Current Procedural Terminology code book published by the American Medical Association.(b) A health care plan requiring a health care provider to use a time-based CPT code to bill for health care services shall not apply a time measurement standard that results in fewer units billed than allowed by the CPT code book, except as required by federal law for federally funded patients.   (Source: P.A. 101-119, eff. 7-22-19; 102-558, eff. 8-20-21.)
215 ILCS 5/369
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 981)Sec. 369.         Rights of  minors.Any minor of the age of fifteen years or more may, notwithstanding such  minority, contract for health and accident insurance on his own life for  his own benefit or for the benefit of his father, mother, husband, wife,  child, brother or sister, and may exercise all such contractual rights and  powers with respect to any such contract of insurance as might be exercised  by a person of full legal age, and may exercise with like effect all rights  and privileges under such contract, including the surrender of his interest  therein and the giving of a valid discharge for any benefit accruing or  money payable thereunder. Such minor shall not, by reason of his minority,  be entitled to rescind, avoid, or repudiate such contract, or any exercise  of a right or privilege thereunder.    (Source: Laws 1937, p. 696.)
215 ILCS 5/370
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 982)Sec. 370.         Policies  issued in violation of article-Penalty.(1) Any company, or any officer or agent thereof, issuing or delivering  to any person in this State any policy in wilful violation of the provision  of this article shall be guilty of a petty offense.(2) The Director may revoke the license of any foreign or alien company,  or of the agent thereof wilfully violating any provision of this article or  suspend such license for any period of time up to, but not to exceed, two  years; or may by order require such insurance company or agent to pay to  the people of the State of Illinois a penalty in a sum not exceeding $1,000,  and upon the failure of such insurance company or agent to  pay such penalty within twenty days after the mailing of such order,  postage prepaid, registered, and addressed to the last known place of  business of such insurance company or agent, unless such order is stayed by  an order of a court of competent jurisdiction, the Director of Insurance  may revoke or suspend the license of such insurance company or agent for  any period of time up to, but not exceeding a period of, two years.    (Source: P.A. 93-32, eff. 7-1-03.)
215 ILCS 5/370a
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 982a)Sec. 370a.     Assignability of Accident and Health Insurance.No provision of the Illinois Insurance Code, or any other law, prohibits  an insured under any policy of accident and health insurance or any other  person who may be the owner of any rights under such policy from making an  assignment of all or any part of his rights and privileges under the policy  including but not limited to the right to designate a beneficiary and to  have an individual policy issued in accordance with its terms. Subject to  the terms of the policy or any contract relating thereto, an assignment by  an insured or by any other owner of rights under the policy, made before or  after the effective date of this amendatory Act of 1969 is valid for the  purpose of vesting in the assignee, in accordance with any provisions  included therein as to the time at which it is effective, all rights and  privileges so assigned. However, such assignment is without prejudice to  the company on account of any payment it makes or individual policy it  issues before receipt of notice of the assignment. This amendatory Act of  1969 acknowledges, declares and codifies the existing right of assignment  of interests under accident and health insurance policies.  If an enrollee or insured of an insurer, health maintenance organization,  managed care plan, health care plan, preferred provider organization, or third  party administrator assigns a claim to a health care professional or health  care facility, then payment  shall be made directly to the health care professional or health care facility  including any interest  required under Section 368a, of this Code for failure to pay  claims  within 30  days after receipt by the insurer of due proof of loss.  Nothing in this  Section shall be construed to prevent any parties from reconciling duplicate  payments.    (Source: P.A. 91-605, eff. 12-14-99; 91-788, eff. 6-9-00.)
215 ILCS 5/370b
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 982b)Sec. 370b.     Reimbursement on equal basis.     Notwithstanding any provision  of any individual or group  policy of accident and health insurance, or any provision of a policy,  contract, plan or agreement for hospital or medical service or indemnity,  wherever such policy, contract, plan or agreement provides for  reimbursement for any service provided by persons licensed under the Medical Practice Act of 1987 or the Podiatric Medical  Practice  Act of 1987, the person entitled to benefits or person performing services  under such policy, contract, plan or agreement is entitled to reimbursement  on an equal basis for such service, when the service is performed by a  person licensed under the Medical Practice Act of 1987 or the  Podiatric Medical Practice Act of 1987.  The provisions of this Section do  not apply to any policy, contract, plan or agreement in effect prior to  September 19, 1969 or to  preferred provider arrangements or benefit agreements.    (Source: P.A. 90-14, eff. 7-1-97.)
215 ILCS 5/370b.1
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 370b.1. Surgical assistant payments. Payment for services rendered by a registered surgical assistant, as defined in the Registered Surgical Assistant and Registered Surgical Technologist Title Protection Act, who is neither an employee of an ambulatory surgical treatment center, as defined in the Ambulatory Surgical Treatment Center Act, nor an employee of a hospital shall be paid at the appropriate non-physician modifier rate if the payor would have made payment had the same services been provided by a physician.  (Source: P.A. 99-100, eff. 1-1-16.)
215 ILCS 5/370d
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

 (from Ch. 73, par. 982d)Sec. 370d.         Companies which issue insurance policies under this Article  containing business overhead expense coverage shall make available to persons  whose occupation is that of homemaker and who are not otherwise gainfully  employed, coverage which provides for reimbursement of certain specified  expenses ordinarily incurred by members of the household due to the incapacity  of the homemaker during periods of his or her total disability resulting  from injury or sickness, provided that such companies shall be required  to offer coverage which is at least 80% of total eligible expenses or $300  per month, whichever provides the lesser coverage.    (Source: P.A. 81-916.)
215 ILCS 5/370d.1
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

Sec. 370d.1. Group policies; chambers of commerce. Companies that issue group policies of accident and health insurance under this Article must offer such policies to local chambers of commerce.  (Source: P.A. 102-611, eff. 1-1-22.)
215 ILCS 5/370e
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX - Accident And Health Insurance

(215 ILCS 5/370e) (from Ch. 73, par. 982e)Sec. 370e.         Companies which issue group accident and health policies  or blanket accident and health plans to employer groups in this State shall  provide the employer with notice of termination of a group or blanket accident  and health plan because of the employer's failure to pay the premium when  due.  The insurance company shall send a copy of such notice to the Department.    (Source: P.A. 83-1006.)
215 ILCS 5/Art. XX.5 heading
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 ARTICLE XX-1/2      HEALTH CARE REIMBURSEMENT
215 ILCS 5/370f
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982f)Sec. 370f.     Short Title.     This Article may be cited as the "Health Care  Reimbursement Reform Act of 1985".    (Source: P.A. 84-618.)
215 ILCS 5/370g
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982g)Sec. 370g. Definitions. As used in this Article, the following definitions  apply:(a) "Health care services" means health care services or products  rendered or sold by a provider within the scope of the provider's license  or legal authorization.  The term includes, but is not limited to, hospital,  medical, surgical, dental, vision and pharmaceutical services or products.(b) "Insurer" means an insurance company or a health service corporation  authorized in this State to issue policies or subscriber contracts which  reimburse for expenses of health care services.(c) "Insured" means an individual entitled to reimbursement for expenses  of health care services under a policy or subscriber contract issued or  administered by an insurer.(d) "Provider" means an individual or entity duly licensed or legally  authorized to provide health care services.(e) "Noninstitutional provider" means any person licensed under the Medical  Practice Act of 1987, as now or hereafter amended.(f) "Beneficiary" means an individual entitled to reimbursement for  expenses of or the discount of provider fees for health care services under  a program where the beneficiary has an incentive to utilize the services of a  provider which has entered into an agreement or arrangement with an  administrator.(g) "Administrator" means any person, partnership or corporation, other  than an insurer or health maintenance organization holding a certificate of  authority under the "Health Maintenance Organization Act", as now or hereafter  amended, that arranges, contracts with, or administers contracts with a  provider whereby beneficiaries are provided an incentive to use the services of  such provider.(h) "Emergency medical condition" has the meaning given to that term in Section 10 of the Managed Care Reform and Patient Rights Act. (Source: P.A. 102-409, eff. 1-1-22.)
215 ILCS 5/370h
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982h)Sec. 370h.     Noninstitutional providers.     Before entering into any agreement  under this Article an insurer or administrator shall establish terms and  conditions that must be met by noninstitutional providers wishing to enter into  an agreement with the insurer or administrator.  These terms and conditions may  not discriminate unreasonably against or among noninstitutional providers.  Neither difference in prices among noninstitutional providers produced by  a process of individual negotiation nor price differences among other  noninstitutional providers in different geographical areas or different  specialties constitutes unreasonable discrimination.An insurer or administrator shall not refuse to contract with any  noninstitutional provider who meets the terms and conditions  established by the insurer or administrator.    (Source: P.A. 90-655, eff. 7-30-98.)
215 ILCS 5/370i
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982i)Sec. 370i.         Policies, agreements or arrangements with incentives or  limits on reimbursement authorized.(a) Policies, agreements or arrangements issued under this Article may  not contain terms or conditions that would operate unreasonably to restrict  the access and availability of health care services for the insured.(b) An insurer or administrator may:(1) enter into agreements with certain providers of     its choice relating to health care services which may be rendered to insureds or beneficiaries of the insurer or administrator, including agreements relating to the amounts to be charged the insureds or beneficiaries for services rendered;(2) issue or administer programs, policies or     subscriber contracts in this State that include incentives for the insured or beneficiary to utilize the services of a provider which has entered into an agreement with the insurer or administrator pursuant to paragraph (1) above.(c) After the effective date of this amendatory Act of the 92nd General  Assembly, any insurer  that arranges, contracts with, or administers contracts with a provider whereby  beneficiaries are  provided an incentive to use the services of such provider must include the  following disclosure  on its contracts and evidences of coverage: "WARNING, LIMITED BENEFITS WILL  BE  PAID WHEN NON-PARTICIPATING PROVIDERS ARE USED. You should be aware that  when you elect to utilize the services of a non-participating provider for a  covered service in  non-emergency situations, benefit payments to such non-participating provider  are not based  upon the amount billed. The basis of your benefit payment will be determined  according to your  policy's fee schedule, usual and customary charge (which is determined by  comparing charges  for similar services adjusted to the geographical area where the services are  performed), or other  method as defined by the policy. YOU CAN EXPECT TO PAY MORE THAN THE  COINSURANCE AMOUNT DEFINED IN THE POLICY AFTER THE PLAN HAS PAID ITS  REQUIRED PORTION. Non-participating providers may bill members for any amount  up to  the billed charge after the plan has paid its portion of the bill.  Participating providers have  agreed to accept discounted payments for services with no additional billing to  the member other  than co-insurance and deductible amounts. You may obtain further information  about the  participating status of professional providers and information on out-of-pocket  expenses by  calling the toll free telephone number on your identification card.".    (Source: P.A. 92-579, eff. 1-1-03.)
215 ILCS 5/370j
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982j)Sec. 370j.     Requirements not applicable to insurers.     Except as otherwise  provided, no insurer authorized to do business in this State shall be subject to any  of the requirements of this Article that are applicable to administrators.Requirements not applicable to self-insured  employers, employee benefit trust funds, other ERISA exempt  organizations or the State of Illinois.  Such organizations are not  subject to any provisions of  this Article even though they may contract with administrators for  administration of health insurance claims subject to contractual  arrangements of the administrator's preferred provider program.    (Source: P.A. 84-1431.)
215 ILCS 5/370k
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982k)Sec. 370k.     Registration.(a) All administrators of a preferred provider  program subject to this Article shall register with the Department of  Insurance, which shall by rule establish criteria for such registration  including minimum solvency requirements and an annual registration fee for  each administrator.(b) The Department of Insurance shall compile and maintain a listing  updated  at least annually of administrators and insurers offering agreements  authorized under this Article.(c) Preferred provider administrators are subject  to the provisions of Sections 368b, 368c, 368d, and 368e of this  Code.    (Source: P.A. 93-261, eff. 1-1-04.)
215 ILCS 5/370l
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982l)Sec. 370l.     Fiduciary and bonding requirements.     Each  administrator who handles money for purposes of payment for providers  services subject to this Article shall (1) establish and maintain  a fiduciary account, separate and apart from any and all other accounts,  for the receipt and disbursement of funds for reimbursement for programs  covered under this Article, or (2) post or cause to be posted, a bond of  indemnity in an amount equal to not less than 10% of the total estimated  annual reimbursements under such programs.If a bond of indemnity is posted, it shall be held by the Director of  Insurance for the benefit and indemnification of the beneficiaries and  payors of services under the programs subject to  this Article.An administrator who operates more than one such program may establish  and maintain a separate fiduciary account or bond of indemnity for each  such program, or may operate and maintain a consolidated fiduciary account  or bond of indemnity for all such programs.    (Source: P.A. 84-618.)
215 ILCS 5/370m
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982m)Sec. 370m.     Program Requirements.     Each  administrator shall provide to each beneficiary of any program subject to  this Article a document which (1) sets forth those providers with which  agreements or arrangements have been made to provide health care services  to such beneficiary, a source for the beneficiary to contact regarding  changes in such providers and a clear description of any incentives for the  beneficiary to utilize such providers, (2) discloses the extent of coverage  as well as any limitations or exclusions of health care services under the  program, (3) clearly sets out the circumstances under which reimbursement  will be made to a beneficiary unable to utilize the services of a provider  with which an arrangement or agreement has been made, (4) a description of  the process for addressing a beneficiary complaint under the program, and  (5) discloses deductible and coinsurance amounts charged to any person  receiving health care services from such a provider.    (Source: P.A. 84-618.)
215 ILCS 5/370n
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982n)Sec. 370n.     Utilization Review Requirements:     Any preferred provider  organization providing hospital, medical or dental services must include a  program of utilization review.This Section applies to insurers and administrators.    (Source: P.A. 84-1431.)
215 ILCS 5/370o
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982o)Sec. 370o.     Emergency Care.     Any preferred provider contract, subject to  this Article shall provide the beneficiary or insured emergency care  coverage such that payment for this coverage is not dependent upon whether  such services are performed by a preferred or nonpreferred provider and  such coverage shall be at the same benefit level as if the service or  treatment had been rendered by a plan provider.    (Source: P.A. 85-476.)
215 ILCS 5/370p
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982p)Sec. 370p.     Failure to register.     Any  administrator subject to this Article who fails to register or pay the fee  required by this Article shall be construed to be an unauthorized insurer as  defined in Article VII of the "Illinois Insurance Code", as now or  hereafter amended, and shall be subject to the penalties contained therein.    (Source: P.A. 84-618.)
215 ILCS 5/370q
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982q)Sec. 370q.         To the extent of any conflict between this Article and any  other statutory provision, this Article prevails over the conflicting  provision. Agreements may be entered into under this Article  notwithstanding any policy provision to the contrary.    (Source: P.A. 84-618.)
215 ILCS 5/370r
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

 (from Ch. 73, par. 982r)Sec. 370r.     (Renumbered).        (Source: Renumbered by P.A. 95-331, eff. 8-21-07.)
215 ILCS 5/370s
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 5/ - Illinois Insurance Code.|Article XX-1/2 - Health Care Reimbursement

Sec. 370s.     Managed Care Reform and Patient Rights Act.     All  administrators shall comply with Sections 55 and  85 of the Managed Care Reform and Patient  Rights Act.    (Source: P.A. 91-617, eff. 1-1-00.)