reglab/housing_qa huggingface dataset:
215 ILCS 130/2003
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 2 - Certificate Of Authority; General Corporate And Financial Requirements

 (from Ch. 73, par. 1502-3)Sec. 2003. Powers of limited health service organizations. The powers of a limited health service organization include, but are not  limited to the following:(1) The purchase, lease, construction, renovation,     operation or maintenance of limited health service facilities and their ancillary equipment, and such property as may reasonably be required for its principal office or for such other purposes as may be necessary in the transaction of the business of the organization.(2) The making of loans to a provider group under     contract with it and in furtherance of its program or the making of loans to a corporation or corporations under its control for the purpose of acquiring or constructing limited health service facilities or in furtherance of a program providing limited health services for enrollees.(3) The furnishing of limited health services through     providers which are under contract with or employed by the limited health service organization.(4) The contracting with any person for the     performance on its behalf of certain functions such as marketing, enrollment and administration.(5) The contracting with an insurance company     licensed in this State, or with a hospital, medical, voluntary, dental, vision or pharmaceutical service corporation authorized to do business in this State, for the provision of insurance, indemnity or reimbursement against the cost of limited health service provided by the limited health service organization.(6) Rendering services related to the functions     involved in the operation of its limited health service business including, but not limited to, providing limited health services, data processing, accounting, claims.(7) Indemnity benefits covering out of area or     emergency services directly related to the provision of limited health service.(8) The offering of point-of-service products as     authorized under Section 3009.(9) Any other business activity reasonably     complementary or supplementary to its limited health service business to the extent approved by the Director. (Source: P.A. 97-813, eff. 7-13-12.)
215 ILCS 130/2005
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 2 - Certificate Of Authority; General Corporate And Financial Requirements

 (from Ch. 73, par. 1502-5)Sec. 2005.     Claims liabilities.(a) Every limited health service organization shall, at all times, maintain  liabilities in an amount estimated in the aggregate to provide for the  payment of all claims incurred and any due and unpaid provider capitation,  whether reported or unreported, which are unpaid and for which such  organization is or may be liable, and to provide for the expense of  adjustment or settlement of such claims.  Such liabilities shall be  computed in accordance with regulations promulgated by the Director upon  reasonable consideration of the ascertained experience and character of  such business for the purpose of adequately protecting enrollees and  securing the solvency of such organizations.(b) Whenever the claim and claim expense experience of any such organization  shows the liabilities calculated in accordance with such regulations to be  inadequate, the Director may require such organization to maintain additional liabilities.    (Source: P.A. 86-600.)
215 ILCS 130/2006
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 2 - Certificate Of Authority; General Corporate And Financial Requirements

 (from Ch. 73, par. 1502-6)Sec. 2006.     Statutory deposits.(a) An organization subject to the provisions of this Act  shall make and  maintain with the Director, for the protection of enrollees of the  organization, a deposit of securities that are in the form authorized under  Section 2-6 of the Health Maintenance Organization Act having a fair market  value equal to the minimum net worth required under subsection (a) of Section  2004.  The amount on deposit shall remain as an admitted asset of the  organization in the determination of its net worth.  The Director may release  the required deposit of securities required by this Section  upon receipt of  an order of a court having proper jurisdiction or  upon: (i)  certification by the organization that it has no outstanding  enrollee creditors, enrollees, certificate holders, or enrollee obligations  in effect and no plans to engage in the  business of insurance as a limited health service organization; (ii) receipt of  a lawful resolution of the  organization's governing body effecting the surrender of  its certificate of authority, articles of incorporation, or other  organizational documents to their issuing governmental officer for voluntary or  administrative dissolution; and (iii) receipt of the name and  forwarding address for each of the final officers and directors of the  organization,  together with a plan of dissolution approved by the Director.(b) An LHSO that offers a POS contract shall, in addition to the  deposit required by subsection (a), deposit and maintain with the Director  cash or securities that are authorized investments under Section 1003  having a fair market value equal to the greater of:(1) $50,000 if the LHSO's expenditures for     out-of-plan covered services do not exceed 10% of its total limited health expenditures in any calendar quarter; or(2) $100,000 if the LHSO's expenditures for     out-of-plan covered services exceeds 10% but are less than 20% of its total limited health services expenditure in any calendar quarter; or(3) 120% of its current actual monthly out-of-plan     covered service claims expense plus incurred but not reported balances for out-of-plan covered services.(c) The combined deposit amount required in subsections (a) and (b) shall  not exceed $200,000.    (Source: P.A. 92-75, eff. 7-12-01.)
215 ILCS 130/2007
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 2 - Certificate Of Authority; General Corporate And Financial Requirements

Sec. 2007. (Repealed).        (Source: P.A. 91-549, eff. 8-14-99. Repealed by P.A. 97-486, eff. 1-1-12.)
215 ILCS 130/2008
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 2 - Certificate Of Authority; General Corporate And Financial Requirements

 (from Ch. 73, par. 1502-8)Sec. 2008.     Provider contracts.(a) All contracts with providers or with  entities which subcontract for the provision of limited health services to  enrollees on a prepayment or  other basis and any contract with any  subcontractor thereof shall contain the following hold-harmless clause:  "The provider agrees that in no event including, but not limited to,  nonpayment by the organization of amounts due the provider under this  contract, insolvency of the organization or any breach of this contract by  the organization, shall the provider or its assignees or subcontractors  have a right to seek any type of payment from, bill, charge, collect a  deposit from or have any recourse against the enrollee, persons acting on  the enrollee's behalf (other than the organization), the employer or group  contractholder for services provided pursuant to this contract except for  the payment of applicable copayments for services covered by the  organization or fees for services not covered by the organization.  The  requirements of this clause shall survive any termination of this contract  for services rendered prior to such termination, regardless of the cause of  such termination.  The organization's enrollees shall be third party  beneficiaries of this clause.  This clause supersedes any oral or written  agreement now existing or hereafter entered into between the provider and  the enrollee or persons acting on the enrollee's behalf (other than the  organization).".  To the extent that any provider or subcontractor's  contract, fails to incorporate such provisions, such provisions shall be  deemed incorporated into such contracts by operation of law.(b) All provider and subcontractor contracts must contain provisions  whereby the provider or subcontractor shall provide, arrange for or  participate in the quality assessment programs mandated by this Act, unless  the Department of Insurance certifies that such programs will  be fully implemented without any participation or action from such  contracting provider.(c) The Director may promulgate rules requiring that provider contracts  contain provisions concerning reasonable notices to be given between the  parties and for the organization to provide reasonable notice to its  enrollees and to the Director.  Notice shall be given for such events as,  but not limited to, termination of insurance protection, quality assessment  or availability of medical area.    (Source: P.A. 86-600; 86-1408.)
215 ILCS 130/2009
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 2 - Certificate Of Authority; General Corporate And Financial Requirements

(215 ILCS 130/2009) (from Ch. 73, par. 1502-9)Sec. 2009.     Subordinated  indebtedness.     An organization having a  certificate of authority under this Act may borrow or assume a liability  for the repayment of a sum of money upon a written agreement that the loan  or advance with interest thereon not exceeding a reasonable rate shall be  repaid only out of net worth of the organization in excess of such minimum  net worth as is  stipulated in and by the agreement.  The agreement shall  first be submitted to and approved by the appropriate authoritative body of  the organization and the Director.  Repayment of principal or payment of  interest may be made only with the approval of the Director when he is  satisfied that the financial condition of the organization warrants such  action, but such approval may not be withheld if the organization shall  have and submit satisfactory evidence of net worth of not less than the  amount stipulated in the repayment of principal or interest payment clause  of the agreement. No loan or advance made under this Section or interest  accruing thereon shall form a part of the legal liabilities of the  organization until authorized for payment by the Director, but until such  authorization all statements published by the organization or filed with  the Director shall show the amount thereof then remaining unpaid as a  special surplus account.  Nothing in this Section shall be construed to  mean that an organization may not otherwise borrow money, but the amount so  borrowed with accrued interest thereon shall be carried by the company as  a liability.    (Source: P.A. 86-600.)
215 ILCS 130/Art. 3 heading
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 ARTICLE 3.      DELIVERY OF SERVICES; REQUIRED PROVISIONS AND MARKETING
215 ILCS 130/3001
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-1)Sec. 3001.     Description and securing of services.     The limited health service organization shall issue to each subscriber or  enrollee a group contract or evidence of coverage.  Any such group contract  or evidence of coverage shall provide for the rendering of limited health  services as defined therein for a period of 12 months from the date of  issuance; and shall provide that it shall be renewed from year to year  unless there has been 31 days written notice of termination prior to the  annual renewal of the contract by the subscriber, enrollee or the limited  health service organization.  The group contract, evidence of coverage and  related material shall be delivered or issued for delivery to an enrollee  within 30 days from the later of the effective date of coverage or the date  on which the limited health service organization is notified of enrollment.    (Source: P.A. 86-600.)
215 ILCS 130/3002
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-2)Sec. 3002.     Complaint system.     Every limited health service organization  shall establish and maintain a complaint system providing reasonable  procedures for resolving complaints initiated by enrollees.  Nothing herein  shall be construed to preclude an enrollee or a provider from filing a  complaint with the Director or as limiting the Director's ability to  investigate such complaints.    (Source: P.A. 86-600.)
215 ILCS 130/3003
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-3)Sec. 3003.     Department complaint handling procedure.     (a) When a complaint is received by the Department of Insurance  (Department) against a limited health service organization (respondent) or  producer (respondent), the respondent shall be notified of the complaint.  The Department in its notification shall specify the date when a report is  to be received from the respondent, which shall be no later than 21 days  after notification is sent to the respondent.  A failure to reply by the  date specified may be followed by a collect telephone call or collect  telegram.  Repeated instances of failing to reply by the date specified may  result in further regulatory action.(b) Contents of response or report.(1) Each respondent shall supply adequate     documentation which explains all actions taken or not taken and which were the basis for the complaint.(2) Documents necessary to support the respondent's     position and information requested by the Department, shall be furnished with the respondent's reply.(3) The respondent's reply shall be duplicate, but     duplicate copies of supporting documents shall not be required.(4) The respondent's reply shall include the name,     telephone number and address of the individual assigned to the complaint.(5) The Department shall respect the confidentiality     of medical reports and other documents which by law are confidential. Any other information furnished by a respondent shall be marked "confidential" if the respondent does not wish it to be released to the complainant.(c) Follow-up conclusion. Upon receipt of the respondent's report, the  investigating deputy shall evaluate the material submitted; and(1) advise the complainant of the action taken and     disposition of his complaint;(2) pursue further investigation with respondent or     complainant; or(3) refer the investigation report to the appropriate     unit within the Department of Insurance for further regulatory action.   (Source: P.A. 86-600.)
215 ILCS 130/3004
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-4)Sec. 3004.     Solicitations of enrollees.     (a) Solicitations of enrollees by a  limited health service organization authorized under this Act, or its  representatives shall not be construed to be violative of any provisions  of law relating to solicitation or advertising by health professionals.  Nothing in this Section precludes a limited health service organization  from providing to a particular potential enrollee the names of health  providers. No limited health service organization, or representative  thereof, may cause or knowingly permit the use of advertising which is  untrue or misleading, solicitation which is untrue or misleading or any  form of evidence of coverage which is deceptive. Limited health service  organizations shall be subject to Section 143c or the Illinois Insurance  Code as now or hereafter amended.(b) If the Director finds that any advertisement of a plan has materially  failed to comply with the provisions of this Act or the rules hereunder,  the Director may, by order, require the plan to publish in the same or  similar medium, an approved correction or retraction of any untrue,  misleading or deceptive statement contained in the advertising and may  prohibit such plan from publishing, distributing or allowing to be  published or distributed on its behalf such advertisement or any new  materially revised advertisement without first having filed a copy thereof  with the Director 30 days prior to the publication or distribution thereof,  or any shorter period specified in such order. An order issued under this  Section shall be effective for 12 months from its issuance and may be  renewed by order if the advertisements submitted under this Section  indicate difficulties of voluntary compliance with the applicable  provisions of this Act and the rules hereunder.    (Source: P.A. 86-600.)
215 ILCS 130/3005
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-5)Sec. 3005.     Producers.     No person may apply, procure, solicit,  negotiate, or place for others any evidence of coverage of a limited health  service organization unless that person holds a valid limited insurance  representative license or producers license to sell accident and health  insurance policies pursuant to Article XXXI of the Illinois Insurance Code,  as now and hereafter amended.    (Source: P.A. 86-600.)
215 ILCS 130/3006
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-6)Sec. 3006.         Changes in rate methodology and benefits; material modifications;  addition of limited health services.(a) A limited health service organization shall file with the Director  prior to use, a notice of any change in rate methodology, charges or  benefits and of any material modification of any matter or document  furnished pursuant to Section 2001, together with such supporting documents  as are necessary to fully explain the change or modification.(1) Contract modifications described in paragraphs     (5) and (6) of subsection (c) of Section 2001 shall include all agreements between the organization and enrollees, providers, administrators of services and insurers of limited health services; also other material transactions or series of transactions, the total annual value of which exceeds the greater of $100,000 or 5% of net earned subscription revenue for the most current 12 month period as determined from filed financial statements.(2) Contract modification for reinsurance. Any     agreement between the organization and an insurer shall be subject to the provisions of Article XI of the Illinois Insurance Code, as now or hereafter amended. All reinsurance agreements must be filed with the Director. Approval of the Director in required agreements must be filed. Approval of the director is required for all agreements except individual stop loss, aggregate excess, hospitalization benefits or out-of-area of the participating providers, unless 20% or more of the organization's total risk is reinsured, in which case all reinsurance agreements shall require approval.(b) If a limited health service organization desires to add one or more  additional limited health services, it shall file a notice with the Director  and, at the same time, submit the information required by Section  2001 if different from that filed with the prepaid limited health service  organization's application.  Issuance of such an amended certificate of  authority shall be subject to the conditions of Section 2002 of this Act.    (Source: P.A. 86-600.)
215 ILCS 130/3008
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

 (from Ch. 73, par. 1503-8)Sec. 3008.     Evidence of coverage.     (a) Every subscriber shall be issued  an evidence of coverage, which shall contain a clear and complete statement of:(1) The limited health services to which each     enrollee is entitled.(2) Eligibility requirements indicating the     conditions which must be met to enroll in a limited health care plan.(3) Any limitation of the services or benefits to be     provided, and exclusions, including any copayment, or other charges.(4) The terms or conditions upon which coverage may     be cancelled or otherwise terminated.(5) Where and in what manner information is available     as to where and how services may be obtained.(6) The method for resolving complaints.(b) Any amendment to the evidence of coverage may be provided to the  subscriber in a separate document.    (Source: P.A. 86-600.)
215 ILCS 130/3010
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 3 - Delivery Of Services; Required Provisions And Marketing

(215 ILCS 130/3010)Sec. 3010. Purchase of ophthalmic goods or services. An organization may not require a provider, as a condition of participation in the organization's limited health care plan, 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 limited health care plan.  (Source: P.A. 93-1077, eff. 1-18-05.)
215 ILCS 130/Art. 4 heading
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 4 - General Provisions

 ARTICLE 4.      GENERAL PROVISIONS
215 ILCS 130/4001
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 4 - General Provisions

 (from Ch. 73, par. 1504-1)Sec. 4001.         Applicability of Section 155 of the Illinois Insurance  Code to limited health service organizations.  Section 155 of the Illinois  Insurance Code, as now or hereafter amended, shall apply to limited health  service organizations; except that no actions shall be brought for an  unreasonable delay in the settling of a claim if the delay is caused by the  failure of the enrollee to execute a lien as requested by the health care plan.    (Source: P.A. 86-600.)
215 ILCS 130/4002
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 4 - General Provisions

 (from Ch. 73, par. 1504-2)Sec. 4002.     Health Maintenance Organization Act.     Limited health service  organizations shall be subject to the provisions of Sections 1-3  and 3-1 of the Health Maintenance Organization Act, as now or hereafter  amended.    (Source: P.A. 86-600.)
215 ILCS 130/4002.1
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 4 - General Provisions

Sec. 4002.1.     Woman's health care provider.     Limited health  service organizations are subject to the provisions of Section 356r  of the Illinois Insurance Code.    (Source: P.A. 89-514, eff. 7-17-96.)
215 ILCS 130/4002.5
2021 Illinois Compiled Statutes|Chapter 215 - INSURANCE|215 ILCS 130/ - Limited Health Service Organization Act.|Article 4 - General Provisions

Sec. 4002.5.     Illinois Health Insurance Portability and Accountability Act.      The provisions of this Act are subject to the Illinois Health Insurance  Portability and Accountability Act as provided in Section 15 of that Act.    (Source: P.A. 90-30, eff. 7-1-97.)