215 ILCS 130/3007
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. 1503-7)Sec. 3007.     Prior approval of policy forms.(a) No limited health  service organization shall issue or deliver, in this State, a group  contract or evidence of coverage, attach an endorsement or rider thereto,  incorporate by reference, bylaws or other matter therein or use an  application blank in this State until the form and content of such group  contract or evidence of coverage, endorsement, rider, bylaw or other matter  incorporated by reference or application blank has been filed with and  approved by the Director and, provided further, except that any such  endorsement or rider which is to be attached to a group contract or  evidence of coverage subsequent to the date the group contract or evidence  of coverage is issued must be filed with, reviewed and approved by the  Director prior to the date it is attached to a group contract or evidence  of coverage issued or delivered in this State.  The Director shall withhold  approval of any such group contract, evidence of coverage, endorsement,  rider, bylaw or other matter incorporated by reference or application blank  if it contains provisions which may encourage misrepresentation or are  unjust, unfair,  inequitable, ambiguous, misleading, inconsistent,  deceptive, contrary to law or to the public policy of this State, or  contains exceptions and conditions that unreasonably or deceptively affect  the risk purported to be assumed in the general coverage of the group  contract or evidence of coverage.  In all cases the Director shall approve  or disapprove any such form within 60 days after submission unless the  Director extends, by not more than an additional 30 days, the period within  which he shall approve or disapprove any such form by giving written notice  to the organization of such extension before expiration of the initial 60  day period.  The Director shall withdraw his approval of a group contract  or evidence of coverage, endorsement rider, bylaw or other matter  incorporated by reference or application blank if he subsequently  determines that such group contract or evidence of coverage, endorsement,  rider, bylaw, other matter incorporated by reference or  application blank is misrepresentative, unjust, unfair, unequitable,  ambiguous, misleading, inconsistent, deceptive, contrary to law or public  policy of this State, or contains exceptions or conditions which  unreasonably or deceptively affect the risk purported to be assumed in the  general coverage of the group contract or evidence of coverage.(b) If a previously approved group contract or evidence of coverage,  endorsement, rider, bylaw or other matter incorporated by reference or  application blank is withdrawn from use, the Director shall serve upon the  company an order of withdrawal of use, either personally or by mail, and if  by mail, such service shall be completed if such notice is deposited in the  post office, postage prepaid, addressed to the limited health service  organization's last known address specified in the records of the  Department of Insurance.  The order of withdrawal of use shall take effect  30 days from the date of mailing, but shall be stayed if within the 30 day  period a written request for hearing is filed with the Director.  Such  hearing shall be held at such time and place as designated in the order  given by the Director.  The hearing may be held either in the City of  Springfield, the City of Chicago or in the county where the principal  business address of the limited health service organization is located.  The action of the Director in disapproving or withdrawing such form shall  be subject to judicial review under the Administrative Review Law, as now or  hereafter amended.    (Source: P.A. 86-600.)