Illinois Administrative Code › Title 50 - INSURANCE › Part 2002 - ADVERTISING OF ACCIDENT AND SICKNESS INSURANCE › Section 2002.40 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
An "advertisement," for the purpose of this Part, shall
				include:
printed and published material, audio-visual material, and
				descriptive literature of an insurer used in direct mail, email, internet
				pages, blogs, social media, newspapers, magazines, radio scripts, TV scripts,
				billboards and similar displays; and
descriptive literature and sales aids of all kinds issued by an
				insurer, agent or broker for presentation to members of the insurance buying
				public, including but not limited to circulars, leaflets, booklets, depictions,
				illustrations, and form letters; and
prepared sales talks, presentations and material for use by
				agents, brokers and solicitors. The Guideline for this definition is found in
				Appendix A, Illustration D.
"Exception," for the purpose of this Part, shall mean any
				provision in a policy whereby coverage for a specified hazard is entirely
				eliminated; it is a statement of a risk not assumed under the policy.
"Health Insurance Marketplace" means the Illinois Health
				Benefits Exchange established in accordance with
				215 ILCS
				122/5-5 and
				42 USC
				18031.
"Institutional Advertisement", for the purpose of this Part,
				shall mean an advertisement having as its sole purpose the promotion of the
				reader's or viewer's interest in the concept of accident and sickness insurance
				or the promotion of the insurer.
"Insurer", for the purpose of this Part, shall include any
				individual, corporation, association, partnership, reciprocal exchange,
				inter-insurer, Lloyds, fraternal benefit society, health maintenance
				organization, and any other legal entity that is defined as an "insurer" in the
				Insurance Code of Illinois and is engaged in the advertisement of a policy, as
				"policy" is defined in this Section.
"Invitation to Contract", for the purpose of this Part, shall
				mean an advertisement that is neither an invitation to inquire nor an
				institutional advertisement.
"Invitation to Inquire", for the purpose of this Part, shall
				mean an advertisement having as one of its objectives, but not necessarily the
				main objective, the creation of a desire to inquire further about the product
				or products and that is limited to a brief description of the loss or losses
				for which the benefit is payable, and that may contain the dollar amount of
				benefit payable and/or the period of time during which the benefit is payable,
				provided the advertisement does not refer to cost. An ad that is an invitation
				to inquire and that contains a dollar amount of benefit payable, and/or the
				period of time during which a benefit is payable, shall contain a provision in
				effect as follows:
"For costs and further details of the coverage, including
				exclusions, any reductions or limitations and the terms under which the policy
				may be continued in force, see your agent or write to the company."
"Limitation", for the purpose of this Part, shall mean any
				provision that restricts coverage under the policy other than an exception or a
				reduction.
"Policy", for the purpose of this Part, shall include any
				policy, plan, certificate, contract, agreement, statement of coverage, rider or
				endorsement that provides accident or sickness benefits, or medical, surgical
				or hospital expense benefits, whether on an indemnity, reimbursement, service
				or prepaid basis, except when issued in connection with another kind of
				insurance other than life, and except disability, waiver of premium and double
				indemnity benefits included in life insurance and annuity contracts. The
				Guideline for this definition is found in Appendix A, Illustration E.
"Reduction", for the purpose of this Part, shall mean any
				provision that reduces the amount of the benefit. A risk of loss is assumed,
				but payment upon the occurrence of the loss is limited to some amount or period
				less than would be otherwise payable had the reduction not been
				used.