Article
Accident and Health Insurance
- 215 ILCS 5/352— Scope of Article
- 215 ILCS 5/352a— Mandated Coverages
- 215 ILCS 5/352b— Excepted benefits exempted
- 215 ILCS 5/352c— Short-term, limited-duration insurance prohibited
- 215 ILCS 5/353— Non-cancellable accident and health insurance reserves
- 215 ILCS 5/353a— Accident and health reserves
- 215 ILCS 5/354— Accident and health loss reserves
- 215 ILCS 5/355— Accident and health policies; provisions
- 215 ILCS 5/355.1
- 215 ILCS 5/355.2— Dental coverage reimbursement rates
- 215 ILCS 5/355.3— Noncovered dental services
- 215 ILCS 5/355.4— Provider notification of network plan changes
- 215 ILCS 5/355.5— Dental coverage reimbursement; prohibitions
- 215 ILCS 5/355.6— Health care provider reimbursement
- 215 ILCS 5/355.7— Medical loss ratio report and premium rebate
- 215 ILCS 5/355a— Standardization of terms and coverage
- 215 ILCS 5/355b— Claim-related information; alternative means of communication
- 215 ILCS 5/355c— Availability of information on qualified health plans
- 215 ILCS 5/355d— Denials of claims submitted after prior authorization
- 215 ILCS 5/356a— Form of policy
- 215 ILCS 5/356b— (a) This Section applies to the hospital and medical expense provisions of an individual accident or health insurance policy
- 215 ILCS 5/356c
- 215 ILCS 5/356d— Conversion privileges for insured former spouses
- 215 ILCS 5/356e— Victims of certain offenses
- 215 ILCS 5/356f— No individual policy of accident or health insurance or any renewal thereof shall be denied or cancelled by the insurer, nor shall any such policy contain any exception or exclusion of benefits, solely because the mother of the insured has taken diethylstilbestrol, commonly referred to as DES
- 215 ILCS 5/356g— Mammograms; mastectomies
- 215 ILCS 5/356g.5— Clinical breast exam
- 215 ILCS 5/356g.5-1— Breast cancer pain medication and therapy
- 215 ILCS 5/356h
- 215 ILCS 5/356i— Medical assistance; coverage of child
- 215 ILCS 5/356j— (Repealed)
- 215 ILCS 5/356K— Coverage for Organ Transplantation Procedures
- 215 ILCS 5/356L
- 215 ILCS 5/356m— Infertility coverage
- 215 ILCS 5/356n— Fibrocystic condition; denial of coverage
- 215 ILCS 5/356p— Breast implant removal
- 215 ILCS 5/356q
- 215 ILCS 5/356r— Access to obstetrical and gynecological care
- 215 ILCS 5/356s— Post-parturition care
- 215 ILCS 5/356t— Post-mastectomy care
- 215 ILCS 5/356u— Pap tests and prostate cancer screenings
- 215 ILCS 5/356u.5— Coverage for genetic testing for breast and ovarian cancer susceptibility
- 215 ILCS 5/356u.10— Genetic testing and evidence-based screenings for an inherited gene mutation
- 215 ILCS 5/356v— Use of information derived from genetic testing
- 215 ILCS 5/356w— Diabetes self-management training and education
- 215 ILCS 5/356x— Coverage for colorectal cancer examination and screening
- 215 ILCS 5/356y— (Repealed)
- 215 ILCS 5/356z.1— Prenatal HIV testing
- 215 ILCS 5/356z.2— Coverage for adjunctive services in dental care
- 215 ILCS 5/356z.3— Disclosure of limited benefit
- 215 ILCS 5/356z.3a— Billing; emergency services; nonparticipating providers
- 215 ILCS 5/356z.4— Coverage for contraceptives
- 215 ILCS 5/356z.4a— Coverage for abortion
- 215 ILCS 5/356z.4b— Billing for long-acting reversible contraceptives
- 215 ILCS 5/356z.5— Prescription inhalers
- 215 ILCS 5/356z.6— Bone mass measurement; osteoporosis
- 215 ILCS 5/356z.7— Prescription drugs; cancer treatment
- 215 ILCS 5/356z.8— Multiple sclerosis preventative physical therapy
- 215 ILCS 5/356z.9— Human papillomavirus vaccine
- 215 ILCS 5/356z.10— Amino acid-based elemental formulas
- 215 ILCS 5/356z.11— Dependent students; medical leave of absence
- 215 ILCS 5/356z.12— Dependent coverage
- 215 ILCS 5/356z.13— Shingles vaccine
- 215 ILCS 5/356z.14— Autism spectrum disorders
- 215 ILCS 5/356z.15— Habilitative services for children
- 215 ILCS 5/356z.16— (Repealed)
- 215 ILCS 5/356z.17— Wellness coverage
- 215 ILCS 5/356z.18— Prosthetic and customized orthotic devices
- 215 ILCS 5/356z.19— Cardiovascular disease
- 215 ILCS 5/356z.20— Cancer drug parity
- 215 ILCS 5/356z.21— Tobacco use cessation programs; coverage offer
- 215 ILCS 5/356z.22— Coverage for telehealth services
- 215 ILCS 5/356z.23— Coverage for opioid antagonists
- 215 ILCS 5/356z.24— Immune gamma globulin therapy
- 215 ILCS 5/356z.25— Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome
- 215 ILCS 5/356z.26— Synchronization
- 215 ILCS 5/356z.27— (Repealed)
- 215 ILCS 5/356z.28— Dry needling by a physical therapist
- 215 ILCS 5/356z.29— Stage 4 advanced, metastatic cancer
- 215 ILCS 5/356z.30— Coverage for hearing aids
- 215 ILCS 5/356z.30a— (Repealed)
- 215 ILCS 5/356z.31— Recovery housing for persons with substance use disorders
- 215 ILCS 5/356z.32— Coverage for fertility preservation services
- 215 ILCS 5/356z.33— Coverage for epinephrine injectors
- 215 ILCS 5/356z.34— Coverage for cardiopulmonary monitors
- 215 ILCS 5/356z.35— Long-term antibiotic therapy for tick-borne diseases
- 215 ILCS 5/356z.36— Coverage of treatment models for early treatment of serious mental illnesses
- 215 ILCS 5/356z.37— Whole body skin examination
- 215 ILCS 5/356z.38— Human breast milk coverage
- 215 ILCS 5/356z.39— Coverage of the psychiatric Collaborative Care Model
- 215 ILCS 5/356z.40— Pregnancy and postpartum coverage
- 215 ILCS 5/356z.40a— Pregnancy as a qualifying life event for qualified health plans
- 215 ILCS 5/356z.41— Cost sharing in prescription insulin drugs; limits; confidentiality of rebate information
- 215 ILCS 5/356z.42— (Repealed)
- 215 ILCS 5/356z.43— (Repealed)
- 215 ILCS 5/356z.44— Vitamin D testing
- 215 ILCS 5/356z.45— Coverage for patient care services provided by a pharmacist
- 215 ILCS 5/356z.46— Biomarker testing
- 215 ILCS 5/356z.47— Coverage for pancreatic cancer screening
- 215 ILCS 5/356z.48— Colonoscopy coverage
- 215 ILCS 5/356z.49— A1C testing
- 215 ILCS 5/356z.50— Comprehensive cancer testing
- 215 ILCS 5/356z.51— Coverage for port-wine stain treatment
- 215 ILCS 5/356z.53— Coverage for home health services
- 215 ILCS 5/356z.54— Coverage for breast reduction surgery
- 215 ILCS 5/356z.55— Coverage for cleft lip and cleft palate
- 215 ILCS 5/356z.56— Coverage for hormonal and non-hormonal therapy to treat menopause
- 215 ILCS 5/356z.57— Pediatric palliative care
- 215 ILCS 5/356z.58— Prenatal vitamins coverage
- 215 ILCS 5/356z.59— Coverage for continuous glucose monitors
- 215 ILCS 5/356z.60— Coverage for abortifacients, hormonal therapy, and human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis
- 215 ILCS 5/356z.61— Coverage for liver disease screening
- 215 ILCS 5/356z.62— Coverage of preventive health services
- 215 ILCS 5/356z.63— Coverage of pharmacy testing, screening, vaccinations, and treatment
- 215 ILCS 5/356z.64— Coverage for compression sleeves
- 215 ILCS 5/356z.65— Coverage for reconstructive services
- 215 ILCS 5/356z.66— Proton beam therapy
- 215 ILCS 5/356z.67— Coverage of prescription estrogen
- 215 ILCS 5/356z.68— Home saliva cancer screening
- 215 ILCS 5/356z.69— Coverage for children with neuromuscular, neurological, or cognitive impairment
- 215 ILCS 5/356z.70— Coverage of no-cost mental health prevention and wellness visits
- 215 ILCS 5/356z.71— Coverage for mobile integrated health care services
- 215 ILCS 5/356z.72— Wigs and hair prostheses
- 215 ILCS 5/356z.73— Insurance coverage for dependent parents
- 215 ILCS 5/356z.74— Coverage for annual menopause health visit
- 215 ILCS 5/356z.75— Coverage during a generic drug shortage
- 215 ILCS 5/356z.76— Coverage for at-home pregnancy tests
- 215 ILCS 5/356z.77— Coverage of vaccination administration fees
- 215 ILCS 5/356z.78— Coverage for medically necessary care and treatment to address a major injury to the jaw either through an accident or disease
- 215 ILCS 5/356z.80— Coverage for treatments to slow the progression of Alzheimer's disease and related dementias
- 215 ILCS 5/357.1— Accident and health policy provisions required
- 215 ILCS 5/357.2— "ENTIRE CONTRACT; CHANGES: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance
- 215 ILCS 5/357.3
- 215 ILCS 5/357.4
- 215 ILCS 5/357.5
- 215 ILCS 5/357.6— "NOTICE OF CLAIM: Written notice of claim must be given to the company within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible
- 215 ILCS 5/357.7— "CLAIM FORMS: The company, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss
- 215 ILCS 5/357.8
- 215 ILCS 5/357.9— "TIME OF PAYMENT OF CLAIMS: Indemnities payable under this policy for any loss other than loss for which this policy provides any periodic payment will be paid immediately upon receipt of due written proof of such loss
- 215 ILCS 5/357.9a— Delay in payment of claims
- 215 ILCS 5/357.10— "PAYMENT OF CLAIMS: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment
- 215 ILCS 5/357.11
- 215 ILCS 5/357.12— "LEGAL ACTIONS: No civil action shall be brought to recover on this policy prior to the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of this policy
- 215 ILCS 5/357.13
- 215 ILCS 5/357.14
- 215 ILCS 5/357.15
- 215 ILCS 5/357.16
- 215 ILCS 5/357.17
- 215 ILCS 5/357.18
- 215 ILCS 5/357.19
- 215 ILCS 5/357.20
- 215 ILCS 5/357.21
- 215 ILCS 5/357.22
- 215 ILCS 5/357.23
- 215 ILCS 5/357.24
- 215 ILCS 5/357.25— (Repealed)
- 215 ILCS 5/357.26
- 215 ILCS 5/357.27
- 215 ILCS 5/357.28
- 215 ILCS 5/357.29
- 215 ILCS 5/357.30— The Director may make such reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to this article as are necessary, proper or advisable to the administration of this article
- 215 ILCS 5/357.31
- 215 ILCS 5/358a— Conforming to statute
- 215 ILCS 5/359a— Application
- 215 ILCS 5/359b— (Repealed)
- 215 ILCS 5/359c— (Repealed)
- 215 ILCS 5/360a— Notice, waiver
- 215 ILCS 5/361a— Age limit
- 215 ILCS 5/362a— (Repealed)
- 215 ILCS 5/363— Medicare supplement policies; minimum standards
- 215 ILCS 5/363a— Medicare supplement policies; disclosure, advertising, loss ratio standards
- 215 ILCS 5/364— Discrimination prohibited
- 215 ILCS 5/364.01— Qualified clinical cancer trials
- 215 ILCS 5/364.1
- 215 ILCS 5/364.2— Purchase of ophthalmic goods or services
- 215 ILCS 5/364.3— Insurer uniform electronic prior authorization form; prescription benefits
- 215 ILCS 5/367— Group accident and health insurance
- 215 ILCS 5/367.2— Spousal continuation privilege; group contracts
- 215 ILCS 5/367.2-5— Dependent child continuation privilege; group contracts
- 215 ILCS 5/367.3— Group accident and health insurance; discretionary groups
- 215 ILCS 5/367a— Blanket accident and health insurance
- 215 ILCS 5/367b— (a) This Section applies to the hospital and medical expense provisions of a group accident or health insurance policy
- 215 ILCS 5/367c— No claim shall be denied, under any group accident and health policy delivered or renewed in this State after the effective date of this Amendatory Act, for treatment or services for mental illness rendered in a hospital solely because such hospital lacks surgical facilities
- 215 ILCS 5/367d
- 215 ILCS 5/367d.1
- 215 ILCS 5/367e— Continuation of Group Hospital, Surgical and Major Medical Coverage After Termination of Employment or Membership
- 215 ILCS 5/367e.1— Group Accident and Health Insurance Conversion Privilege
- 215 ILCS 5/367f— Firefighters' continuance privilege
- 215 ILCS 5/367g— Police officer's continuance privilege
- 215 ILCS 5/367h— Deputy's continuance privilege
- 215 ILCS 5/367i— Discontinuance and replacement of coverage
- 215 ILCS 5/367j— Municipal employee's continuance privilege
- 215 ILCS 5/367k— Intoxication and narcotics; exclusion of coverage prohibited
- 215 ILCS 5/367m— Early intervention services
- 215 ILCS 5/368— Industrial accident and health insurance
- 215 ILCS 5/368a— Timely payment for health care services
- 215 ILCS 5/368b— Contracting procedures
- 215 ILCS 5/368c— Remittance advice and procedures
- 215 ILCS 5/368d— Recoupments
- 215 ILCS 5/368e— Administration and enforcement
- 215 ILCS 5/368f— Military service member insurance reinstatement
- 215 ILCS 5/368g— Time-based billing
- 215 ILCS 5/369— Rights of minors
- 215 ILCS 5/370— Policies issued in violation of article-Penalty
- 215 ILCS 5/370a— Assignability of accident and health insurance, including dental insurance
- 215 ILCS 5/370b— Reimbursement on equal basis
- 215 ILCS 5/370b.1— Surgical assistant payments
- 215 ILCS 5/370c— Mental and emotional disorders
- 215 ILCS 5/370c.1— Mental, emotional, nervous, or substance use disorder or condition parity
- 215 ILCS 5/370c.2— (Repealed)
- 215 ILCS 5/370c.3— Parity for coverage for nonopioid medications to treat acute pain
- 215 ILCS 5/370c.4— Mental health and substance use parity
- 215 ILCS 5/370d
- 215 ILCS 5/370d.1— Group policies; chambers of commerce
- 215 ILCS 5/370e— 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