Sec. 367.3. Group accident and health insurance; discretionary groups.

379 words·~2 min read·/il/chapter-215/act-5/367-3

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(a)No group health insurance offered to a resident of this State under a policy issued to a group, other than one specifically described in Section 367(1), shall be delivered or issued for delivery in this State unless the Director determines that:

(1)the issuance of the policy is not contrary to the public interest;

(2)the issuance of the policy will result in economies of acquisition and

administration; and

(3)the benefits under the policy are reasonable in relation to the premium charged.

(b)No such group health insurance may be offered in this State under a policy issued in another state unless this State or the state in which the group policy is issued has made a determination that the requirements of subsection

(a)have been met.

Where insurance is to be offered in this State under a policy described in this subsection, the insurer shall file for informational review purposes:

(1)a copy of the group master contract;

(2)a copy of the statute authorizing the issuance of the group policy in the state of

situs, which statute has the same or similar requirements as this State, or in the absence of such statute, a certification by an officer of the company that the policy meets the Illinois minimum standards required for individual accident and health policies under authority of Section 401 of this Code, as now or hereafter amended, as promulgated by rule at 50 Illinois Administrative Code, Ch. I, Sec. 2007, et seq., as now or hereafter amended, or by a successor rule;

(3)evidence of approval by the state of situs of the group master policy; and

(4)copies of all supportive material furnished to the state of situs to satisfy the

criteria for approval.

(c)The Director may, at any time after receipt of the information required under subsection

(b)and after finding that the standards of subsection

(a)have not been met, order the insurer to cease the issuance or marketing of that coverage in this State.

(d)Notwithstanding subsections

(a)and (b), group accident and health insurance subject to the provisions of this Section is also subject to the provisions of Sections 352c and 367i of this Code and rules thereunder.