Illinois Compiled Statutes 215 ILCS 125 Health Maintenance Organization Act. Section 4-14

    (215 ILCS 125/4-14) (from Ch. 111 1/2, par. 1409.7)

    Sec. 4-14. Evidence of Coverage.

    (a) Every subscriber shall be issued an evidence of coverage, which shall contain a clear and complete statement of:

        (1) The health services to which each enrollee is

    entitled;

        (2) Eligibility requirements indicating the

    conditions which must be met to enroll in a Health Care Plan;

        (3) Any limitation of the services, kinds of services

    or benefits to be provided, and exclusions, including any reasonable deductibles, copayments, 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; and

        (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. 97-1148, eff. 1-24-13.)

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Last modified: February 18, 2015