Ill. Admin. Code tit. 50, § 2001.3
Discretionary Clauses Prohibited
Effective Jul 1, 200529 Ill. Reg. 10172AUTHORITY: Implementing Sections 143, 355, 355a, 356a, 356z.62, and 356z.77 and Articles IX and XX of the Illinois Insurance Code [215 ILCS 5], Section 28 of the Dental Service Plan Act [215 ILCS 110], Sections 4-13, 4.5-1, and 5-7 of the Health Maintenance Organization Act [215 ILCS 125], Sections 3007, 3009, and 4007 of the Limited Health Service Organization Act [215 ILCS 130], Section 13 of the Voluntary Health Services Plans Act [215 ILCS 165], Section 6.11 of the State Employees Group Insurance Act of 1971 [5 ILCS 375], Section 5-1069.3 of the Counties Code [55 ILCS 5], Section 10-4-2.3 of the Illinois Municipal Code [65 ILCS 5], and Section 10-22.3f of the School Code [105 ILCS 5], and authorized by Section 401 of the Illinois Insurance Code.DEPARTMENT OF INSURANCE
No policy, contract, certificate, endorsement, rider application or agreement offered or issued in this State, by a health carrier, to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services or of a disability may contain a provision purporting to reserve discretion to the health carrier to interpret the terms of the contract, or to provide standards of interpretation or review that are inconsistent with the laws of this State.
(Source: Added at 29 Ill. Reg. 10172, effective July 1, 2005)