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Illinois Compiled Statutes

215 ILCS 125/2-3 (2026)

Powers of health maintenance organizations

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(215 ILCS 125/2-3) (from Ch. 111 1/2, par. 1405)
    Sec. 2-3. Powers of health maintenance organizations. The powers of a health maintenance organization include, but are not limited to the following:
        (a) The purchase, lease, construction, renovation,
    
operation, or maintenance of hospitals, medical facilities or both, and their ancillary equipment, and such property as may reasonably be required for its principal office or for such other purposes as may be necessary in the transaction of the business of the organization.
        (b) The making of loans to a medical group under
    
contract with it and in furtherance of its program or the making of loans to a corporation or corporations under its control for the purpose of acquiring or constructing medical facilities at hospitals or in furtherance of a program providing health care services for enrollees.
        (c) The furnishing of health care services through
    
providers which are under contract with or employed by the health maintenance organization.
        (d) The contracting with any person for the
    
performance on its behalf of certain functions such as marketing, enrollment and administration.
        (d-5) The voluntary use of a referral system for
    
enrollees to access providers under contract with or employed by the health maintenance organization. Nothing in this subsection (d-5) shall be construed as requiring the use of a referral system with the health maintenance organization's contracted or employed providers to obtain a certificate of authority as set forth in Section 2-1.
        (e) The contracting with an insurance company
    
licensed in this State, or with a hospital, medical, dental, vision or pharmaceutical service corporation authorized to do business in this State, for the provision of insurance, indemnity, or reimbursement against the cost of health care service provided by the health maintenance organization.
        (f) The offering, in addition to basic health care
    
services, of (1) health care services, (2) indemnity benefits covering out of area or emergency services, (3) indemnity benefits provided through insurers or hospital, medical, dental, vision, or pharmaceutical service corporations, and (4) health maintenance organization point-of-service benefits as authorized under Article 4.5.
        (g) Rendering services related to the functions
    
involved in the operating of its health maintenance organization business including but not limited to providing health services, data processing, accounting, or claims.
        (g-5) Indemnification for services provided to a
    
child as required under subdivision (e)(3) of Section 4-2.
        (h) Any other business activity reasonably
    
complementary or supplementary to its health maintenance organization business to the extent approved by the Director.
(Source: P.A. 103-104, eff. 1-1-24.)

    
Notes of Decisions
Cited in 2 cases, 1993–1996 · leading case: In the Matter of Est. of Medcare Hmo, Debtor-Appellant, 998 F.2d 436 (7th Cir. 1993).
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In the Matter of Est. of Medcare Hmo, Debtor-Appellant, 998 F.2d 436 (7th Cir. 1993). “To say that an HMO not licensed under the Insurance Code cannot underwrite pure indemnity insurance is not entirely accurate.”
Berlin v. Sarah Bush Lincoln Health Ctr., 664 N.E.2d 337 (Ill. App. Ct. 4th Dist. 1996). “The Health Maintenance Organization Act (HMO Act), enacted in 1974, specifically granted authority to health maintenance organizations (HMOs) to contract with or employ health care providers (215 ILCS 125/2-3(c) (West 1994)). The HMO Act provides for a comprehensive regulatory…”
215 ILCS 125/2-3(c): 1 case
Berlin v. Sarah Bush Lincoln Health Ctr., 664 N.E.2d 337 (Ill. App. Ct. 4th Dist. 1996). “The Health Maintenance Organization Act (HMO Act), enacted in 1974, specifically granted authority to health maintenance organizations (HMOs) to contract with or employ health care providers (215 ILCS 125/2-3(c) (West 1994)). The HMO Act provides for a comprehensive regulatory…”
215 ILCS 125/2-3(f): 1 case
In the Matter of Est. of Medcare Hmo, Debtor-Appellant, 998 F.2d 436 (7th Cir. 1993). “To say that an HMO not licensed under the Insurance Code cannot underwrite pure indemnity insurance is not entirely accurate.”
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