ILCS » Chapter 215 · Act 5

215 ILCS 5/370i

Policies, agreements or arrangements with incentives or limits on reimbursement authorized

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(215 ILCS 5/370i) (from Ch. 73, par. 982i)
    Sec. 370i. Policies, agreements or arrangements with incentives or limits on reimbursement authorized.
    (a) Policies, agreements or arrangements issued under this Article may not contain terms or conditions that would operate unreasonably to restrict the access and availability of health care services for the insured.
    (b) An insurer or administrator may:
        (1) enter into agreements with certain providers of
    
its choice relating to health care services which may be rendered to insureds or beneficiaries of the insurer or administrator, including agreements relating to the amounts to be charged the insureds or beneficiaries for services rendered;
        (2) issue or administer programs, policies or
    
subscriber contracts in this State that include incentives for the insured or beneficiary to utilize the services of a provider which has entered into an agreement with the insurer or administrator pursuant to paragraph (1) above.
    (c) (Blank).
(Source: P.A. 103-718, eff. 7-19-24.)

    
Notes of Decisions
Cited in 3 cases, 2010–2015 · leading case: Walsh Chiropractic, Ltd. v. StrataCare, Inc.
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Walsh Chiropractic, Ltd. v. StrataCare, Inc. (2010) ilsd “See 215 ILCS 5/370i(b). Further, the contracts at issue make no mention of financial incentives 4 .”
Bemis v. Employers Mutual Casualty Company (2015) illappct · cites it 4× “According to Bemis, because section 370i of the Illinois Insurance Code (215 ILCS 5/370i (West 2008)) defines a PPO as an arrangement requiring incentives, and because administrative regulations governing PPO networks (see 50 Ill.”
Bemis v. Employers Mutual Casualty Company (2015) illappct · cites it 3× “According to Bemis, because section 370i of the Illinois Insurance Code (215 ILCS 5/370i (West 2008)) defines a PPO as an arrangement requiring incentives, and because administrative regulations governing PPO networks (see 50 Ill.”
— 215 ILCS 5/370i(b) — 3 cases
Walsh Chiropractic, Ltd. v. StrataCare, Inc. (2010) ilsd “See 215 ILCS 5/370i(b). Further, the contracts at issue make no mention of financial incentives 4 .”
Bemis v. Employers Mutual Casualty Company (2015) illappct “According to Bemis, because section 370i of the Illinois Insurance Code (215 ILCS 5/370i (West 2008)) defines a PPO as an arrangement requiring incentives, and because administrative regulations governing PPO networks (see 50 Ill.”
Bemis v. Employers Mutual Casualty Company (2015) illappct “According to Bemis, because section 370i of the Illinois Insurance Code (215 ILCS 5/370i (West 2008)) defines a PPO as an arrangement requiring incentives, and because administrative regulations governing PPO networks (see 50 Ill.”
— 215 ILCS 5/370i(c) — 2 cases
Bemis v. Employers Mutual Casualty Company (2015) illappct “According to Bemis, because section 370i of the Illinois Insurance Code (215 ILCS 5/370i (West 2008)) defines a PPO as an arrangement requiring incentives, and because administrative regulations governing PPO networks (see 50 Ill.”
Bemis v. Employers Mutual Casualty Company (2015) illappct “According to Bemis, because section 370i of the Illinois Insurance Code (215 ILCS 5/370i (West 2008)) defines a PPO as an arrangement requiring incentives, and because administrative regulations governing PPO networks (see 50 Ill.”
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