50 Ill. Adm. Code 2002.40
Definitions
Section 2002
Section 2002.40 Definitions
An "advertisement," for the purpose of this Part,
shall include:
printed and published material, audio-visual material, and
descriptive literature of an insurer used in direct mail,
email,
internet pages, blogs, social media, newspapers, magazines, radio scripts, TV
scripts, billboards and similar displays; and
descriptive literature and sales aids of all kinds issued by
an insurer, agent or broker for presentation to members of the insurance buying
public, including but not limited to circulars, leaflets, booklets, depictions,
illustrations, and form letters; and
prepared sales talks, presentations and material for use by
agents, brokers and solicitors. The Guideline for this definition is found in
Appendix A, Illustration D.
"Exception," for the purpose of this Part, shall
mean any provision in a policy whereby coverage for a specified hazard is
entirely eliminated; it is a statement of a risk not assumed under the policy.
"Health Insurance Marketplace" means the Illinois
Health Benefits Exchange established in accordance with 215 ILCS 122/5-5 and 42
USC 18031.
"Institutional Advertisement", for the purpose of
this Part, shall mean an advertisement having as its sole purpose the promotion
of the reader's or viewer's interest in the concept of accident and sickness
insurance or the promotion of the insurer.
"Insurer", for the purpose of this Part, shall
include any individual, corporation, association, partnership, reciprocal
exchange, inter-insurer, Lloyds, fraternal benefit society, health maintenance
organization, and any other legal entity that is defined as an
"insurer" in the Insurance Code of Illinois and is engaged in the
advertisement of a policy, as "policy" is defined in this Section.
"Invitation to Contract", for the purpose of this
Part, shall mean an advertisement that is neither an invitation to inquire nor
an institutional advertisement.
"Invitation to Inquire", for the purpose of this
Part, shall mean an advertisement having as one of its objectives, but not
necessarily the main objective, the creation of a desire to inquire further
about the product or products and that is limited to a brief description of the
loss or losses for which the benefit is payable, and that may contain the
dollar amount of benefit payable and/or the period of time during which the
benefit is payable, provided the advertisement does not refer to cost. An ad that
is an invitation to inquire and that contains a dollar amount of benefit
payable, and/or the period of time during which a benefit is payable, shall
contain a provision in effect as follows:
"For costs and further details of the coverage, including
exclusions, any reductions or limitations and the terms under which the policy
may be continued in force, see your agent or write to the company."
"Limitation", for the purpose of this Part, shall
mean any provision that restricts coverage under the policy other than an
exception or a reduction.
"Policy", for the purpose of this Part, shall
include any policy, plan, certificate, contract, agreement, statement of
coverage, rider or endorsement that provides accident or sickness benefits, or
medical, surgical or hospital expense benefits, whether on an indemnity,
reimbursement, service or prepaid basis, except when issued in connection with
another kind of insurance other than life, and except disability, waiver of
premium and double indemnity benefits included in life insurance and annuity
contracts. The Guideline for this definition is found in Appendix A,
Illustration E.
"Reduction", for the purpose of this Part, shall
mean any provision that reduces the amount of the benefit. A risk of loss is
assumed, but payment upon the occurrence of the loss is limited to some amount
or period less than would be otherwise payable had the reduction not been used.