50 Ill. Adm. Code 2028.20
Definitions
Section 2028.20 Definitions
As used in this Part:
"Accident
and health insurance" shall have the meaning set forth in Section 4 Class
1(b) and Class 2(a) of the Code and includes those coverages authorized by the
Health Maintenance Organization Act [215 ILCS 125], the Limited Health Service
Organization Act [215 ILCS 130], and the Voluntary Health Services Plan Act
[215 ILCS 165]. With regard to a fraternal benefit society, the term includes
coverages authorized by Section 297.1(4) and (5) of the Code.
"Address"
means a street address, mailing address or e-mail address.
"Claim
related information" means all claim or billing information relating
specifically to an insured, subscriber or person covered by an individual or
group policy of accident and health insurance issued, delivered, amended or
renewed by a company doing business in this State.
"Code"
means the Illinois Insurance Code [215 ILCS 5].
"Company" means a
company, as defined in Section 2 of the Code, that issues, delivers, amends or
renews an individual or group policy of accident and health insurance or other
insurance providing accident and health insurance benefits.
"Director" means the
Director of the Illinois Department of Insurance.
"Fraternal
benefit society" shall have the meaning set forth in Section 282.1 of the
Code.
"Insured"
means a natural person who is, has been or will be covered under an individual
or group accident and health policy or a policy including accident and health
coverage.
"Person"
means a natural person or legal entity, including a partnership, limited
liability company, association, trust or corporation.
"Policy"
means a policy, contract or certificate of accident and health insurance.
"Policyholder"
means a person to whom a policy has been issued.
"Reasonable
request" means:
a statement
that disclosure of all or part of the claim related information to which the
request pertains could endanger an individual; or
a copy of a valid protective order from a court of competent jurisdiction.
The request
shall specify an alternative address, telephone number or other method of
contact.
"Requestor"
means an insured making a request to receive claim-related information by
alternative means, or the insured's legal representative, or, with regard to an
insured who is a child, the child's parent or guardian.