In Illinois, the administration, regulation and oversight of the private health insurance market is undertaken by the State of Illinois Department of Insurance, led by its Director, Michael McRaith. Several private health insurance providers operate in Illinois, including the Health Care Service Corporation-owned Blue Cross Blue Shield of Illinois, a member of the national Blue Cross Blue Shield federation of private health insurers. Illinois health insurance regulations require private health insurers to cover a range of ‘mandated benefits’ on all their plans. Mandated benefits include the treatment of alcoholism, autism (with special requirements for Illinois group health insurance providers with 51 or more employees), a variety of cancer screenings, outpatient contraceptives approved by the Food and Drug Administration, the HPV vaccine, infertility, maternity care, pap smears and the shingles vaccination. This list is not exhaustive or definitive – for an up-to-date exhaustive list, please visit the Illinois Department of Insurance web site at http://www.insurance.illinois.gov. Illinois health insurance regulation requires health insurance providers to pay or deny a claim within 30 days of receiving all the information needed to pay a claim, or else pay a financial penalty of 9% per annum starting from the 31st day and ending on the day on which the claim is paid.
Illinois law also allows private health insurance providers to revoke health insurance coverage for up to two years following sign-up under certain circumstances. Should the patient report their information inaccurately on their initial application form, this may affect the way a policy has been issued (an exclusionary rider may have been placed, premiums may have been higher or the policy may not have been issued at all), so insurers can revoke coverage if they choose after confirmation of accurate information following the first claim. It is possible to make a complaint with the Illinois Department of Insurance should you believe at any time that a private health insurance provider is acting in an untoward manner. For more information on Department of Insurance regulations, visit http://www.insurance.illinois.gov or telephone the Office of Consumer Health Insurance on +1 (877) 527-9431 (toll free if dialled from inside the state of Illinois).