Ill. Admin. Code tit. 50, § 2010.30 - Definitions
a) Advertisement
1) "Advertisement" shall include:
A) printed and published material, audio
visual material and descriptive literature used by or on behalf of an insurer
in direct mail, newspapers, magazines, radio scripts, television scripts,
billboards and similar displays;
B)
descriptive literature and sales aids of all kinds issued by an insurer or an
insurance producer as that term is defined in Section 491.1 of the Illinois
Insurance Code (Ill. Rev. Stat. 1989, ch. 73, par. 1065.38 -1), for
presentation to members of the insurance-buying public; including, but not
limited to, circulars, leaflets, booklets, depictions, illustrations, form
letters and lead generating devices of all kinds as herein defined; and
C) prepared sales talks,
presentations and material for use by the insurer or the producer;
and
D) advertising material
included with a policy when the policy is delivered and material used in the
solicitation of renewals and reinstatements.
2) The definition of "advertisement" does not
include:
A) material to be used solely for the
training and education of an insurer's employees or producers;
B) material used in-house by
insurers;
C) communications within
an insurer's own organization not intended for dissemination to the
public;
D) individual
communications of a personal nature with current policyholders other than
material urging such policyholders to increase or expand coverages;
E) correspondence between a prospective group
or blanket policyholder and an insurer in the course of negotiating a group or
blanket contract;
F) court approved
material ordered by a court to be disseminated to policyholders; or
G) a general announcement from a group or
blanket policyholder to eligible individuals on an employment or membership
list that a contract or program has been written or arranged; provided the
announcement must clearly indicate that it is preliminary to the issuance of a
booklet.
b)
"Medicare Supplement Insurance" means a group or individual policy of accident
and health insurance as defined in paragraph (a) of subsection (2) of Section
355a of this Code or a subscriber contract delivered or issued for delivery in
this State by an insurer, fraternal benefit society, nonprofit health, hospital
or medical service corporation, prepaid health plan, or any similar
organization which is advertised, marketed or designed primarily as a
supplement to reimbursements under Medicare for the hospital, medical or
surgical expenses of persons eligible for Medicare by reason of age (Section
363(2)(c) of the Code).
c)
"Certificate" means any certificate issued under a group Medicare supplement
policy, which certificate has been delivered or issued for delivery in this
State (Section 363(2)(b) of the Code).
d) "Insurer" means any insurance company,
nonprofit health, hospital or medical service plan corporation, prepaid health
plan or any other legal entity which has or is proposing to deliver or issue
for delivery in this State Medicare supplement insurance and is engaged in the
advertisement of itself, or Medicare supplement insurance.
e) "Exception" means 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.
f) "Reduction" means any provision which
reduces the amount of the benefit; a risk of loss is assumed but payment upon
the occurrence of such loss is limited to some amount or period less than would
be otherwise payable had such reduction not been used.
g) "Limitation" means any provision which
restricts coverage under the policy other than an exception or a
reduction.
h) "Institutional
Advertisement" means an advertisement having as its sole purpose the promotion
of the reader's, viewer's or listener's interest in the concept of Medicare
supplement insurance, or the promotion of the insurer as a seller of Medicare
supplement insurance.
i)
"Invitation to Inquire" means an advertisement having as its objective the
creation of a desire to inquire further about Medicare supplement insurance
which is limited to a brief description of coverage, and which shall contain a
provision in the following or substantially similar form:
"This policy has [exclusions] [limitations] [reductions of benefits] [terms under which the policy may be continued in force or discontinued]. For costs and complete details of the coverage, call [or write] your insurance agent or the company [whichever is applicable]."
j) "Invitation to Contract" means
an advertisement which is neither an institutional advertisement nor an
invitation to inquire.
k) "Person"
means any natural person, association, organization, partnership, trust, group,
discretionary group, corporation or any other entity.
l) "Medicare" means the "Health Insurance for
the Aged Act," Title XVIII of The Social Security Amendments of 1965, as now or
later amended, including the "Medicare Catastrophic Coverage Act of 1988" (
P.L. 100-360 ) (Section 363(2)(d) of the Code).
m) "Lead-Generating Device" shall mean any
communication directed to the public which, regardless of form, content or
stated purpose, is intended to result in the compilation or qualification of a
list containing names and other personal information to be used to solicit
residents of this State for the purchase of Medicare supplement
insurance.
n) "Code" means the
Illinois Insurance Code (Ill. Rev. Stat. 1989, ch. 73, par. 613, et
seq.)
Notes
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