Illinois § 4005

§ 4005.

Suspension or revocation or denial of certification of authority. (a) The Director may suspend or revoke any certificate of authority issued to a limited health service organization under this Act or deny an application for a certificate of authority if he finds: (1) That the limited health service organization is operating significantly in contravention of its basic organizational document, its health care plan or in a manner contrary to that described in any information submitted under Sections 2001 or 3006. (2) The limited health service organization issues contracts or evidences of coverage or uses a schedule of charges for health care services which do not comply with the requirements of Sections 2001 or 3006. (3) The limited health care plan does not provide or arrange for limited health services. (4) That the limited health service organization has failed to meet the requirements for issuance of a certificate of authority as set forth in Section 2002. (5) That the limited health service organization is unable to fulfill its obligation to furnish limited health services as required under its limited health care plan. (6) The limited health service organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees. (7) The limited health service organization, or any person on its behalf, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner. (8) The continued operation of the limited health service organization would be hazardous to its enrollees. (9) The limited health service organization has neglected to correct, within the time prescribed by subsection (c) of Section 2004, any deficiency occurring due to such organization's prescribed minimum net worth. (10) The limited health service organization has otherwise failed to substantially comply with this Act. (b) When the certificate of authority of a limited health service organization is revoked, such organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of such organization. The Director may permit such further operation of the organization as he may find to be in the best interest of enrollees to the end that the enrollees will be afforded the greatest practical opportunity to obtain limited health services. (Source: P.A. 86-600.)