Helping Illinois health maintenance organization enrollees when they need it most.
Learning your health maintenance organization (HMO) is in trouble can be frightening. The Illinois Health Maintenance Organization Guaranty Association provides protection for HMO contracts owned by Illinois residents.
The Illinois Health Maintenance Organization Guaranty Association is a non-profit association of HMO member organizations. It was created by Illinois law to provide certain protections for Illinois enrollees against certain HMO insolvencies.
To provide this protection, the Association may directly pay benefits to providers, continue coverage, transfer contracts to another HMO or take other actions authorized by law. This site provides further information about the Association and how it protects covered enrollees in the event of an HMO insolvency.
On August 3, 2018 Illinois Governor Bruce Rauner signed into law HB 5251 (also see Public Act 100-0687). The new law streamlines and modernizes the important consumer protections found in Illinois statutes which safeguard policyholders and enrollees of life, health, and annuity insurance companies and HMO companies which fail financially. The law unifies the protections provided to health insurance consumers by merging the smaller Illinois Health Maintenance Organization Guaranty Association into the Illinois Life and Health Insurance Guaranty Association, which will now protect HMO enrollees in addition to the policyholders of life, annuity and indemnity health insurance companies. Responsibility for funding long term care obligations is expanded to include not only indemnity health insurance companies, but also HMOs, life and annuity companies. Thus, an improved and greater base for supporting long term care obligations is created in terms of dollars and in terms of the number and types of companies providing funds. The law clarifies that medical providers are also protected from financial failure of health companies.
Please use the Contact Us page for any further inquiries.
This website is for general information purposes and should not be relied upon as legal advice.