The powers of a health maintenance organization include, but are not limited to the following:
         (a) The purchase, lease, construction, renovation,
    
operation, or maintenance of hospitals, medical facilities or both, and their ancillary equipment, and such property as may reasonably be required for its principal office or for such other purposes as may be necessary in the transaction of the business of the organization.
        (b) The making of loans to a medical group under
    
contract with it and in furtherance of its program or the making of loans to a corporation or corporations under its control for the purpose of acquiring or constructing medical facilities at hospitals or in furtherance of a program providing health care services for enrollees.
        (c) The furnishing of health care services through
    
providers which are under contract with or employed by the health maintenance organization.
        (d) The contracting with any person for the
    
performance on its behalf of certain functions such as marketing, enrollment and administration.
        (d-5) The voluntary use of a referral system for
    
enrollees to access providers under contract with or employed by the health maintenance organization. Nothing in this subsection (d-5) shall be construed as requiring the use of a referral system with the health maintenance organization’s contracted or employed providers to obtain a certificate of authority as set forth in Section 2-1.
        (e) The contracting with an insurance company
    
licensed in this State, or with a hospital, medical, dental, vision or pharmaceutical service corporation authorized to do business in this State, for the provision of insurance, indemnity, or reimbursement against the cost of health care service provided by the health maintenance organization.
        (f) The offering, in addition to basic health care
    
services, of (1) health care services, (2) indemnity benefits covering out of area or emergency services, (3) indemnity benefits provided through insurers or hospital, medical, dental, vision, or pharmaceutical service corporations, and (4) health maintenance organization point-of-service benefits as authorized under Article 4.5.
        (g) Rendering services related to the functions
    
involved in the operating of its health maintenance organization business including but not limited to providing health services, data processing, accounting, or claims.
        (g-5) Indemnification for services provided to a
    
child as required under subdivision (e)(3) of Section 4-2.
        (h) Any other business activity reasonably
    
complementary or supplementary to its health maintenance organization business to the extent approved by the Director.
lawyer at desk

Ask a legal question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

Terms Used In Illinois Compiled Statutes 215 ILCS 125/2-3

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14
  Previous section
Next section  
 Article II Contents