Public Accountability Report

The Department of Insurance (DOI) licenses, regulates, examines, and, if appropriate, disciplines individuals and entities engaged in Illinois in the business of insurance. DOI’s responsibilities include, but are not limited to, all aspects of insurance company solvency; the conduct of agents, brokers, and companies; the collection of insurance taxes and assessments; and, more broadly, the authority to regulate any individual or company involved with the management, distribution, sales, or marketing of insurance or insurance-related matters in Illinois. DOI is the sole regulator of all aspects of the insurance industry in Illinois. DOI works diligently to protect the insurance interests of each and every Illinois resident and business. DOI initiatives that most reflect the Department's commitment to Illinois insurance consumers include our continuing efforts to implement the various facets of the federal Affordable Care Act (ACA) and our Consumer Protection and Education Initiative.

The Department was instrumental in launching Get Covered Illinois, the state’s comprehensive education and enrollment online platform for uninsured residents to sign up for health coverage under the ACA. In reinforcing our commitment to improve the health and well-being of the people of this State, Illinois has authorized a new state-based marketplace (SBM) for health insurance, which will give the State the additional tools necessary to create a more consumer-focused exchange and better identify traditionally uninsured communities. This move will transition Illinois from using the federal platform to a state platform. Legislation signed in June 2023 establishes a state-based exchange for policies sold under the Affordable Care Act and gives the Illinois Department of Insurance the authority to modify or reject proposed rate increases. The Department of Insurance state-based exchange will be fully operational by 2026.

DOI protects and educates consumers by providing information needed to make decisions on a broad range of insurance issues and assisting consumers with specific concerns pertaining to coverage, claims, underwriting, and other consumer financial issues.

Consumer protection and education is accomplished through various means. The Consumer Division utilizes an electronic complaint database that allows for the immediate exchange of information and complaint resolution. With the passage of the revised Health Carrier External Review Act, the Division is responsible for facilitating a consumer’s ability to appeal adverse determinations with the Director of Insurance. The Division also monitors and revises consumer fact sheets and posts these fact sheets on DOI’s website to educate consumers of any changes to insurance laws or regulations. The Division also utilizes a toll-free consumer hotline that enables consumers to easily reach Consumer Services Section analysts with questions or complaints regarding an insurance policy or company. The Health Products Division oversees consumer protection and education programs; registers and regulates the activities of healthcare insurers, workers’ compensation, and pharmaceutical provider networks, utilization review organizations, external independent review organizations, and third-party administrators; and monitors marketplace operations of insurance companies through policy analysis and complaint tracking.

DOI will continue to work diligently to protect citizens’ lives and property to increase the protection of the public through education and enforcement of legal standards in insurance.