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1 | AN ACT concerning government.
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2 | Be it enacted by the People of the State of Illinois,
| ||||||||||||||||||||||||||||||
3 | represented in the General Assembly:
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4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||||||||||||||||||||||||||
5 | is amended by changing Sections 6, 7, and 10 and by adding | ||||||||||||||||||||||||||||||
6 | Section 10.5 as follows:
| ||||||||||||||||||||||||||||||
7 | (5 ILCS 375/6) (from Ch. 127, par. 526)
| ||||||||||||||||||||||||||||||
8 | Sec. 6. Program of health benefits.
| ||||||||||||||||||||||||||||||
9 | (a) The program of health benefits shall provide for | ||||||||||||||||||||||||||||||
10 | protection
against the financial costs of health care expenses | ||||||||||||||||||||||||||||||
11 | incurred in and out
of hospital including basic | ||||||||||||||||||||||||||||||
12 | hospital-surgical-medical coverages. The program
may include, | ||||||||||||||||||||||||||||||
13 | but shall not be limited to, such supplemental coverages as
| ||||||||||||||||||||||||||||||
14 | out-patient diagnostic X-ray and laboratory expenses, | ||||||||||||||||||||||||||||||
15 | prescription drugs,
dental services, hearing evaluations, | ||||||||||||||||||||||||||||||
16 | hearing aids, the dispensing and
fitting
of hearing aids, and | ||||||||||||||||||||||||||||||
17 | similar group benefits
as are now or may become available. | ||||||||||||||||||||||||||||||
18 | However, nothing in this Act shall
be construed to permit, on | ||||||||||||||||||||||||||||||
19 | or after July 1, 1980, the non-contributory portion
of any such | ||||||||||||||||||||||||||||||
20 | program to include the expenses of obtaining an abortion, | ||||||||||||||||||||||||||||||
21 | induced
miscarriage or induced premature birth unless, in the | ||||||||||||||||||||||||||||||
22 | opinion of a physician,
such procedures are necessary for the | ||||||||||||||||||||||||||||||
23 | preservation of the life of the woman
seeking such treatment, |
| |||||||
| |||||||
1 | or except an induced premature birth intended to
produce a live | ||||||
2 | viable child and such procedure is necessary for the health
of | ||||||
3 | the mother or the unborn child. The program may also include
| ||||||
4 | coverage for those who rely on treatment by prayer or spiritual | ||||||
5 | means
alone for healing in accordance with the tenets and | ||||||
6 | practice of a
recognized religious denomination.
| ||||||
7 | The program of health benefits shall be designed by the | ||||||
8 | Director
(1) to provide a reasonable relationship between the | ||||||
9 | benefits to be
included and the expected distribution of | ||||||
10 | expenses of each such type to
be incurred by the covered | ||||||
11 | members and dependents,
(2) to specify, as covered benefits and | ||||||
12 | as optional benefits, the
medical services of practitioners in | ||||||
13 | all categories licensed under the
Medical Practice Act of 1987, | ||||||
14 | (3) to include
reasonable controls, which may include | ||||||
15 | deductible and co-insurance
provisions, applicable to some or | ||||||
16 | all of the benefits, or a coordination
of benefits provision, | ||||||
17 | to prevent or minimize unnecessary utilization of
the various | ||||||
18 | hospital, surgical and medical expenses to be provided and
to | ||||||
19 | provide reasonable assurance of stability of the program, and | ||||||
20 | (4) to
provide benefits to the extent possible to members | ||||||
21 | throughout the
State, wherever located, on an equitable basis.
| ||||||
22 | Notwithstanding any other provision of this Section or Act,
for | ||||||
23 | all members or dependents who are eligible for benefits under | ||||||
24 | Social
Security or the
Railroad Retirement system or who had | ||||||
25 | sufficient Medicare-covered government
employment,
the
| ||||||
26 | Department shall reduce benefits
which would otherwise be paid |
| |||||||
| |||||||
1 | by Medicare, by the amount of benefits for
which the member or | ||||||
2 | dependents are eligible
under Medicare, except that such | ||||||
3 | reduction in benefits shall apply only to
those members or | ||||||
4 | dependents who (1) first become
eligible for such medicare | ||||||
5 | coverage on or after the effective date of this
amendatory Act | ||||||
6 | of 1992; or (2) are Medicare-eligible members or dependents of
| ||||||
7 | a local government unit which began participation in the | ||||||
8 | program on or after
July 1, 1992; or (3) remain eligible for | ||||||
9 | but no longer receive
Medicare coverage which they had been | ||||||
10 | receiving on or after the effective date
of this amendatory Act | ||||||
11 | of 1992.
| ||||||
12 | Notwithstanding any other provisions of this Act, where a | ||||||
13 | covered member or
dependents are eligible for benefits under | ||||||
14 | the federal Medicare health
insurance program (Title XVIII of | ||||||
15 | the Social Security Act as added by
Public Law 89-97, 89th | ||||||
16 | Congress), benefits paid under the State of Illinois
program or | ||||||
17 | plan will be reduced by the amount of benefits paid by | ||||||
18 | Medicare.
For members or dependents
who are eligible for | ||||||
19 | benefits under Social Security
or the Railroad Retirement | ||||||
20 | system or who had sufficient Medicare-covered
government | ||||||
21 | employment, benefits shall be reduced by the amount for which
| ||||||
22 | the member or dependent is eligible under Medicare,
except that | ||||||
23 | such reduction in benefits shall apply only to those
members or | ||||||
24 | dependents who (1) first become eligible for such
Medicare | ||||||
25 | coverage on or after the effective date of this amendatory Act
| ||||||
26 | of 1992; or (2) are Medicare-eligible members or dependents of |
| |||||||
| |||||||
1 | a local
government unit which began participation in the | ||||||
2 | program on or after July 1,
1992; or (3) remain eligible for, | ||||||
3 | but no longer receive Medicare
coverage which they had been | ||||||
4 | receiving on or after the effective date of this
amendatory Act | ||||||
5 | of 1992. Premiums may be adjusted, where applicable, to an
| ||||||
6 | amount deemed by the Director to be reasonably consistent with | ||||||
7 | any reduction
of benefits.
| ||||||
8 | (b) (Blank). A member, not otherwise covered by this Act, | ||||||
9 | who has retired as a
participating member under Article 2 of | ||||||
10 | the Illinois Pension Code
but is ineligible for the retirement | ||||||
11 | annuity under Section 2-119 of the
Illinois
Pension Code, shall | ||||||
12 | pay the premiums for coverage, not
exceeding the amount paid by | ||||||
13 | the State for the non-contributory coverage for
other members, | ||||||
14 | under the group health benefits program under this Act. The
| ||||||
15 | Director shall determine the premiums to be paid
by a member | ||||||
16 | under this subsection (b).
| ||||||
17 | (Source: P.A. 93-47, eff. 7-1-03.)
| ||||||
18 | (5 ILCS 375/7) (from Ch. 127, par. 527)
| ||||||
19 | Sec. 7. Group life insurance program.
| ||||||
20 | (a) The basic noncontributory group life insurance program | ||||||
21 | shall
provide coverage as follows:
| ||||||
22 | (1) employees shall be insured in an amount equal to | ||||||
23 | the basic annual
salary rate, exclusive of overtime, bonus, | ||||||
24 | or other cumulative additional
income factors, raised to | ||||||
25 | the next round hundred dollar
amount if it is not already a |
| |||||||
| |||||||
1 | round hundred dollar amount;
| ||||||
2 | (2) annuitants shall be insured in the same manner as | ||||||
3 | described for
active employees, based on the salary in | ||||||
4 | force immediately before
retirement, with coverage | ||||||
5 | becoming effective on the effective date of
retirement | ||||||
6 | benefits or the first day of the month of application, | ||||||
7 | whichever
occurs later, except that at age 60 the amount of | ||||||
8 | coverage for the
annuitant shall be reduced to $5,000;
| ||||||
9 | (3) survivors whose coverage became effective prior to | ||||||
10 | September 22,
1979 shall be insured for $2,000;
| ||||||
11 | (4) retired employees shall not be eligible under the | ||||||
12 | group life insurance
program contracted to begin or | ||||||
13 | continue after June 30, 1973.
| ||||||
14 | (a-5) There shall also be available on an optional basis to | ||||||
15 | employees,
annuitants whose retirement benefits begin within | ||||||
16 | one year of their receipt of
final compensation, and survivors | ||||||
17 | whose coverage became effective prior to
September 22, 1979, a | ||||||
18 | contributory program of:
| ||||||
19 | (1) supplemental life insurance in an amount not | ||||||
20 | exceeding 8 times the
basic life benefits for active | ||||||
21 | employees and annuitants under age 60 and not exceeding 4 | ||||||
22 | times the basic life benefits for annuitants age 60 and | ||||||
23 | over, as described above, except that (a) amounts selected
| ||||||
24 | by employees and annuitants must be in full multiples of | ||||||
25 | the basic amount,
and (b) premiums may be adjusted by age | ||||||
26 | bracket established in rules
supplementing this Act; |
| |||||||
| |||||||
1 | beginning July 1, 1981, survivors whose coverage
becomes | ||||||
2 | effective on or after September 22, 1979, shall have the | ||||||
3 | option of
participating in the contributory program of life | ||||||
4 | insurance in an amount of
$5,000 coverage;
| ||||||
5 | (2) accidental death and dismemberment, with the | ||||||
6 | employee and annuitant
having the option of electing an | ||||||
7 | amount equal to the basic noncontributory
life benefits | ||||||
8 | only, or an amount equaling the combined total of basic | ||||||
9 | plus
optional life benefits not exceeding 5 times basic | ||||||
10 | life benefits, or $3,000,000, whichever is less;
| ||||||
11 | (3) dependent life insurance in an amount of $10,000 | ||||||
12 | coverage on the
spouse; however, coverage reduces to $5,000 | ||||||
13 | when the eligible annuitant turns 60; and
| ||||||
14 | (4) dependent life insurance in an amount of $10,000
| ||||||
15 | coverage on each
dependent other than the spouse.
| ||||||
16 | (b) (Blank). A member, not otherwise covered by this Act, | ||||||
17 | who has retired as a
participating member under Article 2 of | ||||||
18 | the Illinois Pension
Code, but is ineligible for the retirement | ||||||
19 | annuity under Section 2-119
of the Illinois Pension Code, shall | ||||||
20 | pay the premiums for coverage under
the group life insurance | ||||||
21 | program under this Act. The Director shall promulgate
rules and | ||||||
22 | regulations to determine the premiums to be paid by a member
| ||||||
23 | under this subsection (b).
| ||||||
24 | (Source: P.A. 94-95, eff. 7-1-05 .)
| ||||||
25 | (5 ILCS 375/10) (from Ch. 127, par. 530)
|
| |||||||
| |||||||
1 | Sec. 10. Contributions by the State and members.
| ||||||
2 | (a) Except as otherwise provided in Section 10.5 of this | ||||||
3 | Act, the The State shall pay the cost of basic non-contributory | ||||||
4 | group life
insurance and, subject to member paid contributions | ||||||
5 | set by the Department or
required by this Section and except as | ||||||
6 | provided in this Section, the basic program of group health | ||||||
7 | benefits on each
eligible member, except a member, not | ||||||
8 | otherwise
covered by this Act, who has retired as a | ||||||
9 | participating member under Article 2
of the Illinois Pension | ||||||
10 | Code but is ineligible for the retirement annuity under
Section | ||||||
11 | 2-119 of the Illinois Pension Code, and part of each eligible | ||||||
12 | member's
and retired member's premiums for health insurance | ||||||
13 | coverage for enrolled
dependents as provided by Section 9. The | ||||||
14 | State shall pay the cost of the basic
program of group health | ||||||
15 | benefits only after benefits are reduced by the amount
of | ||||||
16 | benefits covered by Medicare for all members and dependents
who | ||||||
17 | are eligible for benefits under Social Security or
the Railroad | ||||||
18 | Retirement system or who had sufficient Medicare-covered
| ||||||
19 | government employment, except that such reduction in benefits | ||||||
20 | shall apply only
to those members and dependents who (1) first | ||||||
21 | become eligible
for such Medicare coverage on or after July 1, | ||||||
22 | 1992; or (2) are
Medicare-eligible members or dependents of a | ||||||
23 | local government unit which began
participation in the program | ||||||
24 | on or after July 1, 1992; or (3) remain eligible
for, but no | ||||||
25 | longer receive Medicare coverage which they had been receiving | ||||||
26 | on
or after July 1, 1992. The Department may determine the |
| |||||||
| |||||||
1 | aggregate level of the
State's contribution on the basis of | ||||||
2 | actual cost of medical services adjusted
for age, sex or | ||||||
3 | geographic or other demographic characteristics which affect
| ||||||
4 | the costs of such programs.
| ||||||
5 | The cost of participation in the basic program of group | ||||||
6 | health benefits
for the dependent or survivor of a living or | ||||||
7 | deceased retired employee who was
formerly employed by the | ||||||
8 | University of Illinois in the Cooperative Extension
Service and | ||||||
9 | would be an annuitant but for the fact that he or she was made
| ||||||
10 | ineligible to participate in the State Universities Retirement | ||||||
11 | System by clause
(4) of subsection (a) of Section 15-107 of the | ||||||
12 | Illinois Pension Code shall not
be greater than the cost of | ||||||
13 | participation that would otherwise apply to that
dependent or | ||||||
14 | survivor if he or she were the dependent or survivor of an
| ||||||
15 | annuitant under the State Universities Retirement System.
| ||||||
16 | (a-1) (Blank).
| ||||||
17 | (a-2) (Blank).
| ||||||
18 | (a-3) (Blank).
| ||||||
19 | (a-4) (Blank).
| ||||||
20 | (a-5) (Blank).
| ||||||
21 | (a-6) (Blank).
| ||||||
22 | (a-7) (Blank).
| ||||||
23 | (a-8) Any annuitant, survivor, or retired employee may | ||||||
24 | waive or terminate coverage in
the program of group health | ||||||
25 | benefits. Any such annuitant, survivor, or retired employee
who | ||||||
26 | has waived or terminated coverage may enroll or re-enroll in |
| |||||||
| |||||||
1 | the
program of group health benefits only during the annual | ||||||
2 | benefit choice period,
as determined by the Director; except | ||||||
3 | that in the event of termination of
coverage due to nonpayment | ||||||
4 | of premiums, the annuitant, survivor, or retired employee
may | ||||||
5 | not re-enroll in the program.
| ||||||
6 | (a-8.5) Beginning on the effective date of this amendatory | ||||||
7 | Act of the 97th General Assembly, the Director of Central | ||||||
8 | Management Services shall, on an annual basis, determine the | ||||||
9 | amount that the State shall contribute toward the basic program | ||||||
10 | of group health benefits on behalf of annuitants (including | ||||||
11 | individuals who (i) participated in the General Assembly | ||||||
12 | Retirement System, the State Employees' Retirement System of | ||||||
13 | Illinois, the State Universities Retirement System, the | ||||||
14 | Teachers' Retirement System of the State of Illinois, or the | ||||||
15 | Judges Retirement System of Illinois and (ii) qualify as | ||||||
16 | annuitants under subsection (b) of Section 3 of this Act), | ||||||
17 | survivors (including individuals who (i) receive an annuity as | ||||||
18 | a survivor of an individual who participated in the General | ||||||
19 | Assembly Retirement System, the State Employees' Retirement | ||||||
20 | System of Illinois, the State Universities Retirement System, | ||||||
21 | the Teachers' Retirement System of the State of Illinois, or | ||||||
22 | the Judges Retirement System of Illinois and (ii) qualify as | ||||||
23 | survivors under subsection (q) of Section 3 of this Act), and | ||||||
24 | retired employees (as defined in subsection (p) of Section 3 of | ||||||
25 | this Act). The remainder of the cost of coverage for each | ||||||
26 | annuitant, survivor, or retired employee, as determined by the |
| |||||||
| |||||||
1 | Director of Central Management Services, shall be the | ||||||
2 | responsibility of that annuitant, survivor, or retired | ||||||
3 | employee. | ||||||
4 | Except as otherwise provided in Section 10.5 of this Act, | ||||||
5 | contributions Contributions required of annuitants, survivors, | ||||||
6 | and retired employees shall be the same for all retirement | ||||||
7 | systems and shall also be based on whether an individual has | ||||||
8 | made an election under Section 15-135.1 of the Illinois Pension | ||||||
9 | Code. Contributions may be based on annuitants', survivors', or | ||||||
10 | retired employees' Medicare eligibility, but may not be based | ||||||
11 | on Social Security eligibility. | ||||||
12 | (a-9) No later than May 1 of each calendar year, the | ||||||
13 | Director
of Central Management Services shall certify in | ||||||
14 | writing to the Executive
Secretary of the State Employees' | ||||||
15 | Retirement System of Illinois the amounts
of the Medicare | ||||||
16 | supplement health care premiums and the amounts of the
health | ||||||
17 | care premiums for all other retirees who are not Medicare | ||||||
18 | eligible.
| ||||||
19 | A separate calculation of the premiums based upon the | ||||||
20 | actual cost of each
health care plan shall be so certified.
| ||||||
21 | The Director of Central Management Services shall provide | ||||||
22 | to the
Executive Secretary of the State Employees' Retirement | ||||||
23 | System of
Illinois such information, statistics, and other data | ||||||
24 | as he or she
may require to review the premium amounts | ||||||
25 | certified by the Director
of Central Management Services.
| ||||||
26 | The Department of Central Management Services, or any |
| |||||||
| |||||||
1 | successor agency designated to procure healthcare contracts | ||||||
2 | pursuant to this Act, is authorized to establish funds, | ||||||
3 | separate accounts provided by any bank or banks as defined by | ||||||
4 | the Illinois Banking Act, or separate accounts provided by any | ||||||
5 | savings and loan association or associations as defined by the | ||||||
6 | Illinois Savings and Loan Act of 1985 to be held by the | ||||||
7 | Director, outside the State treasury, for the purpose of | ||||||
8 | receiving the transfer of moneys from the Local Government | ||||||
9 | Health Insurance Reserve Fund. The Department may promulgate | ||||||
10 | rules further defining the methodology for the transfers. Any | ||||||
11 | interest earned by moneys in the funds or accounts shall inure | ||||||
12 | to the Local Government Health Insurance Reserve Fund. The | ||||||
13 | transferred moneys, and interest accrued thereon, shall be used | ||||||
14 | exclusively for transfers to administrative service | ||||||
15 | organizations or their financial institutions for payments of | ||||||
16 | claims to claimants and providers under the self-insurance | ||||||
17 | health plan. The transferred moneys, and interest accrued | ||||||
18 | thereon, shall not be used for any other purpose including, but | ||||||
19 | not limited to, reimbursement of administration fees due the | ||||||
20 | administrative service organization pursuant to its contract | ||||||
21 | or contracts with the Department.
| ||||||
22 | (b) State employees who become eligible for this program on | ||||||
23 | or after January
1, 1980 in positions normally requiring actual | ||||||
24 | performance of duty not less
than 1/2 of a normal work period | ||||||
25 | but not equal to that of a normal work period,
shall be given | ||||||
26 | the option of participating in the available program. If the
|
| |||||||
| |||||||
1 | employee elects coverage, the State shall contribute on behalf | ||||||
2 | of such employee
to the cost of the employee's benefit and any | ||||||
3 | applicable dependent supplement,
that sum which bears the same | ||||||
4 | percentage as that percentage of time the
employee regularly | ||||||
5 | works when compared to normal work period.
| ||||||
6 | (c) The basic non-contributory coverage from the basic | ||||||
7 | program of
group health benefits shall be continued for each | ||||||
8 | employee not in pay status or
on active service by reason of | ||||||
9 | (1) leave of absence due to illness or injury,
(2) authorized | ||||||
10 | educational leave of absence or sabbatical leave, or (3)
| ||||||
11 | military leave. This coverage shall continue until
expiration | ||||||
12 | of authorized leave and return to active service, but not to | ||||||
13 | exceed
24 months for leaves under item (1) or (2). This | ||||||
14 | 24-month limitation and the
requirement of returning to active | ||||||
15 | service shall not apply to persons receiving
ordinary or | ||||||
16 | accidental disability benefits or retirement benefits through | ||||||
17 | the
appropriate State retirement system or benefits under the | ||||||
18 | Workers' Compensation
or Occupational Disease Act.
| ||||||
19 | (d) The basic group life insurance coverage shall continue, | ||||||
20 | with
full State contribution, where such person is (1) absent | ||||||
21 | from active
service by reason of disability arising from any | ||||||
22 | cause other than
self-inflicted, (2) on authorized educational | ||||||
23 | leave of absence or
sabbatical leave, or (3) on military leave.
| ||||||
24 | (e) Where the person is in non-pay status for a period in | ||||||
25 | excess of
30 days or on leave of absence, other than by reason | ||||||
26 | of disability,
educational or sabbatical leave, or military |
| |||||||
| |||||||
1 | leave, such
person may continue coverage only by making | ||||||
2 | personal
payment equal to the amount normally contributed by | ||||||
3 | the State on such person's
behalf. Such payments and coverage | ||||||
4 | may be continued: (1) until such time as
the person returns to | ||||||
5 | a status eligible for coverage at State expense, but not
to | ||||||
6 | exceed 24 months or (2) until such person's employment or | ||||||
7 | annuitant status
with the State is terminated (exclusive of any | ||||||
8 | additional service imposed pursuant to law).
| ||||||
9 | (f) The Department shall establish by rule the extent to | ||||||
10 | which other
employee benefits will continue for persons in | ||||||
11 | non-pay status or who are
not in active service.
| ||||||
12 | (g) The State shall not pay the cost of the basic | ||||||
13 | non-contributory
group life insurance, program of health | ||||||
14 | benefits and other employee benefits
for members who are | ||||||
15 | survivors as defined by paragraphs (1) and (2) of
subsection | ||||||
16 | (q) of Section 3 of this Act. The costs of benefits for these
| ||||||
17 | survivors shall be paid by the survivors or by the University | ||||||
18 | of Illinois
Cooperative Extension Service, or any combination | ||||||
19 | thereof.
However, the State shall pay the amount of the | ||||||
20 | reduction in the cost of
participation, if any, resulting from | ||||||
21 | the amendment to subsection (a) made
by this amendatory Act of | ||||||
22 | the 91st General Assembly.
| ||||||
23 | (h) Those persons occupying positions with any department | ||||||
24 | as a result
of emergency appointments pursuant to Section 8b.8 | ||||||
25 | of the Personnel Code
who are not considered employees under | ||||||
26 | this Act shall be given the option
of participating in the |
| |||||||
| |||||||
1 | programs of group life insurance, health benefits and
other | ||||||
2 | employee benefits. Such persons electing coverage may | ||||||
3 | participate only
by making payment equal to the amount normally | ||||||
4 | contributed by the State for
similarly situated employees. Such | ||||||
5 | amounts shall be determined by the
Director. Such payments and | ||||||
6 | coverage may be continued until such time as the
person becomes | ||||||
7 | an employee pursuant to this Act or such person's appointment | ||||||
8 | is
terminated.
| ||||||
9 | (i) Any unit of local government within the State of | ||||||
10 | Illinois
may apply to the Director to have its employees, | ||||||
11 | annuitants, and their
dependents provided group health | ||||||
12 | coverage under this Act on a non-insured
basis. To participate, | ||||||
13 | a unit of local government must agree to enroll
all of its | ||||||
14 | employees, who may select coverage under either the State group
| ||||||
15 | health benefits plan or a health maintenance organization that | ||||||
16 | has
contracted with the State to be available as a health care | ||||||
17 | provider for
employees as defined in this Act. A unit of local | ||||||
18 | government must remit the
entire cost of providing coverage | ||||||
19 | under the State group health benefits plan
or, for coverage | ||||||
20 | under a health maintenance organization, an amount determined
| ||||||
21 | by the Director based on an analysis of the sex, age, | ||||||
22 | geographic location, or
other relevant demographic variables | ||||||
23 | for its employees, except that the unit of
local government | ||||||
24 | shall not be required to enroll those of its employees who are
| ||||||
25 | covered spouses or dependents under this plan or another group | ||||||
26 | policy or plan
providing health benefits as long as (1) an |
| |||||||
| |||||||
1 | appropriate official from the unit
of local government attests | ||||||
2 | that each employee not enrolled is a covered spouse
or | ||||||
3 | dependent under this plan or another group policy or plan, and | ||||||
4 | (2) at least
50% of the employees are enrolled and the unit of | ||||||
5 | local government remits
the entire cost of providing coverage | ||||||
6 | to those employees, except that a
participating school district | ||||||
7 | must have enrolled at least 50% of its full-time
employees who | ||||||
8 | have not waived coverage under the district's group health
plan | ||||||
9 | by participating in a component of the district's cafeteria | ||||||
10 | plan. A
participating school district is not required to enroll | ||||||
11 | a full-time employee
who has waived coverage under the | ||||||
12 | district's health plan, provided that an
appropriate official | ||||||
13 | from the participating school district attests that the
| ||||||
14 | full-time employee has waived coverage by participating in a | ||||||
15 | component of the
district's cafeteria plan. For the purposes of | ||||||
16 | this subsection, "participating
school district" includes a | ||||||
17 | unit of local government whose primary purpose is
education as | ||||||
18 | defined by the Department's rules.
| ||||||
19 | Employees of a participating unit of local government who | ||||||
20 | are not enrolled
due to coverage under another group health | ||||||
21 | policy or plan may enroll in
the event of a qualifying change | ||||||
22 | in status, special enrollment, special
circumstance as defined | ||||||
23 | by the Director, or during the annual Benefit Choice
Period. A | ||||||
24 | participating unit of local government may also elect to cover | ||||||
25 | its
annuitants. Dependent coverage shall be offered on an | ||||||
26 | optional basis, with the
costs paid by the unit of local |
| |||||||
| |||||||
1 | government, its employees, or some combination
of the two as | ||||||
2 | determined by the unit of local government. The unit of local
| ||||||
3 | government shall be responsible for timely collection and | ||||||
4 | transmission of
dependent premiums.
| ||||||
5 | The Director shall annually determine monthly rates of | ||||||
6 | payment, subject
to the following constraints:
| ||||||
7 | (1) In the first year of coverage, the rates shall be | ||||||
8 | equal to the
amount normally charged to State employees for | ||||||
9 | elected optional coverages
or for enrolled dependents | ||||||
10 | coverages or other contributory coverages, or
contributed | ||||||
11 | by the State for basic insurance coverages on behalf of its
| ||||||
12 | employees, adjusted for differences between State | ||||||
13 | employees and employees
of the local government in age, | ||||||
14 | sex, geographic location or other relevant
demographic | ||||||
15 | variables, plus an amount sufficient to pay for the | ||||||
16 | additional
administrative costs of providing coverage to | ||||||
17 | employees of the unit of
local government and their | ||||||
18 | dependents.
| ||||||
19 | (2) In subsequent years, a further adjustment shall be | ||||||
20 | made to reflect
the actual prior years' claims experience | ||||||
21 | of the employees of the unit of
local government.
| ||||||
22 | In the case of coverage of local government employees under | ||||||
23 | a health
maintenance organization, the Director shall annually | ||||||
24 | determine for each
participating unit of local government the | ||||||
25 | maximum monthly amount the unit
may contribute toward that | ||||||
26 | coverage, based on an analysis of (i) the age,
sex, geographic |
| |||||||
| |||||||
1 | location, and other relevant demographic variables of the
| ||||||
2 | unit's employees and (ii) the cost to cover those employees | ||||||
3 | under the State
group health benefits plan. The Director may | ||||||
4 | similarly determine the
maximum monthly amount each unit of | ||||||
5 | local government may contribute toward
coverage of its | ||||||
6 | employees' dependents under a health maintenance organization.
| ||||||
7 | Monthly payments by the unit of local government or its | ||||||
8 | employees for
group health benefits plan or health maintenance | ||||||
9 | organization coverage shall
be deposited in the Local | ||||||
10 | Government Health Insurance Reserve Fund.
| ||||||
11 | The Local Government Health Insurance Reserve Fund is | ||||||
12 | hereby created as a nonappropriated trust fund to be held | ||||||
13 | outside the State Treasury, with the State Treasurer as | ||||||
14 | custodian. The Local Government Health Insurance Reserve Fund | ||||||
15 | shall be a continuing
fund not subject to fiscal year | ||||||
16 | limitations. The Local Government Health Insurance Reserve | ||||||
17 | Fund is not subject to administrative charges or charge-backs, | ||||||
18 | including but not limited to those authorized under Section 8h | ||||||
19 | of the State Finance Act. All revenues arising from the | ||||||
20 | administration of the health benefits program established | ||||||
21 | under this Section shall be deposited into the Local Government | ||||||
22 | Health Insurance Reserve Fund. Any interest earned on moneys in | ||||||
23 | the Local Government Health Insurance Reserve Fund shall be | ||||||
24 | deposited into the Fund. All expenditures from this Fund
shall | ||||||
25 | be used for payments for health care benefits for local | ||||||
26 | government and rehabilitation facility
employees, annuitants, |
| |||||||
| |||||||
1 | and dependents, and to reimburse the Department or
its | ||||||
2 | administrative service organization for all expenses incurred | ||||||
3 | in the
administration of benefits. No other State funds may be | ||||||
4 | used for these
purposes.
| ||||||
5 | A local government employer's participation or desire to | ||||||
6 | participate
in a program created under this subsection shall | ||||||
7 | not limit that employer's
duty to bargain with the | ||||||
8 | representative of any collective bargaining unit
of its | ||||||
9 | employees.
| ||||||
10 | (j) Any rehabilitation facility within the State of | ||||||
11 | Illinois may apply
to the Director to have its employees, | ||||||
12 | annuitants, and their eligible
dependents provided group | ||||||
13 | health coverage under this Act on a non-insured
basis. To | ||||||
14 | participate, a rehabilitation facility must agree to enroll all
| ||||||
15 | of its employees and remit the entire cost of providing such | ||||||
16 | coverage for
its employees, except that the rehabilitation | ||||||
17 | facility shall not be
required to enroll those of its employees | ||||||
18 | who are covered spouses or
dependents under this plan or | ||||||
19 | another group policy or plan providing health
benefits as long | ||||||
20 | as (1) an appropriate official from the rehabilitation
facility | ||||||
21 | attests that each employee not enrolled is a covered spouse or
| ||||||
22 | dependent under this plan or another group policy or plan, and | ||||||
23 | (2) at least
50% of the employees are enrolled and the | ||||||
24 | rehabilitation facility remits
the entire cost of providing | ||||||
25 | coverage to those employees. Employees of a
participating | ||||||
26 | rehabilitation facility who are not enrolled due to coverage
|
| |||||||
| |||||||
1 | under another group health policy or plan may enroll
in the | ||||||
2 | event of a qualifying change in status, special enrollment, | ||||||
3 | special
circumstance as defined by the Director, or during the | ||||||
4 | annual Benefit Choice
Period. A participating rehabilitation | ||||||
5 | facility may also elect
to cover its annuitants. Dependent | ||||||
6 | coverage shall be offered on an optional
basis, with the costs | ||||||
7 | paid by the rehabilitation facility, its employees, or
some | ||||||
8 | combination of the 2 as determined by the rehabilitation | ||||||
9 | facility. The
rehabilitation facility shall be responsible for | ||||||
10 | timely collection and
transmission of dependent premiums.
| ||||||
11 | The Director shall annually determine quarterly rates of | ||||||
12 | payment, subject
to the following constraints:
| ||||||
13 | (1) In the first year of coverage, the rates shall be | ||||||
14 | equal to the amount
normally charged to State employees for | ||||||
15 | elected optional coverages or for
enrolled dependents | ||||||
16 | coverages or other contributory coverages on behalf of
its | ||||||
17 | employees, adjusted for differences between State | ||||||
18 | employees and
employees of the rehabilitation facility in | ||||||
19 | age, sex, geographic location
or other relevant | ||||||
20 | demographic variables, plus an amount sufficient to pay
for | ||||||
21 | the additional administrative costs of providing coverage | ||||||
22 | to employees
of the rehabilitation facility and their | ||||||
23 | dependents.
| ||||||
24 | (2) In subsequent years, a further adjustment shall be | ||||||
25 | made to reflect
the actual prior years' claims experience | ||||||
26 | of the employees of the
rehabilitation facility.
|
| |||||||
| |||||||
1 | Monthly payments by the rehabilitation facility or its | ||||||
2 | employees for
group health benefits shall be deposited in the | ||||||
3 | Local Government Health
Insurance Reserve Fund.
| ||||||
4 | (k) Any domestic violence shelter or service within the | ||||||
5 | State of Illinois
may apply to the Director to have its | ||||||
6 | employees, annuitants, and their
dependents provided group | ||||||
7 | health coverage under this Act on a non-insured
basis. To | ||||||
8 | participate, a domestic violence shelter or service must agree | ||||||
9 | to
enroll all of its employees and pay the entire cost of | ||||||
10 | providing such coverage
for its employees. The domestic | ||||||
11 | violence shelter shall not be required to enroll those of its | ||||||
12 | employees who are covered spouses or dependents under this plan | ||||||
13 | or another group policy or plan providing health benefits as | ||||||
14 | long as (1) an appropriate official from the domestic violence | ||||||
15 | shelter attests that each employee not enrolled is a covered | ||||||
16 | spouse or dependent under this plan or another group policy or | ||||||
17 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
18 | domestic violence shelter remits the entire cost of providing | ||||||
19 | coverage to those employees. Employees of a participating | ||||||
20 | domestic violence shelter who are not enrolled due to coverage | ||||||
21 | under another group health policy or plan may enroll in the | ||||||
22 | event of a qualifying change in status, special enrollment, or | ||||||
23 | special circumstance as defined by the Director or during the | ||||||
24 | annual Benefit Choice Period. A participating domestic | ||||||
25 | violence shelter may also elect
to cover its annuitants. | ||||||
26 | Dependent coverage shall be offered on an optional
basis, with
|
| |||||||
| |||||||
1 | employees, or some combination of the 2 as determined by the | ||||||
2 | domestic violence
shelter or service. The domestic violence | ||||||
3 | shelter or service shall be
responsible for timely collection | ||||||
4 | and transmission of dependent premiums.
| ||||||
5 | The Director shall annually determine rates of payment,
| ||||||
6 | subject to the following constraints:
| ||||||
7 | (1) In the first year of coverage, the rates shall be | ||||||
8 | equal to the
amount normally charged to State employees for | ||||||
9 | elected optional coverages
or for enrolled dependents | ||||||
10 | coverages or other contributory coverages on
behalf of its | ||||||
11 | employees, adjusted for differences between State | ||||||
12 | employees and
employees of the domestic violence shelter or | ||||||
13 | service in age, sex, geographic
location or other relevant | ||||||
14 | demographic variables, plus an amount sufficient
to pay for | ||||||
15 | the additional administrative costs of providing coverage | ||||||
16 | to
employees of the domestic violence shelter or service | ||||||
17 | and their dependents.
| ||||||
18 | (2) In subsequent years, a further adjustment shall be | ||||||
19 | made to reflect
the actual prior years' claims experience | ||||||
20 | of the employees of the domestic
violence shelter or | ||||||
21 | service.
| ||||||
22 | Monthly payments by the domestic violence shelter or | ||||||
23 | service or its employees
for group health insurance shall be | ||||||
24 | deposited in the Local Government Health
Insurance Reserve | ||||||
25 | Fund.
| ||||||
26 | (l) A public community college or entity organized pursuant |
| |||||||
| |||||||
1 | to the
Public Community College Act may apply to the Director | ||||||
2 | initially to have
only annuitants not covered prior to July 1, | ||||||
3 | 1992 by the district's health
plan provided health coverage | ||||||
4 | under this Act on a non-insured basis. The
community college | ||||||
5 | must execute a 2-year contract to participate in the
Local | ||||||
6 | Government Health Plan.
Any annuitant may enroll in the event | ||||||
7 | of a qualifying change in status, special
enrollment, special | ||||||
8 | circumstance as defined by the Director, or during the
annual | ||||||
9 | Benefit Choice Period.
| ||||||
10 | The Director shall annually determine monthly rates of | ||||||
11 | payment subject to
the following constraints: for those | ||||||
12 | community colleges with annuitants
only enrolled, first year | ||||||
13 | rates shall be equal to the average cost to cover
claims for a | ||||||
14 | State member adjusted for demographics, Medicare
| ||||||
15 | participation, and other factors; and in the second year, a | ||||||
16 | further adjustment
of rates shall be made to reflect the actual | ||||||
17 | first year's claims experience
of the covered annuitants.
| ||||||
18 | (l-5) The provisions of subsection (l) become inoperative | ||||||
19 | on July 1, 1999.
| ||||||
20 | (m) The Director shall adopt any rules deemed necessary for
| ||||||
21 | implementation of this amendatory Act of 1989 (Public Act | ||||||
22 | 86-978).
| ||||||
23 | (n) Any child advocacy center within the State of Illinois | ||||||
24 | may apply to the Director to have its employees, annuitants, | ||||||
25 | and their dependents provided group health coverage under this | ||||||
26 | Act on a non-insured basis. To participate, a child advocacy |
| |||||||
| |||||||
1 | center must agree to enroll all of its employees and pay the | ||||||
2 | entire cost of providing coverage for its employees. The child
| ||||||
3 | advocacy center shall not be required to enroll those of its
| ||||||
4 | employees who are covered spouses or dependents under this plan
| ||||||
5 | or another group policy or plan providing health benefits as
| ||||||
6 | long as (1) an appropriate official from the child advocacy
| ||||||
7 | center attests that each employee not enrolled is a covered
| ||||||
8 | spouse or dependent under this plan or another group policy or
| ||||||
9 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
10 | child advocacy center remits the entire cost of providing | ||||||
11 | coverage to those employees. Employees of a participating child | ||||||
12 | advocacy center who are not enrolled due to coverage under | ||||||
13 | another group health policy or plan may enroll in the event of | ||||||
14 | a qualifying change in status, special enrollment, or special | ||||||
15 | circumstance as defined by the Director or during the annual | ||||||
16 | Benefit Choice Period. A participating child advocacy center | ||||||
17 | may also elect to cover its annuitants. Dependent coverage | ||||||
18 | shall be offered on an optional basis, with the costs paid by | ||||||
19 | the child advocacy center, its employees, or some combination | ||||||
20 | of the 2 as determined by the child advocacy center. The child | ||||||
21 | advocacy center shall be responsible for timely collection and | ||||||
22 | transmission of dependent premiums. | ||||||
23 | The Director shall annually determine rates of payment, | ||||||
24 | subject to the following constraints: | ||||||
25 | (1) In the first year of coverage, the rates shall be | ||||||
26 | equal to the amount normally charged to State employees for |
| |||||||
| |||||||
1 | elected optional coverages or for enrolled dependents | ||||||
2 | coverages or other contributory coverages on behalf of its | ||||||
3 | employees, adjusted for differences between State | ||||||
4 | employees and employees of the child advocacy center in | ||||||
5 | age, sex, geographic location, or other relevant | ||||||
6 | demographic variables, plus an amount sufficient to pay for | ||||||
7 | the additional administrative costs of providing coverage | ||||||
8 | to employees of the child advocacy center and their | ||||||
9 | dependents. | ||||||
10 | (2) In subsequent years, a further adjustment shall be | ||||||
11 | made to reflect the actual prior years' claims experience | ||||||
12 | of the employees of the child advocacy center. | ||||||
13 | Monthly payments by the child advocacy center or its | ||||||
14 | employees for group health insurance shall be deposited into | ||||||
15 | the Local Government Health Insurance Reserve Fund. | ||||||
16 | (Source: P.A. 97-695, eff. 7-1-12; 98-488, eff. 8-16-13 .)
| ||||||
17 | (5 ILCS 375/10.5 new) | ||||||
18 | Sec. 10.5. Ending State-funded benefits for retired | ||||||
19 | elected officials. | ||||||
20 | (a) For the purposes of this Section, "retired elected | ||||||
21 | official" means an annuitant under Article 2 of the Illinois | ||||||
22 | Pension Code, a person receiving a survivor's annuity under | ||||||
23 | Article 2 of the Pension Code, or a member, not otherwise | ||||||
24 | covered by this Act, who has retired as a participating member | ||||||
25 | under Article 2 of the Pension Code but is ineligible for the |
| |||||||
| |||||||
1 | retirement annuity under Section 2-119 of the Illinois Pension | ||||||
2 | Code. | ||||||
3 | (b) Notwithstanding any other provision of law, on and | ||||||
4 | after the effective date of this amendatory Act of the 100th | ||||||
5 | General Assembly, the State shall not pay or otherwise make | ||||||
6 | contributions toward the costs of any group life insurance | ||||||
7 | program or program of health benefits provided under this Act | ||||||
8 | for retired elected officials. | ||||||
9 | (c) Notwithstanding any other provision of law, a retired | ||||||
10 | elected official enrolled in any group life insurance program | ||||||
11 | or program of health benefits provided under this Act shall pay | ||||||
12 | the entirety of the cost of coverage, unless he or she has | ||||||
13 | waived or terminated coverage under subsection (d) of this | ||||||
14 | Section. The cost of coverage shall be determined by the | ||||||
15 | Director. Nothing in this Section shall be construed to prevent | ||||||
16 | any retired elected official from receiving group health or | ||||||
17 | life insurance benefits under this Act, where that retired | ||||||
18 | elected official contributes the entirety of the cost of | ||||||
19 | coverage. | ||||||
20 | (d) Any retired elected official may waive or terminate | ||||||
21 | coverage in
the program of health benefits or group life | ||||||
22 | insurance. Any retired elected official
who has waived or | ||||||
23 | terminated coverage may enroll or re-enroll in the
program of | ||||||
24 | group health benefits or group life insurance only during the | ||||||
25 | annual benefit choice period,
as determined by the Director; | ||||||
26 | except that in the event of termination of
coverage due to |
| |||||||
| |||||||
1 | nonpayment of premiums, the retired elected official
may not | ||||||
2 | re-enroll in the program.
| ||||||
3 | Section 99. Effective date. This Act takes effect upon | ||||||
4 | becoming law.
|