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1 | AN ACT concerning public health.
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2 | Be it enacted by the People of the State of Illinois,
| ||||||||||||||||||||||||||||
3 | represented in the General Assembly:
| ||||||||||||||||||||||||||||
4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||||||||||||||||||||||||
5 | is amended by changing Sections 3 and 10 as follows:
| ||||||||||||||||||||||||||||
6 | (5 ILCS 375/3) (from Ch. 127, par. 523)
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7 | Sec. 3. Definitions. Unless the context otherwise | ||||||||||||||||||||||||||||
8 | requires, the
following words and phrases as used in this Act | ||||||||||||||||||||||||||||
9 | shall have the following
meanings. The Department may define | ||||||||||||||||||||||||||||
10 | these and other words and phrases
separately for the purpose of | ||||||||||||||||||||||||||||
11 | implementing specific programs providing benefits
under this | ||||||||||||||||||||||||||||
12 | Act.
| ||||||||||||||||||||||||||||
13 | (a) "Administrative service organization" means any | ||||||||||||||||||||||||||||
14 | person, firm or
corporation experienced in the handling of | ||||||||||||||||||||||||||||
15 | claims which is
fully qualified, financially sound and capable | ||||||||||||||||||||||||||||
16 | of meeting the service
requirements of a contract of | ||||||||||||||||||||||||||||
17 | administration executed with the Department.
| ||||||||||||||||||||||||||||
18 | (b) "Annuitant" means (1) an employee who retires, or has | ||||||||||||||||||||||||||||
19 | retired,
on or after January 1, 1966 on an immediate annuity | ||||||||||||||||||||||||||||
20 | under the provisions
of Articles 2, 14, 15 (including an | ||||||||||||||||||||||||||||
21 | employee who has retired under the optional
retirement program | ||||||||||||||||||||||||||||
22 | established under Section 15-158.2),
paragraphs (2), (3), or | ||||||||||||||||||||||||||||
23 | (5) of Section 16-106, or
Article 18 of the Illinois Pension | ||||||||||||||||||||||||||||
24 | Code; (2) any person who was receiving
group insurance coverage | ||||||||||||||||||||||||||||
25 | under this Act as of March 31, 1978 by
reason of his status as | ||||||||||||||||||||||||||||
26 | an annuitant, even though the annuity in relation
to which such | ||||||||||||||||||||||||||||
27 | coverage was provided is a proportional annuity based on less
| ||||||||||||||||||||||||||||
28 | than the minimum period of service required for a retirement | ||||||||||||||||||||||||||||
29 | annuity in
the system involved; (3) any person not otherwise | ||||||||||||||||||||||||||||
30 | covered by this Act
who has retired as a participating member | ||||||||||||||||||||||||||||
31 | under Article 2 of the Illinois
Pension Code but is ineligible | ||||||||||||||||||||||||||||
32 | for the retirement annuity under Section
2-119 of the Illinois |
| |||||||
| |||||||
1 | Pension Code; (4) the spouse of any person who
is receiving a | ||||||
2 | retirement annuity under Article 18 of the Illinois Pension
| ||||||
3 | Code and who is covered under a group health insurance program | ||||||
4 | sponsored
by a governmental employer other than the State of | ||||||
5 | Illinois and who has
irrevocably elected to waive his or her | ||||||
6 | coverage under this Act and to have
his or her spouse | ||||||
7 | considered as the "annuitant" under this Act and not as
a | ||||||
8 | "dependent"; or (5) an employee who retires, or has retired, | ||||||
9 | from a
qualified position, as determined according to rules | ||||||
10 | promulgated by the
Director, under a qualified local government | ||||||
11 | or a qualified rehabilitation
facility or a qualified domestic | ||||||
12 | violence shelter or service. (For definition
of "retired | ||||||
13 | employee", see (p) post).
| ||||||
14 | (b-5) "New SERS annuitant" means a person who, on or after | ||||||
15 | January 1,
1998, becomes an annuitant, as defined in subsection | ||||||
16 | (b), by virtue of
beginning to receive a retirement annuity | ||||||
17 | under Article 14 of the Illinois
Pension Code, and is eligible | ||||||
18 | to participate in the basic program of group
health benefits | ||||||
19 | provided for annuitants under this Act.
| ||||||
20 | (b-6) "New SURS annuitant" means a person who (1) on or | ||||||
21 | after January 1,
1998, becomes an annuitant, as defined in | ||||||
22 | subsection (b), by virtue of
beginning to receive a retirement | ||||||
23 | annuity under Article 15 of the Illinois
Pension Code, (2) has | ||||||
24 | not made the election authorized under Section 15-135.1
of the | ||||||
25 | Illinois Pension Code, and (3) is eligible to participate in | ||||||
26 | the basic
program of group
health benefits provided for | ||||||
27 | annuitants under this Act.
| ||||||
28 | (b-7) "New TRS State annuitant" means a person who, on or | ||||||
29 | after July
1, 1998, becomes an annuitant, as defined in | ||||||
30 | subsection (b), by virtue of
beginning to receive a retirement | ||||||
31 | annuity under Article 16 of the Illinois
Pension Code based on | ||||||
32 | service as a teacher as defined in
paragraph (2), (3), or (5) | ||||||
33 | of Section 16-106 of that Code, and is eligible
to participate | ||||||
34 | in the basic program of group health benefits provided for
| ||||||
35 | annuitants under this Act.
| ||||||
36 | (c) "Carrier" means (1) an insurance company, a corporation |
| |||||||
| |||||||
1 | organized
under the Limited Health Service Organization Act or | ||||||
2 | the Voluntary Health
Services Plan Act, a partnership, or other | ||||||
3 | nongovernmental organization,
which is authorized to do group | ||||||
4 | life or group health insurance business in
Illinois, or (2) the | ||||||
5 | State of Illinois as a self-insurer.
| ||||||
6 | (d) "Compensation" means salary or wages payable on a | ||||||
7 | regular
payroll by the State Treasurer on a warrant of the | ||||||
8 | State Comptroller out
of any State, trust or federal fund, or | ||||||
9 | by the Governor of the State
through a disbursing officer of | ||||||
10 | the State out of a trust or out of
federal funds, or by any | ||||||
11 | Department out of State, trust, federal or
other funds held by | ||||||
12 | the State Treasurer or the Department, to any person
for | ||||||
13 | personal services currently performed, and ordinary or | ||||||
14 | accidental
disability benefits under Articles 2, 14, 15 | ||||||
15 | (including ordinary or accidental
disability benefits under | ||||||
16 | the optional retirement program established under
Section | ||||||
17 | 15-158.2), paragraphs (2), (3), or (5) of
Section 16-106, or | ||||||
18 | Article 18 of the Illinois Pension Code, for disability
| ||||||
19 | incurred after January 1, 1966, or benefits payable under the | ||||||
20 | Workers'
Compensation or Occupational Diseases Act or benefits | ||||||
21 | payable under a sick
pay plan established in accordance with | ||||||
22 | Section 36 of the State Finance Act.
"Compensation" also means | ||||||
23 | salary or wages paid to an employee of any
qualified local | ||||||
24 | government or qualified rehabilitation facility or a
qualified | ||||||
25 | domestic violence shelter or service.
| ||||||
26 | (e) "Commission" means the State Employees Group Insurance | ||||||
27 | Advisory
Commission authorized by this Act. Commencing July 1, | ||||||
28 | 1984, "Commission"
as used in this Act means the Illinois | ||||||
29 | Economic and Fiscal Commission as
established by the | ||||||
30 | Legislative Commission Reorganization Act of 1984.
| ||||||
31 | (f) "Contributory", when referred to as contributory | ||||||
32 | coverage, shall
mean optional coverages or benefits elected by | ||||||
33 | the member toward the cost of
which such member makes | ||||||
34 | contribution, or which are funded in whole or in part
through | ||||||
35 | the acceptance of a reduction in earnings or the foregoing of | ||||||
36 | an
increase in earnings by an employee, as distinguished from |
| |||||||
| |||||||
1 | noncontributory
coverage or benefits which are paid entirely by | ||||||
2 | the State of Illinois
without reduction of the member's salary.
| ||||||
3 | (g) "Department" means any department, institution, board,
| ||||||
4 | commission, officer, court or any agency of the State | ||||||
5 | government
receiving appropriations and having power to | ||||||
6 | certify payrolls to the
Comptroller authorizing payments of | ||||||
7 | salary and wages against such
appropriations as are made by the | ||||||
8 | General Assembly from any State fund, or
against trust funds | ||||||
9 | held by the State Treasurer and includes boards of
trustees of | ||||||
10 | the retirement systems created by Articles 2, 14, 15, 16 and
18 | ||||||
11 | of the Illinois Pension Code. "Department" also includes the | ||||||
12 | Illinois
Comprehensive Health Insurance Board, the Board of | ||||||
13 | Examiners established under
the Illinois Public Accounting | ||||||
14 | Act, and the Illinois Finance Authority.
| ||||||
15 | (h) "Dependent", when the term is used in the context of | ||||||
16 | the health
and life plan, means a member's spouse and any | ||||||
17 | unmarried child (1) from
birth to age 19 including an adopted | ||||||
18 | child, a child who lives with the
member from the time of the | ||||||
19 | filing of a petition for adoption until entry
of an order of | ||||||
20 | adoption, a stepchild or recognized child who lives with the
| ||||||
21 | member in a parent-child relationship, or a child who lives | ||||||
22 | with the member
if such member is a court appointed guardian of | ||||||
23 | the child, or (2)
age 19 to 23 enrolled as a full-time student | ||||||
24 | in any accredited school,
financially dependent upon the | ||||||
25 | member, and eligible to be claimed as a
dependent for income | ||||||
26 | tax purposes, or (3) age 19 or over who is mentally
or | ||||||
27 | physically handicapped. For
the health plan only, the term | ||||||
28 | "dependent" also includes any person
enrolled prior to the | ||||||
29 | effective date of this Section who is dependent upon
the member | ||||||
30 | to the extent that the member may claim such person as a
| ||||||
31 | dependent for income tax deduction purposes; no other such
| ||||||
32 | person may be enrolled.
For the health plan only, the term | ||||||
33 | "dependent" also includes any person who
has received after | ||||||
34 | June 30, 2000 an organ transplant and who is financially
| ||||||
35 | dependent upon the member and eligible to be claimed as a | ||||||
36 | dependent for income
tax purposes.
|
| |||||||
| |||||||
1 | (i) "Director" means the Director of the Illinois | ||||||
2 | Department of Central
Management Services.
| ||||||
3 | (j) "Eligibility period" means the period of time a member | ||||||
4 | has to
elect enrollment in programs or to select benefits | ||||||
5 | without regard to
age, sex or health.
| ||||||
6 | (k) "Employee" means and includes each officer or employee | ||||||
7 | in the
service of a department who (1) receives his | ||||||
8 | compensation for
service rendered to the department on a | ||||||
9 | warrant issued pursuant to a payroll
certified by a department | ||||||
10 | or on a warrant or check issued and drawn by a
department upon | ||||||
11 | a trust, federal or other fund or on a warrant issued
pursuant | ||||||
12 | to a payroll certified by an elected or duly appointed officer
| ||||||
13 | of the State or who receives payment of the performance of | ||||||
14 | personal
services on a warrant issued pursuant to a payroll | ||||||
15 | certified by a
Department and drawn by the Comptroller upon the | ||||||
16 | State Treasurer against
appropriations made by the General | ||||||
17 | Assembly from any fund or against
trust funds held by the State | ||||||
18 | Treasurer, and (2) is employed full-time or
part-time in a | ||||||
19 | position normally requiring actual performance of duty
during | ||||||
20 | not less than 1/2 of a normal work period, as established by | ||||||
21 | the
Director in cooperation with each department, except that | ||||||
22 | persons elected
by popular vote will be considered employees | ||||||
23 | during the entire
term for which they are elected regardless of | ||||||
24 | hours devoted to the
service of the State, and (3) except that | ||||||
25 | "employee" does not include any
person who is not eligible by | ||||||
26 | reason of such person's employment to
participate in one of the | ||||||
27 | State retirement systems under Articles 2, 14, 15
(either the | ||||||
28 | regular Article 15 system or the optional retirement program
| ||||||
29 | established under Section 15-158.2) or 18, or under paragraph | ||||||
30 | (2), (3), or
(5) of Section 16-106, of the Illinois
Pension | ||||||
31 | Code, but such term does include persons who are employed | ||||||
32 | during
the 6 month qualifying period under Article 14 of the | ||||||
33 | Illinois Pension
Code. Such term also includes any person who | ||||||
34 | (1) after January 1, 1966,
is receiving ordinary or accidental | ||||||
35 | disability benefits under Articles
2, 14, 15 (including | ||||||
36 | ordinary or accidental disability benefits under the
optional |
| |||||||
| |||||||
1 | retirement program established under Section 15-158.2), | ||||||
2 | paragraphs
(2), (3), or (5) of Section 16-106, or Article 18 of | ||||||
3 | the
Illinois Pension Code, for disability incurred after | ||||||
4 | January 1, 1966, (2)
receives total permanent or total | ||||||
5 | temporary disability under the Workers'
Compensation Act or | ||||||
6 | Occupational Disease Act as a result of injuries
sustained or | ||||||
7 | illness contracted in the course of employment with the
State | ||||||
8 | of Illinois, or (3) is not otherwise covered under this Act and | ||||||
9 | has
retired as a participating member under Article 2 of the | ||||||
10 | Illinois Pension
Code but is ineligible for the retirement | ||||||
11 | annuity under Section 2-119 of
the Illinois Pension Code. | ||||||
12 | However, a person who satisfies the criteria
of the foregoing | ||||||
13 | definition of "employee" except that such person is made
| ||||||
14 | ineligible to participate in the State Universities Retirement | ||||||
15 | System by
clause (4) of subsection (a) of Section 15-107 of the | ||||||
16 | Illinois Pension
Code is also an "employee" for the purposes of | ||||||
17 | this Act. "Employee" also
includes any person receiving or | ||||||
18 | eligible for benefits under a sick pay
plan established in | ||||||
19 | accordance with Section 36 of the State Finance Act.
"Employee" | ||||||
20 | also includes each officer or employee in the service of a
| ||||||
21 | qualified local government, including persons appointed as | ||||||
22 | trustees of
sanitary districts regardless of hours devoted to | ||||||
23 | the service of the
sanitary district, and each employee in the | ||||||
24 | service of a qualified
rehabilitation facility and each | ||||||
25 | full-time employee in the service of a
qualified domestic | ||||||
26 | violence shelter or service, as determined according to
rules | ||||||
27 | promulgated by the Director.
| ||||||
28 | (l) "Member" means an employee, annuitant, retired | ||||||
29 | employee or survivor.
| ||||||
30 | (m) "Optional coverages or benefits" means those coverages | ||||||
31 | or
benefits available to the member on his or her voluntary | ||||||
32 | election, and at
his or her own expense.
| ||||||
33 | (n) "Program" means the group life insurance, health | ||||||
34 | benefits and other
employee benefits designed and contracted | ||||||
35 | for by the Director under this Act.
| ||||||
36 | (o) "Health plan" means a health benefits
program offered
|
| |||||||
| |||||||
1 | by the State of Illinois for persons eligible for the plan.
| ||||||
2 | (p) "Retired employee" means any person who would be an | ||||||
3 | annuitant as
that term is defined herein but for the fact that | ||||||
4 | such person retired prior to
January 1, 1966. Such term also | ||||||
5 | includes any person formerly employed by
the University of | ||||||
6 | Illinois in the Cooperative Extension Service who would
be an | ||||||
7 | annuitant but for the fact that such person was made ineligible | ||||||
8 | to
participate in the State Universities Retirement System by | ||||||
9 | clause (4) of
subsection (a) of Section 15-107 of the Illinois
| ||||||
10 | Pension Code.
| ||||||
11 | (q) "Survivor" means a person receiving an annuity as a | ||||||
12 | survivor of an
employee or of an annuitant. "Survivor" also | ||||||
13 | includes: (1) the surviving
dependent of a person who satisfies | ||||||
14 | the definition of "employee" except that
such person is made | ||||||
15 | ineligible to participate in the State Universities
Retirement | ||||||
16 | System by clause (4) of subsection (a)
of Section 15-107 of the | ||||||
17 | Illinois Pension Code; and (2) the surviving
dependent of any | ||||||
18 | person formerly employed by the University of Illinois in
the | ||||||
19 | Cooperative Extension Service who would be an annuitant except | ||||||
20 | for the
fact that such person was made ineligible to | ||||||
21 | participate in the State
Universities Retirement System by | ||||||
22 | clause (4) of subsection (a) of Section
15-107 of the Illinois | ||||||
23 | Pension Code.
| ||||||
24 | (q-5) "New SERS survivor" means a survivor, as defined in | ||||||
25 | subsection (q),
whose annuity is paid under Article 14 of the | ||||||
26 | Illinois Pension Code and is
based on the death of (i) an | ||||||
27 | employee whose death occurs on or after January 1,
1998, or | ||||||
28 | (ii) a new SERS annuitant as defined in subsection (b-5).
| ||||||
29 | (q-6) "New SURS survivor" means a survivor, as defined in | ||||||
30 | subsection (q),
whose annuity is paid under Article 15 of the | ||||||
31 | Illinois Pension Code and is
based on the death of (i) an | ||||||
32 | employee whose death occurs on or after January 1,
1998, or | ||||||
33 | (ii) a new SURS annuitant as defined in subsection (b-6).
| ||||||
34 | (q-7) "New TRS State survivor" means a survivor, as defined | ||||||
35 | in subsection
(q), whose annuity is paid under Article 16 of | ||||||
36 | the Illinois Pension Code and is
based on the death of (i) an |
| |||||||
| |||||||
1 | employee who is a teacher as defined in paragraph
(2), (3), or | ||||||
2 | (5) of Section 16-106 of that Code and whose death occurs on or
| ||||||
3 | after July 1, 1998, or (ii) a new TRS State annuitant as | ||||||
4 | defined in subsection
(b-7).
| ||||||
5 | (r) "Medical services" means the services provided within | ||||||
6 | the scope
of their licenses by practitioners in all categories | ||||||
7 | licensed under the
Medical Practice Act of 1987.
| ||||||
8 | (s) "Unit of local government" means any county, | ||||||
9 | municipality,
township, school district (including a | ||||||
10 | combination of school districts under
the Intergovernmental | ||||||
11 | Cooperation Act), special district or other unit,
designated as | ||||||
12 | a
unit of local government by law, which exercises limited | ||||||
13 | governmental
powers or powers in respect to limited | ||||||
14 | governmental subjects, any
not-for-profit association with a | ||||||
15 | membership that primarily includes
townships and township | ||||||
16 | officials, that has duties that include provision of
research | ||||||
17 | service, dissemination of information, and other acts for the
| ||||||
18 | purpose of improving township government, and that is funded | ||||||
19 | wholly or
partly in accordance with Section 85-15 of the | ||||||
20 | Township Code; any
not-for-profit corporation or association, | ||||||
21 | with a membership consisting
primarily of municipalities, that | ||||||
22 | operates its own utility system, and
provides research, | ||||||
23 | training, dissemination of information, or other acts to
| ||||||
24 | promote cooperation between and among municipalities that | ||||||
25 | provide utility
services and for the advancement of the goals | ||||||
26 | and purposes of its
membership;
the Southern Illinois | ||||||
27 | Collegiate Common Market, which is a consortium of higher
| ||||||
28 | education institutions in Southern Illinois; and the Illinois | ||||||
29 | Association of
Park Districts. "Qualified
local government" | ||||||
30 | means a unit of local government approved by the Director and
| ||||||
31 | participating in a program created under subsection (i) of | ||||||
32 | Section 10 of this
Act.
| ||||||
33 | (s-1) "Long-term care entity" means any entity (i) that is | ||||||
34 | licensed under the Nursing Home Care Act by the Department of | ||||||
35 | Public Health to provide services to the elderly or | ||||||
36 | developmentally disabled, (ii) that participates in Title 18 or |
| |||||||
| |||||||
1 | Title 19 of the Social Security Act, and (iii) that | ||||||
2 | participates in a program created under subsection (j-1) of | ||||||
3 | Section 10 of this Act.
| ||||||
4 | (t) "Qualified rehabilitation facility" means any | ||||||
5 | not-for-profit
organization that is accredited by the | ||||||
6 | Commission on Accreditation of
Rehabilitation Facilities or | ||||||
7 | certified by the Department
of Human Services (as successor to | ||||||
8 | the Department of Mental Health
and Developmental | ||||||
9 | Disabilities) to provide services to persons with
disabilities
| ||||||
10 | and which receives funds from the State of Illinois for | ||||||
11 | providing those
services, approved by the Director and | ||||||
12 | participating in a program created
under subsection (j) of | ||||||
13 | Section 10 of this Act.
| ||||||
14 | (u) "Qualified domestic violence shelter or service" means | ||||||
15 | any Illinois
domestic violence shelter or service and its | ||||||
16 | administrative offices funded
by the Department of Human | ||||||
17 | Services (as successor to the Illinois Department of
Public | ||||||
18 | Aid),
approved by the Director and
participating in a program | ||||||
19 | created under subsection (k) of Section 10.
| ||||||
20 | (v) "TRS benefit recipient" means a person who:
| ||||||
21 | (1) is not a "member" as defined in this Section; and
| ||||||
22 | (2) is receiving a monthly benefit or retirement | ||||||
23 | annuity
under Article 16 of the Illinois Pension Code; and
| ||||||
24 | (3) either (i) has at least 8 years of creditable | ||||||
25 | service under Article
16 of the Illinois Pension Code, or | ||||||
26 | (ii) was enrolled in the health insurance
program offered | ||||||
27 | under that Article on January 1, 1996, or (iii) is the | ||||||
28 | survivor
of a benefit recipient who had at least 8
years of | ||||||
29 | creditable service under Article 16 of the Illinois Pension | ||||||
30 | Code or
was enrolled in the health insurance program | ||||||
31 | offered under that Article on
the effective date of this | ||||||
32 | amendatory Act of 1995, or (iv) is a recipient or
survivor | ||||||
33 | of a recipient of a disability benefit under Article 16 of | ||||||
34 | the
Illinois Pension Code.
| ||||||
35 | (w) "TRS dependent beneficiary" means a person who:
| ||||||
36 | (1) is not a "member" or "dependent" as defined in this |
| |||||||
| |||||||
1 | Section; and
| ||||||
2 | (2) is a TRS benefit recipient's: (A) spouse, (B) | ||||||
3 | dependent parent who
is receiving at least half of his or | ||||||
4 | her support from the TRS benefit
recipient, or (C) | ||||||
5 | unmarried natural or adopted child who is (i) under age
19, | ||||||
6 | or (ii) enrolled as a full-time student in
an accredited | ||||||
7 | school, financially dependent upon the TRS benefit | ||||||
8 | recipient,
eligible to be claimed as a dependent for income | ||||||
9 | tax
purposes, and
either is under age 24 or was, on January | ||||||
10 | 1, 1996, participating as a dependent
beneficiary in the | ||||||
11 | health insurance program offered under Article 16 of the
| ||||||
12 | Illinois Pension Code, or (iii) age 19 or over who is | ||||||
13 | mentally or physically
handicapped.
| ||||||
14 | (x) "Military leave with pay and benefits" refers to | ||||||
15 | individuals in basic
training for reserves, special/advanced | ||||||
16 | training, annual training, emergency
call up, or activation by | ||||||
17 | the President of the United States with approved pay
and | ||||||
18 | benefits.
| ||||||
19 | (y) "Military leave without pay and benefits" refers to
| ||||||
20 | individuals who enlist for active duty in a regular component | ||||||
21 | of the U.S. Armed
Forces or other duty not specified or | ||||||
22 | authorized under military leave with pay
and benefits.
| ||||||
23 | (z) "Community college benefit recipient" means a person | ||||||
24 | who:
| ||||||
25 | (1) is not a "member" as defined in this Section; and
| ||||||
26 | (2) is receiving a monthly survivor's annuity or | ||||||
27 | retirement annuity
under Article 15 of the Illinois Pension | ||||||
28 | Code; and
| ||||||
29 | (3) either (i) was a full-time employee of a community | ||||||
30 | college district or
an association of community college | ||||||
31 | boards created under the Public Community
College Act | ||||||
32 | (other than an employee whose last employer under Article | ||||||
33 | 15 of the
Illinois Pension Code was a community college | ||||||
34 | district subject to Article VII
of the Public Community | ||||||
35 | College Act) and was eligible to participate in a group
| ||||||
36 | health benefit plan as an employee during the time of |
| |||||||
| |||||||
1 | employment with a
community college district (other than a | ||||||
2 | community college district subject to
Article VII of the | ||||||
3 | Public Community College Act) or an association of | ||||||
4 | community
college boards, or (ii) is the survivor of a | ||||||
5 | person described in item (i).
| ||||||
6 | (aa) "Community college dependent beneficiary" means a | ||||||
7 | person who:
| ||||||
8 | (1) is not a "member" or "dependent" as defined in this | ||||||
9 | Section; and
| ||||||
10 | (2) is a community college benefit recipient's: (A) | ||||||
11 | spouse, (B) dependent
parent who is receiving at least half | ||||||
12 | of his or her support from the community
college benefit | ||||||
13 | recipient, or (C) unmarried natural or adopted child who is | ||||||
14 | (i)
under age 19, or (ii) enrolled as a full-time student | ||||||
15 | in an accredited school,
financially dependent upon the | ||||||
16 | community college benefit recipient, eligible
to be | ||||||
17 | claimed as a dependent for income tax purposes and under | ||||||
18 | age 23, or (iii)
age 19 or over and mentally or physically | ||||||
19 | handicapped.
| ||||||
20 | (Source: P.A. 92-16, eff. 6-28-01; 92-186, eff. 1-1-02; 92-204, | ||||||
21 | eff. 8-1-01;
92-651, eff. 7-11-02; 93-205, eff. 1-1-04.)
| ||||||
22 | (5 ILCS 375/10) (from Ch. 127, par. 530)
| ||||||
23 | Sec. 10. Payments by State; premiums.
| ||||||
24 | (a) The State shall pay the cost of basic non-contributory | ||||||
25 | group life
insurance and, subject to member paid contributions | ||||||
26 | set by the Department or
required by this Section, the basic | ||||||
27 | program of group health benefits on each
eligible member, | ||||||
28 | except a member, not otherwise
covered by this Act, who has | ||||||
29 | retired as a participating member under Article 2
of the | ||||||
30 | Illinois Pension Code but is ineligible for the retirement | ||||||
31 | annuity under
Section 2-119 of the Illinois Pension Code, and | ||||||
32 | part of each eligible member's
and retired member's premiums | ||||||
33 | for health insurance coverage for enrolled
dependents as | ||||||
34 | provided by Section 9. The State shall pay the cost of the | ||||||
35 | basic
program of group health benefits only after benefits are |
| |||||||
| |||||||
1 | reduced by the amount
of benefits covered by Medicare for all | ||||||
2 | members and dependents
who are eligible for benefits under | ||||||
3 | Social Security or
the Railroad Retirement system or who had | ||||||
4 | sufficient Medicare-covered
government employment, except that | ||||||
5 | such reduction in benefits shall apply only
to those members | ||||||
6 | and dependents who (1) first become eligible
for such Medicare | ||||||
7 | coverage on or after July 1, 1992; or (2) are
Medicare-eligible | ||||||
8 | members or dependents of a local government unit which began
| ||||||
9 | participation in the program on or after July 1, 1992; or (3) | ||||||
10 | remain eligible
for, but no longer receive Medicare coverage | ||||||
11 | which they had been receiving on
or after July 1, 1992. The | ||||||
12 | Department may determine the aggregate level of the
State's | ||||||
13 | contribution on the basis of actual cost of medical services | ||||||
14 | adjusted
for age, sex or geographic or other demographic | ||||||
15 | characteristics which affect
the costs of such programs.
| ||||||
16 | The cost of participation in the basic program of group | ||||||
17 | health benefits
for the dependent or survivor of a living or | ||||||
18 | deceased retired employee who was
formerly employed by the | ||||||
19 | University of Illinois in the Cooperative Extension
Service and | ||||||
20 | would be an annuitant but for the fact that he or she was made
| ||||||
21 | ineligible to participate in the State Universities Retirement | ||||||
22 | System by clause
(4) of subsection (a) of Section 15-107 of the | ||||||
23 | Illinois Pension Code shall not
be greater than the cost of | ||||||
24 | participation that would otherwise apply to that
dependent or | ||||||
25 | survivor if he or she were the dependent or survivor of an
| ||||||
26 | annuitant under the State Universities Retirement System.
| ||||||
27 | (a-1) Beginning January 1, 1998, for each person who | ||||||
28 | becomes a new SERS
annuitant and participates in the basic | ||||||
29 | program of group health benefits, the
State shall contribute | ||||||
30 | toward the cost of the annuitant's
coverage under the basic | ||||||
31 | program of group health benefits an amount equal
to 5% of that | ||||||
32 | cost for each full year of creditable service upon which the
| ||||||
33 | annuitant's retirement annuity is based, up to a maximum of | ||||||
34 | 100% for an
annuitant with 20 or more years of creditable | ||||||
35 | service.
The remainder of the cost of a new SERS annuitant's | ||||||
36 | coverage under the basic
program of group health benefits shall |
| |||||||
| |||||||
1 | be the responsibility of the
annuitant.
| ||||||
2 | (a-2) Beginning January 1, 1998, for each person who | ||||||
3 | becomes a new SERS
survivor and participates in the basic | ||||||
4 | program of group health benefits, the
State shall contribute | ||||||
5 | toward the cost of the survivor's
coverage under the basic | ||||||
6 | program of group health benefits an amount equal
to 5% of that | ||||||
7 | cost for each full year of the deceased employee's or deceased
| ||||||
8 | annuitant's creditable service in the State Employees' | ||||||
9 | Retirement System of
Illinois on the date of death, up to a | ||||||
10 | maximum of 100% for a survivor of an
employee or annuitant with | ||||||
11 | 20 or more years of creditable service. The
remainder of the | ||||||
12 | cost of the new SERS survivor's coverage under the basic
| ||||||
13 | program of group health benefits shall be the responsibility of | ||||||
14 | the survivor.
| ||||||
15 | (a-3) Beginning January 1, 1998, for each person who | ||||||
16 | becomes a new SURS
annuitant and participates in the basic | ||||||
17 | program of group health benefits, the
State shall contribute | ||||||
18 | toward the cost of the annuitant's
coverage under the basic | ||||||
19 | program of group health benefits an amount equal
to 5% of that | ||||||
20 | cost for each full year of creditable service upon which the
| ||||||
21 | annuitant's retirement annuity is based, up to a maximum of | ||||||
22 | 100% for an
annuitant with 20 or more years of creditable | ||||||
23 | service.
The remainder of the cost of a new SURS annuitant's | ||||||
24 | coverage under the basic
program of group health benefits shall | ||||||
25 | be the responsibility of the
annuitant.
| ||||||
26 | (a-4) (Blank).
| ||||||
27 | (a-5) Beginning January 1, 1998, for each person who | ||||||
28 | becomes a new SURS
survivor and participates in the basic | ||||||
29 | program of group health benefits, the
State shall contribute | ||||||
30 | toward the cost of the survivor's coverage under the
basic | ||||||
31 | program of group health benefits an amount equal to 5% of that | ||||||
32 | cost for
each full year of the deceased employee's or deceased | ||||||
33 | annuitant's creditable
service in the State Universities | ||||||
34 | Retirement System on the date of death, up to
a maximum of 100% | ||||||
35 | for a survivor of an
employee or annuitant with 20 or more | ||||||
36 | years of creditable service. The
remainder of the cost of the |
| |||||||
| |||||||
1 | new SURS survivor's coverage under the basic
program of group | ||||||
2 | health benefits shall be the responsibility of the survivor.
| ||||||
3 | (a-6) Beginning July 1, 1998, for each person who becomes a | ||||||
4 | new TRS
State annuitant and participates in the basic program | ||||||
5 | of group health benefits,
the State shall contribute toward the | ||||||
6 | cost of the annuitant's coverage under
the basic program of | ||||||
7 | group health benefits an amount equal to 5% of that cost
for | ||||||
8 | each full year of creditable service
as a teacher as defined in | ||||||
9 | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||||||
10 | Pension Code
upon which the annuitant's retirement annuity is | ||||||
11 | based, up to a maximum of
100%;
except that
the State | ||||||
12 | contribution shall be 12.5% per year (rather than 5%) for each | ||||||
13 | full
year of creditable service as a regional superintendent or | ||||||
14 | assistant regional
superintendent of schools. The
remainder of | ||||||
15 | the cost of a new TRS State annuitant's coverage under the | ||||||
16 | basic
program of group health benefits shall be the | ||||||
17 | responsibility of the
annuitant.
| ||||||
18 | (a-7) Beginning July 1, 1998, for each person who becomes a | ||||||
19 | new TRS
State survivor and participates in the basic program of | ||||||
20 | group health benefits,
the State shall contribute toward the | ||||||
21 | cost of the survivor's coverage under the
basic program of | ||||||
22 | group health benefits an amount equal to 5% of that cost for
| ||||||
23 | each full year of the deceased employee's or deceased | ||||||
24 | annuitant's creditable
service
as a teacher as defined in | ||||||
25 | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||||||
26 | Pension Code
on the date of death, up to a maximum of 100%;
| ||||||
27 | except that the State contribution shall be 12.5% per year | ||||||
28 | (rather than 5%) for
each full year of the deceased employee's | ||||||
29 | or deceased annuitant's creditable
service as a regional | ||||||
30 | superintendent or assistant regional superintendent of
| ||||||
31 | schools.
The remainder of
the cost of the new TRS State | ||||||
32 | survivor's coverage under the basic program of
group health | ||||||
33 | benefits shall be the responsibility of the survivor.
| ||||||
34 | (a-8) A new SERS annuitant, new SERS survivor, new SURS
| ||||||
35 | annuitant, new SURS survivor, new TRS State
annuitant, or new | ||||||
36 | TRS State survivor may waive or terminate coverage in
the |
| |||||||
| |||||||
1 | program of group health benefits. Any such annuitant or | ||||||
2 | survivor
who has waived or terminated coverage may enroll or | ||||||
3 | re-enroll in the
program of group health benefits only during | ||||||
4 | the annual benefit choice period,
as determined by the | ||||||
5 | Director; except that in the event of termination of
coverage | ||||||
6 | due to nonpayment of premiums, the annuitant or survivor
may | ||||||
7 | not re-enroll in the program.
| ||||||
8 | (a-9) No later than May 1 of each calendar year, the | ||||||
9 | Director
of Central Management Services shall certify in | ||||||
10 | writing to the Executive
Secretary of the State Employees' | ||||||
11 | Retirement System of Illinois the amounts
of the Medicare | ||||||
12 | supplement health care premiums and the amounts of the
health | ||||||
13 | care premiums for all other retirees who are not Medicare | ||||||
14 | eligible.
| ||||||
15 | A separate calculation of the premiums based upon the | ||||||
16 | actual cost of each
health care plan shall be so certified.
| ||||||
17 | The Director of Central Management Services shall provide | ||||||
18 | to the
Executive Secretary of the State Employees' Retirement | ||||||
19 | System of
Illinois such information, statistics, and other data | ||||||
20 | as he or she
may require to review the premium amounts | ||||||
21 | certified by the Director
of Central Management Services.
| ||||||
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
| ||||||
27 | employee elects coverage, the State shall contribute on behalf | ||||||
28 | of such employee
to the cost of the employee's benefit and any | ||||||
29 | applicable dependent supplement,
that sum which bears the same | ||||||
30 | percentage as that percentage of time the
employee regularly | ||||||
31 | works when compared to normal work period.
| ||||||
32 | (c) The basic non-contributory coverage from the basic | ||||||
33 | program of
group health benefits shall be continued for each | ||||||
34 | employee not in pay status or
on active service by reason of | ||||||
35 | (1) leave of absence due to illness or injury,
(2) authorized | ||||||
36 | educational leave of absence or sabbatical leave, or (3)
|
| |||||||
| |||||||
1 | military leave with pay and benefits. This coverage shall | ||||||
2 | continue until
expiration of authorized leave and return to | ||||||
3 | active service, but not to exceed
24 months for leaves under | ||||||
4 | item (1) or (2). This 24-month limitation and the
requirement | ||||||
5 | of returning to active service shall not apply to persons | ||||||
6 | receiving
ordinary or accidental disability benefits or | ||||||
7 | retirement benefits through the
appropriate State retirement | ||||||
8 | system or benefits under the Workers' Compensation
or | ||||||
9 | Occupational Disease Act.
| ||||||
10 | (d) The basic group life insurance coverage shall continue, | ||||||
11 | with
full State contribution, where such person is (1) absent | ||||||
12 | from active
service by reason of disability arising from any | ||||||
13 | cause other than
self-inflicted, (2) on authorized educational | ||||||
14 | leave of absence or
sabbatical leave, or (3) on military leave | ||||||
15 | with pay and benefits.
| ||||||
16 | (e) Where the person is in non-pay status for a period in | ||||||
17 | excess of
30 days or on leave of absence, other than by reason | ||||||
18 | of disability,
educational or sabbatical leave, or military | ||||||
19 | leave with pay and benefits, such
person may continue coverage | ||||||
20 | only by making personal
payment equal to the amount normally | ||||||
21 | contributed by the State on such person's
behalf. Such payments | ||||||
22 | and coverage may be continued: (1) until such time as
the | ||||||
23 | person returns to a status eligible for coverage at State | ||||||
24 | expense, but not
to exceed 24 months, (2) until such person's | ||||||
25 | employment or annuitant status
with the State is terminated, or | ||||||
26 | (3) for a maximum period of 4 years for
members on military | ||||||
27 | leave with pay and benefits and military leave without pay
and | ||||||
28 | benefits (exclusive of any additional service imposed pursuant | ||||||
29 | to law).
| ||||||
30 | (f) The Department shall establish by rule the extent to | ||||||
31 | which other
employee benefits will continue for persons in | ||||||
32 | non-pay status or who are
not in active service.
| ||||||
33 | (g) The State shall not pay the cost of the basic | ||||||
34 | non-contributory
group life insurance, program of health | ||||||
35 | benefits and other employee benefits
for members who are | ||||||
36 | survivors as defined by paragraphs (1) and (2) of
subsection |
| |||||||
| |||||||
1 | (q) of Section 3 of this Act. The costs of benefits for these
| ||||||
2 | survivors shall be paid by the survivors or by the University | ||||||
3 | of Illinois
Cooperative Extension Service, or any combination | ||||||
4 | thereof.
However, the State shall pay the amount of the | ||||||
5 | reduction in the cost of
participation, if any, resulting from | ||||||
6 | the amendment to subsection (a) made
by this amendatory Act of | ||||||
7 | the 91st General Assembly.
| ||||||
8 | (h) Those persons occupying positions with any department | ||||||
9 | as a result
of emergency appointments pursuant to Section 8b.8 | ||||||
10 | of the Personnel Code
who are not considered employees under | ||||||
11 | this Act shall be given the option
of participating in the | ||||||
12 | programs of group life insurance, health benefits and
other | ||||||
13 | employee benefits. Such persons electing coverage may | ||||||
14 | participate only
by making payment equal to the amount normally | ||||||
15 | contributed by the State for
similarly situated employees. Such | ||||||
16 | amounts shall be determined by the
Director. Such payments and | ||||||
17 | coverage may be continued until such time as the
person becomes | ||||||
18 | an employee pursuant to this Act or such person's appointment | ||||||
19 | is
terminated.
| ||||||
20 | (i) Any unit of local government within the State of | ||||||
21 | Illinois
may apply to the Director to have its employees, | ||||||
22 | annuitants, and their
dependents provided group health | ||||||
23 | coverage under this Act on a non-insured
basis. To participate, | ||||||
24 | a unit of local government must agree to enroll
all of its | ||||||
25 | employees, who may select coverage under either the State group
| ||||||
26 | health benefits plan or a health maintenance organization that | ||||||
27 | has
contracted with the State to be available as a health care | ||||||
28 | provider for
employees as defined in this Act. A unit of local | ||||||
29 | government must remit the
entire cost of providing coverage | ||||||
30 | under the State group health benefits plan
or, for coverage | ||||||
31 | under a health maintenance organization, an amount determined
| ||||||
32 | by the Director based on an analysis of the sex, age, | ||||||
33 | geographic location, or
other relevant demographic variables | ||||||
34 | for its employees, except that the unit of
local government | ||||||
35 | shall not be required to enroll those of its employees who are
| ||||||
36 | covered spouses or dependents under this plan or another group |
| |||||||
| |||||||
1 | policy or plan
providing health benefits as long as (1) an | ||||||
2 | appropriate official from the unit
of local government attests | ||||||
3 | that each employee not enrolled is a covered spouse
or | ||||||
4 | dependent under this plan or another group policy or plan, and | ||||||
5 | (2) at least
85% of the employees are enrolled and the unit of | ||||||
6 | local government remits
the entire cost of providing coverage | ||||||
7 | to those employees, except that a
participating school district | ||||||
8 | must have enrolled at least 85% of its full-time
employees who | ||||||
9 | have not waived coverage under the district's group health
plan | ||||||
10 | by participating in a component of the district's cafeteria | ||||||
11 | plan. A
participating school district is not required to enroll | ||||||
12 | a full-time employee
who has waived coverage under the | ||||||
13 | district's health plan, provided that an
appropriate official | ||||||
14 | from the participating school district attests that the
| ||||||
15 | full-time employee has waived coverage by participating in a | ||||||
16 | component of the
district's cafeteria plan. For the purposes of | ||||||
17 | this subsection, "participating
school district" includes a | ||||||
18 | unit of local government whose primary purpose is
education as | ||||||
19 | defined by the Department's rules.
| ||||||
20 | Employees of a participating unit of local government who | ||||||
21 | are not enrolled
due to coverage under another group health | ||||||
22 | policy or plan may enroll in
the event of a qualifying change | ||||||
23 | in status, special enrollment, special
circumstance as defined | ||||||
24 | by the Director, or during the annual Benefit Choice
Period. A | ||||||
25 | participating unit of local government may also elect to cover | ||||||
26 | its
annuitants. Dependent coverage shall be offered on an | ||||||
27 | optional basis, with the
costs paid by the unit of local | ||||||
28 | government, its employees, or some combination
of the two as | ||||||
29 | determined by the unit of local government. The unit of local
| ||||||
30 | government shall be responsible for timely collection and | ||||||
31 | transmission of
dependent premiums.
| ||||||
32 | The Director shall annually determine monthly rates of | ||||||
33 | payment, subject
to the following constraints:
| ||||||
34 | (1) In the first year of coverage, the rates shall be | ||||||
35 | equal to the
amount normally charged to State employees for | ||||||
36 | elected optional coverages
or for enrolled dependents |
| |||||||
| |||||||
1 | coverages or other contributory coverages, or
contributed | ||||||
2 | by the State for basic insurance coverages on behalf of its
| ||||||
3 | employees, adjusted for differences between State | ||||||
4 | employees and employees
of the local government in age, | ||||||
5 | sex, geographic location or other relevant
demographic | ||||||
6 | variables, plus an amount sufficient to pay for the | ||||||
7 | additional
administrative costs of providing coverage to | ||||||
8 | employees of the unit of
local government 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 unit of
local government.
| ||||||
13 | In the case of coverage of local government employees under | ||||||
14 | a health
maintenance organization, the Director shall annually | ||||||
15 | determine for each
participating unit of local government the | ||||||
16 | maximum monthly amount the unit
may contribute toward that | ||||||
17 | coverage, based on an analysis of (i) the age,
sex, geographic | ||||||
18 | location, and other relevant demographic variables of the
| ||||||
19 | unit's employees and (ii) the cost to cover those employees | ||||||
20 | under the State
group health benefits plan. The Director may | ||||||
21 | similarly determine the
maximum monthly amount each unit of | ||||||
22 | local government may contribute toward
coverage of its | ||||||
23 | employees' dependents under a health maintenance organization.
| ||||||
24 | Monthly payments by the unit of local government or its | ||||||
25 | employees for
group health benefits plan or health maintenance | ||||||
26 | organization coverage shall
be deposited in the Local | ||||||
27 | Government Health Insurance Reserve Fund.
| ||||||
28 | The Local Government Health Insurance Reserve Fund shall be | ||||||
29 | a continuing
fund not subject to fiscal year limitations. All | ||||||
30 | expenditures from this Fund
shall be used for payments for | ||||||
31 | health care benefits for local government ,
domestic violence | ||||||
32 | shelter or service, and rehabilitation facility
employees, | ||||||
33 | annuitants, and dependents, and to reimburse the Department or
| ||||||
34 | its administrative service organization for all expenses | ||||||
35 | incurred in the
administration of benefits. No other State | ||||||
36 | funds may be used for these
purposes.
|
| |||||||
| |||||||
1 | A local government employer's participation or desire to | ||||||
2 | participate
in a program created under this subsection shall | ||||||
3 | not limit that employer's
duty to bargain with the | ||||||
4 | representative of any collective bargaining unit
of its | ||||||
5 | employees.
| ||||||
6 | (j) Any rehabilitation facility within the State of | ||||||
7 | Illinois may apply
to the Director to have its employees, | ||||||
8 | annuitants, and their eligible
dependents provided group | ||||||
9 | health coverage under this Act on a non-insured
basis. To | ||||||
10 | participate, a rehabilitation facility must agree to enroll all
| ||||||
11 | of its employees and remit the entire cost of providing such | ||||||
12 | coverage for
its employees, except that the rehabilitation | ||||||
13 | facility shall not be
required to enroll those of its employees | ||||||
14 | who are covered spouses or
dependents under this plan or | ||||||
15 | another group policy or plan providing health
benefits as long | ||||||
16 | as (1) an appropriate official from the rehabilitation
facility | ||||||
17 | attests that each employee not enrolled is a covered spouse or
| ||||||
18 | dependent under this plan or another group policy or plan, and | ||||||
19 | (2) at least
85% of the employees are enrolled and the | ||||||
20 | rehabilitation facility remits
the entire cost of providing | ||||||
21 | coverage to those employees. Employees of a
participating | ||||||
22 | rehabilitation facility who are not enrolled due to coverage
| ||||||
23 | under another group health policy or plan may enroll
in the | ||||||
24 | event of a qualifying change in status, special enrollment, | ||||||
25 | special
circumstance as defined by the Director, or during the | ||||||
26 | annual Benefit Choice
Period. A participating rehabilitation | ||||||
27 | facility may also elect
to cover its annuitants. Dependent | ||||||
28 | coverage shall be offered on an optional
basis, with the costs | ||||||
29 | paid by the rehabilitation facility, its employees, or
some | ||||||
30 | combination of the 2 as determined by the rehabilitation | ||||||
31 | facility. The
rehabilitation facility shall be responsible for | ||||||
32 | timely collection and
transmission of dependent premiums.
| ||||||
33 | The Director shall annually determine quarterly rates of | ||||||
34 | payment, subject
to the following constraints:
| ||||||
35 | (1) In the first year of coverage, the rates shall be | ||||||
36 | 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 rehabilitation facility 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 rehabilitation facility 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
rehabilitation facility.
| ||||||
13 | Monthly payments by the rehabilitation facility or its | ||||||
14 | employees for
group health benefits shall be deposited in the | ||||||
15 | Local Government Health
Insurance Reserve Fund.
| ||||||
16 | (j-1) Any long-term care entity within the State of | ||||||
17 | Illinois may apply to the Director to have its employees, | ||||||
18 | annuitants, and their eligible dependents provided group | ||||||
19 | health coverage under this Act on a non-insured basis. To | ||||||
20 | participate, an entity must agree to enroll all of its | ||||||
21 | employees and pay the entire cost of providing the coverage for | ||||||
22 | its employees. A participating entity may also elect to cover | ||||||
23 | its annuitants. Dependent coverage shall be offered on an | ||||||
24 | optional basis with employees, or some combination of the 2 as | ||||||
25 | determined by the entity. The entity shall be responsible for | ||||||
26 | timely collection and transmission of dependent premiums. | ||||||
27 | The Director shall annually determine quarterly rates of | ||||||
28 | payment, subject to the following constraints: | ||||||
29 | (1) In the first year of coverage, the rates shall be | ||||||
30 | equal to the amount normally charged to State employees for | ||||||
31 | elected optional coverages or for enrolled dependents | ||||||
32 | coverages or other contributory coverages on behalf of its | ||||||
33 | employees, adjusted for differences between State | ||||||
34 | employees and employees of the entity in age, sex, | ||||||
35 | geographic location, or other relevant demographic | ||||||
36 | variables, plus an amount sufficient to pay for the |
| |||||||
| |||||||
1 | additional administrative costs of providing coverage to | ||||||
2 | employees of the long-term care entity and their | ||||||
3 | dependents. | ||||||
4 | (2) In subsequent years, a further adjustment shall be | ||||||
5 | made to reflect the actual prior years' claims experience | ||||||
6 | of the employees of the entity. | ||||||
7 | Monthly payments by the entity or its employees for group | ||||||
8 | health benefits shall be deposited into the Local Government | ||||||
9 | Health Insurance Reserve Fund.
| ||||||
10 | (k) Any domestic violence shelter or service within the | ||||||
11 | State of Illinois
may apply to the Director to have its | ||||||
12 | employees, annuitants, and their
dependents provided group | ||||||
13 | health coverage under this Act on a non-insured
basis. To | ||||||
14 | participate, a domestic violence shelter or service must agree | ||||||
15 | to
enroll all of its employees and pay the entire cost of | ||||||
16 | providing such coverage
for its employees. A participating | ||||||
17 | domestic violence shelter may also elect
to cover its | ||||||
18 | annuitants. Dependent coverage shall be offered on an optional
| ||||||
19 | basis, with the costs paid by the domestic violence shelter or | ||||||
20 | service, its
employees, or some combination of the 2 as | ||||||
21 | determined by the domestic violence
shelter or service. The | ||||||
22 | domestic violence shelter or service shall be
responsible for | ||||||
23 | timely collection and transmission of dependent premiums.
| ||||||
24 | The Director shall annually determine rates of payment,
| ||||||
25 | subject to the following constraints:
| ||||||
26 | (1) In the first year of coverage, the rates shall be | ||||||
27 | equal to the
amount normally charged to State employees for | ||||||
28 | elected optional coverages
or for enrolled dependents | ||||||
29 | coverages or other contributory coverages on
behalf of its | ||||||
30 | employees, adjusted for differences between State | ||||||
31 | employees and
employees of the domestic violence shelter or | ||||||
32 | service in age, sex, geographic
location or other relevant | ||||||
33 | demographic variables, plus an amount sufficient
to pay for | ||||||
34 | the additional administrative costs of providing coverage | ||||||
35 | to
employees of the domestic violence shelter or service | ||||||
36 | and their dependents.
|
| |||||||
| |||||||
1 | (2) In subsequent years, a further adjustment shall be | ||||||
2 | made to reflect
the actual prior years' claims experience | ||||||
3 | of the employees of the domestic
violence shelter or | ||||||
4 | service.
| ||||||
5 | Monthly payments by the domestic violence shelter or | ||||||
6 | service or its employees
for group health insurance shall be | ||||||
7 | deposited in the Local Government Health
Insurance Reserve | ||||||
8 | Fund.
| ||||||
9 | (l) A public community college or entity organized pursuant | ||||||
10 | to the
Public Community College Act may apply to the Director | ||||||
11 | initially to have
only annuitants not covered prior to July 1, | ||||||
12 | 1992 by the district's health
plan provided health coverage | ||||||
13 | under this Act on a non-insured basis. The
community college | ||||||
14 | must execute a 2-year contract to participate in the
Local | ||||||
15 | Government Health Plan.
Any annuitant may enroll in the event | ||||||
16 | of a qualifying change in status, special
enrollment, special | ||||||
17 | circumstance as defined by the Director, or during the
annual | ||||||
18 | Benefit Choice Period.
| ||||||
19 | The Director shall annually determine monthly rates of | ||||||
20 | payment subject to
the following constraints: for those | ||||||
21 | community colleges with annuitants
only enrolled, first year | ||||||
22 | rates shall be equal to the average cost to cover
claims for a | ||||||
23 | State member adjusted for demographics, Medicare
| ||||||
24 | participation, and other factors; and in the second year, a | ||||||
25 | further adjustment
of rates shall be made to reflect the actual | ||||||
26 | first year's claims experience
of the covered annuitants.
| ||||||
27 | (l-5) The provisions of subsection (l) become inoperative | ||||||
28 | on July 1, 1999.
| ||||||
29 | (m) The Director shall adopt any rules deemed necessary for
| ||||||
30 | implementation of this amendatory Act of 1989 (Public Act | ||||||
31 | 86-978).
| ||||||
32 | (Source: P.A. 91-280, eff. 7-23-99; 91-311; eff. 7-29-99; | ||||||
33 | 91-357, eff.
7-29-99; 91-390, eff. 7-30-99; 91-395, eff. | ||||||
34 | 7-30-99; 91-617, eff. 8-19-99;
92-16, eff. 6-28-01; revised | ||||||
35 | 2-25-02.)
|
| |||||||
| |||||||
1 | Section 10. The Department of Public Health Powers and | ||||||
2 | Duties Law of the
Civil Administrative Code of Illinois is | ||||||
3 | amended by adding Section 2310-610 as follows: | ||||||
4 | (20 ILCS 2310/2310-610 new) | ||||||
5 | Sec. 2310-610. Long-term care worker programs. The | ||||||
6 | Director of Public Health shall coordinate all loan | ||||||
7 | forgiveness, grant, and tuition waiver programs and training | ||||||
8 | programs available for licensed and unlicensed health care | ||||||
9 | workers who work or pledge to work in long-term health care | ||||||
10 | settings. The Director shall serve as a clearinghouse on those | ||||||
11 | available programs through the dissemination of information to | ||||||
12 | interested individuals and entities and through the | ||||||
13 | development and performance of public education activities, | ||||||
14 | including outreach.
| ||||||
15 | Section 99. Effective date. This Act takes effect upon | ||||||
16 | becoming law.
|