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Sen. Jeffrey M. Schoenberg
Filed: 5/26/2011
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1 | | AMENDMENT TO SENATE BILL 175
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2 | | AMENDMENT NO. ______. Amend Senate Bill 175 by replacing |
3 | | everything after the enacting clause with the following:
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4 | | "Section 5. The State Employees Group Insurance Act of 1971 |
5 | | is amended by changing Section 10 as follows:
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6 | | (5 ILCS 375/10) (from Ch. 127, par. 530)
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7 | | Sec. 10. Payments by State; premiums.
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8 | | (a) The State shall pay the cost of basic non-contributory |
9 | | group life
insurance and, subject to member paid contributions |
10 | | set by the Department or
required by this Section, the basic |
11 | | program of group health benefits on each
eligible member, |
12 | | except a member, not otherwise
covered by this Act, who has |
13 | | retired as a participating member under Article 2
of the |
14 | | Illinois Pension Code but is ineligible for the retirement |
15 | | annuity under
Section 2-119 of the Illinois Pension Code, and |
16 | | part of each eligible member's
and retired member's premiums |
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1 | | for health insurance coverage for enrolled
dependents as |
2 | | provided by Section 9. The State shall pay the cost of the |
3 | | basic
program of group health benefits only after benefits are |
4 | | reduced by the amount
of benefits covered by Medicare for all |
5 | | members and dependents
who are eligible for benefits under |
6 | | Social Security or
the Railroad Retirement system or who had |
7 | | sufficient Medicare-covered
government employment, except that |
8 | | such reduction in benefits shall apply only
to those members |
9 | | and dependents who (1) first become eligible
for such Medicare |
10 | | coverage on or after July 1, 1992; or (2) are
Medicare-eligible |
11 | | members or dependents of a local government unit which began
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12 | | participation in the program on or after July 1, 1992; or (3) |
13 | | remain eligible
for, but no longer receive Medicare coverage |
14 | | which they had been receiving on
or after July 1, 1992. The |
15 | | Department may determine the aggregate level of the
State's |
16 | | contribution on the basis of actual cost of medical services |
17 | | adjusted
for age, sex or geographic or other demographic |
18 | | characteristics which affect
the costs of such programs.
|
19 | | The cost of participation in the basic program of group |
20 | | health benefits
for the dependent or survivor of a living or |
21 | | deceased retired employee who was
formerly employed by the |
22 | | University of Illinois in the Cooperative Extension
Service and |
23 | | would be an annuitant but for the fact that he or she was made
|
24 | | ineligible to participate in the State Universities Retirement |
25 | | System by clause
(4) of subsection (a) of Section 15-107 of the |
26 | | Illinois Pension Code shall not
be greater than the cost of |
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1 | | participation that would otherwise apply to that
dependent or |
2 | | survivor if he or she were the dependent or survivor of an
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3 | | annuitant under the State Universities Retirement System.
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4 | | (a-1) Beginning January 1, 1998, for each person who |
5 | | becomes a new SERS
annuitant and participates in the basic |
6 | | program of group health benefits, the
State shall contribute |
7 | | toward the cost of the annuitant's
coverage under the basic |
8 | | program of group health benefits an amount equal
to 5% of that |
9 | | cost for each full year of creditable service upon which the
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10 | | annuitant's retirement annuity is based, up to a maximum of |
11 | | 100% for an
annuitant with 20 or more years of creditable |
12 | | service.
The remainder of the cost of a new SERS annuitant's |
13 | | coverage under the basic
program of group health benefits shall |
14 | | be the responsibility of the
annuitant. In the case of a new |
15 | | SERS annuitant who has elected to receive an alternative |
16 | | retirement cancellation payment under Section 14-108.5 of the |
17 | | Illinois Pension Code in lieu of an annuity, for the purposes |
18 | | of this subsection the annuitant shall be deemed to be |
19 | | receiving a retirement annuity based on the number of years of |
20 | | creditable service that the annuitant had established at the |
21 | | time of his or her termination of service under SERS.
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22 | | (a-2) Beginning January 1, 1998, for each person who |
23 | | becomes a new SERS
survivor and participates in the basic |
24 | | program of group health benefits, the
State shall contribute |
25 | | toward the cost of the survivor's
coverage under the basic |
26 | | program of group health benefits an amount equal
to 5% of that |
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1 | | cost for each full year of the deceased employee's or deceased
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2 | | annuitant's creditable service in the State Employees' |
3 | | Retirement System of
Illinois on the date of death, up to a |
4 | | maximum of 100% for a survivor of an
employee or annuitant with |
5 | | 20 or more years of creditable service. The
remainder of the |
6 | | cost of the new SERS survivor's coverage under the basic
|
7 | | program of group health benefits shall be the responsibility of |
8 | | the survivor. In the case of a new SERS survivor who was the |
9 | | dependent of an annuitant who elected to receive an alternative |
10 | | retirement cancellation payment under Section 14-108.5 of the |
11 | | Illinois Pension Code in lieu of an annuity, for the purposes |
12 | | of this subsection the deceased annuitant's creditable service |
13 | | shall be determined as of the date of termination of service |
14 | | rather than the date of death.
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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
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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.
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26 | | (a-4) (Blank).
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1 | | (a-5) Beginning January 1, 1998, for each person who |
2 | | becomes a new SURS
survivor and participates in the basic |
3 | | program of group health benefits, the
State shall contribute |
4 | | toward the cost of the survivor's coverage under the
basic |
5 | | program of group health benefits an amount equal to 5% of that |
6 | | cost for
each full year of the deceased employee's or deceased |
7 | | annuitant's creditable
service in the State Universities |
8 | | Retirement System on the date of death, up to
a maximum of 100% |
9 | | for a survivor of an
employee or annuitant with 20 or more |
10 | | years of creditable service. The
remainder of the cost of the |
11 | | new SURS survivor's coverage under the basic
program of group |
12 | | health benefits shall be the responsibility of the survivor.
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13 | | (a-6) Beginning July 1, 1998, for each person who becomes a |
14 | | new TRS
State annuitant and participates in the basic program |
15 | | of group health benefits,
the State shall contribute toward the |
16 | | cost of the annuitant's coverage under
the basic program of |
17 | | group health benefits an amount equal to 5% of that cost
for |
18 | | each full year of creditable service
as a teacher as defined in |
19 | | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois |
20 | | Pension Code
upon which the annuitant's retirement annuity is |
21 | | based, up to a maximum of
100%;
except that
the State |
22 | | contribution shall be 12.5% per year (rather than 5%) for each |
23 | | full
year of creditable service as a regional superintendent or |
24 | | assistant regional
superintendent of schools. The
remainder of |
25 | | the cost of a new TRS State annuitant's coverage under the |
26 | | basic
program of group health benefits shall be the |
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1 | | responsibility of the
annuitant.
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2 | | (a-7) Beginning July 1, 1998, for each person who becomes a |
3 | | new TRS
State survivor and participates in the basic program of |
4 | | group health benefits,
the State shall contribute toward the |
5 | | cost of the survivor's coverage under the
basic program of |
6 | | group health benefits an amount equal to 5% of that cost for
|
7 | | each full year of the deceased employee's or deceased |
8 | | annuitant's creditable
service
as a teacher as defined in |
9 | | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois |
10 | | Pension Code
on the date of death, up to a maximum of 100%;
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11 | | except that the State contribution shall be 12.5% per year |
12 | | (rather than 5%) for
each full year of the deceased employee's |
13 | | or deceased annuitant's creditable
service as a regional |
14 | | superintendent or assistant regional superintendent of
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15 | | schools.
The remainder of
the cost of the new TRS State |
16 | | survivor's coverage under the basic program of
group health |
17 | | benefits shall be the responsibility of the survivor.
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18 | | (a-8) A new SERS annuitant, new SERS survivor, new SURS
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19 | | annuitant, new SURS survivor, new TRS State
annuitant, or new |
20 | | TRS State survivor may waive or terminate coverage in
the |
21 | | program of group health benefits. Any such annuitant or |
22 | | survivor
who has waived or terminated coverage may enroll or |
23 | | re-enroll in the
program of group health benefits only during |
24 | | the annual benefit choice period,
as determined by the |
25 | | Director; except that in the event of termination of
coverage |
26 | | due to nonpayment of premiums, the annuitant or survivor
may |
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1 | | not re-enroll in the program.
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2 | | (a-9) No later than May 1 of each calendar year, the |
3 | | Director
of Central Management Services shall certify in |
4 | | writing to the Executive
Secretary of the State Employees' |
5 | | Retirement System of Illinois the amounts
of the Medicare |
6 | | supplement health care premiums and the amounts of the
health |
7 | | care premiums for all other retirees who are not Medicare |
8 | | eligible.
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9 | | A separate calculation of the premiums based upon the |
10 | | actual cost of each
health care plan shall be so certified.
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11 | | The Director of Central Management Services shall provide |
12 | | to the
Executive Secretary of the State Employees' Retirement |
13 | | System of
Illinois such information, statistics, and other data |
14 | | as he or she
may require to review the premium amounts |
15 | | certified by the Director
of Central Management Services.
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16 | | The Department of Healthcare and Family Services, or any |
17 | | successor agency designated to procure healthcare contracts |
18 | | pursuant to this Act, is authorized to establish funds, |
19 | | separate accounts provided by any bank or banks as defined by |
20 | | the Illinois Banking Act, or separate accounts provided by any |
21 | | savings and loan association or associations as defined by the |
22 | | Illinois Savings and Loan Act of 1985 to be held by the |
23 | | Director, outside the State treasury, for the purpose of |
24 | | receiving the transfer of moneys from the Local Government |
25 | | Health Insurance Reserve Fund. The Department may promulgate |
26 | | rules further defining the methodology for the transfers. Any |
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1 | | interest earned by moneys in the funds or accounts shall inure |
2 | | to the Local Government Health Insurance Reserve Fund. The |
3 | | transferred moneys, and interest accrued thereon, shall be used |
4 | | exclusively for transfers to administrative service |
5 | | organizations or their financial institutions for payments of |
6 | | claims to claimants and providers under the self-insurance |
7 | | health plan. The transferred moneys, and interest accrued |
8 | | thereon, shall not be used for any other purpose including, but |
9 | | not limited to, reimbursement of administration fees due the |
10 | | administrative service organization pursuant to its contract |
11 | | or contracts with the Department.
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12 | | (a-10) Notwithstanding any provision of this Act to the |
13 | | contrary, beginning January 1, 2012, annuitants, retired |
14 | | employees, and survivors must pay premiums in order to obtain |
15 | | coverage for themselves and any dependents under the program of |
16 | | group health benefits provided under this Act. The Director |
17 | | shall determine the amount of the premium to be paid by each |
18 | | annuitant, retired employee, and survivor, based upon a system |
19 | | that takes into account (i) points, which are calculated by |
20 | | summing the retiree's age when benefits commenced and his or |
21 | | her total years of service, and (ii) estimated annual household |
22 | | income, according to the following schedule: |
23 | | (1) For a retired employee, annuitant, or survivor with |
24 | | fewer than 63 points, 100% of the applicable premium. |
25 | | (2) For a retired employee, annuitant, or survivor with |
26 | | 63 to 78 points and: |
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1 | | (A) An estimated annual household income of less |
2 | | than $30,000, 0% of the applicable premium. |
3 | | (B) An estimated annual household income of at |
4 | | least $30,000 but less than $60,000, 55% of the |
5 | | applicable premium. |
6 | | (C) An estimated annual household income of at |
7 | | least $60,000 but less than $100,000, 65% of the |
8 | | applicable premium. |
9 | | (D) An estimated annual household income of at |
10 | | least $100,000 but less than $200,000, 75% of the |
11 | | applicable premium. |
12 | | (E) An estimated annual household income of at |
13 | | least $200,000 but less than $250,000, 100% of the |
14 | | applicable premium. |
15 | | (F) An estimated annual household income of |
16 | | $250,000 or more, 100% of the applicable premium. |
17 | | (3) For a retired employee, annuitant, or survivor with |
18 | | 79 to 85 points and: |
19 | | (A) An estimated annual household income of less |
20 | | than $30,000, 0% of the applicable premium. |
21 | | (B) An estimated annual household income of at |
22 | | least $30,000 but less than $60,000, 50% of the |
23 | | applicable premium. |
24 | | (C) An estimated annual household income of at |
25 | | least $60,000 but less than $100,000, 60% of the |
26 | | applicable premium. |
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1 | | (D) An estimated annual household income of at |
2 | | least $100,000 but less than $200,000, 70% of the |
3 | | applicable premium. |
4 | | (E) An estimated annual household income of at |
5 | | least $200,000 but less than $250,000, 100% of the |
6 | | applicable premium. |
7 | | (F) An estimated annual household income of |
8 | | $250,000 or more, 100% of the applicable premium. |
9 | | (4) For a retired employee, annuitant, or survivor with |
10 | | 86 to 92 points and: |
11 | | (A) An estimated annual household income of less |
12 | | than $30,000, 0% of the applicable premium. |
13 | | (B) An estimated annual household income of at |
14 | | least $30,000 but less than $60,000, 45% of the |
15 | | applicable premium. |
16 | | (C) An estimated annual household income of at |
17 | | least $60,000 but less than $100,000, 55% of the |
18 | | applicable premium. |
19 | | (D) An estimated annual household income of at |
20 | | least $100,000 but less than $200,000, 65% of the |
21 | | applicable premium. |
22 | | (E) An estimated annual household income of at |
23 | | least $200,000 but less than $250,000, 100% of the |
24 | | applicable premium. |
25 | | (F) An estimated annual household income of |
26 | | $250,000 or more, 100% of the applicable premium. |
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1 | | (5) For a retired employee, annuitant, or survivor with |
2 | | 93 or more points and: |
3 | | (A) An estimated annual household income of less |
4 | | than $30,000, 0% of the applicable premium. |
5 | | (B) An estimated annual household income of at |
6 | | least $30,000 but less than $60,000, 35% of the |
7 | | applicable premium. |
8 | | (C) An estimated annual household income of at |
9 | | least $60,000 but less than $100,000, 45% of the |
10 | | applicable premium. |
11 | | (D) An estimated annual household income of at |
12 | | least $100,000 but less than $200,000, 55% of the |
13 | | applicable premium. |
14 | | (E) An estimated annual household income of at |
15 | | least $200,000 but less than $250,000, 100% of the |
16 | | applicable premium. |
17 | | (F) An estimated annual household income of |
18 | | $250,000 or more, 100% of the applicable premium. |
19 | | The Director shall establish a process for determining |
20 | | estimated annual household income by administrative rule. This |
21 | | income-verification process must use pension income as the |
22 | | basis for determining estimated annual household income. The |
23 | | Director shall also establish by rule a process for retired |
24 | | employees, annuitants, and survivors to appeal determinations |
25 | | of estimated annual household income. |
26 | | With respect to any annuitant, retired employee, or |
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1 | | survivor covered by a collective bargaining agreement in effect |
2 | | on the effective date of this amendatory Act of the 97th |
3 | | General Assembly and until that collective bargaining |
4 | | agreement terminates, the obligation of each retired employee, |
5 | | annuitant, or survivor to pay the required premium applies only |
6 | | to the extent that the obligation is consistent with any |
7 | | contractual obligations existing in any collective bargaining |
8 | | agreement. |
9 | | Upon the expiration of any collective bargaining agreement |
10 | | in effect on the effective date of this amendatory Act of the |
11 | | 97th General Assembly, the Director may alter the schedule |
12 | | above to ensure that 49% of the costs associated with the basic |
13 | | program of group health benefits are covered by retired |
14 | | employees, annuitants, and survivors. |
15 | | (b) State employees who become eligible for this program on |
16 | | or after January
1, 1980 in positions normally requiring actual |
17 | | performance of duty not less
than 1/2 of a normal work period |
18 | | but not equal to that of a normal work period,
shall be given |
19 | | the option of participating in the available program. If the
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20 | | employee elects coverage, the State shall contribute on behalf |
21 | | of such employee
to the cost of the employee's benefit and any |
22 | | applicable dependent supplement,
that sum which bears the same |
23 | | percentage as that percentage of time the
employee regularly |
24 | | works when compared to normal work period.
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25 | | (c) The basic non-contributory coverage from the basic |
26 | | program of
group health benefits shall be continued for each |
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1 | | employee not in pay status or
on active service by reason of |
2 | | (1) leave of absence due to illness or injury,
(2) authorized |
3 | | educational leave of absence or sabbatical leave, or (3)
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4 | | military leave. This coverage shall continue until
expiration |
5 | | of authorized leave and return to active service, but not to |
6 | | exceed
24 months for leaves under item (1) or (2). This |
7 | | 24-month limitation and the
requirement of returning to active |
8 | | service shall not apply to persons receiving
ordinary or |
9 | | accidental disability benefits or retirement benefits through |
10 | | the
appropriate State retirement system or benefits under the |
11 | | Workers' Compensation
or Occupational Disease Act.
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12 | | (d) The basic group life insurance coverage shall continue, |
13 | | with
full State contribution, where such person is (1) absent |
14 | | from active
service by reason of disability arising from any |
15 | | cause other than
self-inflicted, (2) on authorized educational |
16 | | leave of absence or
sabbatical leave, or (3) on military leave.
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17 | | (e) Where the person is in non-pay status for a period in |
18 | | excess of
30 days or on leave of absence, other than by reason |
19 | | of disability,
educational or sabbatical leave, or military |
20 | | leave, such
person may continue coverage only by making |
21 | | personal
payment equal to the amount normally contributed by |
22 | | the State on such person's
behalf. Such payments and coverage |
23 | | may be continued: (1) until such time as
the person returns to |
24 | | a status eligible for coverage at State expense, but not
to |
25 | | exceed 24 months or (2) until such person's employment or |
26 | | annuitant status
with the State is terminated (exclusive of any |
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1 | | additional service imposed pursuant to law).
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2 | | (f) The Department shall establish by rule the extent to |
3 | | which other
employee benefits will continue for persons in |
4 | | non-pay status or who are
not in active service.
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5 | | (g) The State shall not pay the cost of the basic |
6 | | non-contributory
group life insurance, program of health |
7 | | benefits and other employee benefits
for members who are |
8 | | survivors as defined by paragraphs (1) and (2) of
subsection |
9 | | (q) of Section 3 of this Act. The costs of benefits for these
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10 | | survivors shall be paid by the survivors or by the University |
11 | | of Illinois
Cooperative Extension Service, or any combination |
12 | | thereof.
However, the State shall pay the amount of the |
13 | | reduction in the cost of
participation, if any, resulting from |
14 | | the amendment to subsection (a) made
by this amendatory Act of |
15 | | the 91st General Assembly.
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16 | | (h) Those persons occupying positions with any department |
17 | | as a result
of emergency appointments pursuant to Section 8b.8 |
18 | | of the Personnel Code
who are not considered employees under |
19 | | this Act shall be given the option
of participating in the |
20 | | programs of group life insurance, health benefits and
other |
21 | | employee benefits. Such persons electing coverage may |
22 | | participate only
by making payment equal to the amount normally |
23 | | contributed by the State for
similarly situated employees. Such |
24 | | amounts shall be determined by the
Director. Such payments and |
25 | | coverage may be continued until such time as the
person becomes |
26 | | an employee pursuant to this Act or such person's appointment |
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1 | | is
terminated.
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2 | | (i) Any unit of local government within the State of |
3 | | Illinois
may apply to the Director to have its employees, |
4 | | annuitants, and their
dependents provided group health |
5 | | coverage under this Act on a non-insured
basis. To participate, |
6 | | a unit of local government must agree to enroll
all of its |
7 | | employees, who may select coverage under either the State group
|
8 | | health benefits plan or a health maintenance organization that |
9 | | has
contracted with the State to be available as a health care |
10 | | provider for
employees as defined in this Act. A unit of local |
11 | | government must remit the
entire cost of providing coverage |
12 | | under the State group health benefits plan
or, for coverage |
13 | | under a health maintenance organization, an amount determined
|
14 | | by the Director based on an analysis of the sex, age, |
15 | | geographic location, or
other relevant demographic variables |
16 | | for its employees, except that the unit of
local government |
17 | | shall not be required to enroll those of its employees who are
|
18 | | covered spouses or dependents under this plan or another group |
19 | | policy or plan
providing health benefits as long as (1) an |
20 | | appropriate official from the unit
of local government attests |
21 | | 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 unit of |
24 | | local government remits
the entire cost of providing coverage |
25 | | to those employees, except that a
participating school district |
26 | | must have enrolled at least 50% of its full-time
employees who |
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1 | | have not waived coverage under the district's group health
plan |
2 | | by participating in a component of the district's cafeteria |
3 | | plan. A
participating school district is not required to enroll |
4 | | a full-time employee
who has waived coverage under the |
5 | | district's health plan, provided that an
appropriate official |
6 | | from the participating school district attests that the
|
7 | | full-time employee has waived coverage by participating in a |
8 | | component of the
district's cafeteria plan. For the purposes of |
9 | | this subsection, "participating
school district" includes a |
10 | | unit of local government whose primary purpose is
education as |
11 | | defined by the Department's rules.
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12 | | Employees of a participating unit of local government who |
13 | | are not enrolled
due to coverage under another group health |
14 | | policy or plan may enroll in
the event of a qualifying change |
15 | | in status, special enrollment, special
circumstance as defined |
16 | | by the Director, or during the annual Benefit Choice
Period. A |
17 | | participating unit of local government may also elect to cover |
18 | | its
annuitants. Dependent coverage shall be offered on an |
19 | | optional basis, with the
costs paid by the unit of local |
20 | | government, its employees, or some combination
of the two as |
21 | | determined by the unit of local government. The unit of local
|
22 | | government shall be responsible for timely collection and |
23 | | transmission of
dependent premiums.
|
24 | | The Director shall annually determine monthly rates of |
25 | | payment, subject
to the following constraints:
|
26 | | (1) In the first year of coverage, the rates shall be |
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1 | | equal to the
amount normally charged to State employees for |
2 | | elected optional coverages
or for enrolled dependents |
3 | | coverages or other contributory coverages, or
contributed |
4 | | by the State for basic insurance coverages on behalf of its
|
5 | | employees, adjusted for differences between State |
6 | | employees and employees
of the local government in age, |
7 | | sex, geographic location or other relevant
demographic |
8 | | variables, plus an amount sufficient to pay for the |
9 | | additional
administrative costs of providing coverage to |
10 | | employees of the unit of
local government and their |
11 | | dependents.
|
12 | | (2) In subsequent years, a further adjustment shall be |
13 | | made to reflect
the actual prior years' claims experience |
14 | | of the employees of the unit of
local government.
|
15 | | In the case of coverage of local government employees under |
16 | | a health
maintenance organization, the Director shall annually |
17 | | determine for each
participating unit of local government the |
18 | | maximum monthly amount the unit
may contribute toward that |
19 | | coverage, based on an analysis of (i) the age,
sex, geographic |
20 | | location, and other relevant demographic variables of the
|
21 | | unit's employees and (ii) the cost to cover those employees |
22 | | under the State
group health benefits plan. The Director may |
23 | | similarly determine the
maximum monthly amount each unit of |
24 | | local government may contribute toward
coverage of its |
25 | | employees' dependents under a health maintenance organization.
|
26 | | Monthly payments by the unit of local government or its |
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1 | | employees for
group health benefits plan or health maintenance |
2 | | organization coverage shall
be deposited in the Local |
3 | | Government Health Insurance Reserve Fund.
|
4 | | The Local Government Health Insurance Reserve Fund is |
5 | | hereby created as a nonappropriated trust fund to be held |
6 | | outside the State Treasury, with the State Treasurer as |
7 | | custodian. The Local Government Health Insurance Reserve Fund |
8 | | shall be a continuing
fund not subject to fiscal year |
9 | | limitations. The Local Government Health Insurance Reserve |
10 | | Fund is not subject to administrative charges or charge-backs, |
11 | | including but not limited to those authorized under Section 8h |
12 | | of the State Finance Act. All revenues arising from the |
13 | | administration of the health benefits program established |
14 | | under this Section shall be deposited into the Local Government |
15 | | Health Insurance Reserve Fund. Any interest earned on moneys in |
16 | | the Local Government Health Insurance Reserve Fund shall be |
17 | | deposited into the Fund. All expenditures from this Fund
shall |
18 | | be used for payments for health care benefits for local |
19 | | government and rehabilitation facility
employees, annuitants, |
20 | | and dependents, and to reimburse the Department or
its |
21 | | administrative service organization for all expenses incurred |
22 | | in the
administration of benefits. No other State funds may be |
23 | | used for these
purposes.
|
24 | | A local government employer's participation or desire to |
25 | | participate
in a program created under this subsection shall |
26 | | not limit that employer's
duty to bargain with the |
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1 | | representative of any collective bargaining unit
of its |
2 | | employees.
|
3 | | (j) Any rehabilitation facility within the State of |
4 | | Illinois may apply
to the Director to have its employees, |
5 | | annuitants, and their eligible
dependents provided group |
6 | | health coverage under this Act on a non-insured
basis. To |
7 | | participate, a rehabilitation facility must agree to enroll all
|
8 | | of its employees and remit the entire cost of providing such |
9 | | coverage for
its employees, except that the rehabilitation |
10 | | facility shall not be
required to enroll those of its employees |
11 | | who are covered spouses or
dependents under this plan or |
12 | | another group policy or plan providing health
benefits as long |
13 | | as (1) an appropriate official from the rehabilitation
facility |
14 | | attests that each employee not enrolled is a covered spouse or
|
15 | | dependent under this plan or another group policy or plan, and |
16 | | (2) at least
50% of the employees are enrolled and the |
17 | | rehabilitation facility remits
the entire cost of providing |
18 | | coverage to those employees. Employees of a
participating |
19 | | rehabilitation facility who are not enrolled due to coverage
|
20 | | under another group health policy or plan may enroll
in the |
21 | | event of a qualifying change in status, special enrollment, |
22 | | special
circumstance as defined by the Director, or during the |
23 | | annual Benefit Choice
Period. A participating rehabilitation |
24 | | facility may also elect
to cover its annuitants. Dependent |
25 | | coverage shall be offered on an optional
basis, with the costs |
26 | | paid by the rehabilitation facility, its employees, or
some |
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1 | | combination of the 2 as determined by the rehabilitation |
2 | | facility. The
rehabilitation facility shall be responsible for |
3 | | timely collection and
transmission of dependent premiums.
|
4 | | The Director shall annually determine quarterly rates of |
5 | | payment, subject
to the following constraints:
|
6 | | (1) In the first year of coverage, the rates shall be |
7 | | equal to the amount
normally charged to State employees for |
8 | | elected optional coverages or for
enrolled dependents |
9 | | coverages or other contributory coverages on behalf of
its |
10 | | employees, adjusted for differences between State |
11 | | employees and
employees of the rehabilitation facility in |
12 | | age, sex, geographic location
or other relevant |
13 | | demographic variables, plus an amount sufficient to pay
for |
14 | | the additional administrative costs of providing coverage |
15 | | to employees
of the rehabilitation facility and their |
16 | | dependents.
|
17 | | (2) In subsequent years, a further adjustment shall be |
18 | | made to reflect
the actual prior years' claims experience |
19 | | of the employees of the
rehabilitation facility.
|
20 | | Monthly payments by the rehabilitation facility or its |
21 | | employees for
group health benefits shall be deposited in the |
22 | | Local Government Health
Insurance Reserve Fund.
|
23 | | (k) Any domestic violence shelter or service within the |
24 | | State of Illinois
may apply to the Director to have its |
25 | | employees, annuitants, and their
dependents provided group |
26 | | health coverage under this Act on a non-insured
basis. To |
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1 | | participate, a domestic violence shelter or service must agree |
2 | | to
enroll all of its employees and pay the entire cost of |
3 | | providing such coverage
for its employees. The domestic |
4 | | violence shelter shall not be required to enroll those of its |
5 | | employees who are covered spouses or dependents under this plan |
6 | | or another group policy or plan providing health benefits as |
7 | | long as (1) an appropriate official from the domestic violence |
8 | | shelter attests that each employee not enrolled is a covered |
9 | | spouse or dependent under this plan or another group policy or |
10 | | plan and (2) at least 50% of the employees are enrolled and the |
11 | | domestic violence shelter remits the entire cost of providing |
12 | | coverage to those employees. Employees of a participating |
13 | | domestic violence shelter who are not enrolled due to coverage |
14 | | under another group health policy or plan may enroll in the |
15 | | event of a qualifying change in status, special enrollment, or |
16 | | special circumstance as defined by the Director or during the |
17 | | annual Benefit Choice Period. A participating domestic |
18 | | violence shelter may also elect
to cover its annuitants. |
19 | | Dependent coverage shall be offered on an optional
basis, with
|
20 | | employees, or some combination of the 2 as determined by the |
21 | | domestic violence
shelter or service. The domestic violence |
22 | | shelter or service shall be
responsible for timely collection |
23 | | 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 |
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1 | | equal to the
amount normally charged to State employees for |
2 | | elected optional coverages
or for enrolled dependents |
3 | | coverages or other contributory coverages on
behalf of its |
4 | | employees, adjusted for differences between State |
5 | | employees and
employees of the domestic violence shelter or |
6 | | service in age, sex, geographic
location or other relevant |
7 | | demographic variables, plus an amount sufficient
to pay for |
8 | | the additional administrative costs of providing coverage |
9 | | to
employees of the domestic violence shelter or service |
10 | | and their dependents.
|
11 | | (2) In subsequent years, a further adjustment shall be |
12 | | made to reflect
the actual prior years' claims experience |
13 | | of the employees of the domestic
violence shelter or |
14 | | service.
|
15 | | Monthly payments by the domestic violence shelter or |
16 | | service or its employees
for group health insurance shall be |
17 | | deposited in the Local Government Health
Insurance Reserve |
18 | | Fund.
|
19 | | (l) A public community college or entity organized pursuant |
20 | | to the
Public Community College Act may apply to the Director |
21 | | initially to have
only annuitants not covered prior to July 1, |
22 | | 1992 by the district's health
plan provided health coverage |
23 | | under this Act on a non-insured basis. The
community college |
24 | | must execute a 2-year contract to participate in the
Local |
25 | | Government Health Plan.
Any annuitant may enroll in the event |
26 | | of a qualifying change in status, special
enrollment, special |
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1 | | circumstance as defined by the Director, or during the
annual |
2 | | Benefit Choice Period.
|
3 | | The Director shall annually determine monthly rates of |
4 | | payment subject to
the following constraints: for those |
5 | | community colleges with annuitants
only enrolled, first year |
6 | | rates shall be equal to the average cost to cover
claims for a |
7 | | State member adjusted for demographics, Medicare
|
8 | | participation, and other factors; and in the second year, a |
9 | | further adjustment
of rates shall be made to reflect the actual |
10 | | first year's claims experience
of the covered annuitants.
|
11 | | (l-5) The provisions of subsection (l) become inoperative |
12 | | on July 1, 1999.
|
13 | | (m) The Director shall adopt any rules deemed necessary for
|
14 | | implementation of this amendatory Act of 1989 (Public Act |
15 | | 86-978).
|
16 | | (n) Any child advocacy center within the State of Illinois |
17 | | may apply to the Director to have its employees, annuitants, |
18 | | and their dependents provided group health coverage under this |
19 | | Act on a non-insured basis. To participate, a child advocacy |
20 | | center must agree to enroll all of its employees and pay the |
21 | | entire cost of providing coverage for its employees. The child
|
22 | | advocacy center shall not be required to enroll those of its
|
23 | | employees who are covered spouses or dependents under this plan
|
24 | | or another group policy or plan providing health benefits as
|
25 | | long as (1) an appropriate official from the child advocacy
|
26 | | center attests that each employee not enrolled is a covered
|
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1 | | spouse or dependent under this plan or another group policy or
|
2 | | plan and (2) at least 50% of the employees are enrolled and the |
3 | | child advocacy center remits the entire cost of providing |
4 | | coverage to those employees. Employees of a participating child |
5 | | advocacy center who are not enrolled due to coverage under |
6 | | another group health policy or plan may enroll in the event of |
7 | | a qualifying change in status, special enrollment, or special |
8 | | circumstance as defined by the Director or during the annual |
9 | | Benefit Choice Period. A participating child advocacy center |
10 | | may also elect to cover its annuitants. Dependent coverage |
11 | | shall be offered on an optional basis, with the costs paid by |
12 | | the child advocacy center, its employees, or some combination |
13 | | of the 2 as determined by the child advocacy center. The child |
14 | | advocacy center shall be responsible for timely collection and |
15 | | transmission of dependent premiums. |
16 | | The Director shall annually determine rates of payment, |
17 | | subject to the following constraints: |
18 | | (1) In the first year of coverage, the rates shall be |
19 | | equal to the amount normally charged to State employees for |
20 | | elected optional coverages or for enrolled dependents |
21 | | coverages or other contributory coverages on behalf of its |
22 | | employees, adjusted for differences between State |
23 | | employees and employees of the child advocacy center in |
24 | | age, sex, geographic location, or other relevant |
25 | | demographic variables, plus an amount sufficient to pay for |
26 | | the additional administrative costs of providing coverage |
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1 | | to employees of the child advocacy center and their |
2 | | dependents. |
3 | | (2) In subsequent years, a further adjustment shall be |
4 | | made to reflect the actual prior years' claims experience |
5 | | of the employees of the child advocacy center. |
6 | | Monthly payments by the child advocacy center or its |
7 | | employees for group health insurance shall be deposited into |
8 | | the Local Government Health Insurance Reserve Fund. |
9 | | (Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; |
10 | | 95-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff. |
11 | | 7-23-10; 96-1519, eff. 2-4-11.)
|
12 | | Section 99. Effective date. This Act takes effect January |
13 | | 1, 2012.".
|