SB1245sam005 98TH GENERAL ASSEMBLY

Sen. Christine Radogno

Filed: 5/14/2013

09800SB1245sam005 LRB098 00197 JLS 45891 a

AMENDMENT TO SENATE BILL 1245

AMENDMENT NO. ______. Amend Senate Bill 1245, AS AMENDED, by replacing everything after the enacting clause with the following:

"Section 5. The Public Safety Employee Benefits Act is amended by changing Section 10 as follows:

(820 ILCS 320/10)

Sec. 10. Required health coverage benefits.

(a) An employer who employs a full-time law enforcement, correctional or correctional probation officer, or firefighter (hereinafter referred to as "injured employee"), who, on or after the effective date of this Act suffers a catastrophic injury or is killed in the line of duty shall pay the entire premium of the employer's health insurance plan for the injured employee, the injured employee's spouse, and for each dependent child of the injured employee until the child reaches the age of majority or until the end of the calendar year in which the child reaches the age of 25 if the child continues to be dependent for support or the child is a full-time or part-time student and is dependent for support. The term "health insurance plan" does not include supplemental benefits that are not part of the basic group health insurance plan. If the injured employee subsequently dies, the employer shall continue to pay the entire health insurance premium for the surviving spouse until remarried and for the dependent children under the conditions established in this Section. However:

(1) Health insurance benefits payable from any other source shall reduce benefits payable under this Section.

(2) It is unlawful for a person to willfully and knowingly make, or cause to be made, or to assist, conspire with, or urge another to make, or cause to be made, any false, fraudulent, or misleading oral or written statement to obtain health insurance coverage as provided under this Section. A violation of this item is a Class A misdemeanor.

(3) Upon conviction for a violation described in item (2), a law enforcement, correctional or correctional probation officer, or other beneficiary who receives or seeks to receive health insurance benefits under this Section shall forfeit the right to receive health insurance benefits and shall reimburse the employer for all benefits paid due to the fraud or other prohibited activity. For purposes of this item, "conviction" means a determination of guilt that is the result of a plea or trial, regardless of whether adjudication is withheld.

(b) In order for the law enforcement, correctional or correctional probation officer, firefighter, spouse, or dependent children to be eligible for insurance coverage under this Act, the injury or death must have occurred as the result of the officer's response to fresh pursuit, the officer or firefighter's response to what is reasonably believed to be an emergency, an unlawful act perpetrated by another, or during the investigation of a criminal act. Nothing in this Section shall be construed to limit health insurance coverage or pension benefits for which the officer, firefighter, spouse, or dependent children may otherwise be eligible.

(c) An injured employee subject to this Act shall be required to file a report with his or her employer as prescribed in this Section. The Commission on Government Forecasting and Accountability (COGFA) shall design the form and prescribe the content of the report. Within 60 days after the effective date of this amendatory Act of the 98th General Assembly, COGFA shall design and remit a copy of this form to all employers subject to this Act. The form shall include the following:

(1) employment by the injured employee within the previous 24-month period;

(2) compensation earned by the injured employee as a result of the employment;

(3) the nature of the injury that entitled the injured employee to a duty disability benefit and benefits as provided under this Act listing the part of the body affected, explaining how it was affected, and including the medical diagnosis, if known;

(4) whether the injured employee or his or her spouse has been offered or has access to any insurance from the injured employee's employment or his or her spouse's employment; and

(5) whether the injured employee or his or her spouse is currently enrolled in any insurance plan from another source.

Within 30 days after receipt of this form, an employer shall notify any employee receiving benefits under this Act of that employee's obligation to file a report under this Section. An employee receiving benefits under this Act must complete and return this form to the employer within 30 days of receipt of such form. Any employee who has been given notice as provided under this Section and who fails to timely file a report under this Section within 30 days after receipt of this form shall be notified by the employer that he or she has 30 days to submit the report or risk losing his or her benefits provided under this Act. An employer may suspend premium payments for an employee who fails to file this report with the employer 30 days after receiving this notice. The employee is responsible for ensuring that premiums are paid during the period of suspension. Employers shall return this form to COGFA within 30 days after receiving the form from the employee.

Any information collected by the employer under this Section shall be exempt from the requirements of the Freedom of Information Act except for data collected in the aggregate that does not reveal any personal information concerning the injured employee.

By July 1 of every odd-numbered year, beginning in 2015, employers subject to this Act must send a form to all employees eligible for benefits under this Act. The employee must complete and return this form by August 1 of that year. Any employee who has been given notice as provided under this Section and who fails to timely file a completed form under this Section within 30 days after receipt of this form shall be notified by the employer that he or she has 30 days to submit the form or risk losing his or her benefits provided under this Act. An employer may suspend premium payments for an employee who fails to complete and file this form with the employer 30 days after receiving this notice. The employee is responsible for ensuring that premiums are paid during the period of suspension. The employer shall resume premium payments upon receipt of the completed form. Employers shall return this form to COGFA within 30 days after receiving the form from the employee.

(d) An employer subject to this Act shall file a claims report with COGFA. COGFA shall design the form and prescribe the content of the report. Within 60 days after the effective date of this amendatory Act of the 98th General Assembly, and by July 1 of every odd-numbered year thereafter beginning in 2015, COGFA shall remit a copy of this form to all employers subject to this Act. An employer covered under this Act shall file a copy of this report with COGFA within 120 days after receipt of the form.

The first claims report filed with COGFA under this Section shall set forth all information gathered pursuant to this Section and, when available, shall submit the information required under this Section for each of the 5 years prior to the year in which this amendatory Act of the 98th General Assembly became law. All claims reports thereafter shall set forth the required information for the 24-month period ending on June 30 preceding the deadline date for filing the report. The claims report shall, at a minimum, contain the following information:

(1) the number of claims filed under this Act during the reporting period;

(2) the number of claims awarded under this Act during the reporting period;

(3) the dollar amount of all claims awarded under this Act during the reporting period;

(4) the number of claims paid under this Act during the reporting period regardless of when the claim was awarded;

(5) the dollar amount of all claims paid under this Act during the reporting period regardless of when the claim was awarded;

(6) the annual cost of the benefit and any available long-term cost projections;

(7) the nature of the injury as described by the injured employee under item (3) of subsection (c);

(8) any employment during the annual reporting period;

(9) the compensation earned as a result of that employment; and

(10) any offered or accessible insurance options through the injured employee's employment or his or her spouse's employment.

The claims report shall redact any information as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Any information submitted to COGFA shall not reveal any personal information of the injured employee. Whenever possible, communication between COGFA and employers as required by this Act shall be through electronic means.

(e) By June 1, 2014, and by January 1 of every even-numbered year thereafter beginning in 2016, COGFA shall submit a report to the Governor and General Assembly setting forth the information received under subsections (c) and (d). The report shall aggregate data in such a way as to not reveal the identity of any singular beneficiary. The requirement for reporting to the General Assembly shall be satisfied by filing copies of the report with the Speaker, Minority Leader, and Clerk of the House of Representatives, the President, Minority Leader, and Secretary of the Senate, the Legislative Research Unit as required under Section 3.1 of the General Assembly Organization Act, and the State Government Report Distribution Center for the General Assembly as required under paragraph (t) of Section 7 of the State Library Act. COGFA shall make this report available electronically on a publicly accessible website.

(Source: P.A. 90-535, eff. 11-14-97.)

Section 99. Effective date. This Act takes effect upon becoming law.".