SB2525 EnrolledLRB096 16690 AMC 31974 b

1    AN ACT concerning public employee benefits.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 3, 6.5, and 10 as follows:
 
6    (5 ILCS 375/3)  (from Ch. 127, par. 523)
7    Sec. 3. Definitions. Unless the context otherwise
8requires, the following words and phrases as used in this Act
9shall have the following meanings. The Department may define
10these and other words and phrases separately for the purpose of
11implementing specific programs providing benefits under this
12Act.
13    (a) "Administrative service organization" means any
14person, firm or corporation experienced in the handling of
15claims which is fully qualified, financially sound and capable
16of meeting the service requirements of a contract of
17administration executed with the Department.
18    (b) "Annuitant" means (1) an employee who retires, or has
19retired, on or after January 1, 1966 on an immediate annuity
20under the provisions of Articles 2, 14 (including an employee
21who has elected to receive an alternative retirement
22cancellation payment under Section 14-108.5 of the Illinois
23Pension Code in lieu of an annuity), 15 (including an employee

 

 

SB2525 Enrolled- 2 -LRB096 16690 AMC 31974 b

1who has retired under the optional retirement program
2established under Section 15-158.2), paragraphs (2), (3), or
3(5) of Section 16-106, or Article 18 of the Illinois Pension
4Code; (2) any person who was receiving group insurance coverage
5under this Act as of March 31, 1978 by reason of his status as
6an annuitant, even though the annuity in relation to which such
7coverage was provided is a proportional annuity based on less
8than the minimum period of service required for a retirement
9annuity in the system involved; (3) any person not otherwise
10covered by this Act who has retired as a participating member
11under Article 2 of the Illinois Pension Code but is ineligible
12for the retirement annuity under Section 2-119 of the Illinois
13Pension Code; (4) the spouse of any person who is receiving a
14retirement annuity under Article 18 of the Illinois Pension
15Code and who is covered under a group health insurance program
16sponsored by a governmental employer other than the State of
17Illinois and who has irrevocably elected to waive his or her
18coverage under this Act and to have his or her spouse
19considered as the "annuitant" under this Act and not as a
20"dependent"; or (5) an employee who retires, or has retired,
21from a qualified position, as determined according to rules
22promulgated by the Director, under a qualified local
23government, a qualified rehabilitation facility, a qualified
24domestic violence shelter or service, or a qualified child
25advocacy center. (For definition of "retired employee", see (p)
26post).

 

 

SB2525 Enrolled- 3 -LRB096 16690 AMC 31974 b

1    (b-5) "New SERS annuitant" means a person who, on or after
2January 1, 1998, becomes an annuitant, as defined in subsection
3(b), by virtue of beginning to receive a retirement annuity
4under Article 14 of the Illinois Pension Code (including an
5employee who has elected to receive an alternative retirement
6cancellation payment under Section 14-108.5 of that Code in
7lieu of an annuity), and is eligible to participate in the
8basic program of group health benefits provided for annuitants
9under this Act.
10    (b-6) "New SURS annuitant" means a person who (1) on or
11after January 1, 1998, becomes an annuitant, as defined in
12subsection (b), by virtue of beginning to receive a retirement
13annuity under Article 15 of the Illinois Pension Code, (2) has
14not made the election authorized under Section 15-135.1 of the
15Illinois Pension Code, and (3) is eligible to participate in
16the basic program of group health benefits provided for
17annuitants under this Act.
18    (b-7) "New TRS State annuitant" means a person who, on or
19after July 1, 1998, becomes an annuitant, as defined in
20subsection (b), by virtue of beginning to receive a retirement
21annuity under Article 16 of the Illinois Pension Code based on
22service as a teacher as defined in paragraph (2), (3), or (5)
23of Section 16-106 of that Code, and is eligible to participate
24in the basic program of group health benefits provided for
25annuitants under this Act.
26    (c) "Carrier" means (1) an insurance company, a corporation

 

 

SB2525 Enrolled- 4 -LRB096 16690 AMC 31974 b

1organized under the Limited Health Service Organization Act or
2the Voluntary Health Services Plan Act, a partnership, or other
3nongovernmental organization, which is authorized to do group
4life or group health insurance business in Illinois, or (2) the
5State of Illinois as a self-insurer.
6    (d) "Compensation" means salary or wages payable on a
7regular payroll by the State Treasurer on a warrant of the
8State Comptroller out of any State, trust or federal fund, or
9by the Governor of the State through a disbursing officer of
10the State out of a trust or out of federal funds, or by any
11Department out of State, trust, federal or other funds held by
12the State Treasurer or the Department, to any person for
13personal services currently performed, and ordinary or
14accidental disability benefits under Articles 2, 14, 15
15(including ordinary or accidental disability benefits under
16the optional retirement program established under Section
1715-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
18Article 18 of the Illinois Pension Code, for disability
19incurred after January 1, 1966, or benefits payable under the
20Workers' Compensation or Occupational Diseases Act or benefits
21payable under a sick pay plan established in accordance with
22Section 36 of the State Finance Act. "Compensation" also means
23salary or wages paid to an employee of any qualified local
24government, qualified rehabilitation facility, qualified
25domestic violence shelter or service, or qualified child
26advocacy center.

 

 

SB2525 Enrolled- 5 -LRB096 16690 AMC 31974 b

1    (e) "Commission" means the State Employees Group Insurance
2Advisory Commission authorized by this Act. Commencing July 1,
31984, "Commission" as used in this Act means the Commission on
4Government Forecasting and Accountability as established by
5the Legislative Commission Reorganization Act of 1984.
6    (f) "Contributory", when referred to as contributory
7coverage, shall mean optional coverages or benefits elected by
8the member toward the cost of which such member makes
9contribution, or which are funded in whole or in part through
10the acceptance of a reduction in earnings or the foregoing of
11an increase in earnings by an employee, as distinguished from
12noncontributory coverage or benefits which are paid entirely by
13the State of Illinois without reduction of the member's salary.
14    (g) "Department" means any department, institution, board,
15commission, officer, court or any agency of the State
16government receiving appropriations and having power to
17certify payrolls to the Comptroller authorizing payments of
18salary and wages against such appropriations as are made by the
19General Assembly from any State fund, or against trust funds
20held by the State Treasurer and includes boards of trustees of
21the retirement systems created by Articles 2, 14, 15, 16 and 18
22of the Illinois Pension Code. "Department" also includes the
23Illinois Comprehensive Health Insurance Board, the Board of
24Examiners established under the Illinois Public Accounting
25Act, and the Illinois Finance Authority.
26    (h) "Dependent", when the term is used in the context of

 

 

SB2525 Enrolled- 6 -LRB096 16690 AMC 31974 b

1the health and life plan, means a member's spouse and any
2unmarried child (1) from birth to age 26 19 including an
3adopted child, a child who lives with the member from the time
4of the filing of a petition for adoption until entry of an
5order of adoption, a stepchild or adjudicated recognized child
6who lives with the member in a parent-child relationship, or a
7child who lives with the member if such member is a court
8appointed guardian of the child or , (2) age 19 to 24 enrolled
9as a full-time student in any accredited school, financially
10dependent upon the member, and eligible to be claimed as a
11dependent for income tax purposes, (2.1) age 19 to 24 on a
12medical leave of absence as described in Section 356z.11 of the
13Illinois Insurance Code (215 ILCS 5/356z.11), or (3) age 19 or
14over who is mentally or physically disabled from a cause
15originating prior to the age of 19 (age 26 if enrolled as an
16adult child dependent) handicapped. For the purposes of item
17(2), an unmarried child age 19 to 24 who is a member of the
18United States Armed Services, including the Illinois National
19Guard, and is mobilized to active duty shall qualify as a
20dependent beyond the age of 24 and until the age of 25 and
21while a full-time student for the amount of time spent on
22active duty between the ages of 19 and 24. The individual
23attempting to qualify for this additional time must submit
24written documentation of active duty service to the Director.
25The changes made by this amendatory Act of the 94th General
26Assembly apply only to individuals mobilized to active duty in

 

 

SB2525 Enrolled- 7 -LRB096 16690 AMC 31974 b

1the United States Armed Services, including the Illinois
2National Guard, on or after January 1, 2002. For the health
3plan only, the term "dependent" also includes (1) any person
4enrolled prior to the effective date of this Section who is
5dependent upon the member to the extent that the member may
6claim such person as a dependent for income tax deduction
7purposes and (2) ; no other such person may be enrolled. For the
8health plan only, the term "dependent" also includes any person
9who has received after June 30, 2000 an organ transplant and
10who is financially dependent upon the member and eligible to be
11claimed as a dependent for income tax purposes. A member
12requesting to cover any dependent must provide documentation as
13requested by the Department of Central Management Services and
14file with the Department any and all forms required by the
15Department.
16    (i) "Director" means the Director of the Illinois
17Department of Central Management Services or of any successor
18agency designated to administer this Act.
19    (j) "Eligibility period" means the period of time a member
20has to elect enrollment in programs or to select benefits
21without regard to age, sex or health.
22    (k) "Employee" means and includes each officer or employee
23in the service of a department who (1) receives his
24compensation for service rendered to the department on a
25warrant issued pursuant to a payroll certified by a department
26or on a warrant or check issued and drawn by a department upon

 

 

SB2525 Enrolled- 8 -LRB096 16690 AMC 31974 b

1a trust, federal or other fund or on a warrant issued pursuant
2to a payroll certified by an elected or duly appointed officer
3of the State or who receives payment of the performance of
4personal services on a warrant issued pursuant to a payroll
5certified by a Department and drawn by the Comptroller upon the
6State Treasurer against appropriations made by the General
7Assembly from any fund or against trust funds held by the State
8Treasurer, and (2) is employed full-time or part-time in a
9position normally requiring actual performance of duty during
10not less than 1/2 of a normal work period, as established by
11the Director in cooperation with each department, except that
12persons elected by popular vote will be considered employees
13during the entire term for which they are elected regardless of
14hours devoted to the service of the State, and (3) except that
15"employee" does not include any person who is not eligible by
16reason of such person's employment to participate in one of the
17State retirement systems under Articles 2, 14, 15 (either the
18regular Article 15 system or the optional retirement program
19established under Section 15-158.2) or 18, or under paragraph
20(2), (3), or (5) of Section 16-106, of the Illinois Pension
21Code, but such term does include persons who are employed
22during the 6 month qualifying period under Article 14 of the
23Illinois Pension Code. Such term also includes any person who
24(1) after January 1, 1966, is receiving ordinary or accidental
25disability benefits under Articles 2, 14, 15 (including
26ordinary or accidental disability benefits under the optional

 

 

SB2525 Enrolled- 9 -LRB096 16690 AMC 31974 b

1retirement program established under Section 15-158.2),
2paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
3the Illinois Pension Code, for disability incurred after
4January 1, 1966, (2) receives total permanent or total
5temporary disability under the Workers' Compensation Act or
6Occupational Disease Act as a result of injuries sustained or
7illness contracted in the course of employment with the State
8of Illinois, or (3) is not otherwise covered under this Act and
9has retired as a participating member under Article 2 of the
10Illinois Pension Code but is ineligible for the retirement
11annuity under Section 2-119 of the Illinois Pension Code.
12However, a person who satisfies the criteria of the foregoing
13definition of "employee" except that such person is made
14ineligible to participate in the State Universities Retirement
15System by clause (4) of subsection (a) of Section 15-107 of the
16Illinois Pension Code is also an "employee" for the purposes of
17this Act. "Employee" also includes any person receiving or
18eligible for benefits under a sick pay plan established in
19accordance with Section 36 of the State Finance Act. "Employee"
20also includes (i) each officer or employee in the service of a
21qualified local government, including persons appointed as
22trustees of sanitary districts regardless of hours devoted to
23the service of the sanitary district, (ii) each employee in the
24service of a qualified rehabilitation facility, (iii) each
25full-time employee in the service of a qualified domestic
26violence shelter or service, and (iv) each full-time employee

 

 

SB2525 Enrolled- 10 -LRB096 16690 AMC 31974 b

1in the service of a qualified child advocacy center, as
2determined according to rules promulgated by the Director.
3    (l) "Member" means an employee, annuitant, retired
4employee or survivor.
5    (m) "Optional coverages or benefits" means those coverages
6or benefits available to the member on his or her voluntary
7election, and at his or her own expense.
8    (n) "Program" means the group life insurance, health
9benefits and other employee benefits designed and contracted
10for by the Director under this Act.
11    (o) "Health plan" means a health benefits program offered
12by the State of Illinois for persons eligible for the plan.
13    (p) "Retired employee" means any person who would be an
14annuitant as that term is defined herein but for the fact that
15such person retired prior to January 1, 1966. Such term also
16includes any person formerly employed by the University of
17Illinois in the Cooperative Extension Service who would be an
18annuitant but for the fact that such person was made ineligible
19to participate in the State Universities Retirement System by
20clause (4) of subsection (a) of Section 15-107 of the Illinois
21Pension Code.
22    (q) "Survivor" means a person receiving an annuity as a
23survivor of an employee or of an annuitant. "Survivor" also
24includes: (1) the surviving dependent of a person who satisfies
25the definition of "employee" except that such person is made
26ineligible to participate in the State Universities Retirement

 

 

SB2525 Enrolled- 11 -LRB096 16690 AMC 31974 b

1System by clause (4) of subsection (a) of Section 15-107 of the
2Illinois Pension Code; (2) the surviving dependent of any
3person formerly employed by the University of Illinois in the
4Cooperative Extension Service who would be an annuitant except
5for the fact that such person was made ineligible to
6participate in the State Universities Retirement System by
7clause (4) of subsection (a) of Section 15-107 of the Illinois
8Pension Code; and (3) the surviving dependent of a person who
9was an annuitant under this Act by virtue of receiving an
10alternative retirement cancellation payment under Section
1114-108.5 of the Illinois Pension Code.
12    (q-2) "SERS" means the State Employees' Retirement System
13of Illinois, created under Article 14 of the Illinois Pension
14Code.
15    (q-3) "SURS" means the State Universities Retirement
16System, created under Article 15 of the Illinois Pension Code.
17    (q-4) "TRS" means the Teachers' Retirement System of the
18State of Illinois, created under Article 16 of the Illinois
19Pension Code.
20    (q-5) "New SERS survivor" means a survivor, as defined in
21subsection (q), whose annuity is paid under Article 14 of the
22Illinois Pension Code and is based on the death of (i) an
23employee whose death occurs on or after January 1, 1998, or
24(ii) a new SERS annuitant as defined in subsection (b-5). "New
25SERS survivor" includes the surviving dependent of a person who
26was an annuitant under this Act by virtue of receiving an

 

 

SB2525 Enrolled- 12 -LRB096 16690 AMC 31974 b

1alternative retirement cancellation payment under Section
214-108.5 of the Illinois Pension Code.
3    (q-6) "New SURS survivor" means a survivor, as defined in
4subsection (q), whose annuity is paid under Article 15 of the
5Illinois Pension Code and is based on the death of (i) an
6employee whose death occurs on or after January 1, 1998, or
7(ii) a new SURS annuitant as defined in subsection (b-6).
8    (q-7) "New TRS State survivor" means a survivor, as defined
9in subsection (q), whose annuity is paid under Article 16 of
10the Illinois Pension Code and is based on the death of (i) an
11employee who is a teacher as defined in paragraph (2), (3), or
12(5) of Section 16-106 of that Code and whose death occurs on or
13after July 1, 1998, or (ii) a new TRS State annuitant as
14defined in subsection (b-7).
15    (r) "Medical services" means the services provided within
16the scope of their licenses by practitioners in all categories
17licensed under the Medical Practice Act of 1987.
18    (s) "Unit of local government" means any county,
19municipality, township, school district (including a
20combination of school districts under the Intergovernmental
21Cooperation Act), special district or other unit, designated as
22a unit of local government by law, which exercises limited
23governmental powers or powers in respect to limited
24governmental subjects, any not-for-profit association with a
25membership that primarily includes townships and township
26officials, that has duties that include provision of research

 

 

SB2525 Enrolled- 13 -LRB096 16690 AMC 31974 b

1service, dissemination of information, and other acts for the
2purpose of improving township government, and that is funded
3wholly or partly in accordance with Section 85-15 of the
4Township Code; any not-for-profit corporation or association,
5with a membership consisting primarily of municipalities, that
6operates its own utility system, and provides research,
7training, dissemination of information, or other acts to
8promote cooperation between and among municipalities that
9provide utility services and for the advancement of the goals
10and purposes of its membership; the Southern Illinois
11Collegiate Common Market, which is a consortium of higher
12education institutions in Southern Illinois; the Illinois
13Association of Park Districts; and any hospital provider that
14is owned by a county that has 100 or fewer hospital beds and
15has not already joined the program. "Qualified local
16government" means a unit of local government approved by the
17Director and participating in a program created under
18subsection (i) of Section 10 of this Act.
19    (t) "Qualified rehabilitation facility" means any
20not-for-profit organization that is accredited by the
21Commission on Accreditation of Rehabilitation Facilities or
22certified by the Department of Human Services (as successor to
23the Department of Mental Health and Developmental
24Disabilities) to provide services to persons with disabilities
25and which receives funds from the State of Illinois for
26providing those services, approved by the Director and

 

 

SB2525 Enrolled- 14 -LRB096 16690 AMC 31974 b

1participating in a program created under subsection (j) of
2Section 10 of this Act.
3    (u) "Qualified domestic violence shelter or service" means
4any Illinois domestic violence shelter or service and its
5administrative offices funded by the Department of Human
6Services (as successor to the Illinois Department of Public
7Aid), approved by the Director and participating in a program
8created under subsection (k) of Section 10.
9    (v) "TRS benefit recipient" means a person who:
10        (1) is not a "member" as defined in this Section; and
11        (2) is receiving a monthly benefit or retirement
12    annuity under Article 16 of the Illinois Pension Code; and
13        (3) either (i) has at least 8 years of creditable
14    service under Article 16 of the Illinois Pension Code, or
15    (ii) was enrolled in the health insurance program offered
16    under that Article on January 1, 1996, or (iii) is the
17    survivor of a benefit recipient who had at least 8 years of
18    creditable service under Article 16 of the Illinois Pension
19    Code or was enrolled in the health insurance program
20    offered under that Article on the effective date of this
21    amendatory Act of 1995, or (iv) is a recipient or survivor
22    of a recipient of a disability benefit under Article 16 of
23    the Illinois Pension Code.
24    (w) "TRS dependent beneficiary" means a person who:
25        (1) is not a "member" or "dependent" as defined in this
26    Section; and

 

 

SB2525 Enrolled- 15 -LRB096 16690 AMC 31974 b

1        (2) is a TRS benefit recipient's: (A) spouse, (B)
2    dependent parent who is receiving at least half of his or
3    her support from the TRS benefit recipient, or (C)
4    unmarried natural, step, adjudicated, or adopted child who
5    is (i) under age 26 19, or (ii) enrolled as a full-time
6    student in an accredited school, financially dependent
7    upon the TRS benefit recipient, eligible to be claimed as a
8    dependent for income tax purposes, and either is under age
9    24 or was, on January 1, 1996, participating as a dependent
10    beneficiary in the health insurance program offered under
11    Article 16 of the Illinois Pension Code, or (iii) age 19 or
12    over who is mentally or physically disabled from a cause
13    originating prior to the age of 19 (age 26 if enrolled as
14    an adult child) handicapped.
15    (x) "Military leave with pay and benefits" refers to
16individuals in basic training for reserves, special/advanced
17training, annual training, emergency call up, or activation by
18the President of the United States, or any other training or
19duty in service to the United States Armed Forces with
20approved pay and benefits.
21    (y) (Blank). "Military leave without pay and benefits"
22refers to individuals who enlist for active duty in a regular
23component of the U.S. Armed Forces or other duty not specified
24or authorized under military leave with pay and benefits.
25    (z) "Community college benefit recipient" means a person
26who:

 

 

SB2525 Enrolled- 16 -LRB096 16690 AMC 31974 b

1        (1) is not a "member" as defined in this Section; and
2        (2) is receiving a monthly survivor's annuity or
3    retirement annuity under Article 15 of the Illinois Pension
4    Code; and
5        (3) either (i) was a full-time employee of a community
6    college district or an association of community college
7    boards created under the Public Community College Act
8    (other than an employee whose last employer under Article
9    15 of the Illinois Pension Code was a community college
10    district subject to Article VII of the Public Community
11    College Act) and was eligible to participate in a group
12    health benefit plan as an employee during the time of
13    employment with a community college district (other than a
14    community college district subject to Article VII of the
15    Public Community College Act) or an association of
16    community college boards, or (ii) is the survivor of a
17    person described in item (i).
18    (aa) "Community college dependent beneficiary" means a
19person who:
20        (1) is not a "member" or "dependent" as defined in this
21    Section; and
22        (2) is a community college benefit recipient's: (A)
23    spouse, (B) dependent parent who is receiving at least half
24    of his or her support from the community college benefit
25    recipient, or (C) unmarried natural, step, adjudicated, or
26    adopted child who is (i) under age 26 19, or (ii) enrolled

 

 

SB2525 Enrolled- 17 -LRB096 16690 AMC 31974 b

1    as a full-time student in an accredited school, financially
2    dependent upon the community college benefit recipient,
3    eligible to be claimed as a dependent for income tax
4    purposes and under age 23, or (iii) age 19 or over and
5    mentally or physically disabled from a cause originating
6    prior to the age of 19 (age 26 if enrolled as an adult
7    child) handicapped.
8    (bb) "Qualified child advocacy center" means any Illinois
9child advocacy center and its administrative offices funded by
10the Department of Children and Family Services, as defined by
11the Children's Advocacy Center Act (55 ILCS 80/), approved by
12the Director and participating in a program created under
13subsection (n) of Section 10.
14(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
1596-756, eff. 1-1-10.)
 
16    (5 ILCS 375/6.5)
17    Sec. 6.5. Health benefits for TRS benefit recipients and
18TRS dependent beneficiaries.
19    (a) Purpose. It is the purpose of this amendatory Act of
201995 to transfer the administration of the program of health
21benefits established for benefit recipients and their
22dependent beneficiaries under Article 16 of the Illinois
23Pension Code to the Department of Central Management Services.
24    (b) Transition provisions. The Board of Trustees of the
25Teachers' Retirement System shall continue to administer the

 

 

SB2525 Enrolled- 18 -LRB096 16690 AMC 31974 b

1health benefit program established under Article 16 of the
2Illinois Pension Code through December 31, 1995. Beginning
3January 1, 1996, the Department of Central Management Services
4shall be responsible for administering a program of health
5benefits for TRS benefit recipients and TRS dependent
6beneficiaries under this Section. The Department of Central
7Management Services and the Teachers' Retirement System shall
8cooperate in this endeavor and shall coordinate their
9activities so as to ensure a smooth transition and
10uninterrupted health benefit coverage.
11    (c) Eligibility. All persons who were enrolled in the
12Article 16 program at the time of the transfer shall be
13eligible to participate in the program established under this
14Section without any interruption or delay in coverage or
15limitation as to pre-existing medical conditions. Eligibility
16to participate shall be determined by the Teachers' Retirement
17System. Eligibility information shall be communicated to the
18Department of Central Management Services in a format
19acceptable to the Department.
20    A TRS dependent beneficiary who is a an unmarried child age
2119 or over and mentally or physically disabled does not become
22ineligible to participate by reason of (i) becoming ineligible
23to be claimed as a dependent for Illinois or federal income tax
24purposes or (ii) receiving earned income, so long as those
25earnings are insufficient for the child to be fully
26self-sufficient.

 

 

SB2525 Enrolled- 19 -LRB096 16690 AMC 31974 b

1    (d) Coverage. The level of health benefits provided under
2this Section shall be similar to the level of benefits provided
3by the program previously established under Article 16 of the
4Illinois Pension Code.
5    Group life insurance benefits are not included in the
6benefits to be provided to TRS benefit recipients and TRS
7dependent beneficiaries under this Act.
8    The program of health benefits under this Section may
9include any or all of the benefit limitations, including but
10not limited to a reduction in benefits based on eligibility for
11federal medicare benefits, that are provided under subsection
12(a) of Section 6 of this Act for other health benefit programs
13under this Act.
14    (e) Insurance rates and premiums. The Director shall
15determine the insurance rates and premiums for TRS benefit
16recipients and TRS dependent beneficiaries, and shall present
17to the Teachers' Retirement System of the State of Illinois, by
18April 15 of each calendar year, the rate-setting methodology
19(including but not limited to utilization levels and costs)
20used to determine the amount of the health care premiums.
21        For Fiscal Year 1996, the premium shall be equal to the
22    premium actually charged in Fiscal Year 1995; in subsequent
23    years, the premium shall never be lower than the premium
24    charged in Fiscal Year 1995.
25        For Fiscal Year 2003, the premium shall not exceed 110%
26    of the premium actually charged in Fiscal Year 2002.

 

 

SB2525 Enrolled- 20 -LRB096 16690 AMC 31974 b

1        For Fiscal Year 2004, the premium shall not exceed 112%
2    of the premium actually charged in Fiscal Year 2003.
3        For Fiscal Year 2005, the premium shall not exceed a
4    weighted average of 106.6% of the premium actually charged
5    in Fiscal Year 2004.
6        For Fiscal Year 2006, the premium shall not exceed a
7    weighted average of 109.1% of the premium actually charged
8    in Fiscal Year 2005.
9        For Fiscal Year 2007, the premium shall not exceed a
10    weighted average of 103.9% of the premium actually charged
11    in Fiscal Year 2006.
12        For Fiscal Year 2008 and thereafter, the premium in
13    each fiscal year shall not exceed 105% of the premium
14    actually charged in the previous fiscal year.
15    Rates and premiums may be based in part on age and
16eligibility for federal medicare coverage. However, the cost of
17participation for a TRS dependent beneficiary who is an
18unmarried child age 19 or over and mentally or physically
19disabled shall not exceed the cost for a TRS dependent
20beneficiary who is an unmarried child under age 19 and
21participates in the same major medical or managed care program.
22    The cost of health benefits under the program shall be paid
23as follows:
24        (1) For a TRS benefit recipient selecting a managed
25    care program, up to 75% of the total insurance rate shall
26    be paid from the Teacher Health Insurance Security Fund.

 

 

SB2525 Enrolled- 21 -LRB096 16690 AMC 31974 b

1    Effective with Fiscal Year 2007 and thereafter, for a TRS
2    benefit recipient selecting a managed care program, 75% of
3    the total insurance rate shall be paid from the Teacher
4    Health Insurance Security Fund.
5        (2) For a TRS benefit recipient selecting the major
6    medical coverage program, up to 50% of the total insurance
7    rate shall be paid from the Teacher Health Insurance
8    Security Fund if a managed care program is accessible, as
9    determined by the Teachers' Retirement System. Effective
10    with Fiscal Year 2007 and thereafter, for a TRS benefit
11    recipient selecting the major medical coverage program,
12    50% of the total insurance rate shall be paid from the
13    Teacher Health Insurance Security Fund if a managed care
14    program is accessible, as determined by the Department of
15    Central Management Services.
16        (3) For a TRS benefit recipient selecting the major
17    medical coverage program, up to 75% of the total insurance
18    rate shall be paid from the Teacher Health Insurance
19    Security Fund if a managed care program is not accessible,
20    as determined by the Teachers' Retirement System.
21    Effective with Fiscal Year 2007 and thereafter, for a TRS
22    benefit recipient selecting the major medical coverage
23    program, 75% of the total insurance rate shall be paid from
24    the Teacher Health Insurance Security Fund if a managed
25    care program is not accessible, as determined by the
26    Department of Central Management Services.

 

 

SB2525 Enrolled- 22 -LRB096 16690 AMC 31974 b

1        (3.1) For a TRS dependent beneficiary who is Medicare
2    primary and enrolled in a managed care plan, or the major
3    medical coverage program if a managed care plan is not
4    available, 25% of the total insurance rate shall be paid
5    from the Teacher Health Security Fund as determined by the
6    Department of Central Management Services. For the purpose
7    of this item (3.1), the term "TRS dependent beneficiary who
8    is Medicare primary" means a TRS dependent beneficiary who
9    is participating in Medicare Parts A and B.
10        (4) Except as otherwise provided in item (3.1), the
11    balance of the rate of insurance, including the entire
12    premium of any coverage for TRS dependent beneficiaries
13    that has been elected, shall be paid by deductions
14    authorized by the TRS benefit recipient to be withheld from
15    his or her monthly annuity or benefit payment from the
16    Teachers' Retirement System; except that (i) if the balance
17    of the cost of coverage exceeds the amount of the monthly
18    annuity or benefit payment, the difference shall be paid
19    directly to the Teachers' Retirement System by the TRS
20    benefit recipient, and (ii) all or part of the balance of
21    the cost of coverage may, at the school board's option, be
22    paid to the Teachers' Retirement System by the school board
23    of the school district from which the TRS benefit recipient
24    retired, in accordance with Section 10-22.3b of the School
25    Code. The Teachers' Retirement System shall promptly
26    deposit all moneys withheld by or paid to it under this

 

 

SB2525 Enrolled- 23 -LRB096 16690 AMC 31974 b

1    subdivision (e)(4) into the Teacher Health Insurance
2    Security Fund. These moneys shall not be considered assets
3    of the Retirement System.
4    (f) Financing. Beginning July 1, 1995, all revenues arising
5from the administration of the health benefit programs
6established under Article 16 of the Illinois Pension Code or
7this Section shall be deposited into the Teacher Health
8Insurance Security Fund, which is hereby created as a
9nonappropriated trust fund to be held outside the State
10Treasury, with the State Treasurer as custodian. Any interest
11earned on moneys in the Teacher Health Insurance Security Fund
12shall be deposited into the Fund.
13    Moneys in the Teacher Health Insurance Security Fund shall
14be used only to pay the costs of the health benefit program
15established under this Section, including associated
16administrative costs, and the costs associated with the health
17benefit program established under Article 16 of the Illinois
18Pension Code, as authorized in this Section. Beginning July 1,
191995, the Department of Central Management Services may make
20expenditures from the Teacher Health Insurance Security Fund
21for those costs.
22    After other funds authorized for the payment of the costs
23of the health benefit program established under Article 16 of
24the Illinois Pension Code are exhausted and until January 1,
251996 (or such later date as may be agreed upon by the Director
26of Central Management Services and the Secretary of the

 

 

SB2525 Enrolled- 24 -LRB096 16690 AMC 31974 b

1Teachers' Retirement System), the Secretary of the Teachers'
2Retirement System may make expenditures from the Teacher Health
3Insurance Security Fund as necessary to pay up to 75% of the
4cost of providing health coverage to eligible benefit
5recipients (as defined in Sections 16-153.1 and 16-153.3 of the
6Illinois Pension Code) who are enrolled in the Article 16
7health benefit program and to facilitate the transfer of
8administration of the health benefit program to the Department
9of Central Management Services.
10    The Department of Healthcare and Family Services, or any
11successor agency designated to procure healthcare contracts
12pursuant to this Act, is authorized to establish funds,
13separate accounts provided by any bank or banks as defined by
14the Illinois Banking Act, or separate accounts provided by any
15savings and loan association or associations as defined by the
16Illinois Savings and Loan Act of 1985 to be held by the
17Director, outside the State treasury, for the purpose of
18receiving the transfer of moneys from the Teacher Health
19Insurance Security Fund. The Department may promulgate rules
20further defining the methodology for the transfers. Any
21interest earned by moneys in the funds or accounts shall inure
22to the Teacher Health Insurance Security Fund. The transferred
23moneys, and interest accrued thereon, shall be used exclusively
24for transfers to administrative service organizations or their
25financial institutions for payments of claims to claimants and
26providers under the self-insurance health plan. The

 

 

SB2525 Enrolled- 25 -LRB096 16690 AMC 31974 b

1transferred moneys, and interest accrued thereon, shall not be
2used for any other purpose including, but not limited to,
3reimbursement of administration fees due the administrative
4service organization pursuant to its contract or contracts with
5the Department.
6    (g) Contract for benefits. The Director shall by contract,
7self-insurance, or otherwise make available the program of
8health benefits for TRS benefit recipients and their TRS
9dependent beneficiaries that is provided for in this Section.
10The contract or other arrangement for the provision of these
11health benefits shall be on terms deemed by the Director to be
12in the best interest of the State of Illinois and the TRS
13benefit recipients based on, but not limited to, such criteria
14as administrative cost, service capabilities of the carrier or
15other contractor, and the costs of the benefits.
16    (g-5) Committee. A Teacher Retirement Insurance Program
17Committee shall be established, to consist of 10 persons
18appointed by the Governor.
19    The Committee shall convene at least 4 times each year, and
20shall consider and make recommendations on issues affecting the
21program of health benefits provided under this Section.
22Recommendations of the Committee shall be based on a consensus
23of the members of the Committee.
24    If the Teacher Health Insurance Security Fund experiences a
25deficit balance based upon the contribution and subsidy rates
26established in this Section and Section 6.6 for Fiscal Year

 

 

SB2525 Enrolled- 26 -LRB096 16690 AMC 31974 b

12008 or thereafter, the Committee shall make recommendations
2for adjustments to the funding sources established under these
3Sections.
4    (h) Continuation of program. It is the intention of the
5General Assembly that the program of health benefits provided
6under this Section be maintained on an ongoing, affordable
7basis.
8    The program of health benefits provided under this Section
9may be amended by the State and is not intended to be a pension
10or retirement benefit subject to protection under Article XIII,
11Section 5 of the Illinois Constitution.
12    (i) Repeal. (Blank).
13(Source: P.A. 95-632, eff. 9-25-07.)
 
14    (5 ILCS 375/10)  (from Ch. 127, par. 530)
15    Sec. 10. Payments by State; premiums.
16    (a) The State shall pay the cost of basic non-contributory
17group life insurance and, subject to member paid contributions
18set by the Department or required by this Section, the basic
19program of group health benefits on each eligible member,
20except a member, not otherwise covered by this Act, who has
21retired as a participating member under Article 2 of the
22Illinois Pension Code but is ineligible for the retirement
23annuity under Section 2-119 of the Illinois Pension Code, and
24part of each eligible member's and retired member's premiums
25for health insurance coverage for enrolled dependents as

 

 

SB2525 Enrolled- 27 -LRB096 16690 AMC 31974 b

1provided by Section 9. The State shall pay the cost of the
2basic program of group health benefits only after benefits are
3reduced by the amount of benefits covered by Medicare for all
4members and dependents who are eligible for benefits under
5Social Security or the Railroad Retirement system or who had
6sufficient Medicare-covered government employment, except that
7such reduction in benefits shall apply only to those members
8and dependents who (1) first become eligible for such Medicare
9coverage on or after July 1, 1992; or (2) are Medicare-eligible
10members or dependents of a local government unit which began
11participation in the program on or after July 1, 1992; or (3)
12remain eligible for, but no longer receive Medicare coverage
13which they had been receiving on or after July 1, 1992. The
14Department may determine the aggregate level of the State's
15contribution on the basis of actual cost of medical services
16adjusted for age, sex or geographic or other demographic
17characteristics which affect the costs of such programs.
18    The cost of participation in the basic program of group
19health benefits for the dependent or survivor of a living or
20deceased retired employee who was formerly employed by the
21University of Illinois in the Cooperative Extension Service and
22would be an annuitant but for the fact that he or she was made
23ineligible to participate in the State Universities Retirement
24System by clause (4) of subsection (a) of Section 15-107 of the
25Illinois Pension Code shall not be greater than the cost of
26participation that would otherwise apply to that dependent or

 

 

SB2525 Enrolled- 28 -LRB096 16690 AMC 31974 b

1survivor if he or she were the dependent or survivor of an
2annuitant under the State Universities Retirement System.
3    (a-1) Beginning January 1, 1998, for each person who
4becomes a new SERS annuitant and participates in the basic
5program of group health benefits, the State shall contribute
6toward the cost of the annuitant's coverage under the basic
7program of group health benefits an amount equal to 5% of that
8cost for each full year of creditable service upon which the
9annuitant's retirement annuity is based, up to a maximum of
10100% for an annuitant with 20 or more years of creditable
11service. The remainder of the cost of a new SERS annuitant's
12coverage under the basic program of group health benefits shall
13be the responsibility of the annuitant. In the case of a new
14SERS annuitant who has elected to receive an alternative
15retirement cancellation payment under Section 14-108.5 of the
16Illinois Pension Code in lieu of an annuity, for the purposes
17of this subsection the annuitant shall be deemed to be
18receiving a retirement annuity based on the number of years of
19creditable service that the annuitant had established at the
20time of his or her termination of service under SERS.
21    (a-2) Beginning January 1, 1998, for each person who
22becomes a new SERS survivor and participates in the basic
23program of group health benefits, the State shall contribute
24toward the cost of the survivor's coverage under the basic
25program of group health benefits an amount equal to 5% of that
26cost for each full year of the deceased employee's or deceased

 

 

SB2525 Enrolled- 29 -LRB096 16690 AMC 31974 b

1annuitant's creditable service in the State Employees'
2Retirement System of Illinois on the date of death, up to a
3maximum of 100% for a survivor of an employee or annuitant with
420 or more years of creditable service. The remainder of the
5cost of the new SERS survivor's coverage under the basic
6program of group health benefits shall be the responsibility of
7the survivor. In the case of a new SERS survivor who was the
8dependent of an annuitant who elected to receive an alternative
9retirement cancellation payment under Section 14-108.5 of the
10Illinois Pension Code in lieu of an annuity, for the purposes
11of this subsection the deceased annuitant's creditable service
12shall be determined as of the date of termination of service
13rather than the date of death.
14    (a-3) Beginning January 1, 1998, for each person who
15becomes a new SURS annuitant and participates in the basic
16program of group health benefits, the State shall contribute
17toward the cost of the annuitant's coverage under the basic
18program of group health benefits an amount equal to 5% of that
19cost for each full year of creditable service upon which the
20annuitant's retirement annuity is based, up to a maximum of
21100% for an annuitant with 20 or more years of creditable
22service. The remainder of the cost of a new SURS annuitant's
23coverage under the basic program of group health benefits shall
24be the responsibility of the annuitant.
25    (a-4) (Blank).
26    (a-5) Beginning January 1, 1998, for each person who

 

 

SB2525 Enrolled- 30 -LRB096 16690 AMC 31974 b

1becomes a new SURS survivor and participates in the basic
2program of group health benefits, the State shall contribute
3toward the cost of the survivor's coverage under the basic
4program of group health benefits an amount equal to 5% of that
5cost for each full year of the deceased employee's or deceased
6annuitant's creditable service in the State Universities
7Retirement System on the date of death, up to a maximum of 100%
8for a survivor of an employee or annuitant with 20 or more
9years of creditable service. The remainder of the cost of the
10new SURS survivor's coverage under the basic program of group
11health benefits shall be the responsibility of the survivor.
12    (a-6) Beginning July 1, 1998, for each person who becomes a
13new TRS State annuitant and participates in the basic program
14of group health benefits, the State shall contribute toward the
15cost of the annuitant's coverage under the basic program of
16group health benefits an amount equal to 5% of that cost for
17each full year of creditable service as a teacher as defined in
18paragraph (2), (3), or (5) of Section 16-106 of the Illinois
19Pension Code upon which the annuitant's retirement annuity is
20based, up to a maximum of 100%; except that the State
21contribution shall be 12.5% per year (rather than 5%) for each
22full year of creditable service as a regional superintendent or
23assistant regional superintendent of schools. The remainder of
24the cost of a new TRS State annuitant's coverage under the
25basic program of group health benefits shall be the
26responsibility of the annuitant.

 

 

SB2525 Enrolled- 31 -LRB096 16690 AMC 31974 b

1    (a-7) Beginning July 1, 1998, for each person who becomes a
2new TRS State survivor and participates in the basic program of
3group health benefits, the State shall contribute toward the
4cost of the survivor's coverage under the basic program of
5group health benefits an amount equal to 5% of that cost for
6each full year of the deceased employee's or deceased
7annuitant's creditable service as a teacher as defined in
8paragraph (2), (3), or (5) of Section 16-106 of the Illinois
9Pension Code on the date of death, up to a maximum of 100%;
10except that the State contribution shall be 12.5% per year
11(rather than 5%) for each full year of the deceased employee's
12or deceased annuitant's creditable service as a regional
13superintendent or assistant regional superintendent of
14schools. The remainder of the cost of the new TRS State
15survivor's coverage under the basic program of group health
16benefits shall be the responsibility of the survivor.
17    (a-8) A new SERS annuitant, new SERS survivor, new SURS
18annuitant, new SURS survivor, new TRS State annuitant, or new
19TRS State survivor may waive or terminate coverage in the
20program of group health benefits. Any such annuitant or
21survivor who has waived or terminated coverage may enroll or
22re-enroll in the program of group health benefits only during
23the annual benefit choice period, as determined by the
24Director; except that in the event of termination of coverage
25due to nonpayment of premiums, the annuitant or survivor may
26not re-enroll in the program.

 

 

SB2525 Enrolled- 32 -LRB096 16690 AMC 31974 b

1    (a-9) No later than May 1 of each calendar year, the
2Director of Central Management Services shall certify in
3writing to the Executive Secretary of the State Employees'
4Retirement System of Illinois the amounts of the Medicare
5supplement health care premiums and the amounts of the health
6care premiums for all other retirees who are not Medicare
7eligible.
8    A separate calculation of the premiums based upon the
9actual cost of each health care plan shall be so certified.
10    The Director of Central Management Services shall provide
11to the Executive Secretary of the State Employees' Retirement
12System of Illinois such information, statistics, and other data
13as he or she may require to review the premium amounts
14certified by the Director of Central Management Services.
15    The Department of Healthcare and Family Services, or any
16successor agency designated to procure healthcare contracts
17pursuant to this Act, is authorized to establish funds,
18separate accounts provided by any bank or banks as defined by
19the Illinois Banking Act, or separate accounts provided by any
20savings and loan association or associations as defined by the
21Illinois Savings and Loan Act of 1985 to be held by the
22Director, outside the State treasury, for the purpose of
23receiving the transfer of moneys from the Local Government
24Health Insurance Reserve Fund. The Department may promulgate
25rules further defining the methodology for the transfers. Any
26interest earned by moneys in the funds or accounts shall inure

 

 

SB2525 Enrolled- 33 -LRB096 16690 AMC 31974 b

1to the Local Government Health Insurance Reserve Fund. The
2transferred moneys, and interest accrued thereon, shall be used
3exclusively for transfers to administrative service
4organizations or their financial institutions for payments of
5claims to claimants and providers under the self-insurance
6health plan. The transferred moneys, and interest accrued
7thereon, shall not be used for any other purpose including, but
8not limited to, reimbursement of administration fees due the
9administrative service organization pursuant to its contract
10or contracts with the Department.
11    (b) State employees who become eligible for this program on
12or after January 1, 1980 in positions normally requiring actual
13performance of duty not less than 1/2 of a normal work period
14but not equal to that of a normal work period, shall be given
15the option of participating in the available program. If the
16employee elects coverage, the State shall contribute on behalf
17of such employee to the cost of the employee's benefit and any
18applicable dependent supplement, that sum which bears the same
19percentage as that percentage of time the employee regularly
20works when compared to normal work period.
21    (c) The basic non-contributory coverage from the basic
22program of group health benefits shall be continued for each
23employee not in pay status or on active service by reason of
24(1) leave of absence due to illness or injury, (2) authorized
25educational leave of absence or sabbatical leave, or (3)
26military leave with pay and benefits. This coverage shall

 

 

SB2525 Enrolled- 34 -LRB096 16690 AMC 31974 b

1continue until expiration of authorized leave and return to
2active service, but not to exceed 24 months for leaves under
3item (1) or (2). This 24-month limitation and the requirement
4of returning to active service shall not apply to persons
5receiving ordinary or accidental disability benefits or
6retirement benefits through the appropriate State retirement
7system or benefits under the Workers' Compensation or
8Occupational Disease Act.
9    (d) The basic group life insurance coverage shall continue,
10with full State contribution, where such person is (1) absent
11from active service by reason of disability arising from any
12cause other than self-inflicted, (2) on authorized educational
13leave of absence or sabbatical leave, or (3) on military leave
14with pay and benefits.
15    (e) Where the person is in non-pay status for a period in
16excess of 30 days or on leave of absence, other than by reason
17of disability, educational or sabbatical leave, or military
18leave with pay and benefits, such person may continue coverage
19only by making personal payment equal to the amount normally
20contributed by the State on such person's behalf. Such payments
21and coverage may be continued: (1) until such time as the
22person returns to a status eligible for coverage at State
23expense, but not to exceed 24 months or , (2) until such
24person's employment or annuitant status with the State is
25terminated, or (3) for a maximum period of 4 years for members
26on military leave with pay and benefits and military leave

 

 

SB2525 Enrolled- 35 -LRB096 16690 AMC 31974 b

1without pay and benefits (exclusive of any additional service
2imposed pursuant to law).
3    (f) The Department shall establish by rule the extent to
4which other employee benefits will continue for persons in
5non-pay status or who are not in active service.
6    (g) The State shall not pay the cost of the basic
7non-contributory group life insurance, program of health
8benefits and other employee benefits for members who are
9survivors as defined by paragraphs (1) and (2) of subsection
10(q) of Section 3 of this Act. The costs of benefits for these
11survivors shall be paid by the survivors or by the University
12of Illinois Cooperative Extension Service, or any combination
13thereof. However, the State shall pay the amount of the
14reduction in the cost of participation, if any, resulting from
15the amendment to subsection (a) made by this amendatory Act of
16the 91st General Assembly.
17    (h) Those persons occupying positions with any department
18as a result of emergency appointments pursuant to Section 8b.8
19of the Personnel Code who are not considered employees under
20this Act shall be given the option of participating in the
21programs of group life insurance, health benefits and other
22employee benefits. Such persons electing coverage may
23participate only by making payment equal to the amount normally
24contributed by the State for similarly situated employees. Such
25amounts shall be determined by the Director. Such payments and
26coverage may be continued until such time as the person becomes

 

 

SB2525 Enrolled- 36 -LRB096 16690 AMC 31974 b

1an employee pursuant to this Act or such person's appointment
2is terminated.
3    (i) Any unit of local government within the State of
4Illinois may apply to the Director to have its employees,
5annuitants, and their dependents provided group health
6coverage under this Act on a non-insured basis. To participate,
7a unit of local government must agree to enroll all of its
8employees, who may select coverage under either the State group
9health benefits plan or a health maintenance organization that
10has contracted with the State to be available as a health care
11provider for employees as defined in this Act. A unit of local
12government must remit the entire cost of providing coverage
13under the State group health benefits plan or, for coverage
14under a health maintenance organization, an amount determined
15by the Director based on an analysis of the sex, age,
16geographic location, or other relevant demographic variables
17for its employees, except that the unit of local government
18shall not be required to enroll those of its employees who are
19covered spouses or dependents under this plan or another group
20policy or plan providing health benefits as long as (1) an
21appropriate official from the unit of local government attests
22that each employee not enrolled is a covered spouse or
23dependent under this plan or another group policy or plan, and
24(2) at least 50% of the employees are enrolled and the unit of
25local government remits the entire cost of providing coverage
26to those employees, except that a participating school district

 

 

SB2525 Enrolled- 37 -LRB096 16690 AMC 31974 b

1must have enrolled at least 50% of its full-time employees who
2have not waived coverage under the district's group health plan
3by participating in a component of the district's cafeteria
4plan. A participating school district is not required to enroll
5a full-time employee who has waived coverage under the
6district's health plan, provided that an appropriate official
7from the participating school district attests that the
8full-time employee has waived coverage by participating in a
9component of the district's cafeteria plan. For the purposes of
10this subsection, "participating school district" includes a
11unit of local government whose primary purpose is education as
12defined by the Department's rules.
13    Employees of a participating unit of local government who
14are not enrolled due to coverage under another group health
15policy or plan may enroll in the event of a qualifying change
16in status, special enrollment, special circumstance as defined
17by the Director, or during the annual Benefit Choice Period. A
18participating unit of local government may also elect to cover
19its annuitants. Dependent coverage shall be offered on an
20optional basis, with the costs paid by the unit of local
21government, its employees, or some combination of the two as
22determined by the unit of local government. The unit of local
23government shall be responsible for timely collection and
24transmission of dependent premiums.
25    The Director shall annually determine monthly rates of
26payment, subject to the following constraints:

 

 

SB2525 Enrolled- 38 -LRB096 16690 AMC 31974 b

1        (1) In the first year of coverage, the rates shall be
2    equal to the amount normally charged to State employees for
3    elected optional coverages or for enrolled dependents
4    coverages or other contributory coverages, or contributed
5    by the State for basic insurance coverages on behalf of its
6    employees, adjusted for differences between State
7    employees and employees of the local government in age,
8    sex, geographic location or other relevant demographic
9    variables, plus an amount sufficient to pay for the
10    additional administrative costs of providing coverage to
11    employees of the unit of local government and their
12    dependents.
13        (2) In subsequent years, a further adjustment shall be
14    made to reflect the actual prior years' claims experience
15    of the employees of the unit of local government.
16    In the case of coverage of local government employees under
17a health maintenance organization, the Director shall annually
18determine for each participating unit of local government the
19maximum monthly amount the unit may contribute toward that
20coverage, based on an analysis of (i) the age, sex, geographic
21location, and other relevant demographic variables of the
22unit's employees and (ii) the cost to cover those employees
23under the State group health benefits plan. The Director may
24similarly determine the maximum monthly amount each unit of
25local government may contribute toward coverage of its
26employees' dependents under a health maintenance organization.

 

 

SB2525 Enrolled- 39 -LRB096 16690 AMC 31974 b

1    Monthly payments by the unit of local government or its
2employees for group health benefits plan or health maintenance
3organization coverage shall be deposited in the Local
4Government Health Insurance Reserve Fund.
5    The Local Government Health Insurance Reserve Fund is
6hereby created as a nonappropriated trust fund to be held
7outside the State Treasury, with the State Treasurer as
8custodian. The Local Government Health Insurance Reserve Fund
9shall be a continuing fund not subject to fiscal year
10limitations. The Local Government Health Insurance Reserve
11Fund is not subject to administrative charges or charge-backs,
12including but not limited to those authorized under Section 8h
13of the State Finance Act. All revenues arising from the
14administration of the health benefits program established
15under this Section shall be deposited into the Local Government
16Health Insurance Reserve Fund. Any interest earned on moneys in
17the Local Government Health Insurance Reserve Fund shall be
18deposited into the Fund. All expenditures from this Fund shall
19be used for payments for health care benefits for local
20government and rehabilitation facility employees, annuitants,
21and dependents, and to reimburse the Department or its
22administrative service organization for all expenses incurred
23in the administration of benefits. No other State funds may be
24used for these purposes.
25    A local government employer's participation or desire to
26participate in a program created under this subsection shall

 

 

SB2525 Enrolled- 40 -LRB096 16690 AMC 31974 b

1not limit that employer's duty to bargain with the
2representative of any collective bargaining unit of its
3employees.
4    (j) Any rehabilitation facility within the State of
5Illinois may apply to the Director to have its employees,
6annuitants, and their eligible dependents provided group
7health coverage under this Act on a non-insured basis. To
8participate, a rehabilitation facility must agree to enroll all
9of its employees and remit the entire cost of providing such
10coverage for its employees, except that the rehabilitation
11facility shall not be required to enroll those of its employees
12who are covered spouses or dependents under this plan or
13another group policy or plan providing health benefits as long
14as (1) an appropriate official from the rehabilitation facility
15attests that each employee not enrolled is a covered spouse or
16dependent under this plan or another group policy or plan, and
17(2) at least 50% of the employees are enrolled and the
18rehabilitation facility remits the entire cost of providing
19coverage to those employees. Employees of a participating
20rehabilitation facility who are not enrolled due to coverage
21under another group health policy or plan may enroll in the
22event of a qualifying change in status, special enrollment,
23special circumstance as defined by the Director, or during the
24annual Benefit Choice Period. A participating rehabilitation
25facility may also elect to cover its annuitants. Dependent
26coverage shall be offered on an optional basis, with the costs

 

 

SB2525 Enrolled- 41 -LRB096 16690 AMC 31974 b

1paid by the rehabilitation facility, its employees, or some
2combination of the 2 as determined by the rehabilitation
3facility. The rehabilitation facility shall be responsible for
4timely collection and transmission of dependent premiums.
5    The Director shall annually determine quarterly rates of
6payment, subject to the following constraints:
7        (1) In the first year of coverage, the rates shall be
8    equal to the amount normally charged to State employees for
9    elected optional coverages or for enrolled dependents
10    coverages or other contributory coverages on behalf of its
11    employees, adjusted for differences between State
12    employees and employees of the rehabilitation facility in
13    age, sex, geographic location or other relevant
14    demographic variables, plus an amount sufficient to pay for
15    the additional administrative costs of providing coverage
16    to employees of the rehabilitation facility and their
17    dependents.
18        (2) In subsequent years, a further adjustment shall be
19    made to reflect the actual prior years' claims experience
20    of the employees of the rehabilitation facility.
21    Monthly payments by the rehabilitation facility or its
22employees for group health benefits shall be deposited in the
23Local Government Health Insurance Reserve Fund.
24    (k) Any domestic violence shelter or service within the
25State of Illinois may apply to the Director to have its
26employees, annuitants, and their dependents provided group

 

 

SB2525 Enrolled- 42 -LRB096 16690 AMC 31974 b

1health coverage under this Act on a non-insured basis. To
2participate, a domestic violence shelter or service must agree
3to enroll all of its employees and pay the entire cost of
4providing such coverage for its employees. The domestic
5violence shelter shall not be required to enroll those of its
6employees who are covered spouses or dependents under this plan
7or another group policy or plan providing health benefits as
8long as (1) an appropriate official from the domestic violence
9shelter attests that each employee not enrolled is a covered
10spouse or dependent under this plan or another group policy or
11plan and (2) at least 50% of the employees are enrolled and the
12domestic violence shelter remits the entire cost of providing
13coverage to those employees. Employees of a participating
14domestic violence shelter who are not enrolled due to coverage
15under another group health policy or plan may enroll in the
16event of a qualifying change in status, special enrollment, or
17special circumstance as defined by the Director or during the
18annual Benefit Choice Period. A participating domestic
19violence shelter may also elect to cover its annuitants.
20Dependent coverage shall be offered on an optional basis, with
21employees, or some combination of the 2 as determined by the
22domestic violence shelter or service. The domestic violence
23shelter or service shall be responsible for timely collection
24and transmission of dependent premiums.
25    The Director shall annually determine rates of payment,
26subject to the following constraints:

 

 

SB2525 Enrolled- 43 -LRB096 16690 AMC 31974 b

1        (1) In the first year of coverage, the rates shall be
2    equal to the amount normally charged to State employees for
3    elected optional coverages or for enrolled dependents
4    coverages or other contributory coverages on behalf of its
5    employees, adjusted for differences between State
6    employees and employees of the domestic violence shelter or
7    service in age, sex, geographic location or other relevant
8    demographic variables, plus an amount sufficient to pay for
9    the additional administrative costs of providing coverage
10    to employees of the domestic violence shelter or service
11    and their 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 domestic violence shelter or
15    service.
16    Monthly payments by the domestic violence shelter or
17service or its employees for group health insurance shall be
18deposited in the Local Government Health Insurance Reserve
19Fund.
20    (l) A public community college or entity organized pursuant
21to the Public Community College Act may apply to the Director
22initially to have only annuitants not covered prior to July 1,
231992 by the district's health plan provided health coverage
24under this Act on a non-insured basis. The community college
25must execute a 2-year contract to participate in the Local
26Government Health Plan. Any annuitant may enroll in the event

 

 

SB2525 Enrolled- 44 -LRB096 16690 AMC 31974 b

1of a qualifying change in status, special enrollment, special
2circumstance as defined by the Director, or during the annual
3Benefit Choice Period.
4    The Director shall annually determine monthly rates of
5payment subject to the following constraints: for those
6community colleges with annuitants only enrolled, first year
7rates shall be equal to the average cost to cover claims for a
8State member adjusted for demographics, Medicare
9participation, and other factors; and in the second year, a
10further adjustment of rates shall be made to reflect the actual
11first year's claims experience of the covered annuitants.
12    (l-5) The provisions of subsection (l) become inoperative
13on July 1, 1999.
14    (m) The Director shall adopt any rules deemed necessary for
15implementation of this amendatory Act of 1989 (Public Act
1686-978).
17    (n) Any child advocacy center within the State of Illinois
18may apply to the Director to have its employees, annuitants,
19and their dependents provided group health coverage under this
20Act on a non-insured basis. To participate, a child advocacy
21center must agree to enroll all of its employees and pay the
22entire cost of providing coverage for its employees. The child
23advocacy center shall not be required to enroll those of its
24employees who are covered spouses or dependents under this plan
25or another group policy or plan providing health benefits as
26long as (1) an appropriate official from the child advocacy

 

 

SB2525 Enrolled- 45 -LRB096 16690 AMC 31974 b

1center attests that each employee not enrolled is a covered
2spouse or dependent under this plan or another group policy or
3plan and (2) at least 50% of the employees are enrolled and the
4child advocacy center remits the entire cost of providing
5coverage to those employees. Employees of a participating child
6advocacy center who are not enrolled due to coverage under
7another group health policy or plan may enroll in the event of
8a qualifying change in status, special enrollment, or special
9circumstance as defined by the Director or during the annual
10Benefit Choice Period. A participating child advocacy center
11may also elect to cover its annuitants. Dependent coverage
12shall be offered on an optional basis, with the costs paid by
13the child advocacy center, its employees, or some combination
14of the 2 as determined by the child advocacy center. The child
15advocacy center shall be responsible for timely collection and
16transmission of dependent premiums.
17    The Director shall annually determine rates of payment,
18subject to the following constraints:
19        (1) In the first year of coverage, the rates shall be
20    equal to the amount normally charged to State employees for
21    elected optional coverages or for enrolled dependents
22    coverages or other contributory coverages on behalf of its
23    employees, adjusted for differences between State
24    employees and employees of the child advocacy center in
25    age, sex, geographic location, or other relevant
26    demographic variables, plus an amount sufficient to pay for

 

 

SB2525 Enrolled- 46 -LRB096 16690 AMC 31974 b

1    the additional administrative costs of providing coverage
2    to employees of the child advocacy center 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 child advocacy center.
7    Monthly payments by the child advocacy center or its
8employees for group health insurance shall be deposited into
9the Local Government Health Insurance Reserve Fund.
10(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
1195-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff.
127-23-10.)
 
13    Section 99. Effective date. This Act takes effect upon
14becoming law.