97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB1251

 

Introduced 2/8/2011, by Sen. Michael W. Frerichs

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/367f  from Ch. 73, par. 979f

    Amends the Illinois Insurance Code. In the provision concerning firemen's continuance privilege, changes the definition of "retirement or disability period" to include the period when the disabled or retired fireman, if not enrolled in the municipal group insurance plan at the time of disability or retirement, may elect to enroll in the municipal group insurance plan during open enrollment. Provides that the disabled or retired fireman, if not enrolled in the municipal group insurance plan at the time of disability or retirement, may elect to enroll during open enrollment but not after the fireman becomes eligible for federal Medicare coverage and not more than once. Provides that the fireman must be insurable and must pay the cost of the insurance premium in order to reenter the insurance plan. Effective immediately.


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A BILL FOR

 

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1    AN ACT concerning insurance.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 367f as follows:
 
6    (215 ILCS 5/367f)  (from Ch. 73, par. 979f)
7    Sec. 367f. Firemen's continuance privilege. As used in this
8Section:
9    1. The terms "municipality", "deferred pensioner" and
10"creditable service" shall have the meaning ascribed to such
11terms by Sections 4-103, 4-105a and 4-108, respectively, of the
12Illinois Pension Code, as now or hereafter amended.
13    2. The terms "fireman" and "firemen" shall have the meaning
14ascribed to the term "firefighter" by Section 4-106 of the
15Illinois Pension Code, and include those persons under the
16coverage of Article 4 of that Code, as heretofore or hereafter
17amended.
18    3. The "retirement or disability period" of a fireman means
19the period:
20        a. which begins on the day the fireman is removed from
21    a municipality's fire department payroll because of the
22    occurrence of any of the following events, to wit: (i) the
23    fireman retires as a deferred pensioner under Section

 

 

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1    4-105a of the Illinois Pension Code, (ii) the fireman
2    retires from active service as a fireman with an attained
3    age and accumulated creditable service which together
4    qualify the fireman for immediate receipt of retirement
5    pension benefits under Section 4-109 of the Illinois
6    Pension Code, or (iii) the fireman's disability is
7    established under Section 4-112 of the Illinois Pension
8    Code; and
9        b. which ends on the first to occur of any of the
10    following events, to wit: (i) the fireman's reinstatement
11    or reentry into active service on the municipality's fire
12    department as provided for under Article 4 of the Illinois
13    Pension Code, (ii) the fireman's exercise of any refund
14    option available under Section 4-116 of the Illinois
15    Pension Code, (iii) the fireman's loss pursuant to Section
16    4-138 of the Illinois Pension Code of any benefits provided
17    for in Article 4 of that Code, or (iv) the fireman's death
18    or -- if at the time of the fireman's death the fireman is
19    survived by a spouse who, in that capacity, is entitled to
20    receive a surviving spouse's monthly pension pursuant to
21    Article 4 of the Illinois Pension Code -- then the death or
22    remarriage of that spouse; and .
23        c. during which, notwithstanding subsections 3a or 3b
24    of this Section, the disabled or retired fireman, if not
25    enrolled in the municipal group insurance plan at the time
26    of disability or retirement, may elect to enroll in the

 

 

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1    municipal group insurance plan during an open enrollment
2    period; the disabled or retired fireman, if not enrolled in
3    the municipal group insurance plan at the time of
4    disability or retirement, may elect to enroll in the
5    municipal group insurance plan during an open enrollment
6    period but not after the fireman becomes eligible for
7    federal Medicare coverage and not more than once; the
8    fireman must be insurable and must pay the cost of the
9    insurance premium at a rate set in accordance with this
10    Code in order to reenter the municipal group insurance
11    plan.
12    No policy of group accident and health insurance under
13which firemen employed by a municipality are insured for their
14individual benefit shall be issued or delivered in this State
15to any municipality unless such group policy provides for the
16election of continued group insurance coverage for the
17retirement or disability period of each fireman or an election
18exercised under subsection 3c of this Section during any open
19enrollment period who is insured under the provisions of the
20group policy on the day immediately preceding the day on which
21the retirement or disability period of such fireman begins. So
22long as any required premiums for continued group insurance
23coverage are paid in accordance with the provisions of the
24group policy, an election made pursuant to this Section shall
25provide continued group insurance coverage for a fireman
26throughout the retirement or disability period of the fireman

 

 

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1and, unless the fireman otherwise elects and subject to any
2other provisions of the group policy which relate either to the
3provision or to the termination of dependents' coverage and
4which are not inconsistent with this Section, for any
5dependents of the fireman who are insured under the group
6policy on the day immediately preceding the day on which the
7retirement or disability period of the fireman begins;
8provided, however, that when such continued group insurance
9coverage is in effect with respect to a fireman on the date of
10the fireman's death but the retirement or disability period of
11the fireman does not end with such fireman's death, then the
12deceased fireman's surviving spouse upon whose death or
13remarriage such retirement or disability period will end shall
14be entitled, without further election and upon payment of any
15required premiums in accordance with the provisions of the
16group policy, to maintain such continued group insurance
17coverage in effect until the end of such retirement or
18disability period. Continued group insurance coverage shall be
19provided in accordance with this Section at the same premium
20rate from time to time charged for equivalent coverage provided
21under the group policy with respect to covered firemen whose
22retirement or disability period has not begun, and no
23distinction or discrimination in the amount or rate of premiums
24or in any waiver of premium or other benefit provision shall be
25made between continued group insurance coverage elected
26pursuant to this Section and equivalent coverage provided to

 

 

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1firemen under the group policy other than pursuant to the
2provisions of this Section; provided that no municipality shall
3be required by reason of any provision of this Section to pay
4any group insurance premium other than one that may be
5negotiated in a collective bargaining agreement. If a person
6electing continued coverage under this Section becomes
7eligible for medicare coverage, benefits under the group policy
8may continue as a supplement to the medicare coverage upon
9payment of any required premiums to maintain the benefits of
10the group policy as supplemental coverage.
11    Within 15 days of the beginning of the retirement or
12disability period of any fireman entitled to elect continued
13group insurance coverage under any group policy affected by
14this Section, the municipality last employing such fireman
15shall give written notice of such beginning by certified mail,
16return receipt requested to the insurance company issuing such
17policy. The notice shall include the fireman's name and last
18known place of residence and the beginning date of the
19fireman's retirement or disability period.
20    Within 15 days of the date of receipt of such notice from
21the municipality, the insurance company by certified mail,
22return receipt requested, shall give written notice to the
23fireman at the fireman's last known place of residence that
24coverage under the group policy may be continued for the
25retirement or disability period of the fireman as provided in
26this Section. Such notice shall set forth: (i) a statement of

 

 

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1election to be filed by the fireman if the fireman wishes to
2continue such group insurance coverage, (ii) the amount of
3monthly premium, including a statement of the portion of such
4monthly premium attributable to any dependents' coverage which
5the fireman may elect, and (iii) instructions as to the return
6of the election form to the insurance company issuing such
7policy. Election shall be made, if at all, by returning the
8statement of election to the insurance company by certified
9mail, return receipt requested within 15 days after having
10received it.
11    If the fireman elects to continue coverage, it shall be the
12obligation of the fireman to pay the monthly premium directly
13to the municipality which shall forward it to the insurance
14company issuing the group insurance policy, or as otherwise
15directed by the insurance company; provided, however, that the
16fireman shall be entitled to designate on the statement of
17election required to be filed with the insurance company that
18the total monthly premium, or such portion thereof as is not
19contributed by a municipality, be deducted by a Firefighter's
20Pension Fund from any monthly pension payment otherwise payable
21to or on behalf of the fireman pursuant to Article 4 of the
22Illinois Pension Code, and be remitted by such Pension Fund to
23the insurance company. The portion, if any, of the monthly
24premium contributed by a municipality for such continued group
25insurance coverage shall be paid by the municipality directly
26to the insurance company issuing the group insurance policy, or

 

 

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1as otherwise directed by the insurance company. Such continued
2group insurance coverage shall relate back to the beginning of
3the fireman's retirement or disability period.
4    The amendment, renewal or extension of any group insurance
5policy affected by this Section shall be deemed to be the
6issuance of a new policy of insurance for purposes of this
7Section.
8    In the event that a municipality makes a program of
9accident, health, hospital or medical benefits available to its
10firemen through self-insurance, or by participation in a pool
11or reciprocal insurer, or by contract in a form other than a
12policy of group insurance with one or more medical service
13plans, health care service corporations, health maintenance
14organizations, or any other professional corporations or plans
15under which health care or reimbursement for the costs thereof
16is provided, whether the cost of such benefits is borne by the
17municipality or the firemen or both, such firemen and their
18surviving spouses shall have the same right to elect continued
19coverage under such program of benefits as they would have if
20such benefits were provided by a policy of group accident and
21health insurance. In such cases, the notice of right to elect
22continued coverage shall be sent by the municipality; the
23statement of election shall be sent to the municipality; and
24references to the required premium shall refer to that portion
25of the cost of such benefits which is not borne by the
26municipality, either voluntarily or pursuant to the provisions

 

 

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1of a collective bargaining agreement. In the case of a
2municipality providing such benefits through self-insurance or
3participation in a pool or reciprocal insurer, the right to
4elect continued coverage which is provided by this paragraph
5shall be implemented and made available to the firemen of the
6municipality and qualifying surviving spouses not later than
7July 1, 1985.
8    The amendment, renewal or extension of any such contract in
9a form other than a policy of group insurance policy shall be
10deemed the formation of a new contract for the purposes of this
11Section.
12    This Section shall not limit the exercise of any conversion
13privileges available under Section 367e.
14    Pursuant to paragraphs (h) and (i) of Section 6 of Article
15VII of the Illinois Constitution, this Section specifically
16denies and limits the exercise by a home rule unit of any power
17which is inconsistent with this Section and all existing laws
18and ordinances which are inconsistent with this Section are
19hereby superseded. This Section does not preempt the concurrent
20exercise by home rule units of powers consistent herewith.
21    The Division of Insurance of the Department of Financial
22and Professional Regulation shall enforce the provisions of
23this Section, including provisions relating to municipality
24self-insured benefit plans.
25(Source: P.A. 94-858, eff. 6-15-06.)
 
26    Section 99. Effective date. This Act takes effect upon

 

 

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1becoming law.