Illinois General Assembly - Full Text of SB3046
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Full Text of SB3046  100th General Assembly

SB3046enr 100TH GENERAL ASSEMBLY

  
  
  

 


 
SB3046 EnrolledLRB100 17219 RJF 32378 b

1    AN ACT concerning government.
 
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 6.5 and 6.9 as follows:
 
6    (5 ILCS 375/6.5)
7    Sec. 6.5. Health benefits for TRS benefit recipients and
8TRS dependent beneficiaries.
9    (a) Purpose. It is the purpose of this amendatory Act of
101995 to transfer the administration of the program of health
11benefits established for benefit recipients and their
12dependent beneficiaries under Article 16 of the Illinois
13Pension Code to the Department of Central Management Services.
14    (b) Transition provisions. The Board of Trustees of the
15Teachers' Retirement System shall continue to administer the
16health benefit program established under Article 16 of the
17Illinois Pension Code through December 31, 1995. Beginning
18January 1, 1996, the Department of Central Management Services
19shall be responsible for administering a program of health
20benefits for TRS benefit recipients and TRS dependent
21beneficiaries under this Section. The Department of Central
22Management Services and the Teachers' Retirement System shall
23cooperate in this endeavor and shall coordinate their

 

 

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1activities so as to ensure a smooth transition and
2uninterrupted health benefit coverage.
3    (c) Eligibility. All persons who were enrolled in the
4Article 16 program at the time of the transfer shall be
5eligible to participate in the program established under this
6Section without any interruption or delay in coverage or
7limitation as to pre-existing medical conditions. Eligibility
8to participate shall be determined by the Teachers' Retirement
9System. Eligibility information shall be communicated to the
10Department of Central Management Services in a format
11acceptable to the Department.
12    Eligible TRS benefit recipients may enroll or re-enroll in
13the program of health benefits established under this Section
14during any applicable annual open enrollment period and as
15otherwise permitted by the Department of Central Management
16Services. A TRS benefit recipient shall not be deemed
17ineligible to participate solely by reason of the TRS benefit
18recipient having made a previous election to disenroll or
19otherwise not participate in the program of health benefits.
20    A TRS dependent beneficiary who is a child age 19 or over
21and mentally or physically disabled does not become ineligible
22to participate by reason of (i) becoming ineligible to be
23claimed 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.

 

 

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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 medicare benefits, that are provided under
12subsection (a) of Section 6 of this Act for other health
13benefit programs under 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.

 

 

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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.

 

 

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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.

 

 

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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

 

 

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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

 

 

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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 Central Management 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

 

 

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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

 

 

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12008 or thereafter, the Committee shall make recommendations
2for adjustments to the funding sources established under these
3Sections.
4    In addition, the Committee shall identify proposed
5solutions to the funding shortfalls that are affecting the
6Teacher Health Insurance Security Fund, and it shall report
7those solutions to the Governor and the General Assembly within
86 months after August 15, 2011 (the effective date of Public
9Act 97-386).
10    (h) Continuation of program. It is the intention of the
11General Assembly that the program of health benefits provided
12under this Section be maintained on an ongoing, affordable
13basis.
14    The program of health benefits provided under this Section
15may be amended by the State and is not intended to be a pension
16or retirement benefit subject to protection under Article XIII,
17Section 5 of the Illinois Constitution.
18    (i) Repeal. (Blank).
19(Source: P.A. 97-386, eff. 8-15-11; 97-813, eff. 7-13-12;
2098-488, eff. 8-16-13.)
 
21    (5 ILCS 375/6.9)
22    Sec. 6.9. Health benefits for community college benefit
23recipients and community college dependent beneficiaries.
24    (a) Purpose. It is the purpose of this amendatory Act of
251997 to establish a uniform program of health benefits for

 

 

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1community college benefit recipients and their dependent
2beneficiaries under the administration of the Department of
3Central Management Services.
4    (b) Creation of program. Beginning July 1, 1999, the
5Department of Central Management Services shall be responsible
6for administering a program of health benefits for community
7college benefit recipients and community college dependent
8beneficiaries under this Section. The State Universities
9Retirement System and the boards of trustees of the various
10community college districts shall cooperate with the
11Department in this endeavor.
12    (c) Eligibility. All community college benefit recipients
13and community college dependent beneficiaries shall be
14eligible to participate in the program established under this
15Section, without any interruption or delay in coverage or
16limitation as to pre-existing medical conditions. Eligibility
17to participate shall be determined by the State Universities
18Retirement System. Eligibility information shall be
19communicated to the Department of Central Management Services
20in a format acceptable to the Department.
21    Eligible community college benefit recipients may enroll
22or re-enroll in the program of health benefits established
23under this Section during any applicable annual open enrollment
24period and as otherwise permitted by the Department of Central
25Management Services. A community college benefit recipient
26shall not be deemed ineligible to participate solely by reason

 

 

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1of the community college benefit recipient having made a
2previous election to disenroll or otherwise not participate in
3the program of health benefits.
4    (d) Coverage. The health benefit coverage provided under
5this Section shall be a program of health, dental, and vision
6benefits.
7    The program of health benefits under this Section may
8include any or all of the benefit limitations, including but
9not limited to a reduction in benefits based on eligibility for
10federal Medicare medicare benefits, that are provided under
11subsection (a) of Section 6 of this Act for other health
12benefit programs under this Act.
13    (e) Insurance rates and premiums. The Director shall
14determine the insurance rates and premiums for community
15college benefit recipients and community college dependent
16beneficiaries. Rates and premiums may be based in part on age
17and eligibility for federal Medicare coverage. The Director
18shall also determine premiums that will allow for the
19establishment of an actuarially sound reserve for this program.
20    The cost of health benefits under the program shall be paid
21as follows:
22        (1) For a community college benefit recipient, up to
23    75% of the total insurance rate shall be paid from the
24    Community College Health Insurance Security Fund.
25        (2) The balance of the rate of insurance, including the
26    entire premium for any coverage for community college

 

 

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1    dependent beneficiaries that has been elected, shall be
2    paid by deductions authorized by the community college
3    benefit recipient to be withheld from his or her monthly
4    annuity or benefit payment from the State Universities
5    Retirement System; except that (i) if the balance of the
6    cost of coverage exceeds the amount of the monthly annuity
7    or benefit payment, the difference shall be paid directly
8    to the State Universities Retirement System by the
9    community college benefit recipient, and (ii) all or part
10    of the balance of the cost of coverage may, at the option
11    of the board of trustees of the community college district,
12    be paid to the State Universities Retirement System by the
13    board of the community college district from which the
14    community college benefit recipient retired. The State
15    Universities Retirement System shall promptly deposit all
16    moneys withheld by or paid to it under this subdivision
17    (e)(2) into the Community College Health Insurance
18    Security Fund. These moneys shall not be considered assets
19    of the State Universities Retirement System.
20    (f) Financing. All revenues arising from the
21administration of the health benefit program established under
22this Section shall be deposited into the Community College
23Health Insurance Security Fund, which is hereby created as a
24nonappropriated trust fund to be held outside the State
25Treasury, with the State Treasurer as custodian. Any interest
26earned on moneys in the Community College Health Insurance

 

 

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1Security Fund shall be deposited into the Fund.
2    Moneys in the Community College Health Insurance Security
3Fund shall be used only to pay the costs of the health benefit
4program established under this Section, including associated
5administrative costs and the establishment of a program
6reserve. Beginning January 1, 1999, the Department of Central
7Management Services may make expenditures from the Community
8College Health Insurance Security Fund for those costs.
9    (g) Contract for benefits. The Director shall by contract,
10self-insurance, or otherwise make available the program of
11health benefits for community college benefit recipients and
12their community college dependent beneficiaries that is
13provided for in this Section. The contract or other arrangement
14for the provision of these health benefits shall be on terms
15deemed by the Director to be in the best interest of the State
16of Illinois and the community college benefit recipients based
17on, but not limited to, such criteria as administrative cost,
18service capabilities of the carrier or other contractor, and
19the costs of the benefits.
20    (h) Continuation of program. It is the intention of the
21General Assembly that the program of health benefits provided
22under this Section be maintained on an ongoing, affordable
23basis. The program of health benefits provided under this
24Section may be amended by the State and is not intended to be a
25pension or retirement benefit subject to protection under
26Article XIII, Section 5 of the Illinois Constitution.

 

 

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1    (i) Other health benefit plans. A health benefit plan
2provided by a community college district (other than a
3community college district subject to Article VII of the Public
4Community College Act) under the terms of a collective
5bargaining agreement in effect on or prior to the effective
6date of this amendatory Act of 1997 shall continue in force
7according to the terms of that agreement, unless otherwise
8mutually agreed by the parties to that agreement and the
9affected retiree. A community college benefit recipient or
10community college dependent beneficiary whose coverage under
11such a plan expires shall be eligible to begin participating in
12the program established under this Section without any
13interruption or delay in coverage or limitation as to
14pre-existing medical conditions.
15    This Act does not prohibit any community college district
16from offering additional health benefits for its retirees or
17their dependents or survivors.
18(Source: P.A. 90-497, eff. 8-18-97; 90-655, eff. 7-30-98.)
 
19    Section 99. Effective date. This Act takes effect upon
20becoming law.