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

SB3046ham001 100TH GENERAL ASSEMBLY

Rep. Jehan Gordon-Booth

Filed: 5/15/2018

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 3046

2    AMENDMENT NO. ______. Amend Senate Bill 3046 by replacing
3everything after the enacting clause with the following:
 
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

 

 

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1Illinois Pension Code through December 31, 1995. Beginning
2January 1, 1996, the Department of Central Management Services
3shall be responsible for administering a program of health
4benefits for TRS benefit recipients and TRS dependent
5beneficiaries under this Section. The Department of Central
6Management Services and the Teachers' Retirement System shall
7cooperate in this endeavor and shall coordinate their
8activities so as to ensure a smooth transition and
9uninterrupted health benefit coverage.
10    (c) Eligibility. All persons who were enrolled in the
11Article 16 program at the time of the transfer shall be
12eligible to participate in the program established under this
13Section without any interruption or delay in coverage or
14limitation as to pre-existing medical conditions. Eligibility
15to participate shall be determined by the Teachers' Retirement
16System. Eligibility information shall be communicated to the
17Department of Central Management Services in a format
18acceptable to the Department.
19    Eligible TRS benefit recipients may enroll or re-enroll in
20the program of health benefits established under this Section
21during any applicable annual open enrollment period and as
22otherwise permitted by the Department of Central Management
23Services. A TRS benefit recipient shall not be deemed
24ineligible to participate solely by reason of the TRS benefit
25recipient having made a previous election to disenroll or
26otherwise not participate in the program of health benefits.

 

 

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1    A TRS dependent beneficiary who is a child age 19 or over
2and mentally or physically disabled does not become ineligible
3to participate by reason of (i) becoming ineligible to be
4claimed as a dependent for Illinois or federal income tax
5purposes or (ii) receiving earned income, so long as those
6earnings are insufficient for the child to be fully
7self-sufficient.
8    (d) Coverage. The level of health benefits provided under
9this Section shall be similar to the level of benefits provided
10by the program previously established under Article 16 of the
11Illinois Pension Code.
12    Group life insurance benefits are not included in the
13benefits to be provided to TRS benefit recipients and TRS
14dependent beneficiaries under this Act.
15    The program of health benefits under this Section may
16include any or all of the benefit limitations, including but
17not limited to a reduction in benefits based on eligibility for
18federal Medicare medicare benefits, that are provided under
19subsection (a) of Section 6 of this Act for other health
20benefit programs under this Act.
21    (e) Insurance rates and premiums. The Director shall
22determine the insurance rates and premiums for TRS benefit
23recipients and TRS dependent beneficiaries, and shall present
24to the Teachers' Retirement System of the State of Illinois, by
25April 15 of each calendar year, the rate-setting methodology
26(including but not limited to utilization levels and costs)

 

 

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1used to determine the amount of the health care premiums.
2        For Fiscal Year 1996, the premium shall be equal to the
3    premium actually charged in Fiscal Year 1995; in subsequent
4    years, the premium shall never be lower than the premium
5    charged in Fiscal Year 1995.
6        For Fiscal Year 2003, the premium shall not exceed 110%
7    of the premium actually charged in Fiscal Year 2002.
8        For Fiscal Year 2004, the premium shall not exceed 112%
9    of the premium actually charged in Fiscal Year 2003.
10        For Fiscal Year 2005, the premium shall not exceed a
11    weighted average of 106.6% of the premium actually charged
12    in Fiscal Year 2004.
13        For Fiscal Year 2006, the premium shall not exceed a
14    weighted average of 109.1% of the premium actually charged
15    in Fiscal Year 2005.
16        For Fiscal Year 2007, the premium shall not exceed a
17    weighted average of 103.9% of the premium actually charged
18    in Fiscal Year 2006.
19        For Fiscal Year 2008 and thereafter, the premium in
20    each fiscal year shall not exceed 105% of the premium
21    actually charged in the previous fiscal year.
22    Rates and premiums may be based in part on age and
23eligibility for federal medicare coverage. However, the cost of
24participation for a TRS dependent beneficiary who is an
25unmarried child age 19 or over and mentally or physically
26disabled shall not exceed the cost for a TRS dependent

 

 

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

 

 

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1    as determined by the Teachers' Retirement System.
2    Effective with Fiscal Year 2007 and thereafter, for a TRS
3    benefit recipient selecting the major medical coverage
4    program, 75% of the total insurance rate shall be paid from
5    the Teacher Health Insurance Security Fund if a managed
6    care program is not accessible, as determined by the
7    Department of Central Management Services.
8        (3.1) For a TRS dependent beneficiary who is Medicare
9    primary and enrolled in a managed care plan, or the major
10    medical coverage program if a managed care plan is not
11    available, 25% of the total insurance rate shall be paid
12    from the Teacher Health Security Fund as determined by the
13    Department of Central Management Services. For the purpose
14    of this item (3.1), the term "TRS dependent beneficiary who
15    is Medicare primary" means a TRS dependent beneficiary who
16    is participating in Medicare Parts A and B.
17        (4) Except as otherwise provided in item (3.1), the
18    balance of the rate of insurance, including the entire
19    premium of any coverage for TRS dependent beneficiaries
20    that has been elected, shall be paid by deductions
21    authorized by the TRS benefit recipient to be withheld from
22    his or her monthly annuity or benefit payment from the
23    Teachers' Retirement System; except that (i) if the balance
24    of the cost of coverage exceeds the amount of the monthly
25    annuity or benefit payment, the difference shall be paid
26    directly to the Teachers' Retirement System by the TRS

 

 

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1    benefit recipient, and (ii) all or part of the balance of
2    the cost of coverage may, at the school board's option, be
3    paid to the Teachers' Retirement System by the school board
4    of the school district from which the TRS benefit recipient
5    retired, in accordance with Section 10-22.3b of the School
6    Code. The Teachers' Retirement System shall promptly
7    deposit all moneys withheld by or paid to it under this
8    subdivision (e)(4) into the Teacher Health Insurance
9    Security Fund. These moneys shall not be considered assets
10    of the Retirement System.
11    (f) Financing. Beginning July 1, 1995, all revenues arising
12from the administration of the health benefit programs
13established under Article 16 of the Illinois Pension Code or
14this Section shall be deposited into the Teacher Health
15Insurance Security Fund, which is hereby created as a
16nonappropriated trust fund to be held outside the State
17Treasury, with the State Treasurer as custodian. Any interest
18earned on moneys in the Teacher Health Insurance Security Fund
19shall be deposited into the Fund.
20    Moneys in the Teacher Health Insurance Security Fund shall
21be used only to pay the costs of the health benefit program
22established under this Section, including associated
23administrative costs, and the costs associated with the health
24benefit program established under Article 16 of the Illinois
25Pension Code, as authorized in this Section. Beginning July 1,
261995, the Department of Central Management Services may make

 

 

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1expenditures from the Teacher Health Insurance Security Fund
2for those costs.
3    After other funds authorized for the payment of the costs
4of the health benefit program established under Article 16 of
5the Illinois Pension Code are exhausted and until January 1,
61996 (or such later date as may be agreed upon by the Director
7of Central Management Services and the Secretary of the
8Teachers' Retirement System), the Secretary of the Teachers'
9Retirement System may make expenditures from the Teacher Health
10Insurance Security Fund as necessary to pay up to 75% of the
11cost of providing health coverage to eligible benefit
12recipients (as defined in Sections 16-153.1 and 16-153.3 of the
13Illinois Pension Code) who are enrolled in the Article 16
14health benefit program and to facilitate the transfer of
15administration of the health benefit program to the Department
16of Central Management Services.
17    The Department of Central Management Services, or any
18successor agency designated to procure healthcare contracts
19pursuant to this Act, is authorized to establish funds,
20separate accounts provided by any bank or banks as defined by
21the Illinois Banking Act, or separate accounts provided by any
22savings and loan association or associations as defined by the
23Illinois Savings and Loan Act of 1985 to be held by the
24Director, outside the State treasury, for the purpose of
25receiving the transfer of moneys from the Teacher Health
26Insurance Security Fund. The Department may promulgate rules

 

 

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1further defining the methodology for the transfers. Any
2interest earned by moneys in the funds or accounts shall inure
3to the Teacher Health Insurance Security Fund. The transferred
4moneys, and interest accrued thereon, shall be used exclusively
5for transfers to administrative service organizations or their
6financial institutions for payments of claims to claimants and
7providers under the self-insurance health plan. The
8transferred moneys, and interest accrued thereon, shall not be
9used for any other purpose including, but not limited to,
10reimbursement of administration fees due the administrative
11service organization pursuant to its contract or contracts with
12the Department.
13    (g) Contract for benefits. The Director shall by contract,
14self-insurance, or otherwise make available the program of
15health benefits for TRS benefit recipients and their TRS
16dependent beneficiaries that is provided for in this Section.
17The contract or other arrangement for the provision of these
18health benefits shall be on terms deemed by the Director to be
19in the best interest of the State of Illinois and the TRS
20benefit recipients based on, but not limited to, such criteria
21as administrative cost, service capabilities of the carrier or
22other contractor, and the costs of the benefits.
23    (g-5) Committee. A Teacher Retirement Insurance Program
24Committee shall be established, to consist of 10 persons
25appointed by the Governor.
26    The Committee shall convene at least 4 times each year, and

 

 

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1shall consider and make recommendations on issues affecting the
2program of health benefits provided under this Section.
3Recommendations of the Committee shall be based on a consensus
4of the members of the Committee.
5    If the Teacher Health Insurance Security Fund experiences a
6deficit balance based upon the contribution and subsidy rates
7established in this Section and Section 6.6 for Fiscal Year
82008 or thereafter, the Committee shall make recommendations
9for adjustments to the funding sources established under these
10Sections.
11    In addition, the Committee shall identify proposed
12solutions to the funding shortfalls that are affecting the
13Teacher Health Insurance Security Fund, and it shall report
14those solutions to the Governor and the General Assembly within
156 months after August 15, 2011 (the effective date of Public
16Act 97-386).
17    (h) Continuation of program. It is the intention of the
18General Assembly that the program of health benefits provided
19under this Section be maintained on an ongoing, affordable
20basis.
21    The program of health benefits provided under this Section
22may be amended by the State and is not intended to be a pension
23or retirement benefit subject to protection under Article XIII,
24Section 5 of the Illinois Constitution.
25    (i) Repeal. (Blank).
26(Source: P.A. 97-386, eff. 8-15-11; 97-813, eff. 7-13-12;

 

 

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198-488, eff. 8-16-13.)
 
2    (5 ILCS 375/6.9)
3    Sec. 6.9. Health benefits for community college benefit
4recipients and community college dependent beneficiaries.
5    (a) Purpose. It is the purpose of this amendatory Act of
61997 to establish a uniform program of health benefits for
7community college benefit recipients and their dependent
8beneficiaries under the administration of the Department of
9Central Management Services.
10    (b) Creation of program. Beginning July 1, 1999, the
11Department of Central Management Services shall be responsible
12for administering a program of health benefits for community
13college benefit recipients and community college dependent
14beneficiaries under this Section. The State Universities
15Retirement System and the boards of trustees of the various
16community college districts shall cooperate with the
17Department in this endeavor.
18    (c) Eligibility. All community college benefit recipients
19and community college dependent beneficiaries shall be
20eligible to participate in the program established under this
21Section, without any interruption or delay in coverage or
22limitation as to pre-existing medical conditions. Eligibility
23to participate shall be determined by the State Universities
24Retirement System. Eligibility information shall be
25communicated to the Department of Central Management Services

 

 

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1in a format acceptable to the Department.
2    Eligible community college benefit recipients may enroll
3or re-enroll in the program of health benefits established
4under this Section during any applicable annual open enrollment
5period and as otherwise permitted by the Department of Central
6Management Services. A community college benefit recipient
7shall not be deemed ineligible to participate solely by reason
8of the community college benefit recipient having made a
9previous election to disenroll or otherwise not participate in
10the program of health benefits.
11    (d) Coverage. The health benefit coverage provided under
12this Section shall be a program of health, dental, and vision
13benefits.
14    The program of health benefits under this Section may
15include any or all of the benefit limitations, including but
16not limited to a reduction in benefits based on eligibility for
17federal Medicare medicare benefits, that are provided under
18subsection (a) of Section 6 of this Act for other health
19benefit programs under this Act.
20    (e) Insurance rates and premiums. The Director shall
21determine the insurance rates and premiums for community
22college benefit recipients and community college dependent
23beneficiaries. Rates and premiums may be based in part on age
24and eligibility for federal Medicare coverage. The Director
25shall also determine premiums that will allow for the
26establishment of an actuarially sound reserve for this program.

 

 

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1    The cost of health benefits under the program shall be paid
2as follows:
3        (1) For a community college benefit recipient, up to
4    75% of the total insurance rate shall be paid from the
5    Community College Health Insurance Security Fund.
6        (2) The balance of the rate of insurance, including the
7    entire premium for any coverage for community college
8    dependent beneficiaries that has been elected, shall be
9    paid by deductions authorized by the community college
10    benefit recipient to be withheld from his or her monthly
11    annuity or benefit payment from the State Universities
12    Retirement System; except that (i) if the balance of the
13    cost of coverage exceeds the amount of the monthly annuity
14    or benefit payment, the difference shall be paid directly
15    to the State Universities Retirement System by the
16    community college benefit recipient, and (ii) all or part
17    of the balance of the cost of coverage may, at the option
18    of the board of trustees of the community college district,
19    be paid to the State Universities Retirement System by the
20    board of the community college district from which the
21    community college benefit recipient retired. The State
22    Universities Retirement System shall promptly deposit all
23    moneys withheld by or paid to it under this subdivision
24    (e)(2) into the Community College Health Insurance
25    Security Fund. These moneys shall not be considered assets
26    of the State Universities Retirement System.

 

 

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1    (f) Financing. All revenues arising from the
2administration of the health benefit program established under
3this Section shall be deposited into the Community College
4Health Insurance Security Fund, which is hereby created as a
5nonappropriated trust fund to be held outside the State
6Treasury, with the State Treasurer as custodian. Any interest
7earned on moneys in the Community College Health Insurance
8Security Fund shall be deposited into the Fund.
9    Moneys in the Community College Health Insurance Security
10Fund shall be used only to pay the costs of the health benefit
11program established under this Section, including associated
12administrative costs and the establishment of a program
13reserve. Beginning January 1, 1999, the Department of Central
14Management Services may make expenditures from the Community
15College Health Insurance Security Fund for those costs.
16    (g) Contract for benefits. The Director shall by contract,
17self-insurance, or otherwise make available the program of
18health benefits for community college benefit recipients and
19their community college dependent beneficiaries that is
20provided for in this Section. The contract or other arrangement
21for the provision of these health benefits shall be on terms
22deemed by the Director to be in the best interest of the State
23of Illinois and the community college benefit recipients based
24on, but not limited to, such criteria as administrative cost,
25service capabilities of the carrier or other contractor, and
26the costs of the benefits.

 

 

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1    (h) Continuation of program. It is the intention of the
2General Assembly that the program of health benefits provided
3under this Section be maintained on an ongoing, affordable
4basis. The program of health benefits provided under this
5Section may be amended by the State and is not intended to be a
6pension or retirement benefit subject to protection under
7Article XIII, Section 5 of the Illinois Constitution.
8    (i) Other health benefit plans. A health benefit plan
9provided by a community college district (other than a
10community college district subject to Article VII of the Public
11Community College Act) under the terms of a collective
12bargaining agreement in effect on or prior to the effective
13date of this amendatory Act of 1997 shall continue in force
14according to the terms of that agreement, unless otherwise
15mutually agreed by the parties to that agreement and the
16affected retiree. A community college benefit recipient or
17community college dependent beneficiary whose coverage under
18such a plan expires shall be eligible to begin participating in
19the program established under this Section without any
20interruption or delay in coverage or limitation as to
21pre-existing medical conditions.
22    This Act does not prohibit any community college district
23from offering additional health benefits for its retirees or
24their dependents or survivors.
25(Source: P.A. 90-497, eff. 8-18-97; 90-655, eff. 7-30-98.)
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.".