Full Text of HB7330 93rd General Assembly
HB7330 93RD GENERAL ASSEMBLY
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93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004 HB7330
Introduced 9/28/2004, by Rep. Raymond Poe SYNOPSIS AS INTRODUCED: |
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5 ILCS 375/6 |
from Ch. 127, par. 526 |
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Amends the State Employees Group Insurance Act of 1971. Requires that the health benefits program include at least 2 vision plans and 2 dental plans available in each region of the State. Effective immediately.
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A BILL FOR
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HB7330 |
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LRB093 23302 JAM 53386 b |
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| AN ACT concerning State employees group insurance.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The State Employees Group Insurance Act of 1971 | 5 |
| is amended by changing Section 6 as follows:
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| (5 ILCS 375/6) (from Ch. 127, par. 526)
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| Sec. 6. Program of health benefits.
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| (a) The program of health benefits shall provide for | 9 |
| protection
against the financial costs of health care expenses | 10 |
| incurred in and out
of hospital including basic | 11 |
| hospital-surgical-medical coverages. The program
may include, | 12 |
| but shall not be limited to, such supplemental coverages as
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| out-patient diagnostic X-ray and laboratory expenses, | 14 |
| prescription drugs,
dental services, hearing evaluations, | 15 |
| hearing aids, the dispensing and
fitting
of hearing aids, and | 16 |
| similar group benefits
as are now or may become available. | 17 |
| However, nothing in this Act shall
be construed to permit, on | 18 |
| or after July 1, 1980, the non-contributory portion
of any such | 19 |
| program to include the expenses of obtaining an abortion, | 20 |
| induced
miscarriage or induced premature birth unless, in the | 21 |
| opinion of a physician,
such procedures are necessary for the | 22 |
| preservation of the life of the woman
seeking such treatment, | 23 |
| or except an induced premature birth intended to
produce a live | 24 |
| viable child and such procedure is necessary for the health
of | 25 |
| the mother or the unborn child. The program may also include
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| coverage for those who rely on treatment by prayer or spiritual | 27 |
| means
alone for healing in accordance with the tenets and | 28 |
| practice of a
recognized religious denomination.
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| The program of health benefits shall be designed by the | 30 |
| Director
(1) to provide a reasonable relationship between the | 31 |
| benefits to be
included and the expected distribution of | 32 |
| expenses of each such type to
be incurred by the covered |
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HB7330 |
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LRB093 23302 JAM 53386 b |
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| members and dependents,
(2) to specify, as covered benefits and | 2 |
| as optional benefits, the
medical services of practitioners in | 3 |
| all categories licensed under the
Medical Practice Act of 1987, | 4 |
| (3) to include
reasonable controls, which may include | 5 |
| deductible and co-insurance
provisions, applicable to some or | 6 |
| all of the benefits, or a coordination
of benefits provision, | 7 |
| to prevent or minimize unnecessary utilization of
the various | 8 |
| hospital, surgical and medical expenses to be provided and
to | 9 |
| provide reasonable assurance of stability of the program, and | 10 |
| (4) to
provide benefits to the extent possible to members | 11 |
| throughout the
State, wherever located, on an equitable basis , | 12 |
| and (5) to provide, to members in each geographic region of the | 13 |
| State, a selection of at least 2 plans for the coverage of | 14 |
| vision services available in that region and a selection of at | 15 |
| least 2 plans for the coverage of dental services available in | 16 |
| that region .
Notwithstanding any other provision of this | 17 |
| Section or Act,
for all members or dependents who are eligible | 18 |
| for benefits under Social
Security or the
Railroad Retirement | 19 |
| system or who had sufficient Medicare-covered government
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| employment,
the
Department shall reduce benefits
which would | 21 |
| otherwise be paid by Medicare, by the amount of benefits for
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| which the member or dependents are eligible
under Medicare, | 23 |
| except that such reduction in benefits shall apply only to
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| those members or dependents who (1) first become
eligible for | 25 |
| such medicare coverage on or after the effective date of this
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| amendatory Act of 1992; or (2) are Medicare-eligible members or | 27 |
| dependents of
a local government unit which began participation | 28 |
| in the program on or after
July 1, 1992; or (3) remain eligible | 29 |
| for but no longer receive
Medicare coverage which they had been | 30 |
| receiving on or after the effective date
of this amendatory Act | 31 |
| of 1992.
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| Notwithstanding any other provisions of this Act, where a | 33 |
| covered member or
dependents are eligible for benefits under | 34 |
| the federal Medicare health
insurance program (Title XVIII of | 35 |
| the Social Security Act as added by
Public Law 89-97, 89th | 36 |
| Congress), benefits paid under the State of Illinois
program or |
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LRB093 23302 JAM 53386 b |
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| plan will be reduced by the amount of benefits paid by | 2 |
| Medicare.
For members or dependents
who are eligible for | 3 |
| benefits under Social Security
or the Railroad Retirement | 4 |
| system or who had sufficient Medicare-covered
government | 5 |
| employment, benefits shall be reduced by the amount for which
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| the member or dependent is eligible under Medicare,
except that | 7 |
| such reduction in benefits shall apply only to those
members or | 8 |
| dependents who (1) first become eligible for such
Medicare | 9 |
| coverage on or after the effective date of this amendatory Act
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| of 1992; or (2) are Medicare-eligible members or dependents of | 11 |
| a local
government unit which began participation in the | 12 |
| program on or after July 1,
1992; or (3) remain eligible for, | 13 |
| but no longer receive Medicare
coverage which they had been | 14 |
| receiving on or after the effective date of this
amendatory Act | 15 |
| of 1992. Premiums may be adjusted, where applicable, to an
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| amount deemed by the Director to be reasonably consistent with | 17 |
| any reduction
of benefits.
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| (b) A member, not otherwise covered by this Act, who has | 19 |
| retired as a
participating member under Article 2 of the | 20 |
| Illinois Pension Code
but is ineligible for the retirement | 21 |
| annuity under Section 2-119 of the
Illinois
Pension Code, shall | 22 |
| pay the premiums for coverage, not
exceeding the amount paid by | 23 |
| the State for the non-contributory coverage for
other members, | 24 |
| under the group health benefits program under this Act. The
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| Director shall determine the premiums to be paid
by a member | 26 |
| under this subsection (b).
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| (Source: P.A. 93-47, eff. 7-1-03.)
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| Section 99. Effective date. This Act takes effect upon | 29 |
| becoming law.
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