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90_SB1921
5 ILCS 375/10 from Ch. 127, par. 530
Amends the State Employees Group Insurance Act of 1971.
Provides that the cost of participation in the basic program
of group health benefits for the dependent or survivor of a
living or deceased retired employee who was formerly employed
by the University of Illinois in the Cooperative Extension
Service and would be an annuitant but for the fact that he or
she was made ineligible to participate in the State
Universities Retirement System by clause (4) of subsection
(a) of Section 15-107 of the Illinois Pension Code shall not
be greater than the cost of participation that would
otherwise apply to that dependent or survivor if he or she
were the dependent or survivor of an annuitant under the
State Universities Retirement System. Also makes technical
corrections. Effective immediately.
LRB9011685EGfg
LRB9011685EGfg
1 AN ACT to amend the State Employees Group Insurance Act
2 of 1971 by changing Section 10.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The State Employees Group Insurance Act of
6 1971 is amended by changing Section 10 as follows:
7 (5 ILCS 375/10) (from Ch. 127, par. 530)
8 Sec. 10. Payments by State; premiums.
9 (a) The State shall pay the cost of basic
10 non-contributory group life insurance and, subject to member
11 paid contributions set by the Department or required by this
12 Section, the basic program of group health benefits on each
13 eligible member, except a member, not otherwise covered by
14 this Act, who has retired as a participating member under
15 Article 2 of the Illinois Pension Code but is ineligible for
16 the retirement annuity under Section 2-119 of the Illinois
17 Pension Code, and part of each eligible member's and retired
18 member's premiums for health insurance coverage for enrolled
19 dependents as provided by Section 9. The State shall pay the
20 cost of the basic program of group health benefits only after
21 benefits are reduced by the amount of benefits covered by
22 Medicare for all retired members and retired dependents aged
23 65 years or older who are entitled to benefits under Social
24 Security or the Railroad Retirement system or who had
25 sufficient Medicare-covered government employment, except
26 that such reduction in benefits shall apply only to those
27 retired members or retired dependents who (1) first become
28 eligible for such Medicare coverage on or after July 1, 1992;
29 or (2) remain eligible for, but no longer receive Medicare
30 coverage which they had been receiving on or after July 1,
31 1992. The Department may determine the aggregate level of
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1 the State's contribution on the basis of actual cost of
2 medical services adjusted for age, sex or geographic or other
3 demographic characteristics which affect the costs of such
4 programs.
5 The cost of participation in the basic program of group
6 health benefits for the dependent or survivor of a living or
7 deceased retired employee who was formerly employed by the
8 University of Illinois in the Cooperative Extension Service
9 and would be an annuitant but for the fact that he or she was
10 made ineligible to participate in the State Universities
11 Retirement System by clause (4) of subsection (a) of Section
12 15-107 of the Illinois Pension Code shall not be greater than
13 the cost of participation that would otherwise apply to that
14 dependent or survivor if he or she were the dependent or
15 survivor of an annuitant under the State Universities
16 Retirement System.
17 (a-1) Beginning January 1, 1998, for each person who
18 becomes a new SERS annuitant and participates in the basic
19 program of group health benefits, the State shall contribute
20 toward the cost of the annuitant's coverage under the basic
21 program of group health benefits an amount equal to 5% of
22 that cost for each full year of creditable service upon which
23 the annuitant's retirement annuity is based, up to a maximum
24 of 100% for an annuitant with 20 or more years of creditable
25 service. The remainder of the cost of a new SERS annuitant's
26 coverage under the basic program of group health benefits
27 shall be the responsibility of the annuitant.
28 (a-2) Beginning January 1, 1998, for each person who
29 becomes a new SERS survivor and participates in the basic
30 program of group health benefits, the State shall contribute
31 toward the cost of the survivor's coverage under the basic
32 program of group health benefits an amount equal to 5% of
33 that cost for each full year of the deceased employee's or
34 deceased annuitant's creditable service in the State
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1 Employees' Retirement System of Illinois on the date of
2 death, up to a maximum of 100% for a survivor of an employee
3 or annuitant with 20 or more years of creditable service.
4 The remainder of the cost of the new SERS survivor's coverage
5 under the basic program of group health benefits shall be the
6 responsibility of the survivor.
7 (a-3) Beginning January 1, 1998, for each person who
8 becomes a new SURS annuitant and participates in the basic
9 program of group health benefits, the State shall contribute
10 toward the cost of the annuitant's coverage under the basic
11 program of group health benefits an amount equal to 5% of
12 that cost for each full year of creditable service upon which
13 the annuitant's retirement annuity is based, up to a maximum
14 of 100% for an annuitant with 20 or more years of creditable
15 service. The remainder of the cost of a new SURS annuitant's
16 coverage under the basic program of group health benefits
17 shall be the responsibility of the annuitant.
18 (a-4) Beginning January 1, 1998, for each person who
19 becomes a new SURS retired employee and participates in the
20 basic program of group health benefits, the State shall
21 contribute toward the cost of the retired employee's coverage
22 under the basic program of group health benefits an amount
23 equal to 5% of that cost for each full year that the retired
24 employee was an employee as defined in Section 3, up to a
25 maximum of 100% for a retired employee who was an employee
26 for 20 or more years. The remainder of the cost of a new
27 SURS retired employee's coverage under the basic program of
28 group health benefits shall be the responsibility of the
29 retired employee.
30 (a-5) Beginning January 1, 1998, for each person who
31 becomes a new SURS survivor and participates in the basic
32 program of group health benefits, the State shall contribute
33 toward the cost of the survivor's coverage under the basic
34 program of group health benefits an amount equal to 5% of
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1 that cost for each full year of the deceased employee's or
2 deceased annuitant's creditable service in the State
3 Universities Employees' Retirement System of Illinois on the
4 date of death, up to a maximum of 100% for a survivor of an
5 employee or annuitant with 20 or more years of creditable
6 service. The remainder of the cost of the new SURS
7 survivor's coverage under the basic program of group health
8 benefits shall be the responsibility of the survivor.
9 (a-6) A new SERS annuitant, new SERS survivor, new SURS
10 annuitant, new SURS retired employee, or new SURS survivor
11 may waive or terminate coverage in the program of group
12 health benefits. Any such annuitant, survivor, or retired
13 employee who has waived or terminated coverage may enroll or
14 re-enroll in the program of group health benefits only during
15 the annual benefit choice period, as determined by the
16 Director; except that in the event of termination of coverage
17 due to nonpayment of premiums, the annuitant, survivor, or
18 retired employee may not re-enroll in the program.
19 (a-7) No later than May 1 of each calendar year, the
20 Director of Central Management Services shall certify in
21 writing to the Executive Secretary of the State Employees'
22 Employee's Retirement System of Illinois the amounts of the
23 Medicare supplement health care premiums and the amounts of
24 the health care premiums for all other retirees who are not
25 Medicare eligible.
26 A separate calculation of the premiums based upon the
27 actual cost of each health care plan shall be so certified.
28 The Director of Central Management Services shall provide
29 to the Executive Secretary of the State Employees' Employee's
30 Retirement System of Illinois such information, statistics,
31 and other data as he or she he/she may require to review the
32 premium amounts certified by the Director of Central
33 Management Services.
34 (b) State employees who become eligible for this program
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1 on or after January 1, 1980 in positions, normally requiring
2 actual performance of duty not less than 1/2 of a normal work
3 period but not equal to that of a normal work period, shall
4 be given the option of participating in the available
5 program. If the employee elects coverage, the State shall
6 contribute on behalf of such employee to the cost of the
7 employee's benefit and any applicable dependent supplement,
8 that sum which bears the same percentage as that percentage
9 of time the employee regularly works when compared to normal
10 work period.
11 (c) The basic non-contributory coverage from the basic
12 program of group health benefits shall be continued for each
13 employee not in pay status or on active service by reason of
14 (1) leave of absence due to illness or injury, (2) authorized
15 educational leave of absence or sabbatical leave, or (3)
16 military leave with pay and benefits. This coverage shall
17 continue until expiration of authorized leave and return to
18 active service, but not to exceed 24 months for leaves under
19 item (1) or (2). This 24-month limitation and the requirement
20 of returning to active service shall not apply to persons
21 receiving ordinary or accidental disability benefits or
22 retirement benefits through the appropriate State retirement
23 system or benefits under the Workers' Compensation or
24 Occupational Disease Act.
25 (d) The basic group life insurance coverage shall
26 continue, with full State contribution, where such person is
27 (1) absent from active service by reason of disability
28 arising from any cause other than self-inflicted, (2) on
29 authorized educational leave of absence or sabbatical leave,
30 or (3) on military leave with pay and benefits.
31 (e) Where the person is in non-pay status for a period
32 in excess of 30 days or on leave of absence, other than by
33 reason of disability, educational or sabbatical leave, or
34 military leave with pay and benefits, such person may
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1 continue coverage only by making personal payment equal to
2 the amount normally contributed by the State on such person's
3 behalf. Such payments and coverage may be continued: (1)
4 until such time as the person returns to a status eligible
5 for coverage at State expense, but not to exceed 24 months,
6 (2) until such person's employment or annuitant status with
7 the State is terminated, or (3) for a maximum period of 4
8 years for members on military leave with pay and benefits and
9 military leave without pay and benefits (exclusive of any
10 additional service imposed pursuant to law).
11 (f) The Department shall establish by rule the extent
12 to which other employee benefits will continue for persons in
13 non-pay status or who are not in active service.
14 (g) The State shall not pay the cost of the basic
15 non-contributory group life insurance, program of health
16 benefits and other employee benefits for members who are
17 survivors as defined by paragraphs (1) and (2) of subsection
18 (q) of Section 3 of this Act. The costs of benefits for
19 these survivors shall be paid by the survivors or by the
20 University of Illinois Cooperative Extension Service, or any
21 combination thereof.
22 (h) Those persons occupying positions with any
23 department as a result of emergency appointments pursuant to
24 Section 8b.8 of the Personnel Code who are not considered
25 employees under this Act shall be given the option of
26 participating in the programs of group life insurance, health
27 benefits and other employee benefits. Such persons electing
28 coverage may participate only by making payment equal to the
29 amount normally contributed by the State for similarly
30 situated employees. Such amounts shall be determined by the
31 Director. Such payments and coverage may be continued until
32 such time as the person becomes an employee pursuant to this
33 Act or such person's appointment is terminated.
34 (i) Any unit of local government within the State of
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1 Illinois may apply to the Director to have its employees,
2 annuitants, and their dependents provided group health
3 coverage under this Act on a non-insured basis. To
4 participate, a unit of local government must agree to enroll
5 all of its employees, who may select coverage under either
6 the State group health insurance plan or a health maintenance
7 organization that has contracted with the State to be
8 available as a health care provider for employees as defined
9 in this Act. A unit of local government must remit the
10 entire cost of providing coverage under the State group
11 health insurance plan or, for coverage under a health
12 maintenance organization, an amount determined by the
13 Director based on an analysis of the sex, age, geographic
14 location, or other relevant demographic variables for its
15 employees, except that the unit of local government shall not
16 be required to enroll those of its employees who are covered
17 spouses or dependents under this plan or another group policy
18 or plan providing health benefits as long as (1) an
19 appropriate official from the unit of local government
20 attests that each employee not enrolled is a covered spouse
21 or dependent under this plan or another group policy or plan,
22 and (2) at least 85% of the employees are enrolled and the
23 unit of local government remits the entire cost of providing
24 coverage to those employees. Employees of a participating
25 unit of local government who are not enrolled due to coverage
26 under another group health policy or plan may enroll at a
27 later date subject to submission of satisfactory evidence of
28 insurability and provided that no benefits shall be payable
29 for services incurred during the first 6 months of coverage
30 to the extent the services are in connection with any
31 pre-existing condition. A participating unit of local
32 government may also elect to cover its annuitants. Dependent
33 coverage shall be offered on an optional basis, with the
34 costs paid by the unit of local government, its employees, or
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1 some combination of the two as determined by the unit of
2 local government. The unit of local government shall be
3 responsible for timely collection and transmission of
4 dependent premiums.
5 The Director shall annually determine monthly rates of
6 payment, subject to the following constraints:
7 (1) In the first year of coverage, the rates shall
8 be equal to the amount normally charged to State
9 employees for elected optional coverages or for enrolled
10 dependents coverages or other contributory coverages, or
11 contributed by the State for basic insurance coverages on
12 behalf of its employees, adjusted for differences between
13 State employees and employees of the local government in
14 age, sex, geographic location or other relevant
15 demographic variables, plus an amount sufficient to pay
16 for the additional administrative costs of providing
17 coverage to employees of the unit of local government and
18 their dependents.
19 (2) In subsequent years, a further adjustment shall
20 be made to reflect the actual prior years' claims
21 experience of the employees of the unit of local
22 government.
23 In the case of coverage of local government employees
24 under a health maintenance organization, the Director shall
25 annually determine for each participating unit of local
26 government the maximum monthly amount the unit may contribute
27 toward that coverage, based on an analysis of (i) the age,
28 sex, geographic location, and other relevant demographic
29 variables of the unit's employees and (ii) the cost to cover
30 those employees under the State group health insurance plan.
31 The Director may similarly determine the maximum monthly
32 amount each unit of local government may contribute toward
33 coverage of its employees' dependents under a health
34 maintenance organization.
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1 Monthly payments by the unit of local government or its
2 employees for group health insurance or health maintenance
3 organization coverage shall be deposited in the Local
4 Government Health Insurance Reserve Fund. The Local
5 Government Health Insurance Reserve Fund shall be a
6 continuing fund not subject to fiscal year limitations. All
7 expenditures from this fund shall be used for payments for
8 health care benefits for local government and rehabilitation
9 facility employees, annuitants, and dependents, and to
10 reimburse the Department or its administrative service
11 organization for all expenses incurred in the administration
12 of benefits. No other State funds may be used for these
13 purposes.
14 A local government employer's participation or desire to
15 participate in a program created under this subsection shall
16 not limit that employer's duty to bargain with the
17 representative of any collective bargaining unit of its
18 employees.
19 (j) Any rehabilitation facility within the State of
20 Illinois may apply to the Director to have its employees,
21 annuitants, and their dependents provided group health
22 coverage under this Act on a non-insured basis. To
23 participate, a rehabilitation facility must agree to enroll
24 all of its employees and remit the entire cost of providing
25 such coverage for its employees, except that the
26 rehabilitation facility shall not be required to enroll those
27 of its employees who are covered spouses or dependents under
28 this plan or another group policy or plan providing health
29 benefits as long as (1) an appropriate official from the
30 rehabilitation facility attests that each employee not
31 enrolled is a covered spouse or dependent under this plan or
32 another group policy or plan, and (2) at least 85% of the
33 employees are enrolled and the rehabilitation facility remits
34 the entire cost of providing coverage to those employees.
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1 Employees of a participating rehabilitation facility who are
2 not enrolled due to coverage under another group health
3 policy or plan may enroll at a later date subject to
4 submission of satisfactory evidence of insurability and
5 provided that no benefits shall be payable for services
6 incurred during the first 6 months of coverage to the extent
7 the services are in connection with any pre-existing
8 condition. A participating rehabilitation facility may also
9 elect to cover its annuitants. Dependent coverage shall be
10 offered on an optional basis, with the costs paid by the
11 rehabilitation facility, its employees, or some combination
12 of the 2 as determined by the rehabilitation facility. The
13 rehabilitation facility shall be responsible for timely
14 collection and transmission of dependent premiums.
15 The Director shall annually determine quarterly rates of
16 payment, subject to the following constraints:
17 (1) In the first year of coverage, the rates shall
18 be equal to the amount normally charged to State
19 employees for elected optional coverages or for enrolled
20 dependents coverages or other contributory coverages on
21 behalf of its employees, adjusted for differences between
22 State employees and employees of the rehabilitation
23 facility in age, sex, geographic location or other
24 relevant demographic variables, plus an amount sufficient
25 to pay for the additional administrative costs of
26 providing coverage to employees of the rehabilitation
27 facility and their dependents.
28 (2) In subsequent years, a further adjustment shall
29 be made to reflect the actual prior years' claims
30 experience of the employees of the rehabilitation
31 facility.
32 Monthly payments by the rehabilitation facility or its
33 employees for group health insurance shall be deposited in
34 the Local Government Health Insurance Reserve Fund.
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1 (k) Any domestic violence shelter or service within the
2 State of Illinois may apply to the Director to have its
3 employees, annuitants, and their dependents provided group
4 health coverage under this Act on a non-insured basis. To
5 participate, a domestic violence shelter or service must
6 agree to enroll all of its employees and pay the entire cost
7 of providing such coverage for its employees. A
8 participating domestic violence shelter may also elect to
9 cover its annuitants. Dependent coverage shall be offered on
10 an optional basis, with employees, or some combination of the
11 2 as determined by the domestic violence shelter or service.
12 The domestic violence shelter or service shall be responsible
13 for timely collection and transmission of dependent premiums.
14 The Director shall annually determine quarterly rates of
15 payment, subject to the following constraints:
16 (1) In the first year of coverage, the rates shall
17 be equal to the amount normally charged to State
18 employees for elected optional coverages or for enrolled
19 dependents coverages or other contributory coverages on
20 behalf of its employees, adjusted for differences between
21 State employees and employees of the domestic violence
22 shelter or service in age, sex, geographic location or
23 other relevant demographic variables, plus an amount
24 sufficient to pay for the additional administrative costs
25 of providing coverage to employees of the domestic
26 violence shelter or service and their dependents.
27 (2) In subsequent years, a further adjustment shall
28 be made to reflect the actual prior years' claims
29 experience of the employees of the domestic violence
30 shelter or service.
31 (3) In no case shall the rate be less than the
32 amount normally charged to State employees or contributed
33 by the State on behalf of its employees.
34 Monthly payments by the domestic violence shelter or
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1 service or its employees for group health insurance shall be
2 deposited in the Local Government Health Insurance Reserve
3 Fund.
4 (l) A public community college or entity organized
5 pursuant to the Public Community College Act may apply to the
6 Director initially to have only annuitants not covered prior
7 to July 1, 1992 by the district's health plan provided health
8 coverage under this Act on a non-insured basis. The
9 community college must execute a 2-year contract to
10 participate in the Local Government Health Plan. Those
11 annuitants enrolled initially under this contract shall have
12 no benefits payable for services incurred during the first 6
13 months of coverage to the extent the services are in
14 connection with any pre-existing condition. Any annuitant
15 who may enroll after this initial enrollment period shall be
16 subject to submission of satisfactory evidence of
17 insurability and to the pre-existing conditions limitation.
18 The Director shall annually determine monthly rates of
19 payment subject to the following constraints: for those
20 community colleges with annuitants only enrolled, first year
21 rates shall be equal to the average cost to cover claims for
22 a State member adjusted for demographics, Medicare
23 participation, and other factors; and in the second year, a
24 further adjustment of rates shall be made to reflect the
25 actual first year's claims experience of the covered
26 annuitants.
27 (m) The Director shall adopt any rules deemed necessary
28 for implementation of this amendatory Act of 1989 (Public Act
29 86-978).
30 (Source: P.A. 89-53, eff. 7-1-95; 89-236, eff. 8-4-95;
31 89-324, eff. 8-13-95; 89-626, eff. 8-9-96; 90-65, eff.
32 7-7-97; revised 1-13-98.)
33 Section 99. Effective date. This Act takes effect upon
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1 becoming law.