State of Illinois
91st General Assembly
Legislation

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91_SB1146eng

 
SB1146 Engrossed                               LRB9106059EGfg

 1        AN  ACT  to amend the State Employees Group Insurance Act
 2    of 1971.

 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 that
26    such  reduction in benefits shall apply only to those retired
27    members or retired dependents who (1) first  become  eligible
28    for  such  Medicare coverage on or after July 1, 1992; or (2)
29    remain eligible for, but no longer receive Medicare  coverage
30    which  they  had been receiving on or after July 1, 1992. The
31    Department may determine the aggregate level of  the  State's
 
SB1146 Engrossed            -2-                LRB9106059EGfg
 1    contribution  on the basis of actual cost of medical services
 2    adjusted for age, sex  or  geographic  or  other  demographic
 3    characteristics which affect the costs of such programs.
 4        (a-1)  Beginning  January  1,  1998,  for each person who
 5    becomes a new SERS annuitant and participates  in  the  basic
 6    program  of group health benefits, the State shall contribute
 7    toward the cost of the annuitant's coverage under  the  basic
 8    program  of  group  health  benefits an amount equal to 5% of
 9    that cost for each full year of creditable service upon which
10    the annuitant's retirement annuity is based, up to a  maximum
11    of  100% for an annuitant with 20 or more years of creditable
12    service.  The remainder of the cost of a new SERS annuitant's
13    coverage under the basic program  of  group  health  benefits
14    shall be the responsibility of the annuitant.
15        (a-2)  Beginning  January  1,  1998,  for each person who
16    becomes a new SERS survivor and  participates  in  the  basic
17    program  of group health benefits, the State shall contribute
18    toward the cost of the survivor's coverage  under  the  basic
19    program  of  group  health  benefits an amount equal to 5% of
20    that cost for each full year of the  deceased  employee's  or
21    deceased   annuitant's   creditable   service  in  the  State
22    Employees' Retirement System  of  Illinois  on  the  date  of
23    death,  up to a maximum of 100% for a survivor of an employee
24    or annuitant with 20 or more  years  of  creditable  service.
25    The remainder of the cost of the new SERS survivor's coverage
26    under the basic program of group health benefits shall be the
27    responsibility of the survivor.
28        (a-3)  Beginning  January  1,  1998,  for each person who
29    becomes a new SURS annuitant and participates  in  the  basic
30    program  of group health benefits, the State shall contribute
31    toward the cost of the annuitant'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 creditable service upon which
34    the annuitant's retirement annuity is based, up to a  maximum
 
SB1146 Engrossed            -3-                LRB9106059EGfg
 1    of  100% for an annuitant with 20 or more years of creditable
 2    service.  The remainder of the cost of a new SURS annuitant's
 3    coverage under the basic program  of  group  health  benefits
 4    shall be the responsibility of the annuitant.
 5        (a-4)  Beginning  January  1,  1998,  for each person who
 6    becomes a new SURS retired employee and participates  in  the
 7    basic  program  of  group  health  benefits,  the State shall
 8    contribute toward the cost of the retired employee's coverage
 9    under the basic program of group health  benefits  an  amount
10    equal  to 5% of that cost for each full year that the retired
11    employee was an employee as defined in Section  3,  up  to  a
12    maximum  of  100%  for a retired employee who was an employee
13    for 20 or more years.  The remainder of the  cost  of  a  new
14    SURS  retired  employee's coverage under the basic program of
15    group health benefits shall  be  the  responsibility  of  the
16    retired employee.
17        (a-5)  Beginning  January  1,  1998,  for each person who
18    becomes a new SURS survivor and  participates  in  the  basic
19    program  of group health benefits, the State shall contribute
20    toward the cost of the survivor'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 the  deceased  employee's  or
23    deceased   annuitant's   creditable   service  in  the  State
24    Universities Retirement System on the date of death, up to  a
25    maximum  of  100%  for a survivor of an employee or annuitant
26    with 20 or more years of creditable service.   The  remainder
27    of  the  cost  of  the new SURS survivor's coverage under the
28    basic  program  of  group  health  benefits  shall   be   the
29    responsibility of the survivor.
30        (a-6)  Beginning  July  1,  1998,  for  each  person  who
31    becomes  a  new  TRS  State annuitant and participates in the
32    basic program of  group  health  benefits,  the  State  shall
33    contribute  toward the cost of the annuitant's coverage under
34    the basic program of group health benefits an amount equal to
 
SB1146 Engrossed            -4-                LRB9106059EGfg
 1    5% of that cost for each full year of creditable service as a
 2    teacher as defined in paragraph (2), (3), or (5)  of  Section
 3    16-106   of   the   Illinois  Pension  Code  upon  which  the
 4    annuitant's retirement annuity is based, up to a  maximum  of
 5    100%;  except  that the State contribution shall be 12.5% per
 6    year (rather than  5%)  for  each  full  year  of  creditable
 7    service  as  a  regional superintendent or assistant regional
 8    superintendent of schools for an annuitant with  20  or  more
 9    years  of such creditable service.  The remainder of the cost
10    of a new TRS  State  annuitant's  coverage  under  the  basic
11    program  of group health benefits shall be the responsibility
12    of the annuitant.
13        (a-7)  Beginning  July  1,  1998,  for  each  person  who
14    becomes a new TRS State  survivor  and  participates  in  the
15    basic  program  of  group  health  benefits,  the State shall
16    contribute toward the cost of the survivor's  coverage  under
17    the basic program of group health benefits an amount equal to
18    5% of that cost for each full year of the deceased employee's
19    or  deceased  annuitant's  creditable service as a teacher as
20    defined in paragraph (2), (3), or (5) of  Section  16-106  of
21    the  Illinois  Pension  Code  on  the  date of death, up to a
22    maximum of 100%; except that the State contribution shall  be
23    12.5%  per  year  (rather  than 5%) for each full year of the
24    deceased  employee's  or  deceased   annuitant's   creditable
25    service  as  a  regional superintendent or assistant regional
26    superintendent of schools for a survivor of  an  employee  or
27    annuitant  with  20 or more years of such creditable service.
28    The remainder of the cost of the  new  TRS  State  survivor's
29    coverage  under  the  basic  program of group health benefits
30    shall be the responsibility of the survivor.
31        (a-8)  A new SERS annuitant, new SERS survivor, new  SURS
32    annuitant,  new SURS retired employee, new SURS survivor, new
33    TRS State annuitant, or new TRS State survivor may  waive  or
34    terminate  coverage  in the program of group health benefits.
 
SB1146 Engrossed            -5-                LRB9106059EGfg
 1    Any such annuitant, survivor, or  retired  employee  who  has
 2    waived  or terminated coverage may enroll or re-enroll in the
 3    program of group  health  benefits  only  during  the  annual
 4    benefit  choice period, as determined by the Director; except
 5    that  in  the  event  of  termination  of  coverage  due   to
 6    nonpayment  of  premiums, the annuitant, survivor, or retired
 7    employee may not re-enroll in the program.
 8        (a-9)  No later than May 1 of  each  calendar  year,  the
 9    Director  of  Central  Management  Services  shall certify in
10    writing to the Executive Secretary of  the  State  Employees'
11    Retirement  System  of  Illinois  the amounts of the Medicare
12    supplement health care premiums and the amounts of the health
13    care premiums for all other retirees  who  are  not  Medicare
14    eligible.
15        A  separate  calculation  of  the premiums based upon the
16    actual cost of each health care plan shall be so certified.
17        The Director of Central Management Services shall provide
18    to the Executive Secretary of the State Employees' Retirement
19    System of Illinois such information,  statistics,  and  other
20    data  as  he or she may require to review the premium amounts
21    certified by the Director of Central Management Services.
22        (b)  State employees who become eligible for this program
23    on or after January 1, 1980 in positions  normally  requiring
24    actual performance of duty not less than 1/2 of a normal work
25    period  but  not equal to that of a normal work period, shall
26    be  given  the  option  of  participating  in  the  available
27    program. If the employee elects  coverage,  the  State  shall
28    contribute  on  behalf  of  such  employee to the cost of the
29    employee's benefit and any applicable  dependent  supplement,
30    that  sum  which bears the same percentage as that percentage
31    of time the employee regularly works when compared to  normal
32    work period.
33        (c)  The  basic  non-contributory coverage from the basic
34    program of group health benefits shall be continued for  each
 
SB1146 Engrossed            -6-                LRB9106059EGfg
 1    employee  not in pay status or on active service by reason of
 2    (1) leave of absence due to illness or injury, (2) authorized
 3    educational leave of absence  or  sabbatical  leave,  or  (3)
 4    military  leave  with  pay  and benefits. This coverage shall
 5    continue until expiration of authorized leave and  return  to
 6    active  service, but not to exceed 24 months for leaves under
 7    item (1) or (2). This 24-month limitation and the requirement
 8    of returning to active service shall  not  apply  to  persons
 9    receiving  ordinary  or  accidental  disability  benefits  or
10    retirement  benefits through the appropriate State retirement
11    system  or  benefits  under  the  Workers'  Compensation   or
12    Occupational Disease Act.
13        (d)  The   basic  group  life  insurance  coverage  shall
14    continue, with full State contribution, where such person  is
15    (1)  absent  from  active  service  by  reason  of disability
16    arising from any cause  other  than  self-inflicted,  (2)  on
17    authorized  educational leave of absence or sabbatical leave,
18    or (3) on military leave with pay and benefits.
19        (e)  Where the person is in non-pay status for  a  period
20    in  excess  of  30 days or on leave of absence, other than by
21    reason of disability, educational  or  sabbatical  leave,  or
22    military  leave  with  pay  and  benefits,  such  person  may
23    continue  coverage  only  by making personal payment equal to
24    the amount normally contributed by the State on such person's
25    behalf. Such payments and  coverage  may  be  continued:  (1)
26    until  such  time  as the person returns to a status eligible
27    for coverage at State expense, but not to exceed  24  months,
28    (2)  until  such person's employment or annuitant status with
29    the State is terminated, or (3) for a  maximum  period  of  4
30    years for members on military leave with pay and benefits and
31    military  leave  without  pay  and benefits (exclusive of any
32    additional service imposed pursuant to law).
33        (f)  The Department shall  establish by rule  the  extent
34    to which other employee benefits will continue for persons in
 
SB1146 Engrossed            -7-                LRB9106059EGfg
 1    non-pay status or who are not in active service.
 2        (g)  The  State  shall  not  pay  the  cost  of the basic
 3    non-contributory group  life  insurance,  program  of  health
 4    benefits  and  other  employee  benefits  for members who are
 5    survivors as defined by paragraphs (1) and (2) of  subsection
 6    (q)  of  Section  3  of  this Act.  The costs of benefits for
 7    these survivors shall be paid by  the  survivors  or  by  the
 8    University  of Illinois Cooperative Extension Service, or any
 9    combination thereof.
10        (h)  Those   persons   occupying   positions   with   any
11    department as a result of emergency appointments pursuant  to
12    Section  8b.8  of  the  Personnel Code who are not considered
13    employees under  this  Act  shall  be  given  the  option  of
14    participating in the programs of group life insurance, health
15    benefits  and other employee benefits.  Such persons electing
16    coverage may participate only by making payment equal to  the
17    amount  normally  contributed  by  the  State  for  similarly
18    situated  employees.  Such amounts shall be determined by the
19    Director.  Such payments and coverage may be continued  until
20    such  time as the person becomes an employee pursuant to this
21    Act or such person's appointment is terminated.
22        (i)  Any unit of local government  within  the  State  of
23    Illinois  may  apply  to  the Director to have its employees,
24    annuitants,  and  their  dependents  provided  group   health
25    coverage   under   this  Act  on  a  non-insured  basis.   To
26    participate, a unit of local government must agree to  enroll
27    all  of  its  employees, who may select coverage under either
28    the State group health insurance plan or a health maintenance
29    organization  that  has  contracted  with  the  State  to  be
30    available as a health care provider for employees as  defined
31    in  this  Act.   A  unit  of  local government must remit the
32    entire cost of  providing  coverage  under  the  State  group
33    health  insurance  plan  or,  for  coverage  under  a  health
34    maintenance   organization,   an  amount  determined  by  the
 
SB1146 Engrossed            -8-                LRB9106059EGfg
 1    Director based on an analysis of  the  sex,  age,  geographic
 2    location,  or  other  relevant  demographic variables for its
 3    employees, except that the unit of local government shall not
 4    be required to enroll those of its employees who are  covered
 5    spouses or dependents under this plan or another group policy
 6    or   plan  providing  health  benefits  as  long  as  (1)  an
 7    appropriate  official  from  the  unit  of  local  government
 8    attests that each employee not enrolled is a  covered  spouse
 9    or dependent under this plan or another group policy or plan,
10    and  (2)  at  least 85% of the employees are enrolled and the
11    unit of local government remits the entire cost of  providing
12    coverage  to  those  employees.  Employees of a participating
13    unit of local government who are not enrolled due to coverage
14    under another group health policy or plan  may  enroll  at  a
15    later  date subject to submission of satisfactory evidence of
16    insurability and provided that no benefits shall  be  payable
17    for  services  incurred during the first 6 months of coverage
18    to the extent  the  services  are   in  connection  with  any
19    pre-existing   condition.   A  participating  unit  of  local
20    government may also elect to cover its annuitants.  Dependent
21    coverage shall be offered on  an  optional  basis,  with  the
22    costs paid by the unit of local government, its employees, or
23    some  combination  of  the  two  as determined by the unit of
24    local government.  The unit  of  local  government  shall  be
25    responsible   for   timely  collection  and  transmission  of
26    dependent premiums.
27        The Director shall annually determine  monthly  rates  of
28    payment, subject to the following constraints:
29             (1)  In  the first year of coverage, the rates shall
30        be  equal  to  the  amount  normally  charged  to   State
31        employees  for elected optional coverages or for enrolled
32        dependents coverages or other contributory coverages,  or
33        contributed by the State for basic insurance coverages on
34        behalf of its employees, adjusted for differences between
 
SB1146 Engrossed            -9-                LRB9106059EGfg
 1        State  employees and employees of the local government in
 2        age,  sex,  geographic   location   or   other   relevant
 3        demographic  variables,  plus an amount sufficient to pay
 4        for the  additional  administrative  costs  of  providing
 5        coverage to employees of the unit of local government and
 6        their dependents.
 7             (2)  In subsequent years, a further adjustment shall
 8        be  made  to  reflect  the  actual  prior  years'  claims
 9        experience   of  the  employees  of  the  unit  of  local
10        government.
11        In the case of coverage  of  local  government  employees
12    under  a  health maintenance organization, the Director shall
13    annually determine  for  each  participating  unit  of  local
14    government the maximum monthly amount the unit may contribute
15    toward  that  coverage,  based on an analysis of (i) the age,
16    sex, geographic  location,  and  other  relevant  demographic
17    variables  of the unit's employees and (ii) the cost to cover
18    those employees under the State group health insurance  plan.
19    The  Director  may  similarly  determine  the maximum monthly
20    amount each unit of local government  may  contribute  toward
21    coverage   of   its  employees'  dependents  under  a  health
22    maintenance organization.
23        Monthly payments by the unit of local government  or  its
24    employees  for  group  health insurance or health maintenance
25    organization  coverage  shall  be  deposited  in  the   Local
26    Government   Health   Insurance   Reserve  Fund.   The  Local
27    Government  Health  Insurance  Reserve  Fund   shall   be   a
28    continuing  fund not subject to fiscal year limitations.  All
29    expenditures from this fund shall be used  for  payments  for
30    health  care benefits for local government and rehabilitation
31    facility  employees,  annuitants,  and  dependents,  and   to
32    reimburse   the  Department  or  its  administrative  service
33    organization for all expenses incurred in the  administration
34    of  benefits.   No  other  State  funds may be used for these
 
SB1146 Engrossed            -10-               LRB9106059EGfg
 1    purposes.
 2        A local government employer's participation or desire  to
 3    participate  in a program created under this subsection shall
 4    not  limit  that  employer's  duty  to   bargain   with   the
 5    representative  of  any  collective  bargaining  unit  of its
 6    employees.
 7        (j)  Any rehabilitation  facility  within  the  State  of
 8    Illinois  may  apply  to  the Director to have its employees,
 9    annuitants,  and  their  dependents  provided  group   health
10    coverage   under   this   Act  on  a  non-insured  basis.  To
11    participate, a rehabilitation facility must agree  to  enroll
12    all  of  its employees and remit the entire cost of providing
13    such  coverage   for   its   employees,   except   that   the
14    rehabilitation facility shall not be required to enroll those
15    of  its employees who are covered spouses or dependents under
16    this plan or another group policy or  plan  providing  health
17    benefits  as  long  as  (1)  an appropriate official from the
18    rehabilitation  facility  attests  that  each  employee   not
19    enrolled  is a covered spouse or dependent under this plan or
20    another group policy or plan, and (2) at  least  85%  of  the
21    employees are enrolled and the rehabilitation facility remits
22    the  entire  cost  of  providing coverage to those employees.
23    Employees of a participating rehabilitation facility who  are
24    not  enrolled  due  to  coverage  under  another group health
25    policy or  plan  may  enroll  at  a  later  date  subject  to
26    submission  of  satisfactory  evidence  of  insurability  and
27    provided  that  no  benefits  shall  be  payable for services
28    incurred during the first 6 months of coverage to the  extent
29    the   services   are  in  connection  with  any  pre-existing
30    condition. A participating rehabilitation facility  may  also
31    elect  to  cover  its annuitants. Dependent coverage shall be
32    offered on an optional basis, with  the  costs  paid  by  the
33    rehabilitation  facility,  its employees, or some combination
34    of the 2 as determined by the  rehabilitation  facility.  The
 
SB1146 Engrossed            -11-               LRB9106059EGfg
 1    rehabilitation  facility  shall  be  responsible  for  timely
 2    collection and transmission of dependent premiums.
 3        The  Director shall annually determine quarterly rates of
 4    payment, subject to the following constraints:
 5             (1)  In the first year of coverage, the rates  shall
 6        be   equal  to  the  amount  normally  charged  to  State
 7        employees for elected optional coverages or for  enrolled
 8        dependents  coverages  or other contributory coverages on
 9        behalf of its employees, adjusted for differences between
10        State  employees  and  employees  of  the  rehabilitation
11        facility  in  age,  sex,  geographic  location  or  other
12        relevant demographic variables, plus an amount sufficient
13        to  pay  for  the  additional  administrative  costs   of
14        providing  coverage  to  employees  of the rehabilitation
15        facility and their dependents.
16             (2)  In subsequent years, a further adjustment shall
17        be  made  to  reflect  the  actual  prior  years'  claims
18        experience  of  the  employees  of   the   rehabilitation
19        facility.
20        Monthly  payments  by  the rehabilitation facility or its
21    employees for group health insurance shall  be  deposited  in
22    the Local Government Health Insurance Reserve Fund.
23        (k)  Any  domestic violence shelter or service within the
24    State of Illinois may apply  to  the  Director  to  have  its
25    employees,  annuitants,  and  their dependents provided group
26    health coverage under this Act on a  non-insured  basis.   To
27    participate,  a  domestic  violence  shelter  or service must
28    agree to enroll all of its employees and pay the entire  cost
29    of   providing   such   coverage   for   its   employees.   A
30    participating domestic violence shelter  may  also  elect  to
31    cover its annuitants.  Dependent coverage shall be offered on
32    an optional basis, with employees, or some combination of the
33    2  as determined by the domestic violence shelter or service.
34    The domestic violence shelter or service shall be responsible
 
SB1146 Engrossed            -12-               LRB9106059EGfg
 1    for timely collection and transmission of dependent premiums.
 2        The Director shall annually determine quarterly rates  of
 3    payment, subject to the following constraints:
 4             (1)  In  the first year of coverage, the rates shall
 5        be  equal  to  the  amount  normally  charged  to   State
 6        employees  for elected optional coverages or for enrolled
 7        dependents coverages or other contributory  coverages  on
 8        behalf of its employees, adjusted for differences between
 9        State  employees  and  employees of the domestic violence
10        shelter or service in age, sex,  geographic  location  or
11        other  relevant  demographic  variables,  plus  an amount
12        sufficient to pay for the additional administrative costs
13        of  providing  coverage  to  employees  of  the  domestic
14        violence shelter or service and their dependents.
15             (2)  In subsequent years, a further adjustment shall
16        be  made  to  reflect  the  actual  prior  years'  claims
17        experience of the  employees  of  the  domestic  violence
18        shelter or service.
19             (3)  In  no  case  shall  the  rate be less than the
20        amount normally charged to State employees or contributed
21        by the State on behalf of its employees.
22        Monthly payments by  the  domestic  violence  shelter  or
23    service  or its employees for group health insurance shall be
24    deposited in the Local Government  Health  Insurance  Reserve
25    Fund.
26        (l)  A  public  community  college  or  entity  organized
27    pursuant to the Public Community College Act may apply to the
28    Director  initially to have only annuitants not covered prior
29    to July 1, 1992 by the district's health plan provided health
30    coverage  under  this  Act  on  a  non-insured  basis.    The
31    community   college   must   execute  a  2-year  contract  to
32    participate in  the  Local  Government  Health  Plan.   Those
33    annuitants  enrolled initially under this contract shall have
34    no benefits payable for services incurred during the first  6
 
SB1146 Engrossed            -13-               LRB9106059EGfg
 1    months  of  coverage  to  the  extent  the  services  are  in
 2    connection  with  any  pre-existing condition.  Any annuitant
 3    who may enroll after this initial enrollment period shall  be
 4    subject   to   submission   of   satisfactory   evidence   of
 5    insurability and to the pre-existing conditions limitation.
 6        The  Director  shall  annually determine monthly rates of
 7    payment subject to  the  following  constraints:   for  those
 8    community  colleges with annuitants only enrolled, first year
 9    rates shall be equal to the average cost to cover claims  for
10    a   State   member   adjusted   for   demographics,  Medicare
11    participation, and other factors; and in the second  year,  a
12    further  adjustment  of  rates  shall  be made to reflect the
13    actual  first  year's  claims  experience  of   the   covered
14    annuitants.
15        (m)  The  Director shall adopt any rules deemed necessary
16    for implementation of this amendatory Act of 1989 (Public Act
17    86-978).
18    (Source:  P.A.  89-53,  eff.  7-1-95;  89-236,  eff.  8-4-95;
19    89-324,  eff.  8-13-95;  89-626,  eff.  8-9-96;  90-65,  eff.
20    7-7-97; 90-582, eff. 5-27-98; 90-655, eff.  7-30-98;  revised
21    8-3-98.)

22        Section  99.  Effective date.  This Act takes effect upon
23    becoming law.

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