State of Illinois
92nd General Assembly
Legislation

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[ Senate Amendment 001 ]


92_SB1859eng

 
SB1859 Engrossed                               LRB9215806EGfg

 1        AN ACT concerning health benefits.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.   The  State Employees Group Insurance Act of
 5    1971 is amended by changing Section 8 as follows:

 6        (5 ILCS 375/8) (from Ch. 127, par. 528)
 7        Sec. 8.  Eligibility.
 8        (a)  Each member eligible under the  provisions  of  this
 9    Act  and  any  rules  and regulations promulgated and adopted
10    hereunder by the Director shall become  immediately  eligible
11    and  covered  for  all benefits available under the programs.
12    Members electing coverage for eligible dependents shall  have
13    the   coverage   effective  immediately,  provided  that  the
14    election is properly filed in accordance with required filing
15    dates and procedures specified by the Director.
16             (1)  Every  member  originally  eligible  to   elect
17        dependent  coverage,  but  not  electing  it  during  the
18        original  eligibility  period,  may  subsequently  obtain
19        dependent  coverage  only  in  the  event of a qualifying
20        change   in   status,   special    enrollment,    special
21        circumstance  as  defined  by the Director, or during the
22        annual Benefit Choice Period.
23             (2)  Members described above being transferred  from
24        previous  coverage  towards  which  the  State  has  been
25        contributing   shall   be   transferred   regardless   of
26        preexisting   conditions,   waiting   periods,  or  other
27        requirements that  might  jeopardize  claim  payments  to
28        which they would otherwise have been entitled.
29             (3)  Eligible  and covered members that are eligible
30        for coverage as dependents except for the fact  of  being
31        members  shall  be  transferred  to,  and  covered under,
 
SB1859 Engrossed            -2-                LRB9215806EGfg
 1        dependent status regardless  of  preexisting  conditions,
 2        waiting   periods,   or  other  requirements  that  might
 3        jeopardize claim payments to which they  would  otherwise
 4        have  been  entitled  upon cessation of member status and
 5        the election of dependent coverage by a  member  eligible
 6        to elect that coverage.
 7        (b)  New  employees  shall be immediately insured for the
 8    basic group life insurance and  covered  by  the  program  of
 9    health  benefits  on  the  first day of active State service.
10    Optional  coverages  or  benefits,  if  elected  during   the
11    relevant  eligibility  period,  will  become effective on the
12    date of employment.  Optional coverages or  benefits  applied
13    for  after  the eligibility period will be effective, subject
14    to satisfactory evidence of insurability when applicable,  or
15    other  necessary qualifications, pursuant to the requirements
16    of the applicable benefit program, unless there is  a  change
17    in  status  that  would  confer new eligibility for change of
18    enrollment under rules established supplementing this Act, in
19    which  event  application  must  be  made  within   the   new
20    eligibility period.
21        (c)  As  to  the group health benefits program contracted
22    to begin or  continue  after  June  30,  1973,  each  retired
23    employee  shall  become  immediately eligible and covered for
24    all benefits available under that program.  Retired employees
25    may elect coverage for eligible dependents and shall have the
26    coverage effective immediately, provided that the election is
27    properly filed in accordance with required filing  dates  and
28    procedures specified by the Director.
29        Where  husband  and  wife are both eligible members, each
30    shall be enrolled as a member and coverage on their  eligible
31    dependent  children,  if any, may be under the enrollment and
32    election of either.
33        Regardless of  other  provisions  herein  regarding  late
34    enrollment  or  other  qualifications,  as  appropriate,  the
 
SB1859 Engrossed            -3-                LRB9215806EGfg
 1    Director  may  periodically authorize open enrollment periods
 2    for each of the benefit programs at which  time  each  member
 3    may  elect  enrollment or change of enrollment without regard
 4    to  age,  sex,  health,  or  other  qualification  under  the
 5    conditions as may be  prescribed  in  rules  and  regulations
 6    supplementing  this Act.  Special open enrollment periods may
 7    be declared by the Director for  certain  members  only  when
 8    special circumstances occur that affect only those members.
 9        (d)  Beginning   with   fiscal  year  2003  and  for  all
10    subsequent  years,  eligible  employees  may  elect  not   to
11    participate  in  the program of health benefits as defined in
12    this Act.  The  election  must  be  made  during  the  annual
13    benefit  choice  period,  subject  to  the conditions in this
14    subsection.
15             (1)  Employees must furnish proof of health  benefit
16        coverage,  either comprehensive major medical coverage or
17        comprehensive managed care plan, from a source other than
18        the Department of Central Management Services in order to
19        elect not to participate in the program.
20             (2)  Employees may re-enroll in  the  Department  of
21        Central  Management  Services  program of health benefits
22        upon showing a qualifying change in status, as defined in
23        the U.S.  Internal  Revenue  Code,  without  evidence  of
24        insurability  and  with  no  limitations  on coverage for
25        pre-existing conditions, provided that there  was  not  a
26        break in coverage of more than 63 days.
27             (3)  Employees  may also re-enroll in the program of
28        health benefits during any annual benefit choice  period,
29        without evidence of insurability.
30             (4)  Employees  who  elect not to participate in the
31        program of health benefits shall be furnished  a  written
32        explanation  of  the requirements and limitations for the
33        election not  to  participate  in  the  program  and  for
34        re-enrolling  in  the program. The explanation shall also
 
SB1859 Engrossed            -4-                LRB9215806EGfg
 1        be included in the annual benefit choice options booklets
 2        furnished to employees.
 3    (Source: P.A. 91-390, eff. 7-30-99.)

 4        Section 99.  Effective date.  This Act takes effect  upon
 5    becoming law.

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