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Public Act 098-0488 |
SB1256 Enrolled | LRB098 06209 KTG 36250 b |
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AN ACT concerning State government.
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Be it enacted by the People of the State of Illinois, |
represented in the General Assembly:
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Section 1. Short title. This Act may be cited as the |
Executive Order 1 (2012) Implementation Act. |
Section 5. Effect. This Act, including all of the |
amendatory provisions of this Act, implements and supersedes |
Executive Order 1 (2012). |
Section 10. Revocation of Executive Order 3 (2005). On the |
date 6 months after the effective date of this Act, Executive |
Order 3 (2005) is revoked and rescinded with the exception of |
Section I (renaming the Department of Public Aid as the |
Department of Healthcare and Family Services), which remains in |
effect. |
Section 15. Transfer back of State healthcare purchasing |
functions transferred by Executive Order 3 (2005). |
(a) On the date 6 months after the effective date of this |
Act or as soon thereafter as practical, all of the powers, |
duties, rights, and responsibilities related to State |
healthcare purchasing that were transferred from the |
Department of Central Management Services, the Department of |
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Corrections, the Department of Human Services, and the |
Department of Veterans' Affairs to the Department of Healthcare |
and Family Services by Executive Order 3 (2005) are transferred |
back to the Departments from which those powers, duties, |
rights, and responsibilities were transferred; however, |
powers, duties, rights, and responsibilities related to State |
healthcare purchasing that were exercised by the Department of |
Corrections before the effective date of Executive Order 3 |
(2005) but that pertain to individuals resident in facilities |
operated by the Department of Juvenile Justice are transferred |
to the Department of Juvenile Justice. |
(b) The functions associated with State healthcare |
purchasing that are transferred from the Department of |
Healthcare and Family Services under this Section include, |
without limitation, the following: |
(1) Rate development and negotiation with hospitals, |
physicians, and managed care providers. |
(2) Health care procurement development. |
(3) Contract implementation and fiscal monitoring. |
(4) Contract amendments. |
(5) Payment processing. |
(6) Purchasing aspects of health care plans |
administered by the State on behalf of the following: |
(A) State employees. These healthcare purchasing |
functions include the following health care plans: |
quality care health plan; managed care health plan; |
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vision plan; pharmacy benefits plan; dental plan; |
behavioral health plan; employee assistance plan; |
utilization management plan; and SHIPs and various |
subrogation agreements. These healthcare purchasing |
functions also include the purchasing and |
administration of flu shots, hepatitis B vaccinations, |
and tuberculosis tests. |
(B) Persons other than State employees. These |
healthcare purchasing functions include the following |
health care plans: the retired teachers' health |
insurance plan under the State Employees Group |
Insurance Act of 1971; the local government health |
insurance plan under the State Employees Group |
Insurance Act of 1971; the community colleges health |
insurance plan under the State Employees Group |
Insurance Act of 1971; the active teacher prescription |
program; and the Illinois Prescription Drug Discount |
Program. |
(C) Residents of State-operated facilities, |
including (i) correctional and youth facilities |
operated by the Department of Corrections or the |
Department of Juvenile Justice, (ii) mental health |
centers and developmental centers operated by the |
Department of Human Services, and (iii) veterans homes |
operated by the Department of Veterans' Affairs. |
(c) The powers, duties, rights, and responsibilities |
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vested in or associated with State healthcare purchasing are |
not affected by this Act, except that all management and staff |
support or other resources necessary to the operation of a |
State healthcare purchasing function shall be provided by the |
Department to which that function is transferred under this |
Act. |
Section 20. Representation on boards or other entities. |
When any provision of an Executive Order or Act provides for |
the membership of the Director of Healthcare and Family |
Services on any council, commission, board, or other entity |
that exercises any of the State healthcare purchasing functions |
transferred by this Act, the Director or Secretary of the |
Department to which the State healthcare purchasing function is |
transferred under this Act, or his or her designee, shall serve |
in the place of the Director of Healthcare and Family Services, |
but only with regard to the exercise of the function |
transferred under this Act. If more than one such person is |
required by law to serve on any council, commission, board, or |
other entity, then an equivalent number of the representatives |
of the Department to which the applicable function is |
transferred under this Act shall so serve. In addition, any |
statutory mandate that provides for action on the part of the |
Director of Healthcare and Family Services relating to a State |
healthcare purchasing function transferred under this Act |
shall become the responsibility of the Director or Secretary of |
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the Department to which that function is transferred under this |
Act. |
Section 25. Personnel transferred. |
(a) Personnel and positions within the Department of |
Healthcare and Family Services that are engaged in the |
performance of State healthcare purchasing functions |
transferred back to the Department of Central Management |
Services are transferred to and shall continue their service |
within the Department of Central Management Services. The |
status and rights of those employees under the Personnel Code |
are not affected by this Act. |
(b) Personnel and positions of the Department of |
Corrections, the Department of Juvenile Justice, the |
Department of Human Services, and the Department of Veterans' |
Affairs were not in fact transferred under Executive Order 3 |
(2005) and are not affected by this Act. |
Section 30. Books and records transferred. All books, |
records, papers, documents, property (real and personal), |
contracts, and pending business pertaining to the powers, |
duties, rights, and responsibilities related to any of the |
State healthcare purchasing functions transferred under this |
Act from the Department of Healthcare and Family Services to |
the Department of Central Management Services, the Department |
of Corrections, the Department of Juvenile Justice, the |
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Department of Human Services, and the Department of Veterans' |
Affairs, including, but not limited to, material in electronic |
or magnetic format and necessary computer hardware and |
software, shall be delivered to the Department to which that |
State healthcare purchasing function is transferred under this |
Act, provided that the delivery of that information may not |
violate any applicable confidentiality constraints. The access |
by personnel of the Department of Central Management Services, |
the Department of Corrections, the Department of Juvenile |
Justice, the Department of Human Services, and the Department |
of Veterans' Affairs to databases and electronic health |
information that are currently maintained by the Department of |
Healthcare and Family Services and that contain data and |
information necessary to the performance of the State |
healthcare purchasing functions shall continue in the same |
manner and level of access as before the effective date of |
Executive Order 1 (2012). Staff of the Department of Central |
Management Services, the Department of Corrections, the |
Department of Juvenile Justice, the Department of Human |
Services, and the Department of Veterans' Affairs may work with |
staff of the Department of Healthcare and Family Services to |
add new information relevant to State healthcare purchasing |
functions. |
Section 35. Unexpended moneys transferred. |
(a) With respect to the State healthcare purchasing |
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functions transferred under this Act, the Department of Central |
Management Services is the successor agency to the Department |
of Healthcare and Family Services under the Successor Agency |
Act and Section 9b of the State Finance Act. All unexpended |
appropriations and balances and other moneys available for use |
in connection with any of the State healthcare purchasing |
functions transferred from the Department of Healthcare and |
Family Services to the Department of Central Management |
Services are transferred for use by the Department of Central |
Management Services for the exercise of those functions |
pursuant to the direction of the Governor. Unexpended balances |
so transferred shall be expended only for the purpose for which |
the appropriations were originally made. |
(b) Appropriations of the Department of Corrections, the |
Department of Juvenile Justice, the Department of Human |
Services, and the Department of Veterans' Affairs were not in |
fact transferred under Executive Order 3 (2005) and are not |
affected by this Act. |
Section 40. Exercise of transferred powers; savings |
provisions. The powers, duties, rights, and responsibilities |
related to the State healthcare purchasing functions |
transferred under this Act are vested in and shall be exercised |
by the Department to which the applicable function is |
transferred. Each act done in the exercise of those powers, |
duties, rights, and responsibilities shall have the same legal |
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effect as if done by the Department of Healthcare and Family |
Services or its divisions, officers, or employees. |
Section 45. Rules. |
(a) Any rules that (i) relate to the Illinois Prescription |
Drug Discount Program or to any other State healthcare |
purchasing function or program transferred to the Department of |
Central Management Services by this Act, (ii) are in full force |
on the effective date of Executive Order 1 (2012), and (iii) |
have been duly adopted by the Department of Healthcare and |
Family Services shall become the rules of the Department of |
Central Management Services. This Act shall not affect the |
legality of any such rules in the Illinois Administrative Code. |
(b) Any proposed rule filed with the Secretary of State by |
the Department of Healthcare and Family Services that pertains |
to the Illinois Prescription Drug Discount Program, or to any |
other State healthcare purchasing function or program |
transferred to the Department of Central Management Services by |
this Act, and that is pending in the rulemaking process on the |
effective date of Executive Order 1 (2012) shall be deemed to |
have been filed by the Department of Central Management |
Services. |
(c) On and after the effective date of Executive Order 1 |
(2012), the Department of Central Management Services may |
propose and adopt, under the Illinois Administrative Procedure |
Act, other rules that relate to the Illinois Prescription Drug |
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Discount Program, or to any other State healthcare purchasing |
function or program transferred to the Department of Central |
Management Services by this Act. |
Section 50. Rights, obligations, and duties unaffected by |
transfer. The
transfer of
powers, duties, rights, and |
responsibilities from the Department of Healthcare and Family |
Services under this Act does not affect any person's rights, |
obligations, or
duties,
including any civil or criminal |
penalties applicable thereto, arising out of
those
transferred |
powers, duties, rights, and responsibilities. |
Section 55. Agency officers; penalties. Every officer of |
the Department of Central Management Services, the Department |
of Corrections, the Department of Juvenile Justice, the |
Department of Human Services, and the Department of Veterans' |
Affairs is, for any offense, subject to the same penalty or |
penalties, civil or criminal, as are prescribed by existing law |
for the same offense by any officer whose powers or duties are |
transferred under this Act. |
Section 60. Reports, notices, or papers. Whenever reports |
or notices are required to be made or given or papers or |
documents furnished or served by any person to or upon the |
Department of Healthcare and Family Services in connection with |
any State healthcare purchasing function transferred under |
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this Act, the same shall be made, given, furnished, or served |
in the same manner to or upon the Department to which that |
State healthcare purchasing function is transferred. |
Section 65. Interagency agreements. To the extent |
necessary or prudent to fully implement the intent of this Act, |
the Department of Central Management Services, the Department |
of Corrections, the Department of Human Services, the |
Department of Juvenile Justice, the Department of Veterans' |
Affairs, and the Department of Healthcare and Family Services |
may enter into one or more interagency agreements to ensure the |
full and appropriate transfer of all State healthcare |
purchasing functions transferred from the Department of |
Healthcare and Family Services under this Act. |
Section 70. Acts and actions unaffected by transfer. This |
Act does not affect any act done, ratified, or canceled, or any |
right occurring or established, before the effective date of |
Executive Order 1 (2012), in connection with any State |
healthcare purchasing function transferred under this Act. |
This Act does not affect any action or proceeding had or |
commenced before the effective date of Executive Order 1 (2012) |
in an administrative, civil, or criminal cause regarding a |
State healthcare purchasing function transferred from the |
Department of Healthcare and Family Services under this Act, |
but any such action or proceeding may be defended, prosecuted, |
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or continued by the Department to which the applicable State |
healthcare purchasing function is transferred. |
Section 900. The State Employees Group Insurance Act of |
1971 is amended by adding Section 2.5 and changing Sections 3, |
6.5, 6.10, 10, and 13.1 as follows: |
(5 ILCS 375/2.5 new)
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Sec. 2.5. State healthcare purchasing. On and after the |
date 6 months after the effective date of this amendatory Act |
of the 98th General Assembly, as provided in the Executive |
Order 1 (2012) Implementation Act, all of the powers, duties, |
rights, and responsibilities related to State healthcare |
purchasing under this Act that were transferred from the |
Department of Central Management Services to the Department of |
Healthcare and Family Services by Executive Order 3 (2005) are |
transferred back to the Department.
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(5 ILCS 375/3) (from Ch. 127, par. 523)
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Sec. 3. Definitions. Unless the context otherwise |
requires, the
following words and phrases as used in this Act |
shall have the following
meanings. The Department may define |
these and other words and phrases
separately for the purpose of |
implementing specific programs providing benefits
under this |
Act.
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(a) "Administrative service organization" means any |
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person, firm or
corporation experienced in the handling of |
claims which is
fully qualified, financially sound and capable |
of meeting the service
requirements of a contract of |
administration executed with the Department.
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(b) "Annuitant" means (1) an employee who retires, or has |
retired,
on or after January 1, 1966 on an immediate annuity |
under the provisions
of Articles 2, 14 (including an employee |
who has elected to receive an alternative retirement |
cancellation payment under Section 14-108.5 of the Illinois |
Pension Code in lieu of an annuity), 15 (including an employee |
who has retired under the optional
retirement program |
established under Section 15-158.2),
paragraphs (2), (3), or |
(5) of Section 16-106, or
Article 18 of the Illinois Pension |
Code; (2) any person who was receiving
group insurance coverage |
under this Act as of March 31, 1978 by
reason of his status as |
an annuitant, even though the annuity in relation
to which such |
coverage was provided is a proportional annuity based on less
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than the minimum period of service required for a retirement |
annuity in
the system involved; (3) any person not otherwise |
covered by this Act
who has retired as a participating member |
under Article 2 of the Illinois
Pension Code but is ineligible |
for the retirement annuity under Section
2-119 of the Illinois |
Pension Code; (4) the spouse of any person who
is receiving a |
retirement annuity under Article 18 of the Illinois Pension
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Code and who is covered under a group health insurance program |
sponsored
by a governmental employer other than the State of |
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Illinois and who has
irrevocably elected to waive his or her |
coverage under this Act and to have
his or her spouse |
considered as the "annuitant" under this Act and not as
a |
"dependent"; or (5) an employee who retires, or has retired, |
from a
qualified position, as determined according to rules |
promulgated by the
Director, under a qualified local |
government, a qualified rehabilitation
facility, a qualified |
domestic violence shelter or service, or a qualified child |
advocacy center. (For definition
of "retired employee", see (p) |
post).
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(b-5) (Blank).
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(b-6) (Blank).
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(b-7) (Blank).
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(c) "Carrier" means (1) an insurance company, a corporation |
organized
under the Limited Health Service Organization Act or |
the Voluntary Health
Services Plan Act, a partnership, or other |
nongovernmental organization,
which is authorized to do group |
life or group health insurance business in
Illinois, or (2) the |
State of Illinois as a self-insurer.
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(d) "Compensation" means salary or wages payable on a |
regular
payroll by the State Treasurer on a warrant of the |
State Comptroller out
of any State, trust or federal fund, or |
by the Governor of the State
through a disbursing officer of |
the State out of a trust or out of
federal funds, or by any |
Department out of State, trust, federal or
other funds held by |
the State Treasurer or the Department, to any person
for |
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personal services currently performed, and ordinary or |
accidental
disability benefits under Articles 2, 14, 15 |
(including ordinary or accidental
disability benefits under |
the optional retirement program established under
Section |
15-158.2), paragraphs (2), (3), or (5) of
Section 16-106, or |
Article 18 of the Illinois Pension Code, for disability
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incurred after January 1, 1966, or benefits payable under the |
Workers'
Compensation or Occupational Diseases Act or benefits |
payable under a sick
pay plan established in accordance with |
Section 36 of the State Finance Act.
"Compensation" also means |
salary or wages paid to an employee of any
qualified local |
government, qualified rehabilitation facility,
qualified |
domestic violence shelter or service, or qualified child |
advocacy center.
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(e) "Commission" means the State Employees Group Insurance |
Advisory
Commission authorized by this Act. Commencing July 1, |
1984, "Commission"
as used in this Act means the Commission on |
Government Forecasting and Accountability as
established by |
the Legislative Commission Reorganization Act of 1984.
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(f) "Contributory", when referred to as contributory |
coverage, shall
mean optional coverages or benefits elected by |
the member toward the cost of
which such member makes |
contribution, or which are funded in whole or in part
through |
the acceptance of a reduction in earnings or the foregoing of |
an
increase in earnings by an employee, as distinguished from |
noncontributory
coverage or benefits which are paid entirely by |
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the State of Illinois
without reduction of the member's salary.
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(g) "Department" means any department, institution, board,
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commission, officer, court or any agency of the State |
government
receiving appropriations and having power to |
certify payrolls to the
Comptroller authorizing payments of |
salary and wages against such
appropriations as are made by the |
General Assembly from any State fund, or
against trust funds |
held by the State Treasurer and includes boards of
trustees of |
the retirement systems created by Articles 2, 14, 15, 16 and
18 |
of the Illinois Pension Code. "Department" also includes the |
Illinois
Comprehensive Health Insurance Board, the Board of |
Examiners established under
the Illinois Public Accounting |
Act, and the Illinois Finance Authority.
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(h) "Dependent", when the term is used in the context of |
the health
and life plan, means a member's spouse and any child |
(1) from
birth to age 26 including an adopted child, a child |
who lives with the
member from the time of the filing of a |
petition for adoption until entry
of an order of adoption, a |
stepchild or adjudicated child, or a child who lives with the |
member
if such member is a court appointed guardian of the |
child or (2)
age 19 or over who is mentally
or physically |
disabled from a cause originating prior to the age of 19 (age |
26 if enrolled as an adult child dependent). For
the health |
plan only, the term "dependent" also includes (1) any person
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enrolled prior to the effective date of this Section who is |
dependent upon
the member to the extent that the member may |
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claim such person as a
dependent for income tax deduction |
purposes and (2) any person who
has received after June 30, |
2000 an organ transplant and who is financially
dependent upon |
the member and eligible to be claimed as a dependent for income
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tax purposes. A member requesting to cover any dependent must |
provide documentation as requested by the Department of Central |
Management Services and file with the Department any and all |
forms required by the Department.
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(i) "Director" means the Director of the Illinois |
Department of Central
Management Services or of any successor |
agency designated to administer this Act .
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(j) "Eligibility period" means the period of time a member |
has to
elect enrollment in programs or to select benefits |
without regard to
age, sex or health.
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(k) "Employee" means and includes each officer or employee |
in the
service of a department who (1) receives his |
compensation for
service rendered to the department on a |
warrant issued pursuant to a payroll
certified by a department |
or on a warrant or check issued and drawn by a
department upon |
a trust, federal or other fund or on a warrant issued
pursuant |
to a payroll certified by an elected or duly appointed officer
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of the State or who receives payment of the performance of |
personal
services on a warrant issued pursuant to a payroll |
certified by a
Department and drawn by the Comptroller upon the |
State Treasurer against
appropriations made by the General |
Assembly from any fund or against
trust funds held by the State |
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Treasurer, and (2) is employed full-time or
part-time in a |
position normally requiring actual performance of duty
during |
not less than 1/2 of a normal work period, as established by |
the
Director in cooperation with each department, except that |
persons elected
by popular vote will be considered employees |
during the entire
term for which they are elected regardless of |
hours devoted to the
service of the State, and (3) except that |
"employee" does not include any
person who is not eligible by |
reason of such person's employment to
participate in one of the |
State retirement systems under Articles 2, 14, 15
(either the |
regular Article 15 system or the optional retirement program
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established under Section 15-158.2) or 18, or under paragraph |
(2), (3), or
(5) of Section 16-106, of the Illinois
Pension |
Code, but such term does include persons who are employed |
during
the 6 month qualifying period under Article 14 of the |
Illinois Pension
Code. Such term also includes any person who |
(1) after January 1, 1966,
is receiving ordinary or accidental |
disability benefits under Articles
2, 14, 15 (including |
ordinary or accidental disability benefits under the
optional |
retirement program established under Section 15-158.2), |
paragraphs
(2), (3), or (5) of Section 16-106, or Article 18 of |
the
Illinois Pension Code, for disability incurred after |
January 1, 1966, (2)
receives total permanent or total |
temporary disability under the Workers'
Compensation Act or |
Occupational Disease Act as a result of injuries
sustained or |
illness contracted in the course of employment with the
State |
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of Illinois, or (3) is not otherwise covered under this Act and |
has
retired as a participating member under Article 2 of the |
Illinois Pension
Code but is ineligible for the retirement |
annuity under Section 2-119 of
the Illinois Pension Code. |
However, a person who satisfies the criteria
of the foregoing |
definition of "employee" except that such person is made
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ineligible to participate in the State Universities Retirement |
System by
clause (4) of subsection (a) of Section 15-107 of the |
Illinois Pension
Code is also an "employee" for the purposes of |
this Act. "Employee" also
includes any person receiving or |
eligible for benefits under a sick pay
plan established in |
accordance with Section 36 of the State Finance Act.
"Employee" |
also includes (i) each officer or employee in the service of a
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qualified local government, including persons appointed as |
trustees of
sanitary districts regardless of hours devoted to |
the service of the
sanitary district, (ii) each employee in the |
service of a qualified
rehabilitation facility, (iii) each |
full-time employee in the service of a
qualified domestic |
violence shelter or service, and (iv) each full-time employee |
in the service of a qualified child advocacy center, as |
determined according to
rules promulgated by the Director.
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(l) "Member" means an employee, annuitant, retired |
employee or survivor. In the case of an annuitant or retired |
employee who first becomes an annuitant or retired employee on |
or after the effective date of this amendatory Act of the 97th |
General Assembly, the individual must meet the minimum vesting |
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requirements of the applicable retirement system in order to be |
eligible for group insurance benefits under that system. In the |
case of a survivor who first becomes a survivor on or after the |
effective date of this amendatory Act of the 97th General |
Assembly, the deceased employee, annuitant, or retired |
employee upon whom the annuity is based must have been eligible |
to participate in the group insurance system under the |
applicable retirement system in order for the survivor to be |
eligible for group insurance benefits under that system.
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(m) "Optional coverages or benefits" means those coverages |
or
benefits available to the member on his or her voluntary |
election, and at
his or her own expense.
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(n) "Program" means the group life insurance, health |
benefits and other
employee benefits designed and contracted |
for by the Director under this Act.
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(o) "Health plan" means a health benefits
program offered
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by the State of Illinois for persons eligible for the plan.
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(p) "Retired employee" means any person who would be an |
annuitant as
that term is defined herein but for the fact that |
such person retired prior to
January 1, 1966. Such term also |
includes any person formerly employed by
the University of |
Illinois in the Cooperative Extension Service who would
be an |
annuitant but for the fact that such person was made ineligible |
to
participate in the State Universities Retirement System by |
clause (4) of
subsection (a) of Section 15-107 of the Illinois
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Pension Code.
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(q) "Survivor" means a person receiving an annuity as a |
survivor of an
employee or of an annuitant. "Survivor" also |
includes: (1) the surviving
dependent of a person who satisfies |
the definition of "employee" except that
such person is 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; (2) the surviving
dependent of any |
person formerly employed by the University of Illinois in
the |
Cooperative Extension Service who would be an annuitant except |
for the
fact that such person 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; and (3) the surviving dependent of a person who |
was an annuitant under this Act by virtue of receiving an |
alternative retirement cancellation payment under Section |
14-108.5 of the Illinois Pension Code.
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(q-2) "SERS" means the State Employees' Retirement System |
of Illinois, created under Article 14 of the Illinois Pension |
Code.
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(q-3) "SURS" means the State Universities Retirement |
System, created under Article 15 of the Illinois Pension Code.
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(q-4) "TRS" means the Teachers' Retirement System of the |
State of Illinois, created under Article 16 of the Illinois |
Pension Code.
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(q-5) (Blank).
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(q-6) (Blank).
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(q-7) (Blank).
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(r) "Medical services" means the services provided within |
the scope
of their licenses by practitioners in all categories |
licensed under the
Medical Practice Act of 1987.
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(s) "Unit of local government" means any county, |
municipality,
township, school district (including a |
combination of school districts under
the Intergovernmental |
Cooperation Act), special district or other unit,
designated as |
a
unit of local government by law, which exercises limited |
governmental
powers or powers in respect to limited |
governmental subjects, any
not-for-profit association with a |
membership that primarily includes
townships and township |
officials, that has duties that include provision of
research |
service, dissemination of information, and other acts for the
|
purpose of improving township government, and that is funded |
wholly or
partly in accordance with Section 85-15 of the |
Township Code; any
not-for-profit corporation or association, |
with a membership consisting
primarily of municipalities, that |
operates its own utility system, and
provides research, |
training, dissemination of information, or other acts to
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promote cooperation between and among municipalities that |
provide utility
services and for the advancement of the goals |
and purposes of its
membership;
the Southern Illinois |
Collegiate Common Market, which is a consortium of higher
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education institutions in Southern Illinois; the Illinois |
Association of
Park Districts; and any hospital provider that |
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is owned by a county that has 100 or fewer hospital beds and |
has not already joined the program. "Qualified
local |
government" means a unit of local government approved by the |
Director and
participating in a program created under |
subsection (i) of Section 10 of this
Act.
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(t) "Qualified rehabilitation facility" means any |
not-for-profit
organization that is accredited by the |
Commission on Accreditation of
Rehabilitation Facilities or |
certified by the Department
of Human Services (as successor to |
the Department of Mental Health
and Developmental |
Disabilities) to provide services to persons with
disabilities
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and which receives funds from the State of Illinois for |
providing those
services, approved by the Director and |
participating in a program created
under subsection (j) of |
Section 10 of this Act.
|
(u) "Qualified domestic violence shelter or service" means |
any Illinois
domestic violence shelter or service and its |
administrative offices funded
by the Department of Human |
Services (as successor to the Illinois Department of
Public |
Aid),
approved by the Director and
participating in a program |
created under subsection (k) of Section 10.
|
(v) "TRS benefit recipient" means a person who:
|
(1) is not a "member" as defined in this Section; and
|
(2) is receiving a monthly benefit or retirement |
annuity
under Article 16 of the Illinois Pension Code; and
|
(3) either (i) has at least 8 years of creditable |
|
service under Article
16 of the Illinois Pension Code, or |
(ii) was enrolled in the health insurance
program offered |
under that Article on January 1, 1996, or (iii) is the |
survivor
of a benefit recipient who had at least 8
years of |
creditable service under Article 16 of the Illinois Pension |
Code or
was enrolled in the health insurance program |
offered under that Article on
the effective date of this |
amendatory Act of 1995, or (iv) is a recipient or
survivor |
of a recipient of a disability benefit under Article 16 of |
the
Illinois Pension Code.
|
(w) "TRS dependent beneficiary" means a person who:
|
(1) is not a "member" or "dependent" as defined in this |
Section; and
|
(2) is a TRS benefit recipient's: (A) spouse, (B) |
dependent parent who
is receiving at least half of his or |
her support from the TRS benefit
recipient, or (C) natural, |
step, adjudicated, or adopted child who is (i) under age |
26, (ii) was, on January 1, 1996, participating as a |
dependent
beneficiary in the health insurance program |
offered under Article 16 of the
Illinois Pension Code, or |
(iii) age 19 or over who is mentally or physically disabled |
from a cause originating prior to the age of 19 (age 26 if |
enrolled as an adult child).
|
"TRS dependent beneficiary" does not include, as indicated |
under paragraph (2) of this subsection (w), a dependent of the |
survivor of a TRS benefit recipient who first becomes a |
|
dependent of a survivor of a TRS benefit recipient on or after |
the effective date of this amendatory Act of the 97th General |
Assembly unless that dependent would have been eligible for |
coverage as a dependent of the deceased TRS benefit recipient |
upon whom the survivor benefit is based. |
(x) "Military leave" refers to individuals in basic
|
training for reserves, special/advanced training, annual |
training, emergency
call up, activation by the President of the |
United States, or any other training or duty in service to the |
United States Armed Forces.
|
(y) (Blank).
|
(z) "Community college benefit recipient" means a person |
who:
|
(1) is not a "member" as defined in this Section; and
|
(2) is receiving a monthly survivor's annuity or |
retirement annuity
under Article 15 of the Illinois Pension |
Code; and
|
(3) either (i) was a full-time employee of a community |
college district or
an association of community college |
boards created under the Public Community
College Act |
(other than an employee whose last employer under Article |
15 of the
Illinois Pension Code was a community college |
district subject to Article VII
of the Public Community |
College Act) and was eligible to participate in a group
|
health benefit plan as an employee during the time of |
employment with a
community college district (other than a |
|
community college district subject to
Article VII of the |
Public Community College Act) or an association of |
community
college boards, or (ii) is the survivor of a |
person described in item (i).
|
(aa) "Community college dependent beneficiary" means a |
person who:
|
(1) is not a "member" or "dependent" as defined in this |
Section; and
|
(2) is a community college benefit recipient's: (A) |
spouse, (B) dependent
parent who is receiving at least half |
of his or her support from the community
college benefit |
recipient, or (C) natural, step, adjudicated, or adopted |
child who is (i)
under age 26, or (ii)
age 19 or over and |
mentally or physically disabled from a cause originating |
prior to the age of 19 (age 26 if enrolled as an adult |
child).
|
"Community college dependent beneficiary" does not |
include, as indicated under paragraph (2) of this subsection |
(aa), a dependent of the survivor of a community college |
benefit recipient who first becomes a dependent of a survivor |
of a community college benefit recipient on or after the |
effective date of this amendatory Act of the 97th General |
Assembly unless that dependent would have been eligible for |
coverage as a dependent of the deceased community college |
benefit recipient upon whom the survivor annuity is based. |
(bb) "Qualified child advocacy center" means any Illinois |
|
child advocacy center and its administrative offices funded by |
the Department of Children and Family Services, as defined by |
the Children's Advocacy Center Act (55 ILCS 80/), approved by |
the Director and participating in a program created under |
subsection (n) of Section 10.
|
(Source: P.A. 96-756, eff. 1-1-10; 96-1519, eff. 2-4-11; |
97-668, eff. 1-13-12; 97-695, eff. 7-1-12.)
|
(5 ILCS 375/6.5)
|
Sec. 6.5. Health benefits for TRS benefit recipients and |
TRS dependent
beneficiaries. |
(a) Purpose. It is the purpose of this amendatory Act of |
1995 to transfer
the administration of the program of health |
benefits established for benefit
recipients and their |
dependent beneficiaries under Article 16 of the Illinois
|
Pension Code to the Department of Central Management Services.
|
(b) Transition provisions. The Board of Trustees of the |
Teachers'
Retirement System shall continue to administer the |
health benefit program
established under Article 16 of the |
Illinois Pension Code through December 31,
1995. Beginning |
January 1, 1996, the Department of Central Management Services
|
shall be responsible for administering a program of health |
benefits for TRS
benefit recipients and TRS dependent |
beneficiaries under this Section.
The Department of Central |
Management Services and the Teachers' Retirement
System shall |
cooperate in this endeavor and shall coordinate their |
|
activities
so as to ensure a smooth transition and |
uninterrupted health benefit coverage.
|
(c) Eligibility. All persons who were enrolled in the |
Article 16 program at
the time of the transfer shall be |
eligible to participate in the program
established under this |
Section without any interruption or delay in coverage
or |
limitation as to pre-existing medical conditions. Eligibility |
to
participate shall be determined by the Teachers' Retirement |
System.
Eligibility information shall be communicated to the |
Department of Central
Management Services in a format |
acceptable to the Department.
|
A TRS dependent beneficiary who is a child age 19 or over |
and
mentally or physically disabled does not become ineligible |
to participate
by reason of (i) becoming ineligible to be |
claimed as a dependent for Illinois
or federal income tax |
purposes or (ii) receiving earned income, so long as
those |
earnings are insufficient for the child to be fully |
self-sufficient.
|
(d) Coverage. The level of health benefits provided under |
this Section
shall be similar to the level of benefits provided |
by the
program previously established under Article 16 of the |
Illinois Pension Code.
|
Group life insurance benefits are not included in the |
benefits
to be provided to TRS benefit recipients and TRS |
dependent beneficiaries under
this Act.
|
The program of health benefits under this Section may |
|
include any or all of
the benefit limitations, including but |
not limited to a reduction in benefits
based on eligibility for |
federal medicare benefits, that are provided under
subsection |
(a) of Section 6 of this Act for other health benefit programs |
under
this Act.
|
(e) Insurance rates and premiums. The Director shall |
determine the
insurance rates and premiums for TRS benefit |
recipients and TRS dependent
beneficiaries,
and shall present |
to the Teachers' Retirement System of
the State of Illinois, by |
April 15 of each calendar year, the rate-setting
methodology |
(including but not limited to utilization levels and costs) |
used
to determine the amount of the health care premiums.
|
For Fiscal Year 1996, the premium shall be equal to the |
premium actually
charged in Fiscal Year 1995; in subsequent |
years, the premium shall
never be lower than the premium |
charged in Fiscal Year 1995. |
For Fiscal Year
2003, the premium shall not exceed 110% |
of the premium actually charged in
Fiscal Year 2002. |
For Fiscal Year 2004, the premium shall not exceed 112% |
of
the premium actually charged in Fiscal Year 2003.
|
For Fiscal Year 2005, the premium shall not exceed a |
weighted average of 106.6% of
the premium actually charged |
in Fiscal Year 2004.
|
For Fiscal Year 2006, the premium shall not exceed a |
weighted average of 109.1% of
the premium actually charged |
in Fiscal Year 2005.
|
|
For Fiscal Year 2007, the premium shall not exceed a |
weighted average of 103.9% of
the premium actually charged |
in Fiscal Year 2006.
|
For Fiscal Year 2008 and thereafter, the premium in |
each fiscal year shall not exceed 105% of
the premium |
actually charged in the previous fiscal year.
|
Rates and premiums may be based in part on age and |
eligibility for federal
medicare coverage. However, the cost of |
participation for a TRS dependent
beneficiary who is an |
unmarried child age 19 or over and mentally or physically
|
disabled shall not exceed the cost for a TRS dependent |
beneficiary who is
an unmarried child under age 19 and |
participates in the same major medical or
managed care program.
|
The cost of health benefits under the program shall be paid |
as follows:
|
(1) For a TRS benefit recipient selecting a managed |
care program, up to
75% of the total insurance rate shall |
be paid from the Teacher Health Insurance
Security Fund. |
Effective with Fiscal Year 2007 and thereafter, for a TRS |
benefit recipient selecting a managed care program, 75% of |
the total insurance rate shall be paid from the Teacher |
Health Insurance
Security Fund.
|
(2) For a TRS benefit recipient selecting the major |
medical coverage
program, up to 50% of the total insurance |
rate shall be paid from the Teacher
Health Insurance |
Security Fund if a managed care program is accessible, as
|
|
determined by the Teachers' Retirement System. Effective |
with Fiscal Year 2007 and thereafter, for a TRS benefit |
recipient selecting the major medical coverage
program, |
50% of the total insurance rate shall be paid from the |
Teacher
Health Insurance Security Fund if a managed care |
program is accessible, as
determined by the Department of |
Central Management Services.
|
(3) For a TRS benefit recipient selecting the major |
medical coverage
program, up to 75% of the total insurance |
rate shall be paid from the Teacher
Health Insurance |
Security Fund if a managed care program is not accessible, |
as
determined by the Teachers' Retirement System. |
Effective with Fiscal Year 2007 and thereafter, for a TRS |
benefit recipient selecting the major medical coverage
|
program, 75% of the total insurance rate shall be paid from |
the Teacher
Health Insurance Security Fund if a managed |
care program is not accessible, as
determined by the |
Department of Central Management Services.
|
(3.1) For a TRS dependent beneficiary who is Medicare |
primary and enrolled in a managed care plan, or the major |
medical coverage program if a managed care plan is not |
available, 25% of the total insurance rate shall be paid |
from the Teacher Health Security Fund as determined by the |
Department of Central Management Services. For the purpose |
of this item (3.1), the term "TRS dependent beneficiary who |
is Medicare primary" means a TRS dependent beneficiary who |
|
is participating in Medicare Parts A and B.
|
(4) Except as otherwise provided in item (3.1), the
|
balance of the rate of insurance, including the entire |
premium of
any coverage for TRS dependent beneficiaries |
that has been elected, shall be
paid
by deductions |
authorized by the TRS benefit recipient to be withheld from |
his
or her monthly annuity or benefit payment from the |
Teachers' Retirement System;
except that (i) if the balance |
of the cost of coverage exceeds the amount of
the monthly |
annuity or benefit payment, the difference shall be paid |
directly
to the Teachers' Retirement System by the TRS |
benefit recipient, and (ii) all
or part of the balance of |
the cost of coverage may, at the school board's
option, be |
paid to the Teachers' Retirement System by the school board |
of the
school district from which the TRS benefit recipient |
retired, in accordance
with Section 10-22.3b of the School |
Code. The Teachers' Retirement System
shall promptly |
deposit all moneys withheld by or paid to it under this
|
subdivision (e)(4) into the Teacher Health Insurance |
Security Fund. These
moneys shall not be considered assets |
of the Retirement System.
|
(f) Financing. Beginning July 1, 1995, all revenues arising |
from the
administration of the health benefit programs |
established under Article 16 of
the Illinois Pension Code or |
this Section shall be deposited into the
Teacher Health |
Insurance Security Fund, which is hereby created as a
|
|
nonappropriated trust fund to be held outside the State |
Treasury, with the
State Treasurer as custodian. Any interest |
earned on moneys in the Teacher
Health Insurance Security Fund |
shall be deposited into the Fund.
|
Moneys in the Teacher Health Insurance Security
Fund shall |
be used only to pay the costs of the health benefit program
|
established under this Section, including associated |
administrative costs, and
the costs associated with the health |
benefit program established under Article
16 of the Illinois |
Pension Code, as authorized in this Section. Beginning
July 1, |
1995, the Department of Central Management Services may make
|
expenditures from the Teacher Health Insurance Security Fund |
for those costs.
|
After other funds authorized for the payment of the costs |
of the health
benefit program established under Article 16 of |
the Illinois Pension Code are
exhausted and until January 1, |
1996 (or such later date as may be agreed upon
by the Director |
of Central Management Services and the Secretary of the
|
Teachers' Retirement System), the Secretary of the Teachers' |
Retirement System
may make expenditures from the Teacher Health |
Insurance Security Fund as
necessary to pay up to 75% of the |
cost of providing health coverage to eligible
benefit |
recipients (as defined in Sections 16-153.1 and 16-153.3 of the
|
Illinois Pension Code) who are enrolled in the Article 16 |
health benefit
program and to facilitate the transfer of |
administration of the health benefit
program to the Department |
|
of Central Management Services.
|
The Department of Central Management Healthcare and Family |
Services, or any successor agency designated to procure |
healthcare contracts pursuant to this Act, is authorized to |
establish funds, separate accounts provided by any bank or |
banks as defined by the Illinois Banking Act, or separate |
accounts provided by any savings and loan association or |
associations as defined by the Illinois Savings and Loan Act of |
1985 to be held by the Director, outside the State treasury, |
for the purpose of receiving the transfer of moneys from the |
Teacher Health Insurance Security Fund. The Department may |
promulgate rules further defining the methodology for the |
transfers. Any interest earned by moneys in the funds or |
accounts shall inure to the Teacher Health Insurance Security |
Fund. The transferred moneys, and interest accrued thereon, |
shall be used exclusively for transfers to administrative |
service organizations or their financial institutions for |
payments of claims to claimants and providers under the |
self-insurance health plan. The transferred moneys, and |
interest accrued thereon, shall not be used for any other |
purpose including, but not limited to, reimbursement of |
administration fees due the administrative service |
organization pursuant to its contract or contracts with the |
Department.
|
(g) Contract for benefits. The Director shall by contract, |
self-insurance,
or otherwise make available the program of |
|
health benefits for TRS benefit
recipients and their TRS |
dependent beneficiaries that is provided for in this
Section. |
The contract or other arrangement for the provision of these |
health
benefits shall be on terms deemed by the Director to be |
in the best interest of
the State of Illinois and the TRS |
benefit recipients based on, but not limited
to, such criteria |
as administrative cost, service capabilities of the carrier
or |
other contractor, and the costs of the benefits.
|
(g-5) Committee. A Teacher Retirement Insurance Program |
Committee shall be established, to consist of 10 persons |
appointed by the Governor.
|
The Committee shall convene at least 4 times each year, and |
shall consider and make recommendations on issues affecting the |
program of health benefits provided under this
Section. |
Recommendations of the Committee shall be based on a consensus |
of the members of the Committee.
|
If the Teacher
Health Insurance Security Fund experiences a |
deficit balance based upon the contribution and subsidy rates |
established in this Section and Section 6.6 for Fiscal Year |
2008 or thereafter, the Committee shall make recommendations |
for adjustments to the funding sources established under these |
Sections. |
In addition, the Committee shall identify proposed |
solutions to the funding shortfalls that are affecting the |
Teacher Health Insurance Security Fund, and it shall report |
those solutions to the Governor and the General Assembly within |
|
6 months after August 15, 2011 (the effective date of Public |
Act 97-386). |
(h) Continuation of program. It is the intention of
the |
General Assembly that the program of health benefits provided |
under this
Section be maintained on an ongoing, affordable |
basis.
|
The program of health benefits provided under this Section |
may be amended by
the State and is not intended to be a pension |
or retirement benefit subject to
protection under Article XIII, |
Section 5 of the Illinois Constitution.
|
(i) Repeal. (Blank).
|
(Source: P.A. 96-1519, eff. 2-4-11; 97-386, eff. 8-15-11; |
97-813, eff. 7-13-12.)
|
(5 ILCS 375/6.10)
|
Sec. 6.10. Contributions to the Community College Health |
Insurance
Security Fund.
|
(a) Beginning January 1, 1999, every active contributor of |
the State
Universities Retirement System (established under |
Article 15 of the Illinois
Pension Code) who (1) is a full-time |
employee of a community college district
(other than a |
community college district subject to Article VII of the Public
|
Community College Act)
or an association of community college |
boards and (2) is not an employee as
defined in Section 3 of |
this Act shall make contributions toward the cost of
community |
college annuitant and survivor health benefits at the rate of |
|
0.50%
of salary.
|
These contributions shall be deducted by the employer and |
paid to the State
Universities Retirement System as service |
agent for the Department of Central
Management Services. The |
System may use the same processes for collecting the
|
contributions required by this subsection that it uses to |
collect the
contributions received from those employees under |
Section 15-157 of the
Illinois Pension Code. An employer may |
agree to pick up or pay the
contributions required under this |
subsection on behalf of the employee;
such contributions shall |
be deemed to have been paid by the employee.
|
The State Universities Retirement System shall promptly |
deposit all moneys
collected under this subsection (a) into the |
Community College Health Insurance
Security Fund created in |
Section 6.9 of this Act. The moneys collected under
this |
Section shall be used only for the purposes authorized in |
Section 6.9 of
this Act and shall not be considered to be |
assets of the State Universities
Retirement System. |
Contributions made under this Section are not transferable
to |
other pension funds or retirement systems and are not |
refundable upon
termination of service.
|
(b) Beginning January 1, 1999, every community college |
district
(other than a community college district subject to |
Article VII of the Public
Community College Act) or association
|
of community college boards that is an employer under the State |
Universities
Retirement System shall contribute toward the |
|
cost of the community college
health benefits provided under |
Section 6.9 of this Act an amount equal to 0.50%
of the salary |
paid to its full-time employees who participate in the State
|
Universities Retirement System and are not members as defined |
in Section 3 of
this Act.
|
These contributions shall be paid by the employer to the |
State Universities
Retirement System as service agent for the |
Department of Central Management
Services. The System may use |
the same processes for collecting the
contributions required by |
this subsection that it uses to collect the
contributions |
received from those employers under Section 15-155 of the
|
Illinois Pension Code.
|
The State Universities Retirement System shall promptly |
deposit all moneys
collected under this subsection (b) into the |
Community College Health Insurance
Security Fund created in |
Section 6.9 of this Act. The moneys collected under
this |
Section shall be used only for the purposes authorized in |
Section 6.9 of
this Act and shall not be considered to be |
assets of the State Universities
Retirement System. |
Contributions made under this Section are not transferable
to |
other pension funds or retirement systems and are not |
refundable upon
termination of service.
|
The Department of Central Management Healthcare and Family |
Services, or any successor agency designated to procure |
healthcare contracts pursuant to this Act, is authorized to |
establish funds, separate accounts provided by any bank or |
|
banks as defined by the Illinois Banking Act, or separate |
accounts provided by any savings and loan association or |
associations as defined by the Illinois Savings and Loan Act of |
1985 to be held by the Director, outside the State treasury, |
for the purpose of receiving the transfer of moneys from the |
Community College Health Insurance Security Fund. The |
Department may promulgate rules further defining the |
methodology for the transfers. Any interest earned by moneys in |
the funds or accounts shall inure to the Community College |
Health Insurance Security Fund. The transferred moneys, and |
interest accrued thereon, shall be used exclusively for |
transfers to administrative service organizations or their |
financial institutions for payments of claims to claimants and |
providers under the self-insurance health plan. The |
transferred moneys, and interest accrued thereon, shall not be |
used for any other purpose including, but not limited to, |
reimbursement of administration fees due the administrative |
service organization pursuant to its contract or contracts with |
the Department.
|
(c) On or before November 15 of each year, the Board of |
Trustees of the
State Universities Retirement System shall |
certify to the Governor, the
Director of Central Management |
Services, and the State
Comptroller its estimate of the total |
amount of contributions to be paid under
subsection (a) of this |
Section for the next fiscal year. Beginning in fiscal year |
2008, the amount certified shall be decreased or increased each |
|
year by the amount that the actual active employee |
contributions either fell short of or exceeded the estimate |
used by the Board in making the certification for the previous |
fiscal year. The State Universities Retirement System shall |
calculate the amount of actual active employee contributions in |
fiscal years 1999 through 2005. Based upon this calculation, |
the fiscal year 2008 certification shall include an amount |
equal to the cumulative amount that the actual active employee |
contributions either fell short of or exceeded the estimate |
used by the Board in making the certification for those fiscal |
years. The certification
shall include a detailed explanation |
of the methods and information that the
Board relied upon in |
preparing its estimate. As soon as possible after the
effective |
date of this Section, the Board shall submit its estimate for |
fiscal
year 1999.
|
(d) Beginning in fiscal year 1999, on the first day of each |
month, or as
soon thereafter as may be practical, the State |
Treasurer and the State
Comptroller shall transfer from the |
General Revenue Fund to the Community
College Health Insurance |
Security Fund 1/12 of the annual amount appropriated
for that |
fiscal year to the State Comptroller for deposit into the |
Community
College Health Insurance Security Fund under Section |
1.4 of the State Pension
Funds Continuing Appropriation Act.
|
(e) Except where otherwise specified in this Section, the |
definitions
that apply to Article 15 of the Illinois Pension |
Code apply to this Section.
|
|
(Source: P.A. 94-839, eff. 6-6-06; 95-632, eff. 9-25-07.)
|
(5 ILCS 375/10) (from Ch. 127, par. 530)
|
Sec. 10. Contributions by the State and members.
|
(a) The State shall pay the cost of basic non-contributory |
group life
insurance and, subject to member paid contributions |
set by the Department or
required by this Section and except as |
provided in this Section, the basic program of group health |
benefits on each
eligible member, except a member, not |
otherwise
covered by this Act, who has retired as a |
participating member under Article 2
of the Illinois Pension |
Code but is ineligible for the retirement annuity under
Section |
2-119 of the Illinois Pension Code, and part of each eligible |
member's
and retired member's premiums for health insurance |
coverage for enrolled
dependents as provided by Section 9. The |
State shall pay the cost of the basic
program of group health |
benefits only after benefits are reduced by the amount
of |
benefits covered by Medicare for all members and dependents
who |
are eligible for benefits under Social Security or
the Railroad |
Retirement system or who had sufficient Medicare-covered
|
government employment, except that such reduction in benefits |
shall apply only
to those members and dependents who (1) first |
become eligible
for such Medicare coverage on or after July 1, |
1992; or (2) are
Medicare-eligible members or dependents of a |
local government unit which began
participation in the program |
on or after July 1, 1992; or (3) remain eligible
for, but no |
|
longer receive Medicare coverage which they had been receiving |
on
or after July 1, 1992. The Department may determine the |
aggregate level of the
State's contribution on the basis of |
actual cost of medical services adjusted
for age, sex or |
geographic or other demographic characteristics which affect
|
the costs of such programs.
|
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.
|
(a-1) (Blank).
|
(a-2) (Blank).
|
(a-3) (Blank).
|
(a-4) (Blank).
|
(a-5) (Blank).
|
(a-6) (Blank).
|
(a-7) (Blank).
|
(a-8) Any annuitant, survivor, or retired employee may |
waive or terminate coverage in
the program of group health |
|
benefits. Any such annuitant, survivor, or retired employee
who |
has waived or terminated coverage may enroll or re-enroll in |
the
program of group health benefits only during the annual |
benefit choice period,
as determined by the Director; except |
that in the event of termination of
coverage due to nonpayment |
of premiums, the annuitant, survivor, or retired employee
may |
not re-enroll in the program.
|
(a-8.5) Beginning on the effective date of this amendatory |
Act of the 97th General Assembly, the Director of Central |
Management Services shall, on an annual basis, determine the |
amount that the State shall contribute toward the basic program |
of group health benefits on behalf of annuitants (including |
individuals who (i) participated in the General Assembly |
Retirement System, the State Employees' Retirement System of |
Illinois, the State Universities Retirement System, the |
Teachers' Retirement System of the State of Illinois, or the |
Judges Retirement System of Illinois and (ii) qualify as |
annuitants under subsection (b) of Section 3 of this Act), |
survivors (including individuals who (i) receive an annuity as |
a survivor of an individual who participated in the General |
Assembly Retirement System, the State Employees' Retirement |
System of Illinois, the State Universities Retirement System, |
the Teachers' Retirement System of the State of Illinois, or |
the Judges Retirement System of Illinois and (ii) qualify as |
survivors under subsection (q) of Section 3 of this Act), and |
retired employees (as defined in subsection (p) of Section 3 of |
|
this Act). The remainder of the cost of coverage for each |
annuitant, survivor, or retired employee, as determined by the |
Director of Central Management Services, shall be the |
responsibility of that annuitant, survivor, or retired |
employee. |
Contributions required of annuitants, survivors, and |
retired employees shall be the same for all retirement systems |
and shall also be based on whether an individual has made an |
election under Section 15-135.1 of the Illinois Pension Code. |
Contributions may be based on annuitants', survivors', or |
retired employees' Medicare eligibility, but may not be based |
on Social Security eligibility. |
(a-9) No later than May 1 of each calendar year, the |
Director
of Central Management Services shall certify in |
writing to the Executive
Secretary of the State Employees' |
Retirement System of Illinois the amounts
of the Medicare |
supplement health care premiums and the amounts of the
health |
care premiums for all other retirees who are not Medicare |
eligible.
|
A separate calculation of the premiums based upon the |
actual cost of each
health care plan shall be so certified.
|
The Director of Central Management Services shall provide |
to the
Executive Secretary of the State Employees' Retirement |
System of
Illinois such information, statistics, and other data |
as he or she
may require to review the premium amounts |
certified by the Director
of Central Management Services.
|
|
The Department of Central Management Healthcare and Family |
Services, or any successor agency designated to procure |
healthcare contracts pursuant to this Act, is authorized to |
establish funds, separate accounts provided by any bank or |
banks as defined by the Illinois Banking Act, or separate |
accounts provided by any savings and loan association or |
associations as defined by the Illinois Savings and Loan Act of |
1985 to be held by the Director, outside the State treasury, |
for the purpose of receiving the transfer of moneys from the |
Local Government Health Insurance Reserve Fund. The Department |
may promulgate rules further defining the methodology for the |
transfers. Any interest earned by moneys in the funds or |
accounts shall inure to the Local Government Health Insurance |
Reserve Fund. The transferred moneys, and interest accrued |
thereon, shall be used exclusively for transfers to |
administrative service organizations or their financial |
institutions for payments of claims to claimants and providers |
under the self-insurance health plan. The transferred moneys, |
and interest accrued thereon, shall not be used for any other |
purpose including, but not limited to, reimbursement of |
administration fees due the administrative service |
organization pursuant to its contract or contracts with the |
Department.
|
(b) State employees who become eligible for this program on |
or after January
1, 1980 in positions normally requiring actual |
performance of duty not less
than 1/2 of a normal work period |
|
but not equal to that of a normal work period,
shall be given |
the option of participating in the available program. If the
|
employee elects coverage, the State shall contribute on behalf |
of such employee
to the cost of the employee's benefit and any |
applicable dependent supplement,
that sum which bears the same |
percentage as that percentage of time the
employee regularly |
works when compared to normal work period.
|
(c) The basic non-contributory coverage from the basic |
program of
group health benefits shall be continued for each |
employee not in pay status or
on active service by reason of |
(1) leave of absence due to illness or injury,
(2) authorized |
educational leave of absence or sabbatical leave, or (3)
|
military leave. This coverage shall continue until
expiration |
of authorized leave and return to active service, but not to |
exceed
24 months for leaves under item (1) or (2). This |
24-month limitation and the
requirement of returning to active |
service shall not apply to persons receiving
ordinary or |
accidental disability benefits or retirement benefits through |
the
appropriate State retirement system or benefits under the |
Workers' Compensation
or Occupational Disease Act.
|
(d) The basic group life insurance coverage shall continue, |
with
full State contribution, where such person is (1) absent |
from active
service by reason of disability arising from any |
cause other than
self-inflicted, (2) on authorized educational |
leave of absence or
sabbatical leave, or (3) on military leave.
|
(e) Where the person is in non-pay status for a period in |
|
excess of
30 days or on leave of absence, other than by reason |
of disability,
educational or sabbatical leave, or military |
leave, such
person may continue coverage only by making |
personal
payment equal to the amount normally contributed by |
the State on such person's
behalf. Such payments and coverage |
may be continued: (1) until such time as
the person returns to |
a status eligible for coverage at State expense, but not
to |
exceed 24 months or (2) until such person's employment or |
annuitant status
with the State is terminated (exclusive of any |
additional service imposed pursuant to law).
|
(f) The Department shall establish by rule the extent to |
which other
employee benefits will continue for persons in |
non-pay status or who are
not in active service.
|
(g) The State shall not pay the cost of the basic |
non-contributory
group life insurance, program of health |
benefits and other employee benefits
for members who are |
survivors as defined by paragraphs (1) and (2) of
subsection |
(q) of Section 3 of this Act. The costs of benefits for these
|
survivors shall be paid by the survivors or by the University |
of Illinois
Cooperative Extension Service, or any combination |
thereof.
However, the State shall pay the amount of the |
reduction in the cost of
participation, if any, resulting from |
the amendment to subsection (a) made
by this amendatory Act of |
the 91st General Assembly.
|
(h) Those persons occupying positions with any department |
as a result
of emergency appointments pursuant to Section 8b.8 |
|
of the Personnel Code
who are not considered employees under |
this Act shall be given the option
of participating in the |
programs of group life insurance, health benefits and
other |
employee benefits. Such persons electing coverage may |
participate only
by making payment equal to the amount normally |
contributed by the State for
similarly situated employees. Such |
amounts shall be determined by the
Director. Such payments and |
coverage may be continued until such time as the
person becomes |
an employee pursuant to this Act or such person's appointment |
is
terminated.
|
(i) Any unit of local government within the State of |
Illinois
may apply to the Director to have its employees, |
annuitants, and their
dependents provided group health |
coverage under this Act on a non-insured
basis. To participate, |
a unit of local government must agree to enroll
all of its |
employees, who may select coverage under either the State group
|
health benefits plan or a health maintenance organization that |
has
contracted with the State to be available as a health care |
provider for
employees as defined in this Act. A unit of local |
government must remit the
entire cost of providing coverage |
under the State group health benefits plan
or, for coverage |
under a health maintenance organization, an amount determined
|
by the Director based on an analysis of the sex, age, |
geographic location, or
other relevant demographic variables |
for its employees, except that the unit of
local government |
shall not be required to enroll those of its employees who are
|
|
covered spouses or dependents under this plan or another group |
policy or plan
providing health benefits as long as (1) an |
appropriate official from the unit
of local government attests |
that each employee not enrolled is a covered spouse
or |
dependent under this plan or another group policy or plan, and |
(2) at least
50% of the employees are enrolled and the unit of |
local government remits
the entire cost of providing coverage |
to those employees, except that a
participating school district |
must have enrolled at least 50% of its full-time
employees who |
have not waived coverage under the district's group health
plan |
by participating in a component of the district's cafeteria |
plan. A
participating school district is not required to enroll |
a full-time employee
who has waived coverage under the |
district's health plan, provided that an
appropriate official |
from the participating school district attests that the
|
full-time employee has waived coverage by participating in a |
component of the
district's cafeteria plan. For the purposes of |
this subsection, "participating
school district" includes a |
unit of local government whose primary purpose is
education as |
defined by the Department's rules.
|
Employees of a participating unit of local government who |
are not enrolled
due to coverage under another group health |
policy or plan may enroll in
the event of a qualifying change |
in status, special enrollment, special
circumstance as defined |
by the Director, or during the annual Benefit Choice
Period. A |
participating unit of local government may also elect to cover |
|
its
annuitants. Dependent coverage shall be offered on an |
optional basis, with the
costs paid by the unit of local |
government, its employees, or some combination
of the two as |
determined by the unit of local government. The unit of local
|
government shall be responsible for timely collection and |
transmission of
dependent premiums.
|
The Director shall annually determine monthly rates of |
payment, subject
to the following constraints:
|
(1) In the first year of coverage, the rates shall be |
equal to the
amount normally charged to State employees for |
elected optional coverages
or for enrolled dependents |
coverages or other contributory coverages, or
contributed |
by the State for basic insurance coverages on behalf of its
|
employees, adjusted for differences between State |
employees and employees
of the local government in age, |
sex, geographic location or other relevant
demographic |
variables, plus an amount sufficient to pay for the |
additional
administrative costs of providing coverage to |
employees of the unit of
local government and their |
dependents.
|
(2) In subsequent years, a further adjustment shall be |
made to reflect
the actual prior years' claims experience |
of the employees of the unit of
local government.
|
In the case of coverage of local government employees under |
a health
maintenance organization, the Director shall annually |
determine for each
participating unit of local government the |
|
maximum monthly amount the unit
may contribute toward that |
coverage, based on an analysis of (i) the age,
sex, geographic |
location, and other relevant demographic variables of the
|
unit's employees and (ii) the cost to cover those employees |
under the State
group health benefits plan. The Director may |
similarly determine the
maximum monthly amount each unit of |
local government may contribute toward
coverage of its |
employees' dependents under a health maintenance organization.
|
Monthly payments by the unit of local government or its |
employees for
group health benefits plan or health maintenance |
organization coverage shall
be deposited in the Local |
Government Health Insurance Reserve Fund.
|
The Local Government Health Insurance Reserve Fund is |
hereby created as a nonappropriated trust fund to be held |
outside the State Treasury, with the State Treasurer as |
custodian. The Local Government Health Insurance Reserve Fund |
shall be a continuing
fund not subject to fiscal year |
limitations. The Local Government Health Insurance Reserve |
Fund is not subject to administrative charges or charge-backs, |
including but not limited to those authorized under Section 8h |
of the State Finance Act. All revenues arising from the |
administration of the health benefits program established |
under this Section shall be deposited into the Local Government |
Health Insurance Reserve Fund. Any interest earned on moneys in |
the Local Government Health Insurance Reserve Fund shall be |
deposited into the Fund. All expenditures from this Fund
shall |
|
be used for payments for health care benefits for local |
government and rehabilitation facility
employees, annuitants, |
and dependents, and to reimburse the Department or
its |
administrative service organization for all expenses incurred |
in the
administration of benefits. No other State funds may be |
used for these
purposes.
|
A local government employer's participation or desire to |
participate
in a program created under this subsection shall |
not limit that employer's
duty to bargain with the |
representative of any collective bargaining unit
of its |
employees.
|
(j) Any rehabilitation facility within the State of |
Illinois may apply
to the Director to have its employees, |
annuitants, and their eligible
dependents provided group |
health coverage under this Act on a non-insured
basis. To |
participate, a rehabilitation facility must agree to enroll all
|
of its employees and remit the entire cost of providing such |
coverage for
its employees, except that the rehabilitation |
facility shall not be
required to enroll those of its employees |
who are covered spouses or
dependents under this plan or |
another group policy or plan providing health
benefits as long |
as (1) an appropriate official from the rehabilitation
facility |
attests that each employee not enrolled is a covered spouse or
|
dependent under this plan or another group policy or plan, and |
(2) at least
50% of the employees are enrolled and the |
rehabilitation facility remits
the entire cost of providing |
|
coverage to those employees. Employees of a
participating |
rehabilitation facility who are not enrolled due to coverage
|
under another group health policy or plan may enroll
in the |
event of a qualifying change in status, special enrollment, |
special
circumstance as defined by the Director, or during the |
annual Benefit Choice
Period. A participating rehabilitation |
facility may also elect
to cover its annuitants. Dependent |
coverage shall be offered on an optional
basis, with the costs |
paid by the rehabilitation facility, its employees, or
some |
combination of the 2 as determined by the rehabilitation |
facility. The
rehabilitation facility shall be responsible for |
timely collection and
transmission of dependent premiums.
|
The Director shall annually determine quarterly rates of |
payment, subject
to the following constraints:
|
(1) In the first year of coverage, the rates shall be |
equal to the amount
normally charged to State employees for |
elected optional coverages or for
enrolled dependents |
coverages or other contributory coverages on behalf of
its |
employees, adjusted for differences between State |
employees and
employees of the rehabilitation facility in |
age, sex, geographic location
or other relevant |
demographic variables, plus an amount sufficient to pay
for |
the additional administrative costs of providing coverage |
to employees
of the rehabilitation facility and their |
dependents.
|
(2) In subsequent years, a further adjustment shall be |
|
made to reflect
the actual prior years' claims experience |
of the employees of the
rehabilitation facility.
|
Monthly payments by the rehabilitation facility or its |
employees for
group health benefits shall be deposited in the |
Local Government Health
Insurance Reserve Fund.
|
(k) Any domestic violence shelter or service within the |
State of Illinois
may apply to the Director to have its |
employees, annuitants, and their
dependents provided group |
health coverage under this Act on a non-insured
basis. To |
participate, a domestic violence shelter or service must agree |
to
enroll all of its employees and pay the entire cost of |
providing such coverage
for its employees. The domestic |
violence shelter shall not be required to enroll those of its |
employees who are covered spouses or dependents under this plan |
or another group policy or plan providing health benefits as |
long as (1) an appropriate official from the domestic violence |
shelter attests that each employee not enrolled is a covered |
spouse or dependent under this plan or another group policy or |
plan and (2) at least 50% of the employees are enrolled and the |
domestic violence shelter remits the entire cost of providing |
coverage to those employees. Employees of a participating |
domestic violence shelter who are not enrolled due to coverage |
under another group health policy or plan may enroll in the |
event of a qualifying change in status, special enrollment, or |
special circumstance as defined by the Director or during the |
annual Benefit Choice Period. A participating domestic |
|
violence shelter may also elect
to cover its annuitants. |
Dependent coverage shall be offered on an optional
basis, with
|
employees, or some combination of the 2 as determined by the |
domestic violence
shelter or service. The domestic violence |
shelter or service shall be
responsible for timely collection |
and transmission of dependent premiums.
|
The Director shall annually determine rates of payment,
|
subject to the following constraints:
|
(1) In the first year of coverage, the rates shall be |
equal to the
amount normally charged to State employees for |
elected optional coverages
or for enrolled dependents |
coverages or other contributory coverages on
behalf of its |
employees, adjusted for differences between State |
employees and
employees of the domestic violence shelter or |
service in age, sex, geographic
location or other relevant |
demographic variables, plus an amount sufficient
to pay for |
the additional administrative costs of providing coverage |
to
employees of the domestic violence shelter or service |
and their dependents.
|
(2) In subsequent years, a further adjustment shall be |
made to reflect
the actual prior years' claims experience |
of the employees of the domestic
violence shelter or |
service.
|
Monthly payments by the domestic violence shelter or |
service or its employees
for group health insurance shall be |
deposited in the Local Government Health
Insurance Reserve |
|
Fund.
|
(l) A public community college or entity organized pursuant |
to the
Public Community College Act may apply to the Director |
initially to have
only annuitants not covered prior to July 1, |
1992 by the district's health
plan provided health coverage |
under this Act on a non-insured basis. The
community college |
must execute a 2-year contract to participate in the
Local |
Government Health Plan.
Any annuitant may enroll in the event |
of a qualifying change in status, special
enrollment, special |
circumstance as defined by the Director, or during the
annual |
Benefit Choice Period.
|
The Director shall annually determine monthly rates of |
payment subject to
the following constraints: for those |
community colleges with annuitants
only enrolled, first year |
rates shall be equal to the average cost to cover
claims for a |
State member adjusted for demographics, Medicare
|
participation, and other factors; and in the second year, a |
further adjustment
of rates shall be made to reflect the actual |
first year's claims experience
of the covered annuitants.
|
(l-5) The provisions of subsection (l) become inoperative |
on July 1, 1999.
|
(m) The Director shall adopt any rules deemed necessary for
|
implementation of this amendatory Act of 1989 (Public Act |
86-978).
|
(n) Any child advocacy center within the State of Illinois |
may apply to the Director to have its employees, annuitants, |
|
and their dependents provided group health coverage under this |
Act on a non-insured basis. To participate, a child advocacy |
center must agree to enroll all of its employees and pay the |
entire cost of providing coverage for its employees. The child
|
advocacy center shall not be required to enroll those of its
|
employees who are covered spouses or dependents under this plan
|
or another group policy or plan providing health benefits as
|
long as (1) an appropriate official from the child advocacy
|
center attests that each employee not enrolled is a covered
|
spouse or dependent under this plan or another group policy or
|
plan and (2) at least 50% of the employees are enrolled and the |
child advocacy center remits the entire cost of providing |
coverage to those employees. Employees of a participating child |
advocacy center who are not enrolled due to coverage under |
another group health policy or plan may enroll in the event of |
a qualifying change in status, special enrollment, or special |
circumstance as defined by the Director or during the annual |
Benefit Choice Period. A participating child advocacy center |
may also elect to cover its annuitants. Dependent coverage |
shall be offered on an optional basis, with the costs paid by |
the child advocacy center, its employees, or some combination |
of the 2 as determined by the child advocacy center. The child |
advocacy center shall be responsible for timely collection and |
transmission of dependent premiums. |
The Director shall annually determine rates of payment, |
subject to the following constraints: |
|
(1) In the first year of coverage, the rates shall be |
equal to the amount normally charged to State employees for |
elected optional coverages or for enrolled dependents |
coverages or other contributory coverages on behalf of its |
employees, adjusted for differences between State |
employees and employees of the child advocacy center in |
age, sex, geographic location, or other relevant |
demographic variables, plus an amount sufficient to pay for |
the additional administrative costs of providing coverage |
to employees of the child advocacy center and their |
dependents. |
(2) In subsequent years, a further adjustment shall be |
made to reflect the actual prior years' claims experience |
of the employees of the child advocacy center. |
Monthly payments by the child advocacy center or its |
employees for group health insurance shall be deposited into |
the Local Government Health Insurance Reserve Fund. |
(Source: P.A. 96-756, eff. 1-1-10; 96-1232, eff. 7-23-10; |
96-1519, eff. 2-4-11; 97-695, eff. 7-1-12.)
|
(5 ILCS 375/13.1) (from Ch. 127, par. 533.1)
|
Sec. 13.1. (a) All contributions, appropriations, |
interest, and dividend
payments to fund the program of health |
benefits and other employee benefits, and all other revenues |
arising from the administration of any employee health benefits |
program,
shall be deposited in a trust fund outside the State |
|
Treasury, with the State
Treasurer as ex-officio custodian, to |
be known as the Health Insurance Reserve
Fund.
|
(b) Upon the adoption of a self-insurance health plan, any |
monies
attributable to the group health insurance program shall |
be deposited in or
transferred to the Health Insurance Reserve |
Fund for use by the Department.
As of the effective date of |
this amendatory Act of 1986, the Department
shall certify to |
the Comptroller the amount of money in the Group Insurance
|
Premium Fund attributable to the State group health insurance |
program and the
Comptroller shall transfer such money from the |
Group Insurance Premium Fund
to the Health Insurance Reserve |
Fund. Contributions by the State to the
Health Insurance |
Reserve Fund to meet the requirements of this Act, as
|
established by the Director, from the General Revenue Fund and |
the Road
Fund to the Health Insurance Reserve Fund shall be by |
annual
appropriations, and all other contributions to meet the |
requirements of the
programs of health benefits or other |
employee benefits shall be deposited
in the Health Insurance |
Reserve Fund. The Department shall draw the
appropriation from |
the General Revenue Fund and the Road Fund from time to
time as |
necessary to make expenditures authorized under this Act.
|
The Director may employ such assistance and services and |
may purchase
such goods as may be necessary for the proper |
development and
administration of any of the benefit programs |
authorized by this Act. The
Director may promulgate rules and |
regulations in regard to the
administration of these programs.
|
|
All monies received by the Department for deposit in or |
transfer to the
Health Insurance Reserve Fund, through |
appropriation or otherwise, shall be
used to provide for the |
making of payments to claimants and providers and
to reimburse |
the Department for all expenses directly incurred relating to
|
Department development and administration of the program of |
health benefits
and other employee benefits.
|
Any administrative service organization administering any |
self-insurance
health plan and paying claims and benefits under |
authority of this Act may
receive, pursuant to written |
authorization and direction of the Director,
an initial |
transfer and periodic transfers of funds from the Health
|
Insurance Reserve Fund in amounts determined by the Director |
who may
consider the amount recommended by the administrative |
service organization.
Notwithstanding any other statute, such |
transferred funds shall be
retained by the administrative |
service organization in a separate
account provided by any bank |
as defined by the Illinois Banking
Act. The Department may |
promulgate regulations further defining the banks
authorized |
to accept such funds and all methodology for transfer of such
|
funds. Any interest earned by monies in such
account shall |
inure to the Health Insurance Reserve Fund, shall remain
in |
such account and shall be used exclusively to pay claims and |
benefits
under this Act. Such transferred funds shall be used |
exclusively for
administrative service organization payment of |
claims to claimants and
providers under the self-insurance |
|
health plan by the drawing of checks
against such account. The |
administrative service organization may not use
such |
transferred funds, or interest accrued thereon, for any other |
purpose
including, but not limited to, reimbursement of |
administrative expenses or
payments of administration fees due |
the organization pursuant to its
contract or contracts with the |
Department of Central Management Services.
|
The account of the administrative service organization |
established under
this Section, any transfers from the Health |
Insurance Reserve Fund to
such account and the use of such |
account and funds shall be subject
to (1) audit by the |
Department or private contractor authorized by the
Department |
to conduct audits, and (2) post audit pursuant to the
Illinois |
State Auditing Act.
|
The Department of Central Management Healthcare and Family |
Services, or any successor agency designated to procure |
healthcare contracts pursuant to this Act, is authorized to |
establish funds, separate accounts provided by any bank or |
banks as defined by the Illinois Banking Act, or separate |
accounts provided by any savings and loan association or |
associations as defined by the Illinois Savings and Loan Act of |
1985 to be held by the Director, outside the State treasury, |
for the purpose of receiving the transfer of moneys from the |
Health Insurance Reserve Fund. The Department may promulgate |
rules further defining the methodology for the transfers. Any |
interest earned by monies in the funds or accounts shall inure |
|
to the Health Insurance Reserve Fund. The transferred moneys, |
and interest accrued thereon, shall be used exclusively for |
transfers to administrative service organizations or their |
financial institutions for payments of claims to claimants and |
providers under the self-insurance health plan. The |
transferred moneys, and interest accrued thereon, shall not be |
used for any other purpose including, but not limited to, |
reimbursement of administration fees due the administrative |
service organization pursuant to its contract or contracts with |
the Department.
|
(c) The Director, with the advice and consent of the |
Commission, shall
establish premiums for optional coverage for |
dependents of eligible members
for the health plans. The |
eligible members
shall be responsible for their portion of such |
optional
premium. The State shall
contribute an amount per |
month for each eligible member who has
enrolled one or more |
dependents under the health plans. Such contribution
shall be |
made directly to the Health Insurance
Reserve Fund. Those |
employees described in subsection (b) of Section 9 of this
Act |
shall be allowed to continue in the health plan by
making |
personal payments with the premiums to be deposited
in the |
Health Insurance Reserve Fund.
|
(d) The Health Insurance Reserve Fund shall be a continuing |
fund not subject
to fiscal year limitations. All expenditures |
from that fund shall be at
the direction of the Director and |
shall be only for the purpose of:
|
|
(1) the payment of administrative expenses incurred by |
the Department
for the program of health benefits or other |
employee benefit programs,
including but not limited to the |
costs of audits or actuarial
consultations, professional |
and contractual services, electronic data
processing |
systems and services, and expenses in connection with the
|
development and administration of such programs;
|
(2) the payment of administrative expenses incurred by |
the Administrative
Service Organization;
|
(3) the payment of health benefits;
|
(3.5) the payment of medical expenses incurred by the |
Department for the treatment of employees who suffer |
accidental injury or death within the scope of their |
employment;
|
(4) refunds to employees for erroneous payments of |
their selected
dependent coverage;
|
(5) payment of premium for stop-loss or re-insurance;
|
(6) payment of premium to health maintenance |
organizations pursuant to
Section 6.1 of this Act;
|
(7) payment of adoption program benefits; and
|
(8) payment of other benefits offered to members and |
dependents under
this Act.
|
(Source: P.A. 94-839, eff. 6-6-06; 95-632, eff. 9-25-07; |
95-744, eff. 7-18-08.)
|
Section 905. The Department of Central Management Services |
|
Law of the
Civil Administrative Code of Illinois is amended by |
adding Section 405-520 as follows: |
(20 ILCS 405/405-520 new) |
Sec. 405-520. State healthcare purchasing. On and after the |
date 6 months after the effective date of this amendatory Act |
of the 98th General Assembly, as provided in the Executive |
Order 1 (2012) Implementation Act, all of the powers, duties, |
rights, and responsibilities related to State healthcare |
purchasing under this Law that were transferred from the |
Department to the Department of Healthcare and Family Services |
by Executive Order 3 (2005) are transferred back to the |
Department. |
Section 910. The Department of Human Services Act is |
amended by changing Section 1-20 as follows:
|
(20 ILCS 1305/1-20)
|
Sec. 1-20. General powers and duties.
|
(a) The Department shall exercise the rights, powers, |
duties, and functions
provided by law, including (but not |
limited to) the rights, powers, duties, and
functions |
transferred to the Department under Article 80 and Article 90 |
of this
Act.
|
(b) The Department may employ personnel (in accordance with |
the Personnel
Code), provide facilities, contract for goods and |
|
services, and adopt rules as
necessary to carry out its |
functions and purposes, all in accordance with
applicable State |
and federal law.
|
(c) On and after the date 6 months after the effective date |
of this amendatory Act of the 98th General Assembly, as |
provided in the Executive Order 1 (2012) Implementation Act, |
all of the powers, duties, rights, and responsibilities related |
to State healthcare purchasing under this Act that were |
transferred from the Department to the Department of Healthcare |
and Family Services by Executive Order 3 (2005) are transferred |
back to the Department. |
(Source: P.A. 89-507, eff. 7-3-96.)
|
Section 915. The Department of Healthcare and Family |
Services Law of the
Civil Administrative Code of Illinois is |
amended by adding Section 2205-20 as follows: |
(20 ILCS 2205/2205-20 new) |
Sec. 2205-20. State healthcare purchasing. On and after the |
date 6 months after the effective date of this amendatory Act |
of the 98th General Assembly, as provided in the Executive |
Order 1 (2012) Implementation Act, all of the powers, duties, |
rights, and responsibilities related to State healthcare |
purchasing under this Law that were transferred to the |
Department of Healthcare and Family Services by Executive Order |
3 (2005) are transferred back to the Departments from which |
|
those powers, duties, rights, and responsibilities were |
transferred; however, powers, duties, rights, and |
responsibilities related to State healthcare purchasing under |
this Law that were exercised by the Department of Corrections |
before the effective date of Executive Order 3 (2005) but that |
pertain to individuals resident in facilities operated by the |
Department of Juvenile Justice shall be transferred to the |
Department of Juvenile Justice. |
Section 920. The Department of Veterans Affairs Act is |
amended by adding Section 2.08 as follows: |
(20 ILCS 2805/2.08 new) |
Sec. 2.08. State healthcare purchasing. On and after the |
date 6 months after the effective date of this amendatory Act |
of the 98th General Assembly, as provided in the Executive |
Order 1 (2012) Implementation Act, all of the powers, duties, |
rights, and responsibilities related to State healthcare |
purchasing under this Act that were transferred from the |
Department to the Department of Healthcare and Family Services |
by Executive Order 3 (2005) are transferred back to the |
Department. |
Section 925. The School Employee Benefit Act is amended by |
adding Section 7 as follows: |
|
(105 ILCS 55/7 new) |
Sec. 7. State healthcare purchasing. On and after the date |
6 months after the effective date of this amendatory Act of the |
98th General Assembly, as provided in the Executive Order 1 |
(2012) Implementation Act, all of the powers, duties, rights, |
and responsibilities related to State healthcare purchasing |
under this Act that were transferred from the Department to the |
Department of Healthcare and Family Services by Executive Order |
3 (2005) are transferred back to the Department. |
Section 930. The Illinois Prescription Drug Discount |
Program Act is amended by changing Sections 10 and 15 and by |
adding Section 2 as follows: |
(320 ILCS 55/2 new) |
Sec. 2. State healthcare purchasing. On and after the date |
6 months after the effective date of this amendatory Act of the |
98th General Assembly, as provided in the Executive Order 1 |
(2012) Implementation Act, all of the powers, duties, rights, |
and responsibilities related to State healthcare purchasing |
under this Act that were transferred from the Department of |
Central Management Services to the Department of Healthcare and |
Family Services by Executive Order 3 (2005) are transferred |
back to the Department of Central Management Services.
|
(320 ILCS 55/10)
|
|
Sec. 10. Purpose. The purpose of this program is to require |
the
Department
of Central Management
Healthcare and Family
|
Services to establish and administer a program that will
enable
|
eligible Illinois residents to purchase prescription drugs at
|
discounted
prices.
|
(Source: P.A. 93-18, eff. 7-1-03; 94-86, eff. 1-1-06.)
|
(320 ILCS 55/15)
|
Sec. 15. Definitions. As used in this Act:
|
"Authorized pharmacy" means any pharmacy registered in |
this State under the
Pharmacy Practice Act or approved by the |
Department of Financial and Professional Regulation and |
approved by the Department or its program
administrator.
|
"AWP" or "average wholesale price" means the amount |
determined from the
latest publication of the Red Book, a |
universally subscribed pharmacist
reference guide
annually |
published by the Hearst Corporation. "AWP" or "average |
wholesale
price"
may also be derived electronically from the |
drug pricing database synonymous
with the
latest publication of |
the Red Book and furnished in the National Drug Data File
|
(NDDF)
by First Data Bank (FDB), a service of the Hearst |
Corporation.
|
"Covered medication" means any medication included in the |
Illinois Prescription Drug Discount Program.
|
"Department" means the Department of Central Management |
Healthcare and Family Services.
|
|
"Director" means the Director of Central Management |
Healthcare and Family Services.
|
"Drug manufacturer" means any entity (1) that is located |
within or outside
Illinois
that is engaged in (i) the |
production, preparation, propagation, compounding,
conversion,
|
or processing of prescription drug products covered under the |
program, either
directly or
indirectly by extraction from |
substances of natural origin, independently by
means of
|
chemical synthesis, or by a combination of extraction and |
chemical synthesis or
(ii) the
packaging, repackaging, |
leveling, labeling, or distribution of prescription
drug |
products
covered under the program and (2) that elects to |
provide prescription drugs
either directly
or under contract |
with any entity providing prescription drug services on
behalf |
of the
State of Illinois. "Drug manufacturer", however, does |
not include a wholesale
distributor
of drugs or a retail |
pharmacy licensed under Illinois law.
|
"Federal Poverty Limit" or "FPL" means the Federal Poverty |
Income Guidelines published annually in the Federal Register.
|
"Prescription drug" means any prescribed drug that may be |
legally dispensed
by
an authorized pharmacy.
|
"Program" means the Illinois Prescription Drug
Discount |
Program created
under this Act.
|
"Program administrator" means the entity that is chosen by |
the Department to
administer the program. The program |
administrator may, in this case, be the
Director or
a Pharmacy |
|
Benefits Manager (PBM) chosen to subcontract with the Director.
|
"Rules" includes rules adopted and forms prescribed by the |
Department.
|
(Source: P.A. 94-86, eff. 1-1-06; 95-689, eff. 10-29-07.)
|
Section 935. The Unified Code of Corrections is amended by |
changing Sections 3-2-2 and 3-2.5-20 as follows:
|
(730 ILCS 5/3-2-2) (from Ch. 38, par. 1003-2-2)
|
Sec. 3-2-2. Powers and Duties of the Department.
|
(1) In addition to the powers, duties and responsibilities |
which are
otherwise provided by law, the Department shall have |
the following powers:
|
(a) To accept persons committed to it by the courts of |
this State for
care, custody, treatment and |
rehabilitation, and to accept federal prisoners and aliens |
over whom the Office of the Federal Detention Trustee is |
authorized to exercise the federal detention function for |
limited purposes and periods of time.
|
(b) To develop and maintain reception and evaluation |
units for purposes
of analyzing the custody and |
rehabilitation needs of persons committed to
it and to |
assign such persons to institutions and programs under its |
control
or transfer them to other appropriate agencies. In |
consultation with the
Department of Alcoholism and |
Substance Abuse (now the Department of Human
Services), the |
|
Department of Corrections
shall develop a master plan for |
the screening and evaluation of persons
committed to its |
custody who have alcohol or drug abuse problems, and for
|
making appropriate treatment available to such persons; |
the Department
shall report to the General Assembly on such |
plan not later than April 1,
1987. The maintenance and |
implementation of such plan shall be contingent
upon the |
availability of funds.
|
(b-1) To create and implement, on January 1, 2002, a |
pilot
program to
establish the effectiveness of |
pupillometer technology (the measurement of the
pupil's
|
reaction to light) as an alternative to a urine test for |
purposes of screening
and evaluating
persons committed to |
its custody who have alcohol or drug problems. The
pilot |
program shall require the pupillometer technology to be |
used in at
least one Department of
Corrections facility. |
The Director may expand the pilot program to include an
|
additional facility or
facilities as he or she deems |
appropriate.
A minimum of 4,000 tests shall be included in |
the pilot program.
The
Department must report to the
|
General Assembly on the
effectiveness of the program by |
January 1, 2003.
|
(b-5) To develop, in consultation with the Department |
of State Police, a
program for tracking and evaluating each |
inmate from commitment through release
for recording his or |
her gang affiliations, activities, or ranks.
|
|
(c) To maintain and administer all State correctional |
institutions and
facilities under its control and to |
establish new ones as needed. Pursuant
to its power to |
establish new institutions and facilities, the Department
|
may, with the written approval of the Governor, authorize |
the Department of
Central Management Services to enter into |
an agreement of the type
described in subsection (d) of |
Section 405-300 of the
Department
of Central Management |
Services Law (20 ILCS 405/405-300). The Department shall
|
designate those institutions which
shall constitute the |
State Penitentiary System.
|
Pursuant to its power to establish new institutions and |
facilities, the
Department may authorize the Department of |
Central Management Services to
accept bids from counties |
and municipalities for the construction,
remodeling or |
conversion of a structure to be leased to the Department of
|
Corrections for the purposes of its serving as a |
correctional institution
or facility. Such construction, |
remodeling or conversion may be financed
with revenue bonds |
issued pursuant to the Industrial Building Revenue Bond
Act |
by the municipality or county. The lease specified in a bid |
shall be
for a term of not less than the time needed to |
retire any revenue bonds
used to finance the project, but |
not to exceed 40 years. The lease may
grant to the State |
the option to purchase the structure outright.
|
Upon receipt of the bids, the Department may certify |
|
one or more of the
bids and shall submit any such bids to |
the General Assembly for approval.
Upon approval of a bid |
by a constitutional majority of both houses of the
General |
Assembly, pursuant to joint resolution, the Department of |
Central
Management Services may enter into an agreement |
with the county or
municipality pursuant to such bid.
|
(c-5) To build and maintain regional juvenile |
detention centers and to
charge a per diem to the counties |
as established by the Department to defray
the costs of |
housing each minor in a center. In this subsection (c-5),
|
"juvenile
detention center" means a facility to house |
minors during pendency of trial who
have been transferred |
from proceedings under the Juvenile Court Act of 1987 to
|
prosecutions under the criminal laws of this State in |
accordance with Section
5-805 of the Juvenile Court Act of |
1987, whether the transfer was by operation
of
law or |
permissive under that Section. The Department shall |
designate the
counties to be served by each regional |
juvenile detention center.
|
(d) To develop and maintain programs of control, |
rehabilitation and
employment of committed persons within |
its institutions.
|
(d-5) To provide a pre-release job preparation program |
for inmates at Illinois adult correctional centers.
|
(e) To establish a system of supervision and guidance |
of committed persons
in the community.
|
|
(f) To establish in cooperation with the Department of |
Transportation
to supply a sufficient number of prisoners |
for use by the Department of
Transportation to clean up the |
trash and garbage along State, county,
township, or |
municipal highways as designated by the Department of
|
Transportation. The Department of Corrections, at the |
request of the
Department of Transportation, shall furnish |
such prisoners at least
annually for a period to be agreed |
upon between the Director of
Corrections and the Director |
of Transportation. The prisoners used on this
program shall |
be selected by the Director of Corrections on whatever |
basis
he deems proper in consideration of their term, |
behavior and earned eligibility
to participate in such |
program - where they will be outside of the prison
facility |
but still in the custody of the Department of Corrections. |
Prisoners
convicted of first degree murder, or a Class X |
felony, or armed violence, or
aggravated kidnapping, or |
criminal sexual assault, aggravated criminal sexual
abuse |
or a subsequent conviction for criminal sexual abuse, or |
forcible
detention, or arson, or a prisoner adjudged a |
Habitual Criminal shall not be
eligible for selection to |
participate in such program. The prisoners shall
remain as |
prisoners in the custody of the Department of Corrections |
and such
Department shall furnish whatever security is |
necessary. The Department of
Transportation shall furnish |
trucks and equipment for the highway cleanup
program and |
|
personnel to supervise and direct the program. Neither the
|
Department of Corrections nor the Department of |
Transportation shall replace
any regular employee with a |
prisoner.
|
(g) To maintain records of persons committed to it and |
to establish
programs of research, statistics and |
planning.
|
(h) To investigate the grievances of any person |
committed to the
Department, to inquire into any alleged |
misconduct by employees
or committed persons, and to |
investigate the assets
of committed persons to implement |
Section 3-7-6 of this Code; and for
these purposes it may |
issue subpoenas and compel the attendance of witnesses
and |
the production of writings and papers, and may examine |
under oath any
witnesses who may appear before it; to also |
investigate alleged violations
of a parolee's or |
releasee's conditions of parole or release; and for this
|
purpose it may issue subpoenas and compel the attendance of |
witnesses and
the production of documents only if there is |
reason to believe that such
procedures would provide |
evidence that such violations have occurred.
|
If any person fails to obey a subpoena issued under |
this subsection,
the Director may apply to any circuit |
court to secure compliance with the
subpoena. The failure |
to comply with the order of the court issued in
response |
thereto shall be punishable as contempt of court.
|
|
(i) To appoint and remove the chief administrative |
officers, and
administer
programs of training and |
development of personnel of the Department. Personnel
|
assigned by the Department to be responsible for the
|
custody and control of committed persons or to investigate |
the alleged
misconduct of committed persons or employees or |
alleged violations of a
parolee's or releasee's conditions |
of parole shall be conservators of the peace
for those |
purposes, and shall have the full power of peace officers |
outside
of the facilities of the Department in the |
protection, arrest, retaking
and reconfining of committed |
persons or where the exercise of such power
is necessary to |
the investigation of such misconduct or violations.
|
(j) To cooperate with other departments and agencies |
and with local
communities for the development of standards |
and programs for better
correctional services in this |
State.
|
(k) To administer all moneys and properties of the |
Department.
|
(l) To report annually to the Governor on the committed
|
persons, institutions and programs of the Department.
|
(l-5) (Blank).
|
(m) To make all rules and regulations and exercise all |
powers and duties
vested by law in the Department.
|
(n) To establish rules and regulations for |
administering a system of
sentence credits, established in |
|
accordance with Section 3-6-3, subject
to review by the |
Prisoner Review Board.
|
(o) To administer the distribution of funds
from the |
State Treasury to reimburse counties where State penal
|
institutions are located for the payment of assistant |
state's attorneys'
salaries under Section 4-2001 of the |
Counties Code.
|
(p) To exchange information with the Department of |
Human Services and the
Department of Healthcare and Family |
Services
for the purpose of verifying living arrangements |
and for other purposes
directly connected with the |
administration of this Code and the Illinois
Public Aid |
Code.
|
(q) To establish a diversion program.
|
The program shall provide a structured environment for |
selected
technical parole or mandatory supervised release |
violators and committed
persons who have violated the rules |
governing their conduct while in work
release. This program |
shall not apply to those persons who have committed
a new |
offense while serving on parole or mandatory supervised |
release or
while committed to work release.
|
Elements of the program shall include, but shall not be |
limited to, the
following:
|
(1) The staff of a diversion facility shall provide |
supervision in
accordance with required objectives set |
by the facility.
|
|
(2) Participants shall be required to maintain |
employment.
|
(3) Each participant shall pay for room and board |
at the facility on a
sliding-scale basis according to |
the participant's income.
|
(4) Each participant shall:
|
(A) provide restitution to victims in |
accordance with any court order;
|
(B) provide financial support to his |
dependents; and
|
(C) make appropriate payments toward any other |
court-ordered
obligations.
|
(5) Each participant shall complete community |
service in addition to
employment.
|
(6) Participants shall take part in such |
counseling, educational and
other programs as the |
Department may deem appropriate.
|
(7) Participants shall submit to drug and alcohol |
screening.
|
(8) The Department shall promulgate rules |
governing the administration
of the program.
|
(r) To enter into intergovernmental cooperation |
agreements under which
persons in the custody of the |
Department may participate in a county impact
|
incarceration program established under Section 3-6038 or |
3-15003.5 of the
Counties Code.
|
|
(r-5) (Blank).
|
(r-10) To systematically and routinely identify with |
respect to each
streetgang active within the correctional |
system: (1) each active gang; (2)
every existing inter-gang |
affiliation or alliance; and (3) the current leaders
in |
each gang. The Department shall promptly segregate leaders |
from inmates who
belong to their gangs and allied gangs. |
"Segregate" means no physical contact
and, to the extent |
possible under the conditions and space available at the
|
correctional facility, prohibition of visual and sound |
communication. For the
purposes of this paragraph (r-10), |
"leaders" means persons who:
|
(i) are members of a criminal streetgang;
|
(ii) with respect to other individuals within the |
streetgang, occupy a
position of organizer, |
supervisor, or other position of management or
|
leadership; and
|
(iii) are actively and personally engaged in |
directing, ordering,
authorizing, or requesting |
commission of criminal acts by others, which are
|
punishable as a felony, in furtherance of streetgang |
related activity both
within and outside of the |
Department of Corrections.
|
"Streetgang", "gang", and "streetgang related" have the |
meanings ascribed to
them in Section 10 of the Illinois |
Streetgang Terrorism Omnibus Prevention
Act.
|
|
(s) To operate a super-maximum security institution, |
in order to
manage and
supervise inmates who are disruptive |
or dangerous and provide for the safety
and security of the |
staff and the other inmates.
|
(t) To monitor any unprivileged conversation or any |
unprivileged
communication, whether in person or by mail, |
telephone, or other means,
between an inmate who, before |
commitment to the Department, was a member of an
organized |
gang and any other person without the need to show cause or |
satisfy
any other requirement of law before beginning the |
monitoring, except as
constitutionally required. The |
monitoring may be by video, voice, or other
method of |
recording or by any other means. As used in this |
subdivision (1)(t),
"organized gang" has the meaning |
ascribed to it in Section 10 of the Illinois
Streetgang |
Terrorism Omnibus Prevention Act.
|
As used in this subdivision (1)(t), "unprivileged |
conversation" or
"unprivileged communication" means a |
conversation or communication that is not
protected by any |
privilege recognized by law or by decision, rule, or order |
of
the Illinois Supreme Court.
|
(u) To establish a Women's and Children's Pre-release |
Community
Supervision
Program for the purpose of providing |
housing and services to eligible female
inmates, as |
determined by the Department, and their newborn and young
|
children.
|
|
(u-5) To issue an order, whenever a person committed to |
the Department absconds or absents himself or herself, |
without authority to do so, from any facility or program to |
which he or she is assigned. The order shall be certified |
by the Director, the Supervisor of the Apprehension Unit, |
or any person duly designated by the Director, with the |
seal of the Department affixed. The order shall be directed |
to all sheriffs, coroners, and police officers, or to any |
particular person named in the order. Any order issued |
pursuant to this subdivision (1) (u-5) shall be sufficient |
warrant for the officer or person named in the order to |
arrest and deliver the committed person to the proper |
correctional officials and shall be executed the same as |
criminal process.
|
(v) To do all other acts necessary to carry out the |
provisions
of this Chapter.
|
(2) The Department of Corrections shall by January 1, 1998, |
consider
building and operating a correctional facility within |
100 miles of a county of
over 2,000,000 inhabitants, especially |
a facility designed to house juvenile
participants in the |
impact incarceration program.
|
(3) When the Department lets bids for contracts for medical
|
services to be provided to persons committed to Department |
facilities by
a health maintenance organization, medical |
service corporation, or other
health care provider, the bid may |
only be let to a health care provider
that has obtained an |
|
irrevocable letter of credit or performance bond
issued by a |
company whose bonds have an investment grade or higher rating |
by a bond rating
organization.
|
(4) When the Department lets bids for
contracts for food or |
commissary services to be provided to
Department facilities, |
the bid may only be let to a food or commissary
services |
provider that has obtained an irrevocable letter of
credit or |
performance bond issued by a company whose bonds have an |
investment grade or higher rating by a bond rating |
organization.
|
(5) On and after the date 6 months after the effective date |
of this amendatory Act of the 98th General Assembly, as |
provided in the Executive Order 1 (2012) Implementation Act, |
all of the powers, duties, rights, and responsibilities related |
to State healthcare purchasing under this Code that were |
transferred from the Department of Corrections to the |
Department of Healthcare and Family Services by Executive Order |
3 (2005) are transferred back to the Department of Corrections; |
however, powers, duties, rights, and responsibilities related |
to State healthcare purchasing under this Code that were |
exercised by the Department of Corrections before the effective |
date of Executive Order 3 (2005) but that pertain to |
individuals resident in facilities operated by the Department |
of Juvenile Justice are transferred to the Department of |
Juvenile Justice. |
(Source: P.A. 96-1265, eff. 7-26-10; 97-697, eff. 6-22-12; |
|
97-800, eff. 7-13-12; 97-802, eff. 7-13-12; revised 7-23-12.)
|
(730 ILCS 5/3-2.5-20)
|
Sec. 3-2.5-20. General powers and duties. |
(a) In addition to the powers, duties, and responsibilities |
which are otherwise provided by law or transferred to the |
Department as a result of this Article, the Department, as |
determined by the Director, shall have, but are not limited to, |
the following rights, powers, functions and duties: |
(1) To accept juveniles committed to it by the courts |
of this State for care, custody, treatment, and |
rehabilitation. |
(2) To maintain and administer all State juvenile |
correctional institutions previously under the control of |
the Juvenile and Women's & Children Divisions of the |
Department of Corrections, and to establish and maintain |
institutions as needed to meet the needs of the youth |
committed to its care. |
(3) To identify the need for and recommend the funding |
and implementation of an appropriate mix of programs and |
services within the juvenile justice continuum, including |
but not limited to prevention, nonresidential and |
residential commitment programs, day treatment, and |
conditional release programs and services, with the |
support of educational, vocational, alcohol, drug abuse, |
and mental health services where appropriate. |
|
(4) To establish and provide transitional and |
post-release treatment programs for juveniles committed to |
the Department. Services shall include but are not limited |
to: |
(i) family and individual counseling and treatment |
placement; |
(ii) referral services to any other State or local |
agencies; |
(iii) mental health services; |
(iv) educational services; |
(v) family counseling services; and |
(vi) substance abuse services. |
(5) To access vital records of juveniles for the |
purposes of providing necessary documentation for |
transitional services such as obtaining identification, |
educational enrollment, employment, and housing. |
(6) To develop staffing and workload standards and |
coordinate staff development and training appropriate for |
juvenile populations. |
(7) To develop, with the approval of the Office of the |
Governor and the Governor's Office of Management and |
Budget, annual budget requests.
|
(8) To administer the Interstate Compact for |
Juveniles, with respect to all juveniles under its |
jurisdiction, and to cooperate with the Department of Human |
Services with regard to all non-offender juveniles subject |
|
to the Interstate Compact for Juveniles.
|
(b) The Department may employ personnel in accordance with |
the Personnel Code and Section 3-2.5-15 of this Code, provide |
facilities, contract for goods and services, and adopt rules as |
necessary to carry out its functions and purposes, all in |
accordance with applicable State and federal law.
|
(c) On and after the date 6 months after the effective date |
of this amendatory Act of the 98th General Assembly, as |
provided in the Executive Order 1 (2012) Implementation Act, |
all of the powers, duties, rights, and responsibilities related |
to State healthcare purchasing under this Code that were |
transferred from the Department of Corrections to the |
Department of Healthcare and Family Services by Executive Order |
3 (2005) are transferred back to the Department of Corrections; |
however, powers, duties, rights, and responsibilities related |
to State healthcare purchasing under this Code that were |
exercised by the Department of Corrections before the effective |
date of Executive Order 3 (2005) but that pertain to |
individuals resident in facilities operated by the Department |
of Juvenile Justice are transferred to the Department of |
Juvenile Justice. |
(Source: P.A. 94-696, eff. 6-1-06; 95-937, eff. 8-26-08.) |
Section 997. Severability. The provisions of this Act are |
severable under Section 1.31 of the Statute on Statutes.
|
Section 999. Effective date. This Act takes effect upon |